The effect of Prescription Drug Monitoring Programs on county‐level opioid prescribing practices and spillovers

Abstract Most states now legally mandate providers to access the Prescription Drug Monitoring Program (PDMP) database before prescribing controlled substances like opioids. We exploit variation in the adoption of these “must access” mandates between 2010 and 2017 to evaluate their impact on prescribing behavior. We find that counties in “must access” PDMP states have 5.5 fewer retail opioid prescriptions per 100 persons compared to counties in “voluntary access” PDMP states. We find evidence of geographic spillovers in opioid prescribing behavior. Our results underscore the importance recognizing the potential for cross‐border shopping when designing interventions to combat opioid misuse.