Missouri Holds Out on Prescription Drug Monitoring Programs

A prescription drug monitoring program (PDMP) is an official database of information on prescribers and recipients of controlled substances. The idea is that when doctors and pharmacists can see exactly who is obtaining prescription drugs, the public’s ability to abuse those drugs will be minimized. The database is also open to law enforcement. A recent study found that Missouri’s decision not to enact a PDMP makes it a de facto hub for illegal or suspicious prescription drug activity.

Missouri the Only U.S. State Without a PDMP

Conducted by a St. Louis area firm, the study found that people from eight states surrounding Missouri fill more prescriptions in the state than Missouri residents. The study also revealed that a number of Missourians are acting as conduits to supply prescription drugs to neighboring states. Without a formal record of prescriptions, individuals can visit several doctors and make the same complaint, a practice known as doctor shopping. After obtaining multiple prescriptions for painkillers or anti-anxiety medications, the person has a supply that they can abuse or sell to other abusers.

Non-Missourians Filling Majority of Prescriptions

People who come to Missouri from out of state to fill their prescriptions may very well be taking those drugs themselves once they return home. However, it’s equally likely that they are selling them in their home state. The absence of a statewide PDMP has left Missouri as a wild frontier territory in terms of unsupervised prescription drug use.

Questionable Success of PDMPs

The need to take action against prescription drug abuse is real, but the success of PDMPs in curbing that abuse has not been proven. A 2011 study looked at PDMPs in participating states (from 1999-2005) and compared the presence of a state program to mortality rates related to prescription drug overdose. The researchers found no discernible link between implementing a PDMP and reducing the number of overdose deaths. Similarly, there was little impact on the rate of painkiller use in those states.

Doctors Not Required to Participate in PDMPs

It may be that the problem with PDMPs is that few states make physician participation a requirement. If doctors are not required to enter pertinent data, then the safety net will have large gaps. Until physician participation is required, many doctors may view it as another time-consuming government intrusion. The programs are supported by and partially funded by the Department of Justice. Guidelines for establishing a PDMP are available through government sources. Research does not support the hope that such programs will reduce the amount of prescribing or deaths from overdose. On the other hand, being the only state without a program has worked like a magnet to draw in suspect prescription drug activity.

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