Fighting the Opioid Epidemic at the State- and Rx-Level Report

The United States is in the midst of an opioid epidemic. In 2016, more than 42,000 people died of opioid overdoses and recent estimates put the cost of the opioid epidemic in excess of $500 billion annually.

New Opioid Prescribing Laws

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States are taking steps to address this widespread tragedy at its root cause: opioid prescribing.  However, the whos, whats, whys and hows of these key strategies vary widely across the country.

This report was designed to help stakeholders understand the details and complexities of what how states are handling opioid prescriptions. Updated through April 15 2018, Fighting the Opioid Epidemic at the State- and Rx-Level focuses on the range of state responses to the opioid epidemic.



What the report contains

The 33-page report includes details of state responses to opioid prescribing organized around three main trends: 1) prescribing, 2) curbing fraud and abuse, and 3) preventing and treating addiction.  

The analyses are supplemented with 12 figures, including state maps indicating required consultation of Prescription Drug Monitoring Programs (PDMPs) by prescribers and dispensers. A third map focuses on states that have mandated electronic prescribing of controlled substances (EPCS) or proposed doing so.

Specific details are summarized in two Appendices.  Appendix A provides a state-by-state overview of controlled substance rules and limits.  Appendix B highlights controlled substance mid-level prescribing authorities.   

Appendix A

Partial View of Appendix A


This April 2018 report has new and detailed data on state responses to opioid prescribing.  Among the major findings:

  • In total, as described throughout this report, eleven different mandates are being used across states to combat the opioid crisis, all of which are detailed in the report.
  • The states with the highest-observed drug overdose death rates have implemented and proposed the most measures. Those states and their efforts are highlighted.
  • A majority have enacted—or are considering—legislation requiring prescribers to consult PDMPS before prescribing. The report contains a table of which states are doing what.
  • Several states have mandates in place that require prescribers to submit controlled substances via EPCS while others have proposed EPCS mandates in the last few weeks. The components of these mandates are highlighted in the report.
  • An increasing number of states are limiting who can prescribe opioids and Schedule II narcotics as well as fill quantities in addition to requiring additional data such as diagnosis. Which states are doing what is articulated in the report.
  • In another key trend, states are mandating that providers counsel and provide more education to patients around opioid prescribing.

Want to learn more? Click here for a report preview.  POCP’s Regulatory Resource Center also can do a deep dive on this and other state prescribing-related issues.  For more information, contact Connie Sinclair at  

Connie Sinclair

Connie Sinclair