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Will Missouri Adopt A Prescription Drug Monitoring Program?


Efforts to establish a prescription drug monitoring program in Missouri are making a comeback this year. But there’s a twist: the main opponent of establishing such a program is now sponsoring legislation.

“I think it’s a severe intrusion of our liberty to have the government create a database that is accessible by thousands of people, if not tens of thousands of people, who would then have access to sensitive private information,” said Republican Senator Rob Schaaf, a physician in St. Joseph, Mo.

Schaaf successfully led a filibuster for hours against legislation last year that would have set up a prescription drug database in the state. But this session, he recently introduced a similar bill.

There's one main catch: it would require popular approval.

“If the people of Missouri want to have a government-run database, accessible by thousands of people with sensitive information on it, they should be free to do so. But I don’t believe it’s the place of the legislature to do this to them,” Schaaf said, who added that he tried to propose this caveat last year.

While some state drug monitoring programs lack adequate funding, Missouri is the lone state that’s without such a program, period.  That standing caught the attention of the White House's drug czar over the summer, who said Missouri runs the risk of becoming a bastion for ‘pill mills,’ or doctors’ offices that over-prescribe medicines.

Essentially, a prescription drug monitoring program would create a database in which pharmacies could submit the names of doctors prescribing certain medications and the patients receiving them. Doctors and pharmacists would have access to the database, as would law enforcement with a subpoena.

Schaaf's proposal, however, doesn't sit well with the original sponsor of last year’s prescription drug monitoring bill. Representative Kevin Engler, who initially pushed the legislation in the Senate, says campaign tactics would easily defeat the measure in a popular vote. 

“All you have to do is tell people it’s a part of Obamacare, we don’t want it, this is big government interference, they’re going to monitor legal drug use,” said Engler, who adds that he’s a staunch opponent of the federal health law. “The people will vote it down because it’s easily distorted.”

Engler says in reality, the prescription drug database is not about tracking legal drug use.

“It’s only monitoring for multiple prescriptions by the same person that are then being sold illegally,” Engler said. “We need to do this to keep drugs out of the hands of people that shouldn’t have them.”

Engler, a Farmington, Mo. Republican, says all too many funerals in his district involve young adults who’ve overdosed on legal drugs. He says the problem is some people “doctor shop” for opiates, like Oxycontin, and then illegally sell them.

“I’ve just seen too many constituents in my district die,” said Engler. “A doctor in the ER should have the ability to look up before he gives you opiates, the ability to tell if you’ve been to other doctors that month.”

In response, Engler has reintroduced his legislation this session, which would set up a prescription drug monitoring program in the state without requiring a popular vote. The measure has also been introduced in the Senate.

Schaaf, meanwhile, says he'll oppose Engler's measure as adamantly as he did last year.

"I understand their argument, and that they may mean well. But in my opinion, it isn’t my duty as a citizen to give up my right to privacy just to stop some other citizen from breaking the law. There are other ways to stop them," said Schaaf. “If there’s no popular vote, I will be back fighting it tooth and nail."


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