Feedback Positive On Prescription Drug Monitoring Program

It has almost been a year since the Crawford County Commission adopted a prescription drug monitoring program and Honor Evans, the health department’s administrator, said pharmacist feedback has been positive so far.

“(Pharmacists) have been very happy with the program,” said Evans, who pushed for the PDMP last summer. 

The program is overseen by the St. Louis County Health Department, which receives federal funding. Former Gov. Eric Greitens’ administration established a statewide monitoring system that track physicians’ prescriptions.

Missouri is the only state in the nation that doesn’t have a PDMP. Another legislative session came and went in May without any action.

More than 70 jurisdictions have joined St. Louis County’s PDMP. 

Crawford County was not included on last year’s annual report, but Evans says that going off qualitative data from local pharmacists, she believes it is having an effect.

“It makes it easier for them to know and monitor and track prescribing activity,” she said. “It makes easier to communicate with physicians.”

Evans said one of the drawbacks she has heard from pharmacists is they feel physicians aren’t using it as much.

When a patient goes to a pharmacy to get an opioid prescription, the pharmacy notifies that physician.

Evans said some doctors are well aware of how many prescriptions are being doled out to a patient and feel it is necessary. In other cases, they are not aware of how many prescriptions a patient is obtaining.

Doctors and pharmacists are the only users allowed access to the PDMP database and subpoenas must be obtained by state boards, law enforcement, Missouri HealthNet and judicial officers to receive access.

Asked if the PDMP is a tool instead of the strategy of reducing opioid abuse in Missouri, Evans agreed. Her department is looking into other tactics, including being part of a “substantial grant” that would provide a response to the opioid issue.

The health department sees a variety of people looking for help and Evans said there are definitely people battling abuse and dependency. 

“We have a lot of people with substance abuse and substance dependency issues,” she said. “It’s not always opioids, but it’s a problem. It’s such a complicated and complex problem. Not everyone who is opioid dependent feels they are an addict.”

Legislation Stalls

The St. Louis Post-Dispatch reported that a drug-monitoring bill has been introduced in the Missouri legislature every year since 2005, but Missouri remains the only holdout, despite Gov. Mike Parson being on board.

WalletHub ranked Missouri as the third worst state in the country for its drug use. The study was based on a review of arrests, overdose rates, opioid prescriptions and more.

Former State Sen. Rob Schaaf was one of the biggest hurdles and filibustered or insisted on “kill clauses” that would ensure a drug-monitoring bill would never pass the house. Schaaf expressed concern over privacy issues and said a database of patient information being hacked outweighed the benefits.

Schaaf connected the drug-monitoring bill to gun rights, saying it could be used to infringe them.

Rep. Jason Chipman (R-Steelville) argued last summer at a Crawford County commission meeting that the PDMP was a “band-aid” that didn’t fix the problems of opioid dispensation. 

Legislation died again this spring