JEFFERSON CITY, Mo. — By next year, all health care providers will be able to track a patient’s prescriptions with the goal of preventing overdoses and opioid abuse.
Missouri is the last state in the nation to create a statewide prescription drug monitoring program (PDMP). While the legislation, Senate Bill 63, was approved last year, the system is still months away from going online.
Dean Linneman is the executive director of Missouri’s PDMP. The program will be overseen by the Joint Oversight Task Force for Prescription Drug Monitoring.
“Every opportunity we have to lower the number of pills in circulation is an opportunity to save a life,” said Linneman.
The system allows physicians and pharmacists to track a patient’s prescriptions.
“That patient-level information goes into the system and then providers will be able to look at that information again to make better decisions or more informed decisions when they are looking at what types of medications, they need to prescribe their patients,” said Linneman.
Linneman is the former director of the Department of Health and Senior Services (DHSS) Division of Regulation and Licensure. He oversees licensing components for hospitals, long-term care facilities, nursing homes, and childcare facilities. He said he managed the Bureau of Narcotics and Dangerous Drugs.
“Overseeing the activities of that bureau, I learned a lot about opioids and a lot about misuse of opioids,” said Linneman. “The task force is here to protect the dispensation of information and make sure it’s used correctly.”
The bipartisan legislation has received pushback for years, some concerned it would affect their ability to own a firearm.
“There will be no law enforcement, there will be not even licensing boards in the state of Missouri that will not have access to that information,” said Linneman. “Even the state, will not really have access to the patient-level information.”
The program will not track all prescriptions. The drugs are based off of the ability to become addictive or the probability of abuse and include Schedule II, III, and IV controlled substances.
Schedule II drugs are considered high potential for abuse and lead to severe psychological or physical dependence and are considered dangerous. Those substances include:
- Hydrocodone (Dilaudid)
Schedule III drugs may lead to moderate or low physical dependence or high psychological dependence which include:
- Tylenol with codeine
- Anabolic steroids
Schedule IV drugs are substances or chemicals with a low potential for abuse and low risk of dependence and include:
“Not every Missourian is going to be in the PDMP,” said Linneman. “It’s only those that have been prescribed and dispensed controlled substances.”
In 2020, nearly 1,900 Missourians died from an overdose, compared to 1,580 in 2019 and 1,608 in 2018. Sen. Holly Thompson Rehder, R-Sikeston, tried for nearly a decade to get the legislation across the finish line. Last June, the governor signed the bill into law.
“From my standpoint, I think a little bit of misunderstanding and maybe some confusion on how the system would protect the privacy of citizens,” said Linneman when asked why it took so many years to pass.
Currently, 85% of the state’s population uses St. Louis County’s PDMP. That program will dissolve once the state’s system is up and running, which Linneman said is expected to happen in March 2023.
“We’re trying to take advantage of lessons learned from other states and the other states, they’ve wanted Missouri to have this for a long time,” said Linneman.
The data collected in the program will include things like the type of prescription, the amount, whether it was a new prescription or a refill, and the provider who prescribed it. The information would only be kept for three years and cannot be used to obtain a search warrant or arrest.
“This is only going to be viewable by health care providers, like your dentist, your doctor, maybe some nursing staff if you go to an advanced practice nurse,” said Linneman. “It’s information that is going to be there, available for them to educate them on your health history.”
If a provider does not upload a patient’s information to the database, he or she could be fined up to $1,000.
The state has allocated $2.1 million for the program, but Linneman said the task force has also applied for a grant through the Department of Justice that if awarded, could add an additional $400,000.
The task force is made up of six members, two from the Missouri Board of Registration for the Healing Arts, two from the Missouri Pharmacy Board, the state’s dental board, and one from the Missouri Board of Nursing.
Linneman said the next step for the board is to choose the program’s vendor. Once the company is chosen, the system will be built to fit the statute passed by lawmakers and the rules set by the task force.