Missouri Senator sponsors bill he once strongly opposed
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Missouri Senator sponsors bill he once strongly opposed

Date: March 6, 2013
By: Josie Butler
State Capitol Bureau
Links: SB 146, SB 233, HB 347

JEFFERSON CITY - The effort to create a program to monitor prescribed painkillers has lost a major supporter while gaining an unlikely one.

Sen. Rob Schaaf, R-St. Joseph, is sponsoring a bill that would create a program that would allow the Department of Health and Senior Services to establish a program to monitor the prescribing and dispensing of strong painkillers, such as Vicodin or OxyCotin, by doctors.

The Prescription Drug Monitoring Program would require professionals who prescribe or dispense these drugs to electronically submit to the department information of each prescription, purchased by a cash transaction, within seven days. Patient prescription information would not be retained for more than 90 days after the prescription was written or was filled by the patient.

Last year, Rep. Keith Frederick, R-Rolla, proposed a similar bill, which Schaaf strongly opposed, calling it both a freedom issue and a privacy issue. Schaaf vowed to kill it with a filibuster unless it was put to the vote of the people. This time around, Frederick said he has changed his opinion on the program. He said he believed that the benefits outweighed the risks, but he now believes the risks are too great and there is too much potential for misuse.

"The database could be re purposed not to just try to catch doctor shoppers," Frederick said. He said he believes it could be used for other things such as background checks. He said he believes the information submitted to the database could be used to prevent people from purchasing firearms.

The bill would require that all information remain confidential. However, the act specifies the release of non-personal, general information for statistical, educational and research purposes.  

In his bill this year, Schaaf inserted a referendum clause that would put the program on the ballot so it could be put to a vote of the people.

Schaaf said he is supportive of giving the voters the opportunity to decide "if they want to give up their right to privacy."

"I fully believe the people would vote it down," he said.

Even though he's against the program, Frederick said he likes that the bill would go to the people and gives them the opportunity to decide. He said he believes that if the people understand the risks, they will turn it down.

Rep. Kevin Engler, R-Farmington, and Sen. David Sater, R-Cassville, also sponsored bills that would create a prescription drug monitoring program.

Engler said it is important for doctors to have access to a program such as this to see if doctor shopping is occurring. He said Missouri is one of the few states in the nation to not have a prescription drug monitoring program.

According to the Drug Enforcement Agency website, 37 states have operational programs, and 11 other states have programs that are not fully operational.

Engler said he does not think that the issue should go to a vote of the people because it could be "easily confused with Obamacare." Unlike Frederick, Engler said he does not believe the program will be abused because it has not yet been abused in any other states. 

"People are dying because of lack of monitoring," Engler said. "Keeping people from dying would be a benefit to the state."

Brenda Schell, director of Missouri Recovery Network, said that prescription drug abuse generally leads to further drug abuse, which results in overdoses and death. In many cases, prescription drug addictions lead to further addictions, such as heroin. The Missouri Recovery Network supports individuals with alcohol and drug abuse disorders and helps end discrimination toward addiction recovery. Schell said she has spoken to many parents who have lost children due to heroin overdoses. Many parents say their children began buying prescription drugs on the street. When they could not get the prescription drugs or could no longer afford them, many switched to heroin. 

"Not Even Once", a program in St. Louis that aims to increase awareness about the dangers of heroin, shares the stories of young individuals who have died because of drug overdoses on their website. One of these stories is about Michael Heard, who grew up in St. Louis and graduated from Rockwood Summit High School in 2004. According to the program's website, Michael experienced periods of anxiety and depression throughout his life. When he left for college he began self-medicating his anxiety with unprescribed prescription drugs. His self-medication turned into an addiction of opiate and lead to abuse of Xanax and OxyContin. In 2007, Michael sought treatment for his abuse, which had then turned into a heroin addiction. He attended four rehab programs, but on October 1, 2010 he died of an overdose.

Sater, previously a pharmacist in Cassville for 30 years, also believes a monitoring program is essential. He said there is a serious problem with prescription drug abuse.

"I have seen prescription drug abuse skyrocket over the past 10 years," Sater said. 

His bill would set up a computerized system that would record all prescribed scheduled drugs. He said if a pattern of doctor or pharmacy shopping arises, the Department of Health and Senior Services would be informed and an investigation would begin.

Cindy Pharis, a data analyst for Community Systems Group, said the problems arise in communities because there are more and better prescription drugs available and being prescribed without any tracking. The Community Systems Group works with communities to improve them and solve community problems such as prescription drug abuse. Pharis said there is no real follow up to see if the drugs are being used or taken appropriately. She said another problem arises because some professionals, such as dentists, cannot write prescriptions for two days, which would be necessary after a procedure such as a root canal. Pharis said people save the prescription drugs for future pain.

"The theory of a prescription drug monitoring program would hold people on the front end and the back end accountable for what they are doing with prescription drugs," she said.

Sater said he does not believe the monitoring program is an invasion of people's privacy. He said that 80 percent of prescriptions are adjudicated, but only 20 percent are cash transactions, which this bill would monitor. Engler also said that many private insurance companies also monitor scheduled drugs and only the cash transactions are not being monitored.

"For law abiding citizens there is no problem," Sater said. "Only for the bad people."

Sater also said he does not believe it needs to go to the vote of the people. He said that as an elected representative, he is given the responsibility to pass legislation in the best interest of the people.

"If they don't like the way we are doing things they can vote us out," he said. "We have the authority and responsibility to do this."