Cape County commissioners consider prescription-drug monitoring program

Cape Girardeau County may join a prescription-drug monitoring program that has been embraced by 32 Missouri counties and cities.

The Cape Girardeau County Public Health Center Board of Trustees has endorsed the idea and the county commission is considering such action.

“The Prescription Drug Monitoring Program (PDMP) is an effective way to curb the over prescribing of opioids,” public health center director Jane Wernsman wrote in a May 16 letter to the commissioners.

Wernsman said a recent study of national data found implementation of prescription-drug monitoring has led to a 30 percent reduction in the rate of prescribing opioids between 2001 and 2010.

“Drug overdose is a leading cause of accidental death in the U.S. with 52,404 lethal drug overdoses in 2015,” Wernsman wrote.

She said opioid addiction is driving the epidemic with 20,101 overdose deaths resulting from prescription pain relievers and 12,900 overdose deaths from heroin in 2015.

Missouri is the only state in the nation without a statewide prescription-drug database.

State Rep. Holly Rehder, R-Sikeston, long has pushed for passage of a statewide monitoring program. This year, it passed the House, but the Senate passed a watered-down version that was unacceptable to House members.

Rehder has suggested a special session could be called later this year to address the issue. Gov. Eric Greitens has backed Rehder’s bill.

Supporters said the goal is to give physicians, nurse practitioners and pharmacists a tool to see whether patients recently have filled or received prescriptions for opioids or other addictive drugs.

Meanwhile, jurisdictions led by St. Louis County have elected to develop their own prescription-drug monitoring program rather than wait on the state to act.

St. Louis County’s public-health department is administering the electronic database program, which tracks opioid and other controlled-substance prescriptions.

The program commenced April 25 and includes the St. Louis and Kansas City areas.

It began with 14 cities and counties, including Stoddard and Ste. Genevieve counties in Southeast Missouri.

By July 1, another 13 counties and cities will be on board, including Bollinger, Mississippi, New Madrid and Pemiscot counties, according to St. Louis County public health officials.

Another five counties, including Perry County, are set to join the program in August, officials said.

Combined, the 32 jurisdictions account for 58 percent of Missouri’s population, according to program officials.

The PDMP involves more than 2,400 registered prescribers and pharmacists, program officials said.

The Cape Girardeau County Commission would have to approve an ordinance to join the program.

Cape Girardeau County commissioners May 18 agreed to have a draft of a PDMP ordinance reviewed by an attorney. The commissioners, however, have yet to vote on such a measure.

Second District Associate Commissioner Charles Herbst said the commission would have to hold a public hearing before it could vote on the measure.

Cape Girardeau City Council members also have shown interest in the monitoring program. City staff are researching the issue.

Wernsman said there is growing support locally for such a move from pharmacists and medical providers.

Abe Funk, a pharmacist with John’s Pharmacy in Cape Girardeau, welcomed the idea.

“Whether you are a pharmacist, nurse or physician, our goal is to provide quality patient care,” Funk said.

He said the goal should include preventing people with addictions from pill shopping for additional pain medications they should not have.

The monitoring program would help, he said.

Under the program, pharmacists would enter controlled-substance medications into an electronic database. Pharmacists, physicians and nurse practitioners in the member counties and cities would be able to call up a patient’s prescription history.

John’s Pharmacy has several pharmacies, including one in New Madrid County and another in Mississippi County. Although the official implementation date for those counties is listed as July 1, Funk said those two pharmacies already are entering prescriptions into the database.

Doctors are encouraged to check the database before prescribing controlled-substance medications, but they are not required to do so, Funk said.

He said addicts routinely seek to have prescriptions filled at pharmacies in Cape Girardeau and elsewhere in Missouri because they know the state does not have a prescription-drug monitoring program.

Funk said some doctors in Southeast Missouri would not check such a database, preferring instead to write a pain-relief prescription rather than turn a patient away.

But he said the program is a benefit in cases where medical providers check the database.

“It is like locking a door to your car; it keeps an honest person honest,” Funk said.

Prescription drugs often are “a gateway drug” that leads addicts to use heroin and other illegal drugs, he said.

Funk said the database is needed.

“When you have people dying, you have to wake up,” he said.

If Cape Girardeau County joins the program, the county would have to pay annual database licensing and administrative fees of about $5,500, according to Wernsman, the local public health director.

She said fees are based on the number of pharmacists and prescribers in a particular jurisdiction.

Funk said that is a small price to pay to help address prescription-drug addiction.

Wernsman said grant funds may be available to cover the initial costs.

Cape Girardeau County Presiding Commissioner Clint Tracy said the program is “a great tool for monitoring prescription drugs” but he said he doubted it ultimately would address drug addiction.

Tracy said commissioners still are researching the program.

He said it would be preferable for Missouri to have a statewide monitoring program. Otherwise, pill shoppers simply will go to pharmacies in non-program counties, he said.

“This is another example where the state fails to take a leadership role,” he said.

Tracy said the commissioners do not have to make a quick decision about whether to join the St. Louis County-based program.

“We are not under some deadline,” he said.

mbliss@semissourian.com

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