Prescription drug monitoring programs (PDMPs) are databases that track controlled substances at the provider, patient, and pharmacy levels. While these databases are widely available at the state level throughout the United States, several jurisdictions in recent years have mandated the use of these systems by health care providers. This study explores the implementation of mandatory PDMP technology in primary care practice and the effects on treatment of people with possible substance use disorders. Findings are based on 53 in-depth interviews with primary care providers in New York City, collected shortly following the passage of legislation mandating use of a PDMP by health care providers in New York State. Findings suggest that use of the PDMP highlighted tensions between provider stigma toward substance use disorders and the clinical care of people who use drugs, challenging their stereotypes and biases. The parallel clinical and law enforcement purposes of PDMP technology placed providers in dual roles as clinicians and enforcers and encouraged the punitive treatment of patients. Finally, PDMP technology standardized the clinical assessment process toward a "diagnosis first" approach, consistent with prior scholarship on the implementation of emerging medical technologies.

中文翻译：

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物质使用污名，初级保健和纽约州处方药监测计划。

处方药监控程序（PDMP）是在提供者，患者和药房级别跟踪受控物质的数据库。尽管这些数据库在美国全州范围内都可以广泛使用，但近年来，一些司法管辖区已要求医疗保健提供者使用这些系统。这项研究探讨了强制性PDMP技术在基层医疗实践中的实施以及对可能使用毒品的人的治疗的影响。调查结果基于对纽约市初级保健提供者的53次深度访谈，这些访谈是在立法规定纽约州的医疗保健提供者强制使用PDMP之后不久收集的。研究结果表明，PDMP的使用突出了提供者对药物滥用疾病的耻辱与吸毒者的临床护理之间的紧张关系，挑战了他们的刻板印象和偏见。PDMP技术的并行临床和执法目的使提供者具有临床医生和执行者的双重作用，并鼓励对患者进行惩罚性治疗。最后，PDMP技术使临床评估过程朝着“诊断优先”的方法标准化，这与先前对新兴医学技术的实施的研究相一致。