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St. Louis County Drug Monitoring Program Continues To Grow Across Missouri

St. Louis County Council established its own prescription drug monitoring program in 2016 to fill the void left by the absence of an official statewide program. Seventy-five jurisdictions across the state now participate in the program.
Rici Hoffarth | St. Louis Public Radio
St. Louis County Council established its own prescription drug monitoring program in 2016 to fill the void left by the absence of an official statewide program. Seventy-five jurisdictions across the state now participate in the program.

Public health officials in St. Louis are expanding their efforts to reduce opioid addiction statewide.

The St. Louis County Department of Public Health unveiled new online resources Wednesday designed to connect doctors with information on opioids, pain management and substance abuse. The toolkit is the latest addition to the county’s prescription drug monitoring program, which was established in the absence of a statewide program. 

Missouri remains the only state in the nation without a prescription drug database — an electronic tool that can help identify patients who obtain excessive amounts of painkillers. 

The St. Louis County Council voted to establish its own prescription drug monitoring program in 2016, led by then-councilman Sam Page.

“[Missouri is] essentially referred to in law enforcement as ‘America’s drug store,’” said Page, who now serves as county executive. “We have people posing as patients coming in vans from other states ... pretending to have a serious medical illness that most reasonable physicians would think would require a narcotic medication.”

St. Louis County’s drug monitoring program has since gained traction statewide, with 75 Missouri counties and jurisdictions signing on to participate. 

An estimated 94% of health care providers across Missouri are covered, according to the St. Louis County Department of Public Health. 

Spring Schmidt, acting director of the department, said the program has crossed “geographic barriers that everyone thought were firm walls.” 

“This shows the power of what local public health can do,” Schmidt said. “Our physicians and clinicians throughout the state are using this system every single day. So if they ask for something, we want to figure out how to get it.” 

Schmidt was part of the team that developed the online opioid prescription toolkit over the past year — after consulting with physicians and pharmacists to learn more about what they needed.

“A lot of the information that exists out there about prescribing habits is collected at the insurance company level or by Medicaid, but it’s not shared back with the prescriber unless it’s through a prescription drug monitoring program,” Schmidt said. 

The online resources include best practices for prescribing opioids, pain-management techniques and referral recommendations for doctors who suspect their patients may have a substance use disorder.

New efforts to create a statewide program

State lawmakers will likely consider two bills during this legislative session that would establish a statewide drug monitoring program.

Sen. Tony Luetkemeyer, R-Parkville, and Rep. Holly Rehder, R-Sikeston, have separately proposed legislation that would require doctors to submit information when prescribing controlled substances. 

But it’s unclear whether this latest attempt will sway legislators. 

Since 2005, Missouri lawmakers have introduced at least one bill every year to establish a statewide prescription drug monitoring program — but none passed.

Page said previous efforts to create a prescription drug monitoring database in Missouri have failed due to a misunderstanding of the program and overblown concerns about privacy.

“The privacy features in this program are extraordinarily strong,” Page said. “But some people philosophically place privacy above everything in all their decision-making.”

Still, Page said St. Louis County is moving forward regardless of whether the state creates a monitoring program.

“The opioid epidemic is one of the greatest public health crises that we’ve faced in the past 20 years,” Page said. “It’s something that our health department has to be focused on, and we have to bring all of our resources to bear. That’s what we’re doing.”

Follow Shahla on Twitter: @shahlafarzan

Send questions and comments about this story to feedback@stlpublicradio.org

Shahla Farzan was a reporter at St. Louis Public Radio. Before becoming a journalist, Shahla spent six years studying native bees, eventually earning her PhD in ecology from the University of California-Davis. Her work for St. Louis Public Radio on drug overdoses in Missouri prisons won a 2020 Regional Edward R. Murrow Award. 

Send questions and comments about this story to feedback@stlpublicradio.org.