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State senator's opposition to prescription drug database at odds with expert research

Sen. Rob Schaaf, R-St. Joseph
File photo | Jason Rosenbaum I St. Louis Public Radio

A showdown is looming in the Missouri statehouse over an effort to make Missouri the final state in the nation to gain a prescription drug monitoring program.

State Sen. Rob Schaaf, R-St. Joseph, has promised to filibuster House Bill 1892, which would let doctors check a database before giving patients a prescription for opioid painkillers, and require pharmacists to report filling opioid prescriptions within 24 hours.

At Wednesday’s Senate hearing discussing the bill, Schaaf said giving doctors and pharmacists access to a database would infringe on patient privacy.

“It is wrong to take away the liberty of every law-abiding citizen to stop a very few from breaking the law, especially when they are putting their own lives at risk by doing so,” said Schaaf. “The people who overdose must take some responsibility for their actions.”

Schaff is a physician, but his view is at odds with the American Society of Addiction Medicine’s definition of addiction. According to neurological research, addiction is a chronic disease that drives people to seek the substance they are addicted to despite risk and consequences.

The Republican senator is promoting rival legislation that would bar doctors and pharmacists from viewing the database — instead charging the state health department with deciding who’s at risk.

He also wants the issue to be decided by a public referendum on a future ballot, and thinks that public opinion can be swayed to vote against its passage.

Meanwhile, the Centers for Disease Control and Prevention draws a direct correlation between the nation’s fourfold increase in prescribing opioid painkillers since 1999 and the identical fourfold increase in overdose deaths.

“Where you have the highest prescribing rates is where you have the highest rates of death. And when you look at some of the differences between states there can be a three-fold difference between some of the highest prescribing states and the lowest prescribing states,” said Debra Houry, the director of the CDC’s National Center for Injury Prevention and Control. “And I don’t think there’s that much of a difference in patients by state. So again, it’s on physician practices.”

Houry says prescription drug monitoring programs are a key strategy preventing drug overdose and reducing the number of people who become dependent on drugs.

The CDC funds 29 states’ prescription drug monitoring programs and is offering additional funding to states that want to improve their programs to better align with best practices.

Research shows that fewer drugs end up on the street and more people get addiction treatment when doctors use prescription drug monitoring programs, especially when checking the database is either unsolicited or mandated.

“New York implemented their I-Stop, their prescription drug monitoring program where you have to check it before prescribing pain medicines, and they saw a 75 percent drop in patients that were seeing multiple providers for opioids,” said Houry.

The house bill to create a prescription drug monitoring program in Missouri allows doctors and pharmacists to check the database, but does not require it.

It is currently waiting for a third reading and final passage in the state Senate.

Follow Camille Phillips on Twitter:@cmpcamille.

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