Local lawmakers push for drug database, regulations against 'pill mills'

Prescription-drug abuse is starting to become an important issue in Missouri politics.

Gov. Jay Nixon referenced the need for a prescription-drug monitoring program in his State of the State speech Wednesday, calling opiate abuse an epidemic. Missouri is the only state that does not have any sort of prescription-drug database.

The Southeast Missouri Drug Task force has recorded people come from as far away as Georgia and Florida to try to procure prescription medications illegally.

"For us, the more oversight, the more regulation, is probably better due to the fact we see a lot of folks abusing the system as of now," SEMO Drug Task Force director Mark McClendon said.

Holly Rehder

Rep. Holly Rehder, R-Sikeston, has sponsored a bill, HB 1892, creating a prescription-drug-monitoring program.

She has sponsored several similar bills over the past few years.

She said she feels more confident with a change in leadership in both the Senate and House of Representatives, the bill may be passed.

"I believe anything is possible," she said. "I do understand that some of the things absolutely necessary in this bill were things Sen. (Rob) Schaaf said he could not accept."

Law-enforcement representatives said a prescription-drug-monitoring program would help keep illegal prescription drugs off the streets.

Currently, doctors have no way of finding out whether a patient has received prescriptions for opioid pain medications from other doctors.

Schaaf, R-St. Joseph, has been the primary opponent of the bill, based on protecting patient privacy.

Rehder said this version of a prescription-drug-monitoring program goes further in providing protection -- it requires law enforcement to have a court-ordered subpoena to obtain prescription records on a relevant case and includes a clause that prescription-drug information cannot be used to keep someone from buying a gun.

Rehder said the system would allow doctors to communicate to stop abuse before it spirals out of control.

The Missouri Physicians Association supported a monitoring program, executive vice president Tom Holloway said in November.

"This is very much a patient safety bill," Rehder said.

The Department of Health and Human Services would be in charge of creating and maintaining the drug-monitoring program for scheduled II, III and IV narcotics.

The bill would require pharmacies to provide pieces of information electronically, including the quantity of the drug dispensed, the pharmacy's Drug Enforcement Administration number and the patient's identification number, which could include the information from a driver's license and health insurance.

Rehder previously said a federal grant would provide the $500,000 cost to create the program. The bill lists the funding to be subject to the appropriations process governed by the General Assembly.

Kathy Swan

One of three co-sponsors for HB 1892 has her own bill to combat prescription-drug abuse.

With HB 1608, Rep. Kathy Swan, R-Cape Girardeau, hopes to establish regulations to try to prevent pain-management clinics from becoming "pill mills."

The Department of Health and Senior Services would require each clinic to obtain and maintain certification, and all employees and owners would have to prove they never had been denied a license to prescribe medication.

The pain-management clinic also would need to provide hours of operation, information on licenses for its staff, record-keeping and chart requirements and would be required to participate in any prescription-drug-monitoring program.

"I worked on the bill last session and continue to work to identify the best, workable solution to this critical issue," Swan wrote in an email. "Currently, I am exploring additional avenues to addressing the problem, in addition to the regulation approach described in the bill language. And currently, pain-management clinics are not regulated."

Missouri Bureau of Narcotics and Dangerous Drugs investigator Randy Wright said this type of regulation would help, but there are plenty of small doctors' offices serving as pill mills -- some inadvertently.

Wright gave the example of an older doctor who repeatedly prescribed Zyrtec-D, only to have the pseudoephedrine used in a meth-making operation.

"I've seen an anesthesiologist as a pain doctor. I've seen a plastic surgeon as a pain doctor," Wright said. "If state begins to regulate that, it would be tremendous."

Wright also said regardless of the efforts of lawmakers and law enforcement, people will find ways to abuse controlled substances and noncontrolled substances alike.

He gave the example of Gabapentin, which is prescribed for fibromyalgia but is becoming popular as a party drug because it tends to make people happy and outgoing.

"You overdose on it, it will make you like a wet noodle," Wright said. "It can reduce your muscle function to zero."

bkleine@semissourian.com

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