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Do prescription drug monitoring programs actually curb opioid abuse?

An illustration of pills.
Illustration by Rici Hoffarth | St. Louis Public Radio
St. Louis Public Radio
Missouri will soon have two prescription drug monitoring programs. Gov. Eric Greitens' database is accessible by state workers, while medical professionals can use St. Louis County's program.

Missouri’s statewide prescription drug monitoring database will come online next month. There’s a key difference between it and databases throughout the U.S. and even in St. Louis County, which actually covers nearly 60 percent of the state.

The program, created by Gov. Eric Greitens by an executive order, will collect who is writing opioid prescriptions and dispensing the drugs, but only the Missouri Department of Health and Senior Services can access the data. In every other state, pharmacists and doctors can see that type of data — which is the most successful way to stem opioid abuse, according to Sherry Green of the National Alliance for Model State Drug Laws.

An accessible system, Green said, allows doctors or pharmacists to “intervene as early as possible by identifying someone who may be misusing or abusing or perhaps be addicted so they can intervene and refer them to needed help.”

She pointed to Kentucky and Ohio as success stories. Kentucky requires doctors and pharmacists to use its database under certain circumstances, a provision that went into effect more than a decade after the program was established.

Brad Hopkins, who administers Kentucky’s drug monitoring program, said a University of Kentucky study found prescriptions of several opioids dropped once doctors and pharmacists were required to use the database.

Those medical professionals are “on the front lines,” Hopkins said. “They’re the ones when they see this data, they can actually take steps to see what the patient’s doing and actually intervene if the patient might be suffering from a substance abuse disorder.”

St. Louis County Executive Steve Stenger isn’t sure whether Greitens’ program will work if medical professionals can’t see prescription data.

“One of the chief objectives of a monitoring program is to eliminate pill shopping, doctor shopping,” Stenger said. “The governor’s plan really doesn’t do that.”

‘Strong approach’

Greitens told St. Louis Public Radio that the executive order represents a “strong approach” to curb opioid abuse. He also said that the database will be able to pinpoint doctors or pharmacists who are overprescribing drugs and who the state will go after. 

“For example: If you’ve got one doctor in a particular county who is responsible for 90 percent of the opioid prescription, we can address that problem at the source,” he said.

He also responded to critics, like Stenger.

“Any time we take strong action to address the crime problem or opioid addiction, there’s going to be critics and there are going to be politicians who talk and talk and talk about this problem,” the governor said, adding later, “Without this prescription drug monitoring program though, we can’t solve the problem.”

Greitens said that his executive order won’t affect St. Louis County’s program. And state Rep. Holly Rehder said the statewide program and the popular county database aren’t in competition, but instead “two different arms” to wrap around the issue.

“They’re not duplicative in any way,” said the Sikeston Republican, who sponsored a failed bill to set up a database that doctors and pharmacists can use. “[Greitens'] program is like law enforcement tool where they can find people, root them out and take the necessary investigative track to get that fixed. Ours really addresses addiction.”

Follow Jason on Twitter: @jrosenbaum

Jason is the politics correspondent for St. Louis Public Radio.

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