Prescription monitoring office: stimulant prescriptions up among adults; opioid prescriptions steady after declines
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Summary
Adam Birch, administrator of New Hampshire’s Prescription Drug Monitoring Program, told the Health and Human Services Oversight Committee on May 16 that clinician use of the PDMP rose 18 percent year‑over‑year while stimulant prescriptions increased among adults 30 and older and opioid prescriptions have declined then plateaued.
Adam Birch, administrator of New Hampshire’s Prescription Drug Monitoring Program, told the Health and Human Services Oversight Committee on May 16 that the program’s registrant count has been stable while clinician use of the system rose 18 percent year‑over‑year. Birch said opioid prescriptions fell substantially since 2017 and are now largely plateaued, while stimulant prescriptions have increased — particularly among adults aged 30 and older.
Birch said the PDMP shows a marked increase in stimulant prescriptions for adults 30 and over and that the largest growth in prescribing in 12 months was among women in that age group. He attributed some of the rise to broadened diagnostic criteria for attention‑deficit/hyperactivity disorder and to expanded access to telehealth and targeted advertising that may prompt care‑seeking and evaluations. Birch said the total days‑supply per individual has not risen at the same rate, suggesting the increase is mostly more people receiving treatment rather than dramatically larger doses per patient.
On opioids, Birch said high‑risk prescribing has decreased and the number of bad‑faith prescribers has declined; opioid prescribing trends are now relatively flat compared with the sharp reductions seen earlier in the multi‑year effort to reduce risky opioid prescribing.
Birch highlighted improvements to data accuracy and clinician access: the PDMP’s data accuracy is about 99.8 percent and “gateway” integration (electronic‑health‑record query integration) has increased clinician queries about 68 percent year‑over‑year, including improved interstate query functionality.
He urged clinicians to consider querying the PDMP even when prescribing non‑controlled medications that can interact with treatment (for example, medicines that interact with buprenorphine) so prescribers have a full view of potentially interacting treatments.
Why it matters: PDMP trends inform clinical practice, public‑health monitoring and enforcement. The rise in stimulants among adults is a monitoring signal for clinicians and policy makers; high data quality and improved EHR integration make the PDMP more useful in real time.
Committee members asked about county differences and privacy protections; Birch said county differences are driven in part by population density and prescriber access and that the program maintains strict access controls, audit trails and protections against improper access.