Prescription Drug Monitoring Programs (PDMPs) have become a key component to every state, and even the federal response to the opioid epidemic. Over the past few years, state’s (and the federal government) have funneled millions of dollars into PDMPs, improving their technology, expanding access, developing their capabilities, and encouraging doctors, pharmacies, and law enforcement to use them as a resource. However, while momentum is moving in one direction, Missouri isn’t ready to join the party just yet. As of 2017, Missouri became the only state in the country that did not have a PDMP.
But why? We all agree they are a valuable resource, provide doctors with tools to help better serve their patients and give states better ability to identify abuse and diversion. So how come Missouri has lagged behind? Well for starters, privacy. For five years the legislature has seriously considered numerous bills that would have established a PDMP for the state, but for most of those years, the Senate defeated the bill citing privacy concerns. They argued the information was not secure from outside access. That the information could be used inappropriately. That too many people had access to the information. That the state was storing the information for too long. And every year, their argument (and their legislative force) won out.
But during this year’s legislative session there was some hope - the main opponent to the PDMP on privacy grounds, Senator Schaaf, was willing to stand down and seriously consider supporting a PDMP. Missouri was finally on track to join the rest of the country - but not so fast. Legislators couldn’t agree on some of the nuances of how the PDMP would work. Should the information be stored for years or purged after 180 days? Should it collect information on all Schedule II or only opioids? Turns out those nuances were enough to kill the PDMP legislation again in 2017.
Missouri remains the sole holdout. This however, has not stopped counties and other localities from establishing their own PDMPs. St. Louis County went live with their own PDMP back in April, several municipalities including St. Louis and Kansas City, signed up to participate. In July, another wave of counties and municipalities will join. The state might be dragging its feet on a PDMP, but the counties and municipalities facing the reality of the opioid epidemic are taking matters into their own hands.