Table 1. Deficiencies of prescription drug monitoring programs⁷.

PDMP deficiency	Comments
Inadequate data collection	Majority of states do not require reporting of the method of payment; this results in a cash payment loophole where prescription drug abusers who pay cash evade monitoring. Majority of states do not record the identification of the person picking up the prescription. No state collects data on prescribers’ deaths or disciplinary status such as DEA registration suspension.
Ineffective data utilization	Most states do not require prescribers and pharmacists to consult PDMP systems. There is significant resistance to the use of these systems by providers, as consulting them may increase workload. Many systems have a lag time in reporting data. Most states do not have appropriate tools for analyzing the large amount of data within the PDMP.
Insufficient interstate data sharing	There is little to no sharing of data among states; therefore, drug abusers and traffickers can cross state lines to obtain medications.
Underuse of information by law enforcement	Many states prevent access to these data by law enforcement and licensing authorities due to the concerns of prescribers and pharmacists that these authorities will be able to see information about prescribing/dispensing patterns and then undertake a “fishing expedition.” Unsolicited reports from the PDMP are generally not sent to law enforcement or licensing authorities in order to alert them to potential concerns; therefore, these authorities need to know of a concern in advance in order to receive needed data.

Note: DEA = Drug Enforcement Agency; PDMP = prescription drug monitoring program.