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Impact of Florida’s prescription drug monitoring program on drug- related fatal vehicle crashes: a difference-in-differences approach
  1. Moosa Tatar1,2,3,
  2. Mohammad S. Jalali4,5,
  3. Hyo Jung Tak2,
  4. Li-Wu Chen6,
  5. Ozgur M. Araz7,
  6. Fernando A. Wilson1,3
  1. 1 Matheson Center for Health Care Studies, University of Utah Health, Salt Lake City, Utah, USA
  2. 2 Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha, Nebraska, USA
  3. 3 Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
  4. 4 Harvard Medical School, MGH Institute for Technology Assessment, Boston, Massachusetts, USA
  5. 5 Sloan School of Management, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
  6. 6 Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, Missouri, USA
  7. 7 College of Business, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
  1. Correspondence to Dr Moosa Tatar, Matheson Center for Health Care Studies, University of Utah Health, Salt Lake City, UT 84108, USA;{at}


Background Prescription drug use has soared in the USA within the last two decades. Prescription drugs can impair motor skills essential for the safe operation of a motor vehicle, and therefore can affect traffic safety. As one of the epicentres of the opioid epidemic, Florida has been struck by high opioid misuse and overdose rates, and has concurrently suffered major threats to traffic disruptions safety caused by driving under the influence of drugs. To prevent prescription opioid misuse in Florida, Prescription Drug Monitoring Programs (PDMPs) were implemented in September 2011.

Objective To examine the impact of Florida’s implementation of a mandatory PDMP on drug-related MVCs occurring on public roads.

Methods We employed a difference-in-differences approach to estimate the difference in prescription drug-related fatal crashes in Florida associated with its 2011 PDMP implementation relative to those in Georgia, which did not use PDMPs during the same period (2009–2013). The analyses were conducted in 2020.

Results In Florida, there was a significant decline in drug-related vehicle crashes during the 22 months post-PDMP. PDMP implementation was associated with approximately two (−2.21; 95% CI −4.04 to –0.37; p<0.05) fewer prescribed opioid-related fatal crashes every month, indicating 25% reduction in the number of monthly crashes. We conducted sensitivity analyses to investigate the impact of PDMP implementation on central nervous system depressants and stimulants as well as cocaine and marijuana-related fatal crashes but found no robust significant reductions.

Conclusions The implementation of PDMPs in Florida provided important benefits for traffic safety, reducing the rates of prescription opioid-related vehicle crashes.

  • prescription drug monitoring programmes
  • traffic crashes
  • prescription drug misuse
  • health policy

Data availability statement

Data are available in a public, open-access repository.

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Data availability statement

Data are available in a public, open-access repository.

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  • Contributors MT as the corresponding author is responsible for data integrity and data analysis accuracy, and performed the statistical analyses, drafted the manuscript and had full access to all study data. All authors (MT, MSJ, HJT, LWC, OMA and FAW) contributed to concept and design, and critically revised the manuscript for important intellectual content. They approved the final version of the manuscript and are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MT and FAW provided administrative, technical and material support.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.