June 2020. Integration of prescription drug monitoring program (PDMP) databases with electronic health records (EHRs) is an important tool in combating the opioid crisis in the US. We assessed nationwide hospital adoption of three EHR capabilities related to opioid prescribing and PDMP integration: ability to electronically prescribe controlled substances, checking of state PDMPs directly from EHRs, and integration of PDMP data into EHRs. Less than one third of hospitals reported the ability to check state PDMPs, and only 14% reported full PDMP data integration. More troublingly, hospitals in high opioid-prescribing counties were less likely to report these capabilities.