PDMPs and Missouri
COLUMBIA - As supporters of prescription monitoring gear up for another attempt to create such a program this spring, KOMU 8 News looked at whether a prescription drug monitoring program would work in Missouri.
Prescription drug monitoring programs, variously referred to as PDMPs or PMPs, act as a central electronic clearinghouse for all prescriptions written in a state. The programs are intended to help curb the explosion in prescription drug abuse that has occurred in the last decade. Every state except Missouri has such a program in place or is in the process of setting one up. During the 2012 legislative session, a Republican-led bill authorizing a PDMP gained tremendous support from both parties. The bill passed the house of representatives overwhelmingly only to die in the senate after a filibuster by a small group of senators led by Sen. Robert Schaaf, R-St. Joseph, the only practicing physician in the chamber. Schaaf said at the time he would fight prescription monitoring if the issue came up again. He told KOMU 8 News in November that his objection to the practice centers around civil liberties. He said the state should not have a database with someone's private medical information.
Supporters of prescription monitoring acknowledge Schaaf's concerns. Jerry Eames, a licensed clinical addictions counselor, said Schaaf is correct in worrying how such a database is used. However, Eames said the benefits outweigh the risks "immensely."
"It would stop a flow from the pharmacy to the street, maybe a full third of these chemicals would stop hitting the streets," Eames said.
Prescription drug abuse is a serious problem in Missouri. The 2010 Missouri Student Survey, compiled by the Department of Mental Health, found 11 percent of Missourians in the sixth through twelfth grades had used prescription drugs outside of a doctor's orders at some point in their lives--more than any illicit drug except marijuana. By comparison, more than 26 percent of students in that age range had used cigarettes, while slightly fewer than 1 percent had used methamphetamine. The department's most recent statistics show about 3200 Missourians are treated for prescription drug abuse each year. Xanax, Oxycontin and Vicodin are the most commonly abused prescriptions, together accounting for about 86 percent of the prescription drugs abused by these patients.
Bob Twillman, the chair of the Kansas Prescription Monitoring Program Advisory Committee, said a search warrant is needed to access the information held by Kansas' prescription drug monitoring program, called K-TRACS. Any time a prescription is written, information about the prescription, the prescriber and the intended recipient is uploaded into the program. Twillman said the main difference PDMPs make for law enforcement is eliminating the need for police to visit individual pharmacies if they are tracking someone.
Studies of existing prescription monitoring programs offer mixed results. A 2002 Government Accountability Office (GAO) study found such programs improve law enforcement investigation time and productivity and help reduce the availability of abused drugs. The study also found the existence of a PDMP caused drug diversion activities to increase in states without PDMPs--such as Missouri. A 2006 study by the public policy consulting firm Simeone Associates found such programs reduce the per capita availability of prescription pain relievers, thus reducing the likelihood of abuse. That same study found prescription pain reliever abuse is higher in states with PDMPs than without, though the authors caution that the probability of abuse is higher in the absence of such programs.
Both law enforcers and pharmacists said they see incidents of prescription drug abuse on an almost daily basis. Capt. Tim Hull, the director of the Missouri State Highway Patrol's Public Information and Education Division, said state troopers find and seize prescription drugs every day, though he added the quantities seized are quite small.
"It's not like finding 200 or 300 pounds of marijuana," he said.
Hull said state troopers often find prescription drugs and illicit drugs such as heroin and methamphetamine together.
Kilgore's Pharmacy owner Bill Morrissey said his staff looks for telltale signs that a customer is doctor shopping, or getting multiple prescriptions for the same drug from multiple doctors.
"For instance, if we see someone who we know has insurance--or strongly suspect has it--try to pay cash, that's a red flag," Morrissey said, adding a PDMP would make it easier for Kilgore's to catch such customers.
Aides to Kevin Engler, R-Farmington, who was elected to the state house in November after serving two terms in the state senate, said he will introduce PDMP legislation again during the upcoming legislative session.