All states have implemented electronic Prescription Drug Monitoring Programs (PDMPs) (see pdmpassist.org). Although the details of a PDMP may vary from state to state, typically, the program requires pharmacists and prescribers to electronically transmit to the state a record of each controlled substance prescription dispensed. (Some states may not require the reporting of all schedules of controlled substance prescriptions.) PDMPs allow investigators to obtain pharmacy data from multiple locations without actually having to visit each pharmacy. States review the data generated through a PDMP to determine if diversion or abuse exists and can track patients, physicians, and pharmacies. Thus, PDMPs can identify such situations as patients "shopping" multiple prescribers or multiple pharmacies. Most states either allow or mandate treating healthcare professionals to query patient-specific information from the PDMP prior to prescribing or dispensing controlled substances, which may also improve prescribing and dispensing practices. Some states also authorize the state agency responsible for the PDMP to proactively notify healthcare professionals when data indicate that a patient may be engaged in possible diversion or abuse.

Congress and various federal agencies recognize the importance of PDMPs. Since 2002, there have been a variety of federal grant programs allowing states to receive funding to develop or enhance PDMPs. States that receive funding must agree to meet specified standards such as sharing controlled substance data with other states; collecting specified prescription information from pharmacies for schedule II, III, and IV drugs; and allowing prescribers and dispensers access to patient records to determine therapeutic duplication and whether diversion, abuse, or fraud might exist.

A weakness of state PDMP programs had been that the data in one state were unavailable to another state. This obviously presents monitoring problems when patients cross state lines. In response, the NABP established in 2011 a nationwide platform to facilitate the transmission of PDMP data across state lines called NABP PMP InterConnect (https://nabp.pharmacy/members/programs-services/industry-information-networks/pmp-interconnect/). Most states now participate in the system.

PDMPs are considered one of the most important state-level interventions to help with the national opioid epidemic. Furthermore, many states also encourage the use of PDMPs by prescribers and dispensers to assist in their clinical decisions. To help achieve this, various states have integrated PDMP reports into electronic health record and/or dispensing software systems. Since specific details and requirements regarding PDMPs change often, there are a variety of resources to keep up to date on all of the state PDMPs. Two current resources include The Prescription Drug Monitoring Program Training and Technical Assistance Center (PDMP TTAC) website (available at http://www.pdmpassist.org/) and the National Alliance for Model State Drug Laws (available at https://namsdl.org/topics/pdmp/).