TARGET 8: Studies question whether prescription drug monitoring programs work

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JEFFERSON CITY - Missouri is the only state without a prescription drug monitoring program. While some think a House bill creating a monitoring program will pass in the Senate this session, others vow to block the bill like they have in the past.

Rep. Holly Rehder, R-Sikeston, is sponsoring HB 1892, called the Narcotics Control Act. In the past, efforts to create a prescription drug monitoring program have been unsuccessful.

The drug prevention group ACT Missouri said a drug monitoring program is considered best practice.

ACT spokesperson Natalie Newville said, “You know there are people over there that just don’t want this bill to happen. They cite different reasons, privacy and other issues like that.”

Rehder said the funding for the program would come from federal grants, gifts, donations and appropriations. It would cost about $500,000 to $800,000. She said the savings from the penal system and drug abusers would make up for the expense.

Bob Twillman, the executive director of the American Academy of Pain Management, said states that do have a monitoring program, such as Kansas, see evidence that it's effective.

“In a study we did a while back, we saw that 16 percent of doctor shoppers live along the state line in Kansas to go get prescriptions in Missouri,” Twillman said.

Kansas got a prescription drug monitoring program in 2010. Prescription sales get updated daily, whereas some states update the systems about once a week.

According to a February 2015 report from the Kansas Department of Health and Environment, drugs played a role in the deaths of 1,995 Kansas residents in the years 2009-2013. The two leading causes were from opioid analgesics, such as morphine, Oxycodone and Vicadin, and pyschostimulants, such as Ritalin.

Opioid drug-related deaths increased from 94 in 2010, the year Kansas got a drug monitoring program, to 143 in 2013.

The study does not show if the drugs involved in these deaths were obtained legally or illegally.

The Injury Epidemiology Journal found in 2014 implementation of monitoring programs "did not reduce drug overdose mortality in most states.”

Conservative groups like Missouri Liberty do not think a monitoring program is the answer to solving addiction and doctor shopping problems. Missouri Liberty thinks the monitoring program should not be paid for by taxpayers because it is an invasion of privacy. 

Rehder disagreed.

“If no state has thrown it out because it was unconstitutional then that is not a problem. This is something medical professionals need,” Rehder said.

Twillman, who serves on the board at the AAPM with pharmacists, said the Kansas medical community thinks its monitoring program is great.

“That’s why they continue to do it. Because it works. They are willing to make an investment to have the program,” Twillman said. “Is it working? It’s always hard to say on population basis, but we do know in cases where people have been detected and gotten appropriate treatment.”

Sen. Rob Schaaf, R-St. Joseph, and Rep. Jay Barnes, R-Jefferson City, are some members of the Missouri legislature who openly oppose the creation of a prescription drug monitoring program.

Rehder said, “Senator Schaaf is a powerhouse in the Senate when it comes to this. They have the power of filibuster and so, when he says he is going to filibuster this, that’s huge and that has proven huge in the past.”

In an entry on his personal website, Barnes outlined the reasons for why he opposes the monitoring program and cites the right to privacy in the First, Second, Third, Fourth and Fifth Amendments.

Rehder said, “It’s really being trumped up to where it’s like the 'sky is falling' response, or fear. And the public has been catching on to this."

The bill is now waiting to be introduced in the Senate.