Greitens launches PDMP with executive order

JEFFERSON CITY, Mo. – Missouri will officially join the other 49 states in using a prescription drug monitoring program (PDMP).

Governor Eric Greitens on Monday signed Executive Order 17-18, which establishes a statewide drug monitoring program focused on those prescribing drugs and filing prescriptions.

“The opioid crisis in Missouri has taken the lives of hundreds of mothers, fathers, and children. It strikes in our cities and our rural communities. It destroys relationships and drives crime. We must take bold action to address it,” Greitens said in a release.

The Centers for Disease Control and Prevention has declared a national opioid epidemic, and Greitens said the state’s new approach to combatting opioid addiction and overdose deaths could potentially become a national model.

According to the executive order’s language, more than 900 Missourians died from an opioid overdose in 2016, which Greitens says is overwhelming the state’s law enforcement, health care and social service providers.

Greitens’ order calls for the Department of Health and Senior Services (DHSS) to implement a “multi-phase” prescription drug monitoring program.

“We need to be honest and clear about the scale of what we are up against: Opioids are a modern plague,” Greitens said. “Like the plague, opioids kill the young, the old, the healthy, the sick, the virtuous and the sinful. There’s not a corner of our state that hasn’t been visited by this curse. There is no single program, or law, or executive order that can fix this crisis. This program is a step—and it’s a big step. Throughout this week, we will outline the other steps we will take to address the opioid crisis. The only thing we won’t do is wait. We won’t wait for this problem to get worse. That’s not an option.”

The first phase requires DHSS to enter into contracts with all pharmacy organizations to analyze prescriber and pharmacy prescriptions and dispensing data for schedule II-IV controlled substances.

The second phase requires dispensers to submit their controlled substance prescription and dispensing information to DHSS to be looked over in order to identify any instances of controlled substances being inappropriately given out or prescribed.

The final step requires DHSS to work with private companies and government entities to purchase the tools and technology to properly monitor the prescription information that is sent to DHSS or its designee as part of the PDMP.

All information throughout the multi-phase process is required to be confidential.

Greitens made the announcement at the pharmaceutical provider, Express Scripts, in St. Louis. The company will be the private-sector partner in the state’s program.

The estimated cost for the PDMP startup is about $250,000.

Monday’s stop in St. Louis is just one of a week-long tour in which Greitens plans to unveil the new actions that Missouri will take to address the national opioid epidemic. On Tuesday he will be in St. Louis discussing ways to prevent overdose deaths, and will head to Cape Girardeau and Springfield later in the week to outline plans to combat drug traffickers and treat addiction in rural Missouri.

Missouri lawmakers have long debated putting a PDMP into place in the Show-Me State in an effort to combat opioid addiction and doctor shopping, but have never acted on any of the legislation due to strong opposition due to privacy concerns in regard to the use of a database to harbor medical information.

But while the state legislature sat at a draw, a number of counties and municipalities had already taken the matter into their own hands, setting up their own prescription drug monitoring systems. St. Louis County was the first establish a PDMP in 2016, leading others to do the same.

Now, the governor is doing the same thing, and some lawmakers expressed displeasure at the governor’s actions. The tension between lawmakers and the governor has often been an issue at times, and the latest executive order could be seen as an attempt by the governor to circumvent the legislature altogether.

“Governing by executive order because you couldn’t get a bill passed was wrong under Obama and it’s wrong today,” Rep. Shamed Dogan wrote on Twitter.

Governing by executive order because you couldn’t get a bill passed was wrong under Obama and it’s wrong today. #moleg

— Shamed Dogan (@Dogan4Rep) July 17, 2017

“For a “Republican Outsider,” @EricGreitens sure has quickly embraced the Obama doctrine of governing by Executive Order,” Sen. Ryan Silvey tweeted.

Others commented more about the issue with the order’s substance.

“I support PDMP. @EricGreitens’ version doesn’t allow prescribers to see database — totally useless in trying to prevent ‘dr shopping’,” Rep. Lauren Arthur said in a tweet. “This actually undermines successful local efforts to combat this crisis. Intended to make Gov look good despite costs to folks in MO.”

This actually undermines successful local efforts to combat this crisis. Intended to make Gov look good despite costs to folks in MO. https://t.co/cesSxVD3Ul

— Lauren Arthur (@RepLaurenArthur) July 17, 2017