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.