Columbia will establish a prescription drug monitoring program, joining an existing database in St. Louis County, in an effort to address drug-related problems, including opioid addiction.
Columbia City Council voted unanimously Monday night to approve the ordinance that establishes the monitoring program. The city will enter into an agreement with St. Louis County, which has already created a prescription drug monitoring database managed by Appriss, Inc. that many other Missouri cities and counties have already joined including Kansas City, Independence, St. Charles County and Jefferson City, which voted to join earlier Monday.
The program will monitor schedule II through IV drugs, specifically opioid painkillers. The database catalogs information from doctors and pharmacists to track the prescribing of drugs and prevent "doctor shopping" — when people attempt to obtain narcotics from multiple doctors and pharmacists.
According to the ordinance, within 7 days of prescribing a schedule II through IV drug, the prescriber must submit information about the prescription directly to the Appriss database. That information includes, but is not limited to:
- The date of dispensation
- The prescription number
- The quantity prescribed
- Patient information
Only prescribers and dispensers will have full access to the database, while the health department will receive routine reports on prescribing practices. Law enforcement and judicial officials can access the information by court order only, when necessary.
Joining the database will cost the city $26,443.41 for the first two years — prorated for 2017, and the full 2018 year. Costs will be $15,110.52 for each following year. St. Louis County is applying for federal funding through the Federal Bureau of Justice, and the full costs for the first two years could be covered if the application is approved, said Health Department Director Stephanie Browning.
Dr. Christina Goldstein, a spine surgeon at the Missouri Orthopedic Institute, spoke in favor of the ordinance, stating that she had to personally cut back on prescribing narcotics because she can't individually identify patients with a high risk for addiction. With a prescription drug monitoring database, identifying high-risk patients will be much easier, she said.
Missouri is the only state without a database of its own, as bills to create a statewide database have failed in the legislature the past two years. As a result, individual cities and counties have crafted their own establishing ordinances, with Columbia being the most recent to pass one.
Missouri Sen. Rob Schaaf, R-St. Joseph, sponsored SB 74, which would establish a statewide prescription drug monitoring program. The bill has already passed in the Senate, and had its second read in the House of Representatives Monday.
Schaaf's bill, though, would only allow the Department of Health and Senior Services full access to the database, and they would notify doctors and pharmacists of any suspicious prescribing activity accordingly. Even if the statewide bill passes, Columbia's program would initially still operate separately from the statewide program.
Prescription drug monitoring programs not only monitor patients, but also help identify doctors and pharmacists who are operating recklessly.
In a 2016 report published by the Centers for Disease Control and Prevention, opioid-related deaths in the U.S. increased 200 percent between 2000 and 2014. In 2015, 1,066 people died of opioid overdose in Missouri alone. But with a prescription drug monitoring program, doctors and pharmacists have the resources to identify and stop "doctor shoppers" early, potentially preventing future opioid deaths, supporters say.
Missouri sold the highest rate of prescription opioids per capita in 2010, more than any other state in the Midwest.