Until recently, Missouri rated as the only state without a prescription drug monitoring program to help crack down on the opioid epidemic now sweeping the nation.
That a program is desperately needed to identify people who acquire numerous prescriptions for addictive painkillers should go without saying. A well-run program can also identify doctors who overprescribe those medications.
But Missouri lawmakers have refused, over and over again, to establish a program.
There’s no question that the state has a problem. Overdose deaths in Missouri jumped by more than 30 percent between 2015 and 2016, according to data from the Centers for Disease Control and Prevention. Missouri ranks 18th in the nation for overdose deaths.
Given this, it takes a lot of nerve for lawmakers to criticize a prescription drug monitoring program that Gov. Eric Greitens set up last year. Because lawmakers have failed to act year after year, the Republican governor took the only step left to him, which was to establish a program himself via executive order.
“Like the plague, opioids kill the young, the old, the healthy, the sick, the virtuous and the sinful,” Greitens said that day.
These days, lawmakers are not only criticizing Greitens’ program — they’re threatening to defund it. Although the House included $375,000 for the program, a Senate committee eliminated it.
The senators’ beefs are two-fold. Some say it’s the purview of the legislature, not the governor, to establish a program. Others point to the burden the program places on doctors. Under the governor’s program, state investigators track the number of prescriptions that doctors write. If unusual patterns emerge, those investigators trigger a process to intervene. The result has been a hesitation to prescribe opioids even when needed, said state Sen. Rob Schaaf, a St. Joseph Republican and a physician himself.
“As a result of this, patients aren’t getting the opioids that they need,” he said.
In other programs around the country, providers get access to data to see whether a patient has overloaded on recent opioid prescriptions. That’s not part of the governor’s program.
The legislature’s inaction has forced counties to step in and fill the breach. St. Louis County started its own monitoring program last year that now covers more than 80 percent of Missouri doctors and pharmacists. Jackson County has joined that program.
But the St. Louis County drug monitoring program doesn’t cover the entire state, and its focus is different. It looks at consumers. With funding threatened for the governor’s program, Missouri remains in dire shape.
Here’s what needs to happen: First, senators should fund the governor’s proposal. Greitens’ program is flawed but is better than no plan at all, given the scale of the opioid epidemic. Second, the General Assembly next year should finally pass a comprehensive monitoring program.
A bill by Republican state Rep. Holly Rehder of Sikeston last year passed both the House and Senate in different versions, but eventually died. This year, she introduced the measure again, but it didn’t get far because of senators’ misplaced privacy concerns.
Third, the federal government needs to step in with a national prescription drug monitoring program that would fill in gaps in Kansas City and other border areas where patients can hop back and forth across the state line to fill prescriptions. The Trump administration has proposed such a plan.
Missouri must move on this issue. People are dying, and a statewide monitoring program would help.