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Data privacy concerns may keep Jefferson County from tracking opioid prescriptions

The deadline for pharmacy benefits manager Express Scripts and Walgreens to reach a deal is fast approaching.
Stephen Cummings | Flickr
In Jefferson County, where 68 people died last year from overdoses, officials are considering whether the county should join a regional prescription tracking system.

Updated at 11:27 p.m. April 24 with the council's decisions — Two bills that would have established a drug monitoring database in Jefferson County failed during a Monday night meeting of the County Council.

The council heard two competing bills that would have allowed the county to join the local prescription tracking system set up by St. Louis County. But a disagreement over how long a database could keep Jefferson County data, however, likely derailed the whole process, even though council members appear to agree that the rising rate of opioid-related deaths is unacceptable and a prescription drug monitoring database could help prevent overdoses.

Missouri is the only state in the country without a statewide program to track opioid prescriptions, and anti-addiction advocates say it's a critical tool to prevent abuse. 

An ordinance introduced by Jefferson County Executive Ken Waller would have authorized the county to fold into the program run by St. Louis County. Council members voted 4-3 against it, according to Waller's administrative assistant.

The database allows doctors and pharmacists to see how many opioids a patient has been prescribed in about 15 jurisdictions so far, including the St. Louis metro area and Kansas City. The subscription cost for each county is based on the number of prescribers and would cost Jefferson County $3,000 a year, said Dr. Faisal Khan, St. Louis County health director.

Another ordinance, proposed by Council Chairman Bob Boyer, R-Arnold, called for the creation of a “master plan” to prevent addiction in Jefferson County, which has about 221,000 residents. It also would have allowed the county to join St. Louis County’s database, but only if several conditions were met. For example, data provided by pharmacists and doctors in Jefferson County would have had to be purged every 90 days. But that requirement likely would have rendered the county unable to join the system.

Boyer said before the meeting that if the council passed his ordinance, he expected Waller to veto it. But Boyer think concerns about the system’s susceptibility to hacks and misuse outweigh the benefits.

“By sending everybody’s data to a database, that somehow that’s going to stop people from being addicted or stop people from abusing the drug, I don’t think that’s going to happen," Boyer said. "I think we need to change people’s hearts."

Last year, at least 68 people died from overdoses, due to heroin, fentanyl or prescription opioids in Jefferson County, according to the county’s medical examiner.

Jillian Bissell, Jefferson County Drug Prevention Coalition director, said dozens of volunteers were going to Hillsboro on Monday in support of the first bill, which would allow the county to join St. Louis County’s monitoring system. With several surrounding counties already part of the database, she worries that people could easily drive into Jefferson County to fill extra prescriptions for opioids.

“They need this communication between these doctors and pharmacists,” Bissell said. “It is needed to deter people from going down the path of addiction.”

An addiction, she noted, that often leads from prescription pills to their cheaper, illicit cousin — heroin.

More than a year after St. Louis County first passed a law to establish its own prescription drug monitoring database, officials say it’s ready to start at the end of this month.

Missouri Senator Rob Schaaf, R-St. Joseph, reversed his longtime opposition to prescription drug monitoring this year to sponsor a bill that would set up a statewide database, with the caveat that information would be purged every 180 days.

It's highly unusual for states to require deleting data after a year or less. About a dozen states require prescription drug monitoring databases to delete data at all, according to a 2011 review by the National Alliance for Model State Drug Laws. 

The measure passed the Senate last month and is awaiting a committee hearing in the House of Representatives.

Follow Durrie on Twitter: @durrieB.

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