McCaskill says Missouri needs tighter drug monitoring

By ADAM ATON

JEFFERSON CITY, Mo. -- U.S. Sen. Claire McCaskill said Tuesday that Missouri needs more tools to fight opiate abuse, including a prescription-drug monitoring program, more specialized treatment centers and better research about average drug use.

The Senate's committee on aging, on which McCaskill sits as the ranking Democrat, heard testimony on opioid abuse Tuesday during a field hearing in Jefferson City. Opioids include prescription painkillers as well as illegal drugs such as heroin and opium. McCaskill was the only U.S. senator attending, although at least nine state lawmakers sat in on the hearing.

State Rep. Holly Rehder, a Republican from Sikeston, testified her daughter became addicted to opioids after she cut her thumb at work and was prescribed painkillers. It wasn't hard for her daughter to find more painkillers once she ran out, Rehder said, and her next 13 years were spent in and out of rehabilitation programs and prison.

Rehder has introduced a bill to create a prescription drug monitoring program. A House committee is scheduled to review the measure today, and Rehder said House Speaker Todd Richardson is "very much in favor" of her proposal.

Rep. Holly Rehder

Missouri is the only state without a prescription drug monitoring program. State lawmakers have resisted enacting such a program for more than a decade because of worries about the security of a government database with medical information.

"Missourians ought to talk to the other 49 states that have done this. We've heard no outcry of violations of privacy," McCaskill said. "We're the outlier here."

McCaskill also pointed out the Department of Veterans Affairs runs a drug monitoring system without complaints. Wal-Mart and Walgreens also run internal monitoring programs, Rehder said.

Bob Twillman, executive director of the American Academy of Pain Management, said doctors often prescribe enough painkillers to keep a patient from running out, instead of how much a patient needs. That's because little research has been done on the amount of opioids the average person uses, he said.

Dr. Maurice Redden, who teaches geriatric psychiatry at Saint Louis University, said doctors already have little time with patients, and they're sometimes not reimbursed for talking about preventing opioid abuse. It also can be difficult for hospitals to get reimbursed for helping a patient detox, he said.

Measures to fight opiate addiction should be careful not to force people to quit cold turkey, Twillman said, because that doesn't treat their addiction and can force them to seek out street drugs.

Before the hearing, McCaskill said medical marijuana could have a place among other pain-treatment options.