OBJECTIVES : To quantify the effects of Florida’s prescription drug monitoring program (PDMP) and pill mill law on high-risk patients.

METHODS : We used IQVIA LRx Lifelink data to identify patients receiving prescription opioids in Florida (intervention state, N=1.13 million) and Georgia (control state, N=0.54 million). The pre-intervention period was from July 2010 to June 2011, the policy implementation period extended from July 2011 (pill mill law) to September 2011 (PDMP), and the post-intervention period ranged from October 2011 through September 2012. We identified three types of high-risk patients: 1) concomitant users (patients with concomitant use of benzodiazepines and opioids); 2) chronic users (long-term high-dose opioid users); and 3) opioid shoppers (patients visiting ˃3 pharmacies and ˃3 prescribers to acquire opioids). We compared changes in opioid prescriptions between Florida and Georgia before and after policy implementation among high-risk and low-risk patients. Our monthly measures included: (1) average morphine milligram equivalent (MME) per transaction; (2) total opioid volume across all prescriptions; (3) average days supplied per transaction; and (4) total number of opioid prescriptions dispensed.

RESULTS : Among opioid-receiving individuals in Florida, 6.62% were concomitant users, 1.96% were chronic users and 0.46% were opioid shoppers. Following policy implementation, Florida’s high-risk patients experienced relative reductions in: MME (opioid shoppers: -1.08 mg/month, 95% confidence intervals [CI] -1.62 to -0.54), total opioid volume (chronic users: -4.58 kg/month, CI -5.41 to -3.76), and number of dispensed opioid prescriptions (concomitant users: -640 prescriptions/month, CI -950 to -340). Low-risk patients generally did not experience statistically significantly relative reductions.

CONCLUSIONS : Compared to Georgia, Florida’s PDMP and pill mill law were associated with large relative reductions in prescription opioid utilization among high-risk patients.