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April 25, 2013 | 12:00 a.m. CST
On a Friday afternoon at Kilgore’s Medical Pharmacy, pharmacist Bill Morrissey knows at least one person will try to fill an illegal prescription for painkillers. Although people might be trying to get an early refill, doctor shopping, which is when patients seek multiple prescriptions from different doctors and pharmacies, is an even worse issue pharmacists must monitor. Morrissey has to be on the lookout, but what he can do is limited.
Missouri doesn’t have a prescription drug monitoring program, which would allow doctors and pharmacists to access a database to see clients’ prescription history. As part of the 2011 Prescription Drug Abuse Prevention Plan, the Office of National Drug Control Policy encouraged such a program.
Prescription drug abuse is the fastest-growing drug problem in the nation. More overdose deaths involved prescription opioids than heroin and cocaine combined from 2003 until 2007, according to the Centers for Disease Control and Prevention.
Approximately 3,200 Missourians entered substance abuse programs, according to a bulletin from the Missouri Department of Mental Health’s Division of Alcohol and Drug Abuse. Of those people, 60 percent reached 30 days of sobriety after being discharged from treatment. Source for chart: Missouri Division of Alcohol and Drug Abuse, treatment admissions FY 2012
About 40 percent of drug hospitalizations in Columbia involved the use of heroin or opiates in 2010, according to the Missouri Recovery Network.
Morrissey says Missouri should follow the rest of the country and implement a monitoring database. “The technology is there,” he says. “I don’t want it to be something that’s too cumbersome, meaning I want the program to be done right and to be pretty automated.”
Doctor-shopping clients often try to buy subsequent ones with cash rather than using insurance.
Morrissey says he could check clients’ insurance to see if they already have a similar prescription, but this doesn’t always work. Some insurance companies alert pharmacies only when clients have the exact same prescription, so a different dose or brand will not show up in the results.
When that fails, Morrissey faces even more difficulties. Still, he could call a pharmacy near the clients’ residences and hope for answers.
“The issue is that when you have all those guidelines out there, people will always find ways around them,” he says. “Sometimes even good, experienced pharmacists, myself included, get duped anyway.”
During a hearing in March, Sen. Rob Schaaf, R-St. Joseph, sponsored a bill that would take the issue to Missouri voters. Last year, Schaaf filibustered against the legislation of the program. He still opposes the idea because he is concerned about patient privacy.
Rep. Kevin Engler, R-Farmington, told KCUR in Kansas City that political campaign tactics will defeat Schaaf ’s bill. To support the setup of a monitoring program, he reintroduced the bill that requires no popular vote.
Brenda Schell, executive director of the Missouri Recovery Network, says she doubts that many changes will actually be made.
“I think (the bill) is probably not going to go anywhere,” she says.
Engler’s bill is not on the Missouri House calendar or scheduled for a committee hearing.