The network of states connecting their prescription monitoring programs (PMPs) is growing. In a May 28 press release, the National Association of Boards of Pharmacy (NABP) announced that 25 states now share controlled substance filling records through the NABP's PMP InterConnect program.

But while these expansions certainly suggest greater potential for detecting inappropriate controlled substance utilization by patients — particularly across state borders — the question remains about whether these programs are actually accomplishing this.

PMPs — also called PDMPs (prescription drug monitoring programs) — have been defined as "statewide electronic databases that collect designated data on substances dispensed in the state." They were initially developed to allow healthcare professionals access to the recent controlled substance utilization history of a given patient in their office or pharmacy.

Currently all but two states in the U.S. have some degree sort of PMP in place, according to the latest NABP data, one of which has legislation in place to create it. With so many states participating, and 25 of those states connected, one can appreciate the optimism of NABP president Joseph Adams:

"With 25 states of the 48 United States jurisdictions that have operational PMPs participating in NABP PMP InterConnect, thousands of healthcare providers now have a more complete view of their patients' prescription drug history to assist them in their prescribing and dispensing decisions."

But is the optimism warranted? Are these databases actually being utilized and as a result decreasing the diversion of controlled substances, thwarting the efforts of doctor-shoppers and reducing the overall deaths due to over dosages of these potent drugs? This seems to be much harder to prove.

Some studies, like one published in 2011 by Paulozzi and colleagues, didn't show any significant difference in overdose deaths in states that had PMPs and those that did not. That sort of data may be why Missouri — the "show me" state — says the proof just isn't there that these programs work, and is the lone state in the country with no legislation in place for a PMP. We certainly haven't seen any great national trend toward fewer opioid prescriptions or deaths in the past few years at least.

As a practicing pharmacist in the state of Massachusetts, which has a PMP program (though not currently connected with any other state), I can attest to the fact that the system is far from convenient for busy prescribers and/or pharmacists to utilize.

After logging in, one must travel through 2-3 more pages to access the awkward little database. The website logs you off if you are idle for too long. And, according to the website, "it takes up to two to three weeks between dispensing of a prescription and its inclusion in the online PMP." I've been told by friends in other states, like California, that the data can be up to a month or more behind.

There doesn't seem to be a lot of consistency between states either.

For example, with respect to the time gap, the Oklahoma system has data available through the PMP for prescribers and pharmacies to see within just a few hours. In New York, where utilization of the system is mandated for prescribers, there have been concerns that physicians are now not prescribing narcotics even for legitimate pain patients, due to the added burden of utilizing the PMP system. The Pennsylvania PMP system, according to its official website, only collects data on schedule II prescriptions and is only viewable by law enforcement.

Most of the currently-available PMP systems are too irritating, inaccurate or untimely to contribute meaningfully as a deterrent to doctor-shopping. Built by government bureaucracies, I suppose we shouldn't be surprised. Hopefully, that will change, but even a perfectly functioning PMP cannot account for patients with fake IDs — a booming industry at present.

Moreover, the PMP can never deter the patient who sees a single doctor for a large quantity of narcotics every month, and then simply sells them (or most of them) on the side. Their track record will always look fine on paper (or online). But the real damage is done behind closed doors — something not even the best PMP can ever detect.

So states are joining forces and sharing patient controlled substance data in our war on drug abuse and overdose death. But I wonder if anything more than sharing is really going on. If the PMP were a pill, would it be any better than a placebo?

These questions require some answers, and I'm not sure we've found them yet.