House perfects prescription drug monitoring program proposal

The Missouri House has given initial approval to a proposed tracking system for prescription drugs that backers hope will fight opioid abuse in Missouri.  Specifically it aims to help stop “doctor shopping;” the practice of going to multiple doctors seeking multiple prescriptions for valuable and addictive medications.

House Bill 90 would make Missouri the 50^th state to enact a prescription drug monitoring program (PDMP).  The electronic registry would take information on those who prescribe, use, or dispense prescription drugs.

The bill had bipartisan support in a 109-40 vote.  West Plains Republican Shawn Rhoads, a former police detective, said it is an answer to opioid abuse in Missouri.

“There’s just so many times in a career [someone has] had to go to somebody’s house and tell them that their loved one has overdosed and died because somebody was doctor shopping, selling them drugs, and they’ve overdosed on them.  That is the worst thing that you will ever have to do in a career, and I’m telling you I never, ever, want to do it again,” said Rhoads.  “That’s why, Mr. Speaker, I urge the body to vote for this bill.”

The bill is sponsored by Sikeston Republican Holly Rehder, who has spoken publicly many times about her own family’s experience with addiction.

“I grew up in poverty.  One of my stepdads was a dealer.  My sister married a dealer at 16, was a main line user by the time she was 16,” said Rehder.  “I didn’t use drugs because I was afraid of them.  I saw what they did to those around me.”

Rehder said it was that fear that caused her to raise her children “differently,” but when her daughter was given a prescription for opioid painkillers after cutting her thumb at work, she became addicted.

“From that point forward we had 13 years of addiction,” said Rehder.

Rehder said addictions to opioid painkillers often begin with a legal prescription following an injury, such as when a high school athlete gets hurt.

“An athlete breaks a leg or whatever, they go to the doctor, they get an opiate to help with the pain, and then if that person is predisposed to addiction, they become addicted.”

Before giving the bill first-round approval, the House changed it so that by 2020, pharmacists will have to report information to the registry in real-time.

The sponsor of that change, Representative Lynn Morris (R-Nixa), owns a chain of pharmacies.

“By doing real-time, all my stores are connected real-time, and we know how much importance that is in trying to catch people that are drug shopping every day, and we catch them and we don’t fail to catch them,” said Morris.

Opponents say a PDMP creates a government database and poses a threat to the privacy of anyone using prescription drugs.

Harrisonville Republican Rick Brattin also argued PDMPs must not be effective because they exist in all other states, yet President Donald Trump has launched a task force to fight opioid addiction.

“So that would lend to me that this sort of program does not work and it has no effect, and if it has we would not be issuing a task force for the entire country to tackle the overprescribing of opioids,” said Brattin.

Ash Grove Republican Mike Moon also maintains PDMPs are not effective, and urged his fellow lawmakers to consider whether Missouri should launch one.

“As of 2014 Missouri ranked 24^th in the nation related to the number of deaths due to prescription drug overdose, and we’re not participating in the PDMP.  You’d think that Missouri would be number one in the abuse category, but we’re not,” said Moon

Brattin and others offered other changes to HB 90 saying it needed to be strengthened, in part because similar versions have stalled in the state Senate in past years.  Rehder urged legislators to reject them, saying that over the five years she’s handled the issue, stakeholders including law enforcement and medical experts have helped develop the language she’s proposing.  Those amendments were then rejected.

Another favorable vote would send the bill to the Senate, where in past years it has been stopped primarily by Senator Rob Schaaf (R-St. Joseph), who has his own PDMP proposal which cleared that chamber early this month.