{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:10:12Z","timestamp":1783566612050,"version":"3.55.0"},"reference-count":50,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Milbank Quarterly"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"box\" position=\"anchor\">\n                        <jats:caption>\n                          <jats:title>Policy Points<\/jats:title>\n                        <\/jats:caption>\n                        <jats:p>\n                          <jats:list list-type=\"bullet\">\n                            <jats:list-item>\n                              <jats:p>State \u201cmust\u2010query\u201d prescription drug monitoring programs (PDMPs) were associated with increased overdose deaths, suggesting these policies may have unintended consequences.<\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>Black and Hispanic populations experienced disproportionately higher increases in overdose deaths following must\u2010query PDMP adoption, highlighting that these policies may contribute to health disparities.<\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>Addressing systemic inequities in health care access and substance use treatment may help supplement the effective components of PDMPs, ensuring that these policies reduce rather than exacerbate overdose deaths.<\/jats:p>\n                            <\/jats:list-item>\n                          <\/jats:list>\n                        <\/jats:p>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Despite recent declines in national overdose deaths, these reductions have not been equitably experienced. Black and Hispanic communities continue to face rising rates of opioid\u2010related mortality, even as overdose death rates among White individuals have begun to decline. One of the most widely implemented policy responses to the overdose crisis has been the adoption of prescription drug monitoring programs (PDMPs), particularly \u201cmust\u2010query\u201d mandates requiring prescribers to consult the PDMP before issuing controlled substances. However, limited research has examined whether the impact of these mandates varies by race and ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used restricted\u2010use National Vital Statistics System data from 2013 to 2020 to estimate county\u2010level overdose mortality stratified by drug type and race and ethnicity. We categorized deaths as follows: (1) all drug overdoses, (2) all opioid overdoses, and (3) natural\/semisynthetic opioid overdoses. Exposure to must\u2010query mandates was modeled as the proportion of the prior year during which mandates were in effect. Using Bayesian spatiotemporal models with county random effects and spatial autocorrelation, we estimated relative rates (RRs) for each outcome overall and by race and ethnicity, adjusting for state policies and sociodemographic characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Must\u2010query mandates were associated with increases in overdose deaths across all groups, with the largest relative increases among Hispanic (RR\u00a0=\u00a01.32, 95% credible interval [CrI]: 1.21\u20101.44) and Black individuals (RR\u00a0=\u00a01.23, 95% CrI: 1.14\u20101.33) compared with White individuals (RR\u00a0=\u00a01.14, 95% CrI: 1.10\u20101.19). These increases were also observed among Black and Hispanic individuals for natural\/semisynthetic opioid overdoses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PDMP must\u2010query mandates are not uniformly protective across racial and ethnic groups. Increases in overdose mortality following adoption, particularly among Black and Hispanic populations, underscore the need to evaluate drug policies through an equity lens and consider broader structural determinants of health that shape their effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1468-0009.70057","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T01:52:39Z","timestamp":1760406759000},"page":"141-160","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Racial and Ethnic Differences in the Effects of Prescription Drug Monitoring Program Laws on Overdose Deaths in the United States"],"prefix":"10.1111","volume":"103","author":[{"given":"SPRUHA","family":"JOSHI","sequence":"first","affiliation":[{"name":"University of Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"VICTORIA A.","family":"JENT","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SNEHA M.","family":"SUNDER","sequence":"additional","affiliation":[{"name":"University of Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KATHERINE","family":"WHEELER\u2010MARTIN","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8441-7046","authenticated-orcid":false,"given":"MAGDALENA","family":"CERD\u00c1","sequence":"additional","affiliation":[{"name":"NYU Grossman School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.15620\/cdc:135849"},{"key":"e_1_2_6_3_1","unstructured":"Drug overdose deaths: facts and figures.National Institute on Drug Abuse. August 21 2024. Accessed December 31 2024.https:\/\/nida.nih.gov\/research\u2010topics\/trends\u2010statistics\/overdose\u2010death\u2010rates"},{"key":"e_1_2_6_4_1","unstructured":"Overdose prevention: prescription drug monitoring programs (PDMPs).Centers for Disease Control and Prevention. May 21 2024. Accessed January 6 2025.https:\/\/www.cdc.gov\/overdose\u2010prevention\/php\/interventions\/prescription\u2010drug\u2010monitoring\u2010programs.html"},{"key":"e_1_2_6_5_1","volume-title":"StatPearls","author":"D'Souza RS","year":"2024"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.02.010"},{"key":"e_1_2_6_7_1","unstructured":"KilbyAE.Opioids for the Masses: Welfare Tradeoffs in the Regulation of Narcotic Pain Medications. Dissertation.Massachusetts Institute of Technology;2016. Accessed March 6 2025.https:\/\/angelakilby.com\/pdfs\/AKilbyWelfare_2022\u201001.pdf"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13741"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/2197\u20101714\u20101\u20109"},{"issue":"5","key":"e_1_2_6_10_1","first-page":"297","article-title":"State prescription drug monitoring programs and fatal drug overdoses","volume":"23","author":"Nam YH","year":"2017","journal-title":"Am J Manag Care"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526\u20104637.2011.01062.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.36687"},{"key":"e_1_2_6_13_1","unstructured":"KreinerP NikitinR ShieldsTP.Bureau of Justice Assistance Prescription Drug Monitoring Program Performance Measures Report: January 2009 Through June 2012.US Department of Justice Bureau of Justice Assistance;2014."},{"key":"e_1_2_6_14_1","volume-title":"Mandating PDMP Participation by Medical Providers: Current Status and Experience in Selected States","year":"2014"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1162\/ajhe_a_00101"},{"key":"e_1_2_6_16_1","doi-asserted-by":"crossref","unstructured":"BirkE WaddellGR.The mitigating role of prescription drug monitoring programs in the abuse of prescription drugs. IZA Discussion Paper No. 10990. Institute for the Study of Labor (IZA);2017.10.2139\/ssrn.3037875","DOI":"10.2139\/ssrn.3037875"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwae210"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.12.002"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.5055\/jom.2017.0391"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.05.023"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1496"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.13968"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2022.0004"},{"key":"e_1_2_6_24_1","unstructured":"Restricted\u2010use vital statistics data.National Center for Health Statistics. Centers for Disease Control and Prevention. August 24 2023. Accessed March 6 2025.https:\/\/www.cdc.gov\/nchs\/nvss\/nvss\u2010restricted\u2010data.htm"},{"key":"e_1_2_6_25_1","unstructured":"Injury Surveillance Workgroup (ISW) reports.Safe States Alliance website. Accessed September 16 2024.https:\/\/www.safestates.org\/page\/ISWReports"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.13548"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.03.014"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwab192"},{"key":"e_1_2_6_29_1","unstructured":"Prescription Drug Abuse Policy System \u2010 PDAPS.PDAPS website. Accessed August 14 2024.https:\/\/pdaps.org\/"},{"key":"e_1_2_6_30_1","unstructured":"Status of state Medicaid expansion decisions. Kaiser Family Foundation. February 12 2025. Accessed March 6 2025.https:\/\/www.kff.org\/status\u2010of\u2010state\u2010medicaid\u2010expansion\u2010decisions\/"},{"key":"e_1_2_6_31_1","unstructured":"American community survey 5\u2010year data (2009\u20102023).US Census Bureau website. December 12 2024. Accessed March 6 2025.https:\/\/www.census.gov\/data\/developers\/data\u2010sets\/acs\u20105year.html"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780142112"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sste.2012.12.001"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aap.2004.02.004"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1201\/9780203487808"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/wics.1443"},{"key":"e_1_2_6_37_1","unstructured":"R: A language and environment for statistical computing.Version 4.1.1. R;2010."},{"issue":"2","key":"e_1_2_6_38_1","first-page":"242","article-title":"Spatial epidemiology notes","volume":"20","author":"DiMaggio C","year":"2012","journal-title":"Appl Vignettes R"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000001123"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2019.10.001"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000001404"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2018.1491052"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2023.4958"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.06.006"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1089\/heq.2020.0062"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-022-07893-8"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2006.9.1454"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1037\/sah0000426"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1177\/07340168221105002"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11013-016-9496-5"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.107549"}],"container-title":["The Milbank Quarterly"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1468-0009.70057","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T07:31:35Z","timestamp":1764747095000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1468-0009.70057"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,13]]},"references-count":50,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/1468-0009.70057"],"URL":"https:\/\/doi.org\/10.1111\/1468-0009.70057","archive":["Portico"],"relation":{},"ISSN":["0887-378X","1468-0009"],"issn-type":[{"value":"0887-378X","type":"print"},{"value":"1468-0009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,13]]},"assertion":[{"value":"2025-04-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}