Warren County is joining a growing collection of local governments in Missouri using a shared database to monitor the distribution of prescription drugs.

The county commission on Sept. 13 voted to join the Prescription Drug Monitoring Program (PDMP) administered by the St. Louis County Department of Public Health.

PDMP monitors what prescription drugs are being dispensed by pharmacies in participating cities and counties. Doctors and pharmacists can use that information to help keep addictive drugs out of the hands of people who are at risk of misusing them.

There are more than 60 other counties and cities already participating in the PDMP, according to a report from St. Louis County. That includes every other county bordering Warren County.

An increased push for participation in PDMP comes in response to the opioid epidemic, but the database monitors every drug that requires a prescription.

The Warren County Commission voted 2-1 to join the PDMP network. Presiding Commissioner Roger Mauzy and Southern District Commissioner Hubie Kluesner voted in favor, with Northern District Commissioner Dan Hampson voting against.

How it works

PDMP uses a central database to collect and distribute information about drug prescriptions. The database is not accessible to the public, only to authorized medical professionals and state regulators. Law enforcement officers can retrieve specific records if they get a court order.

Officials with the Warren County Health Department said it will take about three months for the county to integrate into PDMP. Participation will be mandatory for all pharmacies in the county. 

Officials said the mandate to upload information only applies to pharmacies. Doctors prescribing medicine will not be required to check PDMP before issuing a prescription, although they will be encouraged to do so.

Within seven business days of dispensing a prescription drug, local pharmacies will be required to submit information about that prescription to the database. The information must include what drug was dispensed and how much, along with some kind of identifier for the patient.

Joining the PDMP network requires a subscription fee, but health officials said the cost for all joining counties is being covered until 2020 by a grant to the PDMP program. If the grant is not renewed after 2020, participation will cost Warren County about $209 per year.

Different from past program

PDMP is different from a statewide drug monitoring program initiated by Gov. Eric Greitens in 2017. That program does not track patient information. It only monitors prescribers to locate doctors and pharmacies that are over-distributing medication.

When Greitens first approved the statewide program, experts pointed out that it wouldn’t prevent “doctor shopping.” That’s when a person visits multiple doctors and pharmacies trying to fill redundant prescriptions.

PDMP puts a roadblock on doctor shopping by informing pharmacies if a patient has already filled a similar prescription at another location. The PDMP database will include information from pharmacies in all participating counties.

Potential benefits

Pharmacist Mitch Graumenz, manager of Legacy Drugstore in Wright City and Warrenton, said joining the St. Louis County PDMP is a good move. He believes Missouri should make the program statewide, as it is the only state in the U.S. without such a prescription database.

Graumenz commented that Warren County being the only regional county not participating in the PDMP has caused people to come here to avoid monitoring.

“We see people come out of the counties that do have (PDMP) in order to get around the database,” Graumenz said. “I know for a fact that (PDMP) is working, because it’s been driving out people from counties that do have it into our county.”

Graumenz is confident PDMP will decrease doctor shopping, and he expects it will not affect people with legitimate need of pain medication or other controlled medicines. 

In fact, Graumenz said the database could benefit patients by helping doctors identify legitimate patients who are showing early signs of addiction.

“The majority of people who end up looking for illegitimate pain prescriptions started out with a legitimate pain need,” Graumenz explained. “What the PDMP is good for is noticing that trend over time. ... It allows the doctor to get in front of it.”

Opposition

The decision to join PDMP isn’t without opposition. County resident Bev Ehlen and other advocates told the county commission that the government monitoring drug prescriptions is an invasion of privacy. They also said the monitoring database wouldn’t do anything to prevent the theft of legally prescribed drugs, which they argued is a chief source of drug abuse.

Ehlen said the county hadn’t taken enough time to gather evidence showing that doctor shopping is an issue in Warren County.

“At least delay participating in (PDMP) and prove the need. ... That would be a pretty easy thing to prove, that people are coming to Warren County to get opioids,” Ehlen said. 

Graumenz, the pharmacist, said other states that have implemented versions of PDMP have not had major privacy issues. He said the point of the database isn’t to give information to the government, it’s to make that information more available to health care practitioners. 

He added that health care professionals won’t be able to look up a person’s information unless they are serving that specific patient.