In the United States, prescription monitoring programs (PMPs) or prescription drug monitoring programs (PDMPs) are state-run programs which collect and distribute data about the prescription and dispensation of federally controlled substances and, as the individual states deem appropriate, other potentially addictive or abusable prescription drugs. PMPs help to prevent adverse drug-related events through opioid overdoses, drug diversion, and substance abuse by decreasing the amount and/or frequency of opioid prescribing. In the United States, prescription monitoring programs (PMPs) or prescription drug monitoring programs (PDMPs) are state-run programs which collect and distribute data about the prescription and dispensation of federally controlled substances and, as the individual states deem appropriate, other potentially addictive or abusable prescription drugs. PMPs help to prevent adverse drug-related events through opioid overdoses, drug diversion, and substance abuse by decreasing the amount and/or frequency of opioid prescribing. Most US health care workers support PMPs, which intend to assist physicians, physician assistants, nurse practitioners, dentists and other prescribers, the pharmacists, chemists and support staff of dispensing establishments, as well as law-enforcement agencies. The collaboration supports the legitimate medical use of controlled substances while limiting their abuse and diversion. Pharmacies dispensing controlled substances and prescribers are typically required to register with their respective state PMPs and (for pharmacies and providers who dispense controlled substances from their offices) to report the dispensation of such prescriptions to an electronic online database. Although forty-nine states have implemented PDMPs, little is known about these programs and their overall effectiveness. In the United States, prescription monitoring programs (PMPs) or prescription drug monitoring programs (PDMPs) are state-run programs which collect and distribute data about the prescription and dispensation of federally controlled substances and, as the individual states deem appropriate, other potentially addictive or abusable prescription drugs. PMPs help to prevent adverse drug events through opioid overdoses, drug diversion, and substance abuse by decreasing the amount and/or frequency of opioid prescribing. A 2017 study found that 'US states that have more robust prescription drug monitoring programs have fewer prescription opioid overdose deaths than states with weaker PMPs.' Legislation and initiatives cannot be uniform throughout the nation. In New York designed a program called the Naloxone Co-payment Assistance Program, or N-CAP, which can help cover out-of-pocket payments when patients are picking up naloxone. On a nationwide level, President Donald Trump’s administration has secured six billion dollars to stop opioid abuse. More specifically, there have also been efforts to strengthen criminal penalties for dealing and trafficking opioids. Prescription drug monitoring programs, or PDMP’s, are an example of one initiative in place to alleviate effects of the opioid crisis. The programs are designed to restrict prescription drug abuse by limiting doctor shopping, diverting controlled substances, and improving decision making. PDMP’s have been implemented in state legislations since 1939 in California, a time before researchers were aware of the highly addictive properties of opioids. Since 2014, 49 states and one US territory have enacted PDMP legislation. Of the 49, 48 have utilized the programs. Missouri is the only state within the United States that doesn’t have a PDMP. One reason is because their republican senator, Rob Schaaf - who is also a physician, ceased any legislation that initiated drug monitoring programs. Moreover, he has introduced his own proposal which is considered medically inept as it doesn’t require physicians to view a patient’s narcotic history. Rather, it forces doctors to send the names of patients they are considering prescribing painkillers to the health department. This would put the decision out of the doctors hands, for better or worse. On the opposition, Missouri Representative Holly Rehder and Senator Dave Schatz have proposed a more common version of the monitoring programs, one that is similar to the rest of the United States. However, both proposals have not been able to be passed through at a cost to the Missouri people. Although prescription drug monitoring programs are not new to state legislation, they are constantly being updated for the current healthcare climate. Currently, a major goal is to streamline provider access and improve provider’s understanding of PDMP reports. This is being done by integrating PDMP reports into health information technologies (HITs) such as health information exchanges (HIE), electronic health record (EHR) systems, and/ or pharmacy dispensing software (PDS) systems. A specific program that has been implemented nine states is called the PDMP Electronic Health Records Integration and Interoperability Expansion, also known as PEHRIIE. PEHRIIE activities strengthen PDMP utilization by distributing PDMP data and increasing data sharing. Moreover, increasing knowledge of separate effective practices has helped many states reach advancements.