Prescription drugs are dispensed to females at a much higher rate than males in Columbia, according to the first quarterly report from Columbia’s drug monitoring program.
The Columbia/Boone County Department of Public Health and Human Services published its first quarterly report Wednesday since joining the St. Louis County Department of Public Health’s Prescription Drug Monitoring Program. The report details prescription drug dispensing information for Columbia residents.
The health department held an informational session about the report Wednesday. It was attended by Mayor Brian Treece, health department director Stephanie Browning, pharmacist Bill Morrissey, MU assistant professor of clinical family and community medicine Lucas Buffaloe and a small group of citizens.
The Columbia City Council voted to establish a prescription drug monitoring program and join the St. Louis program March 6, according to previous Missourian reporting. Missouri is the only state without a statewide program.
The St. Louis County Prescription Drug Monitoring Program monitors the prescribing and dispensing of schedule II-IV controlled substances. Pharmacists must electronically enter information on Schedule II — IV drugs that they dispense within seven business days of dispensing, according to the health department.
The information provided by the program is intended to prevent doctors from prescribing addictive drugs to people who go from one doctor to another in order to obtain them.
The St. Louis County program began on April 25 with just 14 state jurisdictions participating. As of Sept. 30, there were 48 jurisdictions participating. The program aims to improve controlled substance prescribing, inform clinical practices of patients who are at high-risk for addiction and reduce the number of people who misuse, abuse or overdose, according to the quarterly report.
The program has formed good partnerships and the department hopes to work with other physicians, Browning said at the meeting.
The county received two grants from the U.S. Department of Justice, which allows them to hire more staff and cover the participation cost, said Kate Donaldson, St. Louis County prescription drug monitoring program assessment, evaluation and policy manager.
The database does not include information on whether the patient is genetically predisposed to controlled substance addiction, Buffaloe said.
The report only contains the prescriptions dispensed in quarter two, from April to June 2017. At the time of the report, all Columbia pharmacies were submitting data, according to the report.
Only 10 percent of physicians have signed up to be users, Browning said. Hopefully showing them the report’s data and increasing awareness will motivate more to join, Treece said.
When Buffaloe prescribes narcotics, he routinely logs into the database and is able to see what prescriptions the patient has filled, he said. When filling a prescription, he also checks the database to see what other drugs a patient has been prescribed.
“If someone brings in a prescription, you can look that patient up and see if they have that same medicine somewhere,” said Bill Morrissey, Kilgore’s Medical Pharmacy partner and pharmacist. “You look up the person by their name and birthday and see what they have filled.”
Overall, Morrissey said the report wasn’t shocking to him.
“The things that might have stuck out was … the significant increase in the 55–64 age bracket, which makes sense because at that age, there’s more pain,” Morrissey said.
Females also received Schedule II to IV controlled substances at higher rates than males for all age groups except minors, according to the report. Buffaloe attributed this to the possibility that women have higher rates of chronic pain compared to men and are more likely to access medical services.
While Lincoln County, the city of Independence, St. Charles County and Stoddard County had significantly higher opioid dispensing rates, Columbia has no significant difference compared to the total system.
The report also shows the dispensing rates in three categories: less than 50 morphine milligram equivalents (MME), 50–90 MME and greater than 90 MME.
According to the chart, less than 50 MME had the highest rate and 50-90 MME had the lowest.
“Per CDC’S guidelines, prescribers are to prescribe the lowest dosage possible, using caution when writing prescriptions for 50-90 MME, and use extreme caution when exceeding 90 MME,” the report states. “High dose opioid (>90 MME) dispensation rates being higher than medium dose opioids (50-90 MME) can partially be attributed to medication assisted treatment and end of life/palliative care.”