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One step forward, one step back for legislation addressing the opioid crisis in Missouri

A kit containing the opioid overdose antidote naloxone.
File Photo | Camille Phillips | St. Louis Public Radio
St. Louis County police carry nasal naloxone kits. The FDA has now approved a version that needs no assembly, akin to nasal allergy sprays.

Missourians working to reduce the impact of the opioid crisis are close to scoring one victory this legislative session: a measure expanding access to the opioid overdose antidote is on its way to the governor’s desk.

But with one day left in the session, another tool many consider vital in the fight against opioids appears out of reach. Missouri is likely to remain the only state in the nation without a prescription drug monitoring database.

The apparent victory is HB 1568, which was passed by the General Assembly on Tuesday.

Right now, only medical professionals and first responders have access to the opioid overdose antidote naloxone. But if the governor signs the bill into law, people can add it to their medicine cabinet.

That’s important because if the antidote isn’t administered within five or six minutes, the person overdosing will die.

“It truly is all about saving lives,” said bill sponsor Rep. Steve Lynch, R-Waynesville. “It gives the family some hope, which they really haven’t had a whole lot of. It gives them hope of saving their child’s life. And maybe that near-death experience will be that one thing that turns their life back and gets their life back together.” 

A spokesperson for Gov. Jay Nixon said the governor will review the bill before deciding whether to sign it into law.

If the naloxone expansion bill becomes law, Missouri pharmacies can make arrangements to sell the antidote without a prescription.

“It’s similar to flu shots. Pharmacists can give flu shots, but they do it under a protocol with a physician,” said Ron Fitzwater, the CEO of the Missouri Pharmacy Association. “As long as they have that protocol language, then they don’t need a specific prescription. They can do it based on their professional judgment.”

Fitzwater said he expects most Missouri pharmacies will make arrangements to update their drug protocols this summer to be ready to offer naloxone by the time the bill would become law on Aug. 28.

A Senate amendment to the bill bars physician technicians from distributing the antidote, but Fitzwater said that pharmacists must be present for anything behind the pharmacy counter to be sold and the amendment shouldn’t have an impact on access to the drug.

The nasal spray version of naloxone costs about $50-70 without insurance.

It can reverse an overdose and restore breathing if administered before the heart stops.

A loss for advocates

On Thursday state Sen. Rob Schaaf, R-St. Joseph, spent half-an-hour filibustering the bill to create a prescription drug monitoring database before the Senate laid it aside without a vote.

Sen. Rob Schaaf, R-St. Joseph
Credit Jason Rosenbaum I St. Louis Public Radio | file photo
Sen. Rob Schaaf, R-St. Joseph

“We want every citizen in this state to give up a little bit of their liberty, and put your sensitive information on this database so we can use that sensitive information to prevent someone else from breaking the law,” said Schaaf, who has opposed legislative efforts to create a prescription drug monitoring program for the past few years on privacy grounds.

Supporters argued that the database would be protected under existing patient privacy laws and help doctors and pharmacists prevent patients from filling multiple prescriptions for highly-addictive drugs.

“I think it’s shameful. It’s shameful that we’ve not passed this yet. It’s a lifesaving tool that’s showing success in all of the other states,” said the bill’s sponsor, Rep. Holly Rehder, R-Sikeston. “This year, fear mongering just kind of took over.”

Rep. Holly Rehder, R-Sikeston
Credit Marshall Griffin | St. Louis Public Radio | file photo
Rep. Holly Rehder, R-Sikeston

There’s a slight chance the prescription drug monitoring bill could be brought up again before session ends Friday evening, but a vote is very unlikely.

Meanwhile, efforts to create a so-called Good Samaritan law didn’t make it very far this year. Both House versions of the bill are still in committee.

The idea of a Good Samaritan law is to encourage drug users to call 911 if they or someone they’re with needs help by protecting them from prosecution for possessing an illegal drug as long as they only have a limited amount of the drug.

Other action toward the end of the legislative session

Day 4: Beer, fantasy sports bills go to governor; photo ID to the ballot; paycheck protection dies  

Beer companies could lease portable refrigerators to grocers and convenience stores, which could also sell  refillable draft beer containers, known as growlers. 

Missouri Gaming Commission will get authority to license daily fantasy sports sites such as FanDuel and DraftKings. The state would collect roughly 21.5 percent of a daily fantasy site's annual income.

People would need a photo ID and the state would help the poor get the documents needed. A person with nonphoto identification would be allowed to vote if he or signed an affidavit attesting to their identity.

Missouri House expands legal use of deadly force; Stand Your Ground now in Senate

One of the major crime bills in the legislature was amended in the House to include a controversial Stand Your Ground provision. That prompted a filibuster in the Senate, which led Sen. Bob Dixon to shelve the measure.

Missouri legislature adds restrictions on municipalities, changes tax sharing

This year’s bill would curb ordinance violations, such as tall weeds or housing code problems. It would also reduce the maximum traffic fine to $225 and would create a sliding scale for non-traffic fines. 

Follow Camille Phillips on Twitter: @cmpcamille.