Missouri agency seeks more investigators for opioid program

JEFFERSON CITY, Mo. -- A budget proposal to fund two additional investigators for a statewide prescription drug-monitoring program is in limbo as some Missouri state senators still oppose the effort to respond to an increase in drug overdose deaths in the state.

Missouri remains the only state in the nation without a program that allows doctors or pharmacists to track a patient's prescription history, despite being among the 20 worst states for drug overdose deaths.

A program created last year by Republican Gov. Eric Greitens allows the state to track physicians' and pharmacists' prescription habits, but critics say it doesn't give doctors the tools needed to prevent over-prescribing drugs.

Last week, the Missouri Senate declined to approve funds to add two investigators to the program because senators weren't comfortable with the way it operates, said Sen. Dan Brown, a Rolla Republican and chairman of the Senate Appropriations Committee. House members already chose to keep the money in the budget when they approved it last month and the issue now will go to a conference committee, The Kansas City Star reported.

Overdose deaths in Missouri increased by more than 30 percent between 2015 and 2016, and the state's rate of overdose deaths is the 18th-worst in the nation, according to the Centers for Disease Control and Prevention.

Under Greitens' plan, five state investigators get data from Express Scripts, such as the type, strength and quantity of drugs physicians are prescribing and pharmacies are dispensing. The investigators look for unusual patterns in the prescriptions and can open investigations that could result in physicians or pharmacists being disciplined by state or federal officials, said Randall Williams, director of the Missouri Department of Health and Senior Services.

Unlike programs set up in St. Louis County and other states, Missouri's prescription drug-monitoring program doesn't give providers access to data to see whether a patient is getting several prescriptions for opioids at the same time or may be struggling with addiction. St. Louis County's program, started in April 2017, covers more than 80 percent of Missouri doctors and pharmacists on a volunteer basis.

Sen. Rob Schaaf, a St. Joseph Republican and a leading critic of the Greitens program, said it created the "unintended consequence" of hurting people who legitimately need opioids.

"Doctors are afraid to prescribe narcotics, because they're afraid they're going to be criticized and punished by the state," Schaaf said.

Williams said most Missouri doctors are prescribing correctly and the state doesn't want to audit them or go to their offices based on an unwarranted complaint.

"With our proactive ... data, we are able to identify people who are egregiously outliers, and that is more than occupying our time," Williams said, adding if doctors are correctly prescribing drugs, "we clearly don't want them to be intimidated or to worry."

Williams said the health department implemented the program with existing revenue and will continue to operate that way if lawmakers choose not to allocate money for more investigators.

Information from: The Kansas City Star, http://www.kcstar.com