Prescription Drug Overdose: Boost for State Prevention

Kentucky had the 3rd highest age-adjusted drug overdose fatality rate in the nation with 23.6 drug overdose fatalities per 100,000 population in 2010. The state has been an early leader in prescription drug monitoring program (PDMP) development and implementation to support proactive reporting and data analysis. Groundbreaking legislation was passed in 2012 and amended in 2013 (see KRS 218A.172, 118A.205, and 72.026). Supplemented by regulations at KAR 20:207; KAR 9:260; KAR 8:540, Kentucky law now 1) requires a PDMP query by a controlled substance prescriber or delegate when prescribing schedule II-V controlled substances and outlines prescribing standards; and 2) requires decedent testing for controlled substances in post-mortem examinations when no other cause of death has been established to identify the specific drug(s) that resulted in the fatal drug overdose. The purpose of this application by the Kentucky Injury Prevention and Research Center (KIPRC) (the bona fide agent for the Kentucky Department for Public Health) to the CDC National Center of Injury Prevention and Control is to boost state prevention of prescription drug overdoses (PDOs) by enhancing and maximizing Kentucky’s PDMP (Kentucky All Schedule Prescription Electronic Reporting [KASPER]) through adding payment method and milligram morphine equivalent (MME) data fields and algorithms; improving KASPER data quality; increasing border state PDMP data sharing; and producing quarterly threshold and annual analysis reports; as well as establishing a multi-source drug overdose fatality system and toolkit; developing quarterly PDO dashboard reports; and developing annual PDO community profiles and a toolkit, to expand and maximize KASPER as a public health surveillance system. In consultation with CDC staff, KIPRC will also evaluate and perform economic analyses of Kentucky’s laws that require a KASPER query when prescribing schedule II- V controlled substances; and decedent controlled substance testing in post-mortem examinations when no cause of death has been established. Desired actionable outcomes of grant funding for this project include increased safe clinical prescribing decision making and patient safety, as well as evidence and cost-effectiveness of model PDMP attributes, and prescription-drug overdose prevention policies and actions that can be shared with other states.