Grant: Knowledge Synthesis Grant: Prescription Drug Abuse

Prescription pain killers, sedatives and stimulants are important treatment options for patients. Some of these medications also have the potential to cause significant harms (addiction, overdose deaths). In 2013, a pan-Canadian strategy called First Do No Harm: Responding to Canada's Prescription Drug Crisis was launched and prescription monitoring programs (PMPs) were identified as an important component of the overall strategy. PMPs collect and use prescription record information to detect and intervene when there appears to be potentially harmful or risky activity related to medications that have the potential for abuse. Evaluating the effectiveness of these programs has received more attention in recent years. The objectives of this review are to systematically review the existing evidence on the effectiveness of PMPs and to examine what features of a PMP work best and under what circumstances. The review will look at the impact of PMPs, such as their effect on prescribing patterns, diversion rates, abuse and addiction rates and overdose deaths. In addition, evidence related to unintended consequences will be included, such as making it harder for patients to access the medications or seeing an increase in the use of other substances of abuse. Finally, evidence related to the opinions of those running, using or impacted by the program will be assessed. The results of this review will be informative and useful to several groups of stakeholders, including regulatory bodies, federal and provincial governments, program service providers, health care providers, patients and researchers. The ultimate goal of effective PMPs is to optimize the benefits of treatment with monitored prescription drugs while minimizing the harms.