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Opposing prescription drug monitoring bills face off in Senate committee

JEFFERSON CITY, Mo. – Every state in the U.S. has a prescription drug monitoring program (PDMP). Every state but Missouri that is. Yet again, some Missouri lawmakers are looking to fix that.

The issue of prescription drug monitoring has been a hotly-debated topic in the General Assembly for years, especially given the presence of opioid abuse in the state. Among Midwestern states, Missouri ranks number one in the rate of prescription opioids sold in the region.

Several pieces of legislation seeking to implement a PDMP in Missouri stalled in the 2016 legislative session, including a bill sponsored by Rep. Holly Rehder and Sen. Dave Schatz. That bill was met with opposition, led by Sen. Rob Schaaf, who said the bill failed to move forward for five years because the supporters failed to find a compromise.

Rehder and Schatz filed the bill once again, but this time, the St. Joseph senator took the matter into his own hands, filing his own bill, SB 74, to address the situation.

The Senate Committee on Health and Pensions heard testimony on both bills Wednesday, with a packed hallway awaiting the hearing. The two bills were presented together, as both bills seek to establish a database for doctors and pharmacists to monitor prescription drug use in an effort to combat the number of opioid overdoses.

Rep. Holly Rehder

Rehder spoke on behalf of her bill, known as the Narcotics Control Act, telling her own story of how drugs had affected her life. Rehder told the committee how she had lived in a household in which her step-father was a drug dealer, how her sister became addicted and married a drug dealer at 15, and how she lost a cousin to years of opioid abuse.

But her strongest reason for pushing the legislation forward was her daughter’s story.

Rehder says the 17-year-old was prescribed drugs after a visit to the emergency room for a work-related injury and became addicted. Rehder said her daughter has now been clean for two years, but Rehder had to take custody of her grandson, who was born with opiates in his system.

She says this legislation is necessary to combat the rise of opioid addiction in Missouri by cutting down on “doctor-hopping” and pharmacy shops that feed addictions.

Schaaf’s bill, the Prescription Drug Monitoring Act, also seeks to put a PDMP in place, but the senator says that creating a PDMP “does not stop the true problem”, which he says is the over-prescribing of drugs.

Where the bills differ is who will receive access to the database.

Schaaf’s bill wouldn’t allow the medical professionals to have access, Rehder says.

“When a physician can look at their patient’s narcotic history, they can make the best call for their patient,” Rehder told the committee. “We feel it is the most important piece.”

Schaaf argues that the other bill intrudes on privacy and sacrifices of personal liberties.

“Under Sen. Schatz’s proposal, the physician would log on, identify the patient, and up would come a list of all of the prescribed substances a person has received. It would be searchable by the name of the person, the address, the doctor, the drug, everything,” Schaaf said. “All that a physician or nurse practitioner would need to access that would be a username and password, which is the lowest level of protection.”

Rehder disagrees, saying that federal law would only allow the physicians or pharmacists to look up their own patient’s files and that each person would be required to log in with their own PIN number.

Schaaf also pointed out that his bill includes a clause that would leave it up to Missouri’s voters to decide whether his version of the database would be implemented. Schatz and Rehder’s bill does not.

Schaaf also presented another bill before the committee, which would discipline the professional licenses of certain health care providers for failing to follow the CDC guideline for prescribing opioids. He maintains that part of the problem is the amount of narcotics prescriptions being given, saying that some of the blame is on doctors.

Schaaf chairs the committee and called for a vote only on his version of prescription monitoring legislation, which passed. As the chairman of the Senate Health and Pensions Committee, Schaaf could let Schatz and Rehder’s bill die without ever bringing it to a vote.

Even if both pieces of legislation stall once again, there are other options available within Missouri. Several cities and municipalities have already implemented their own PDMPs. Jackson County recently announced an agreement to join the St. Louis County monitoring program, which also includes St. Charles County. St. Louis City, Kansas City, and Independence have also joined the efforts, and just this week, Sen. Claire McCaskill commended the city of Columbia for taking actions to implement their own monitoring program.

“Columbia is taking action against the scourge of opioids despite Jefferson City’s failure to act, and I’m hopeful these efforts will be a blueprint for other cities and counties across the state,” McCaskill said in a statement.

In fact, Missouri counties and cities can now apply for federal funding for local prescription drug monitoring efforts. The Department of Justice released a grant announcement which allows counties, cities, and other regions to apply for prescription drug monitoring program funding to help combat the opioid epidemic.

The deadline for applications to be eligible to receive these funds is April 25, 2017.