Missouri in the Spotlight for All the Wrong Reasons

May 21, 2019
‘Show-Me State’ the only state without a prescription drug monitoring program

Missouri leads Midwestern states in the rate of opioids prescribed, so you would think enacting a prescription drug monitoring program would be a no-brainer, yet it remains the only state in the country without a PDMP. Yet as a scathing editorial in the Kansas City Star and in-depth reporting by Kaiser Health News (KHN) reveal, a cadre of conservative legislators has succeeded in blocking the creation of a PDMP again this year.

Six Senate Republicans who make up the “Conservative Caucus” successfully filibustered a PDMP bill in 2019, citing privacy concerns.

As the Kansas City Star editorial describes, a PDMP “allows doctors and pharmacists to identify and interrupt doctor-shopping and prescription drug abuse. Monitoring can also prevent fatal overdoses from mixing medications that should never be taken at the same time.” And the KHN report notes that the Centers for Disease Control and Prevention has called such statewide patient monitoring databases “among the most promising state-level interventions” to improve opioid prescribing and protect at-risk patients.

Yet the Star notes that “Missouri still does not have such a system, principally because conservative lawmakers here fear that a government database could also be used to keep someone tagged with a possible addiction from buying a gun.”

Yes. Heaven forbid that someone addicted to opioids should have to go through an additional background check. These same legislators probably pay lip service to halting the opioid epidemic as the number of people dying in their rural communities continues to climb.

The KHN story quotes Katie Reichard, a lobbyist with the Missouri Primary Care Association, as saying, “I’ve never seen anything take seven years to get anywhere, and especially something that’s going to be put into place to save lives.”

The story also quotes the former head of the St. Louis County Health Department, Faisal Khan, who in 2017 helped start a voluntary county-based PDMP program that now covers St Louis County and several other portions of the state, as saying the opposition goes deeper than privacy concerns. He said these conservative legislators “view St. Louis County and St. Louis City and St. Louis, in general, as this liberal Democratic bastion that they don’t want anything to do with,” he said. “It’s the usual nonsense that we’re seeing around the country at the moment, and it’s stymying progress in the parts of the state where we need it the most.”

The KHN story quotes St. Joseph pharmacist JulieMarie Nickelson as saying, “No one in the pharmacy or medical world really understands” why Missouri doesn’t have a statewide system. She called it an embarrassment the state can’t figure it out. She’s right. 

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