FDA/DEA/PDMP/UDT: alphabet soup or sensible and integrated risk management?
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Updated: Apr 16, 2026

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Published on: March 17, 2023
Steven D Passik1, Kenneth L Kirsh2, Robert K Twillman3
1Millennium Research Institute, San Diego,California; Vice President, Clinical Research and Advocacy, Millennium Health, San Diego, California.
Objective:
Both prescription drug monitoring programs (PDMP) and urine drug testing (UDT) are recommended as parts of an ongoing risk management approach for controlled substance prescribing. The authors provide an editorial and commentary to discuss the unique contributions of each to promote better clinical decision making for prescribers.
Design:
A commentary is employed along with brief discussion comparing four states with an active PDMP in place to three states without an active PDMP as it relates back to findings on UDT in those states from a laboratory conducting liquid chromatography tandem mass spectrometry.
Conclusions:
The commentary focuses on the place of both tools (UDT and PDMP) in risk management efforts. The argument is made that relying on a PDMP alone would lead to clinical decisions that may miss a great deal of problematic or aberrant behaviors.
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This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...