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Since the 1990s rates of prescription drug abuse and overdose have skyrocketed to unprecedented levels. As a result states have enacted and implemented new drug control policies in hopes of slowing and reversing this health epidemic. The goals of this study were to (a) determine the impact these state-based drug control policies have on prescription drug abuse and overdose and (b) deduce what leads some states to pass stricter policies than others. Results indicated that the prevalence of prescription drug overdose in 2008 largely impacted the future strength of a state’s drug control policy. States with higher rates of drug overdose and abuse in earlier years tended to develop tougher policy by 2013. In addition, states’ Prescription Drug Monitoring Programs (PDMPs) were found to be strongly related to the growth rate of prescription drug abuse in states. While not significantly differing from national trends at first, after about five years of PDMP operation, states began to see a slow or decrease in their rates of prescription drug abuse. Though much more can be done to combat prescription drug abuse and overdose, PDMPs that provide unsolicited reports to users and are accessible to law enforcement and are an effective step to begin to curb the problem.