drug with powder and pills

Missouri may become the last state to create a statewide prescription drug monitoring program.

The Missouri Legislature, after a decade of considering the idea, approved legislation to create the program before the 2021 session ended in mid-May.

The bill awaits Gov. Mike Parson’s signature to become law. He has indicated he supports a statewide PDMP.

Because there is no statewide system, the Jefferson County Health Department has been participating in a registry run by St. Louis County since 2017.

The Health Department, an independent governmental agency, contracted with St. Louis County to be part of the registry after trying for 10 months to convince the Jefferson County Council to join it.

St. Louis County’s PDMP includes 75 counties and cities around Missouri, including 85 percent of the state’s population.

“I’m extremely grateful the state Legislature has moved forward in creating a statewide PDMP,” said Jefferson County Health Department Director Kelley Vollmar. “It will be extremely helpful to our physicians as well as our pharmacists around the state. It will be excellent for all.”

PDMPs are intended to stop the practice of “doctor shopping,” when people go to multiple doctors and multiple pharmacists to obtain opiates, either to abuse or sell them. Supporters say the program will save lives and help get those with addictions into treatment.

Opponents of PDMPs have cited privacy concerns, raising questions about which government agencies have access to the data. Opponents also have said that by denying people access to legal medications, they turn to the streets to obtain even more dangerous substances.

Proponents of the monitoring systems have said medical information would be available only to medical personnel and pharmacists and would be retained only for three years.

Vollmar said she’s been pleased with the program run by St. Louis County.

“I think for our physicians and our pharmacists who have been using the program, it has been extremely beneficial, so it’s been a success,” she said. “I think on our end, we have been receiving some reports, but because of COVID over the past year, a lot of the data that would be reported back so we could do some prevention work, to be able to create educational programs and things like that, hasn’t necessarily been where we’ve been able to get to because of the other response.

“But what it’s intended to do, first and foremost, is to give doctors the information they need to make informed decisions, and on that count, it’s been very successful,” she said.

Vollmar said she hasn’t been able to compare the statewide setup – if Parson signs it into law – with St. Louis County’s PDMP.

“I haven’t had a chance to go thoroughly on the statewide system yet, but we’re going to be able to go through both options and see what’s most beneficial for us,” she said.

Under the legislation, the statewide registry would supersede the St. Louis County program, which would end once the statewide program is available.

The state system can negotiate with St. Louis County to transfer patient information.

Vollmar said the details of that transition are not clear.

“We’d like to sit down with St. Louis County and see if they are going to incorporate with the state and if the state is going to be looking at how they’re going to do this as a whole,” she said.

Vollmar said she doesn’t expect the statewide program to come online immediately. “Looking at a system like that, I know that even with St. Louis County and a system of that magnitude, that an electronic feedback side of it takes an extensive period of time, so it likely would not be active anytime soon,” she said.

Vollmar said moving to the statewide system would save her department a small amount of money.

“My understanding if we went to the state system, there would not be a cost to the Jefferson County Health Department for that,” she said. “I believe we’re spending about $2,200 a year because we didn’t want barriers for providers to the program, so we actually paid their subscription cost.”

Health providers are charged $7 per year to report to St. Louis County’s program.

According to the St. Louis County PDMP website, opioids make up 42.5 percent of all controlled substances dispensed within its area. Hydrocodone, oxycodone and tramadol were the three most frequently prescribed opioids.

In Jefferson County, according to the website, women received more opioid prescriptions than men across all age groups. County residents ages 65 and older averaged two prescriptions. Overall, county residents were dispensed opioids at a rate of 746 per 1,000 people, higher than the total St. Louis County system of 606.4 per 1,000.

The Senate approved the legislation by a 20-12 vote. Locally, Elaine Freeman Gannon (R-De Soto) voted for the bill and Paul Wieland (R-Imperial) voted against it.

In the House, the bill was approved 91-64. Local representatives Dan Shaul (R-Imperial), Cyndi Buchheit-Courtway (R-Festus), Mary Elizabeth Coleman (R-Arnold) and Becky Ruth (R-Festus) voted for it while Shane Roden (R-Cedar Hill), Mike McGirl (R-Potosi) and Rob Vescovo (R-Arnold) cast dissenting votes.