Community Corner
Prescription Drug Monitoring Program Coming To Missouri After Years Of Stalled Efforts
The legislation will allow physicians and pharmacists to keep track of patients opioid prescriptions through a statewide database.
May 19, 2021
After years of conversations and widespread efforts in the Missouri legislature, this spring marked the passage of a statewide prescription drug monitoring program. The legislation, spearheaded by Sen. Holly Rehder, will allow physicians and pharmacists to keep track of patients opioid prescriptions through a statewide database. In doing so, it will alert doctors and pharmacies to patients who are potentially shopping around with their opioid prescriptions. "It serves as a conversation starter," said Dr. Fred Rottnek, who heads Saint Louis University's Addiction Medicine Fellowship. "As in, help me understand why your name is showing up at pharmacies that aren't associated with this practice or under another provider's name." "We don't want PDMP's to turn us into cops," he said. "We want to use it to see what's going on with our patient." Many pharmacists mirror that message. Abe Funk, a pharmacist and co-owner of John's Pharmacy in southeastern Missouri, said he's well versed with having difficult conversations with patients. "It's an uncomfortable conversation to pull someone behind the counter and say, hey, I think you have a problem we need to talk about," he said. "But I feel like that's part of our responsibility in patient care."Often, pharmacies will receive refill requests for certain opioid prescriptions well before they're due, which usually serves as a red flag to those filling it. A quick phone call to the prescribing doctor often reveals a different story, pharmacists say. Right now, St. Louis County offers its own prescription drug monitoring program, which other counties or municipalities can pay to tap into. For doctors unable to access it, Funk said it can hinder their ability to see a patient's opioid prescription history. Instead, they often have to take the patient's word for it. "It's really frustrating for most of those doctors when they have a potentially troublesome patient, that maybe doctor shopping or asking for other things, they want to see what's going on," said Funk. Dr. Rottnek said a history of pain being treated as another vital sign has effected the profession when it comes to treating pain. "We were taught in school, if you're in pain, you don't get addicted," he said. "And that is just not true." In Missouri, doctors are required to submit opioid prescriptions electronically and guidance suggests for no more than seven days, if it's a patient's first time using the medication. In an ER setting, the guidance suggests no more than three days worth of pills. "We're really bad about taking a pill for everything that ails us and this is one of the situations where it bit us and we didn't do a very good job, especially for chronic pain patients," said Dr. Rottnek. Once the statewide program is in place, pharmacies will be required to use the database, while it will remain optional for physicians, according to the Missouri Pharmacy Association.
