Policy mechanisms shaping population health take numerous forms, from behavioral prohibitions to mandates for action to surveillance. Rising drug overdoses undermined the state’s ability to promote population-level health. Using the case of prescription drug monitoring programs (PDMPs), we contend that PDMP implementation highlights state biopower operating via mechanisms of surveillance, whereby prescribers, pharmacists, and patients perceive agency despite choices being constrained. We consider whether such surveillance mechanisms are sufficient or if prescriber/dispenser access or requirements for use are necessary for population health impact. We test whether PDMPs reduced overdose mortality while considering that surveillance may require time to reach effectiveness. PDMPs reduced opioid overdose mortality 2 years postimplementation and sustained effects, with similar effects for prescription opioids, benzodiazepines, and psychostimulants. Access or mandates for action do not reduce mortality beyond surveillance. Overall, PDMP effects on overdose mortality are likely due to self-regulation under surveillance rather than mandated action.
AtluriSairamSudarshanGururauManchikantiLaxmaiah. 2014. “Assessment of the Trends in Medical Use and Misuse of Opioid Analgesics from 2004 to 2011.”Pain Physician17:E119–28.
3.
BachhuberMarcus A.HennessySeanCunninghamChinazo O.StarrelsJoanna L.2016. “Increasing Benzodiazepine Prescriptions and Overdose Mortality in the United States, 1996–2013.”American Journal of Public Health106(4):686–88.
4.
BaoYuhuaPanYijunTaylorArynRadakrishnanSharminiLuoFeijunPincusHarold AlanSchackmanBruce R.2016. “Prescription Drug Monitoring Programs Are Associated with Sustained Reductions in Opioid Prescribing by Physicians.”Health Affairs35(6):1045–51.
5.
BirdChloe E.RiekerPatricia P.2008. Gender and Health: The Effects of Constrained Choices and Social Policies. New York: Cambridge University Press.
6.
BirnbaumHoward G.WhiteAlan G.SchillerMattWaldmanTracyClevelandJody M.RolandCarl L.2011. “Societal Costs of Prescription Opioid Abuse, Dependence, and Misuse in the United States.”Pain Medicine12(4):657–67.
7.
BuchanichJeanine M.BalmertLauren C.WilliamsKarl E.BurkeDonald S.2018. “The Effect of Incomplete Death Certificates on Estimates of Unintentional Opioid-Related Overdose Deaths in the United States, 1999–2015.”Public Health Reports133(4):423–31.
8.
CarlsonRobert G.NahhasRamzi W.MartinsSilvia S.DaniulaityteRaminta. 2016. “Predictors of Transition to Heroin Use among Initially Non-opioid Dependent Illicit Pharmaceutical Opioid Users: A Natural History Study.”Drug and Alcohol Dependence160:127–34.
9.
CaseAnneDeatonAngus. 2015. “Rising Morbidity and Mortality in Midlife among White Non-Hispanic Americans in the 21st Century.”Proceedings of the National Academy of Sciences112(49):15078–83.
10.
Centers for Disease Control and Prevention. 2014. Specific Drugs Involved in Drug Poisoning Deaths, 2008–2013. Atlanta, GA: Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention. 2020. The Three Waves of Opioid Overdose Deaths. Atlanta, GA: Centers for Disease Control and Prevention.
13.
ChiarelloElizabeth. 2015. “The War on Drugs Comes to the Pharmacy Counter: Frontline Work in the Shadow of Discrepant Institutional Logics.”Law & Social Inquiry40(1):86–122.
14.
CiccaroneDaniel. 2021. “The Rise of Illicit Fentanyls, Stimulants and the Fourth Wave of the Opioid Overdose Crisis.”Current Opinion in Psychiatry34(4):344–50.
15.
DartRichard C.SurrattHilary L.CiceroTheodore J.ParrinoMark W.SevertsonS. GeoffBucher-BartelsonBeckiGreenJody L.2015. “Trends in Opioid Analgesic Abuse and Mortality in the United States.”New England Journal of Medicine372(3):241–48.
16.
DavisCorey S.CarrDerek. 2017. “State Legal Innovations to Encourage Naloxone Dispensing.”Journal of the American Pharmacists Association57(2 Supplement):S180–84.
17.
DowellDeborahAriasElizabethKochanekKennethAndersonRobertGuyGery P.Jr.LosbyJan L.BaldwinGrant. 2017. “Contribution of Opioid-Involved Poisoning to the Change in Life Expectancy in the United States, 2000–2015.”JAMA318(11):1065–67.
18.
DubbinLeslie A.ChangJamie SukiShimJanet K.2013. “Cultural Health Capital and the Interactional Dynamics of Patient-Centered Care.”Social Science & Medicine93:113–20.
19.
FairchildAmy L.2003. “Dealing with Humpty Dumpty: Research, Practice, and the Ethics of Public Health Surveillance.”The Journal of Law, Medicine & Ethics31(4):615–23.
20.
FinkDavid S.SchleimerJulia P.SarvetAaronGroverKiran K.DelcherChrisCastillo-CarnigliaAlvaroKimJune H.Rivera-AguirreAriadne E.HenryStephen G.MartinsSilvia S.CerdáMagdalena. 2018. “Association between Prescription Drug Monitoring Programs and Nonfatal and Fatal Drug Overdoses: A Systematic Review.”Annals of Internal Medicine168(11):783–90.
21.
FinleyErin P.GarciaAshleyRosenKristenMcGearyDonPughMary JoPotterJennifer Sharpe. 2017. “Evaluating the Impact of Prescription Drug Monitoring Program Implementation: A Scoping Review.”BMC Health Services Research17(1):420.
22.
FischerBenediktBibbyMeaganBouchardMartin. 2010. “Non-medical Use and Diversion of Psychotropic Prescription Drugs in North America: A Review of Sourcing Routes and Control Measures.”Addiction105(12):2062–70.
23.
FoucaultMichel. 1982. “The Subject and Power.” Pp. 208–28 in Michel Foucault: Beyond Structuralism and Hermeneutics. 2nd ed., edited by DreyfusH. L.RabinowP.Chicago, IL: University of Chicago Press.
24.
FoucaultMichel. 1990. The History of Sexuality: An Introduction, Volume I. New York, NY: Vintage Books.
25.
FoucaultMichel. 1991. “Governmentality.” Pp. 87–104 in The Foucault Effect: Studies in Governmentality, edited by BurchellG.GordonC.MillerP.Chicago, IL: University of Chicago Press.
26.
FoucaultMichel. 1995. Discipline & Punish: The Birth of the Prison. New York, NY: Vintage Books.
27.
GarlandDavid. 1997. “‘Governmentality’ and the Problem of Crime: Foucault, Criminology, Sociology.”Theoretical Criminology1(2):173–214.
28.
GoffmanAlice. 2009. “On the Run: Wanted Men in a Philadelphia Ghetto.”American Sociological Review74(3):339–57.
29.
GriffithsP. E.WestC.2015. “A Balanced Intervention Ladder: Promoting Autonomy through Public Health Action.”Public Health129(8):1092–98.
30.
GugelmannHallam M.PerroneJeanmarie. 2011. “Can Prescription Drug Monitoring Programs Help Limit Opioid Abuse?”JAMA306(20):2258–59.
31.
HaegerichTamara M.PaulozziLeonard J.MannsBrian J.JonesChristopher M.2014. “What We Know, and Don’t Know, about the Impact of State Policy and Systems-Level Interventions on Prescription Drug Overdose.”Drug and Alcohol Dependence145:34–47.
32.
HalabyCharles N.2004. “Panel Models in Sociological Research: Theory into Practice.”Annual Review of Sociology30:507–44.
33.
HoJessica Y.2017. “The Contribution of Drug Overdose to Educational Gradients in Life Expectancy in the United States, 1992–2011.”Demography54(3):1175–202.
34.
HulmeShannBrightDavidNielsenSuzanne. 2018. “The Source and Diversion of Pharmaceutical Drugs for Non-medical Use: A Systematic Review and Meta-analysis.”Drug and Alcohol Dependence186:242–56.
35.
ImtiazSameerProbstCharlotteRehmJürgen. 2018. “Substance Use and Population Life Expectancy in the USA: Interactions with Health Inequalities and Implications for Policy.”Drug and Alcohol Review37(S1):S263–67.
36.
JohnsonMatthew S.2020. “Regulation by Shaming: Deterrence Effects of Publicizing Violations of Workplace Safety and Health Laws.”American Economic Review110(6):1866–904.
37.
KeyesKatherine M.CerdáMagdalenaBradyJoanne E.HavensJennifer R.GaleaSandro. 2014. “Understanding the Rural–Urban Differences in Nonmedical Prescription Opioid Use and Abuse in the United States.”American Journal of Public Health104(2):e52–59.
38.
LightDonaldLevineSol. 1988. “The Changing Character of the Medical Profession: A Theoretical Overview.”The Milbank Quarterly66(Suppl. 2):10–32.
39.
LuhrmannTanya M.1991. Persuasions of the Witch’s Craft: Ritual Magic in Contemporary England. Cambridge, MA: Harvard University Press.
40.
MacCounRobert J.ReuterPeter. 2001. Drug War Heresies: Learning from Other Vices, Times, and Places. New York, NY: Cambridge University Press.
41.
MaxwellJane C.2011. “The Prescription Drug Epidemic in the United States: A Perfect Storm.”Drug and Alcohol Review30(3):264–70.
42.
McCabeSean E.CranfordJames A.WestBrady T.2008. “Trends in Prescription Drug Abuse and Dependence, Co-occurrence with Other Substance Use Disorders, and Treatment Utilization: Results from Two National Surveys.”Addictive Behaviors33(10):1297–305.
43.
MonnatShannon M.2018. “Factors Associated with County-Level Differences in U.S. Drug-Related Mortality Rates.”American Journal of Preventive Medicine54(5):611–19.
44.
MorganStephen L.WinshipChristopher. 2007. Counterfactuals and Causal Inference: Methods and Principles for Social Research. New York, NY: Cambridge University Press.
45.
MorideYolaLemieux-UresandiDanaeCastillonGenaroSoares de MouraCristianoPiloteLouiseFaureMarevaBernartskySasha. 2019. “A Systematic Review of Interventions and Programs Targeting Appropriate Prescribing of Opioids.”Pain Physician22(3):229–40.
46.
MustoDavid F.1999. American Disease: Origins of Narcotic Control. New York, NY: Oxford University Press.
47.
PaulyNathan JamesSlavovaSvetlaDelcherChrisFreemanPatriciaTalbertJeffery. 2018. “Features of Prescription Drug Monitoring Programs Associated with Reduced Rates of Prescription Opioid-Related Poisonings.”Drug and Alcohol Dependence184:26–32.
48.
PerroneJeanmarieNelsonLewis S.2012. “Medication Reconciliation for Controlled Substances—An ‘Ideal’ Prescription-Drug Monitoring Program.”New England Journal of Medicine366(25):2341–43.
49.
PetersDavid J.MonnatShannon M.HochstetlerAndrew L.BergMark T.2020. “The Opioid Hydra: Understanding Overdose Mortality Epidemics and Syndemics across the Rural–Urban Continuum.”Rural Sociology85(3):589–622.
50.
RhodesEmilyWilsonMariaRobinsonAlysiaHaydenJill A.AsbridgeMark. 2019. “The Effectiveness of Prescription Drug Monitoring Programs at Reducing Opioid-Related Harms and Consequences: A Systematic Review.”BMC Health Services Research19(1):784.
51.
RiggKhary K.FordJason A.2014. “The Misuse of Benzodiazepines among Adolescents: Psychosocial Risk Factors in a National Sample.”Drug and Alcohol Dependence137:137–42.
52.
RiggKhary K.MarchSamantha J.InciardiJames A.2010. “Prescription Drug Abuse & Diversion: Role of the Pain Clinic.”Journal of Drug Issues40(3):681–701.
53.
RutkowLainieTurnerLydiaLucasEleanorHwangCatherineAlexanderG. Caleb. 2015. “Most Primary Care Physicians Are Aware of Prescription Drug Monitoring Programs, but Many Find the Data Difficult to Access.”Health Affairs34(3):484–92.
54.
SchollLawrenceSethPujaKariisaMbabaziWilsonNanaBaldwinGrant. 2019. “Drug and Opioid-Involved Overdose Deaths—United States, 2013–2017.”Morbidity and Mortality Weekly Report67(5152):1419–27.
55.
VaiseyStephenMilesAndrew. 2017. “What You Can—and Can’t—Do with Three-Wave Panel Data.”Sociological Methods & Research46(1):44–67.
56.
VuoloMikeKadowakiJoyKellyBrian C.2016. “A Multilevel Test of Constrained Choices Theory: The Case of Tobacco Clean Air Restrictions.”Journal of Health and Social Behavior57(3):351–72.
57.
WatkinsWilliam C.2016. “A Social Learning Approach to Prescription Drug Misuse among College Students.”Deviant Behavior37(6):601–14.
58.
WinshipChristopherMorganStephen L.1999. “The Estimation of Causal Effects from Observational Data.”Annual Review of Sociology25:659–706.
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