The numbers are staggering – about 60,000 Americans died of drug overdoses in 2016, more than 600 in the St. Louis area.
Missouri State Capitol Ceiling
As public health officials scramble for solutions, Ted Cicero, author of “The Changing Face of Heroin in the United States,” says Missouri serves as an example – both for what should and shouldn’t be done.
It’s the only state without an electronic prescription-drug monitoring program (PDMP), after a bill was tabled on the final day of the legislative session.
State House Democrat Crystal Quade of Springfield was a member of a conference committee which tried to negotiate a compromise on the bill. She says it failed because its language was weaker than efforts already in place at the local level, and would have overridden those programs.
“There were many of us who were in support of PDMP who did not want to have to go to municipalities and say ‘Even though you’ve been collecting all this data and you have this fabulous robust program, we’re going to drop to a lessor robust program that’s not going to be as effective'” said Quade.
Governor Eric Greitens recently signed an executive order creating a program targeting hospitals and pharmacies that inappropriately dispense prescription drugs.
Quade thinks Greitens order fails to address the problem because it only calls for one company, Express Scripts, to track the dispensing activity.
“Groups are already doing that. These businesses are already tracking that information. What was disappointing from the governor’s executive order is there was no next step. There was no data sharing with doctors. It is not a prescription drug monitoring program frankly”
Missouri Democratic U.S. Senator Claire McCaskill was also critical of Greitens executive order.
“The welcome mat is still out for drug dealers to shop for prescriptions in our state” said McCaskill. “The real solution here is for our elected officials in Jefferson City to get off the sidelines, and pass a robust statewide program into law that gives law enforcement, pharmacies, and doctors the tools they need.”
Cicero points out Missouri also is among a handful of states to sue opioid manufacturers. He maintains those drug makers deserve to be penalized.
“Any monies that could come from that should be really spent on ways in which we can provide treatment that usually is very costly,” he states.
State Attorney General Josh Hawley announced a lawsuit against three pharmaceutical companies last month. He claimed Purdue Pharmaceutical, Endo Pharmaceuticals, and Janssen Pharmaceuticals have violated Missouri’s consumer-protection laws, committed fraud and perpetrated lies.
While making his announcement, Hawley said 30,000 hospital and emergency room visits in 2015 were attributed to opioids, a 200% increase over the last decade. He added that in the same year, 500 deaths from opioid overdoses or complications took place in Missouri.
Hawley claims he seeking one of the largest judgments in Missouri history with the lawsuit against the three companies.
Cicero, a psychiatry professor at Washington University in St. Louis, says treatment doesn’t always work initially, but he says it does work. He adds schools also need to put a priority on teaching prevention.
Despite the lack of action by the state legislature, the practice of prescription drug monitoring appears to be picking up steam across the state. This month, St. Louis County is expanding its system, which went live in April. Columbia and Boone County are a part of that.
A week ago, the Springfield City Council voted 7-1 to implement a drug monitoring program patterned after the St. Louis system. The following day, the Greene County Commission unanimously adopted a program for all of its jurisdiction outside Springfield and Republic, which also has its own arrangement.
Cicero says anecdotal data has shown some alarming findings – that drug dealers with clients who have died don’t lose business. Instead, he says, people who are addicted will seek out that dealer.
“They think that person must really have good stuff, if people are overdosing and dying,” he states.
Cicero adds his research points to another challenge – in many cases, people with an addiction say they aren’t afraid of overdosing, because they assume emergency responders will have Narcan, a medication to immediately reverse the effects of opioids.
Hank Koebler of Missourinet affiliate KSSZ contributed to this story along with Missourinet’s Jason Taylor