Policy mechanisms shaping population health take numerous forms, from behavioral prohibitions to mandates for action to surveillance. Rising drug overdoses undermined the state’s ability to promote population-level health. Using the case of prescription drug monitoring programs (PDMPs), we contend that PDMP implementation highlights state biopower operating via mechanisms of surveillance, whereby prescribers, pharmacists, and patients perceive agency despite choices being constrained. We consider whether such surveillance mechanisms are sufficient or if prescriber/dispenser access or requirements for use are necessary for population health impact. We test whether PDMPs reduced overdose mortality while considering that surveillance may require time to reach effectiveness. PDMPs reduced opioid overdose mortality 2 years postimplementation and sustained effects, with similar effects for prescription opioids, benzodiazepines, and psychostimulants. Access or mandates for action do not reduce mortality beyond surveillance. Overall, PDMP effects on overdose mortality are likely due to self-regulation under surveillance rather than mandated action.

塑造人口健康的政策机制有多种形式，从行为禁令到行动授权再到监测。不断增加的药物过量破坏了该州促进人口健康的能力。使用处方药监测计划 (PDMP) 的案例，我们认为 PDMP 的实施突出了通过监测机制运作的国家生物权力，尽管选择受到限制，开处方者、药剂师和患者仍能感知机构。我们考虑这种监测机制是否足够，或者处方者/配药者的访问或使用要求是否对人口健康影响是必要的。我们测试了 PDMP 是否降低了过量死亡率，同时考虑到监测可能需要时间才能达到效果。PDMP 降低了实施后 2 年的阿片类药物过量死亡率和持续作用，对处方阿片类药物、苯二氮卓类药物和精神兴奋剂具有相似的作用。获取或行动授权不会降低监测以外的死亡率。总体而言，PDMP 对过量死亡率的影响可能是由于在监督下的自我调节而不是强制行动。