On Thursday afternoon, within a span of 10 minutes, two customers walked into the door at Noel Pharmacy in McDonald County.
They greeted the pharmacy techs as well as Ray Kirk, owner and pharmacist, with warmth, got their prescriptions and left within minutes. At the end of day, their information was automatically downloaded into a centralized database.
The information was then accessible to health care professionals in all of the counties that signed up for a prescription drug monitoring program administered through St. Louis County. McDonald County’s prescription drug monitoring program has been live since Oct. 1.
The county authorized joining St. Louis County’s program back in July after state lawmakers failed to pass a statewide prescription drug monitoring program during the last legislative session. Because St. Louis County acquired a federal grant, McDonald County didn’t have to pay the $235 yearly fee this year.
Missouri is the only state that does not have a statewide prescription drug monitoring program.
Two weeks into the program’s launch, Kirk said the program has been smooth sailing.
“It’s no biggie,” Kirk said. “It barely involves any effort.”
Kirk said he’s in favor of the program because he wants people to stop abusing opioids and he views the program as “a tool against people who are trying to beat the system.” The program flags “pharmacy hoppers,” or people who fill multiple prescriptions at different pharmacies. Pharmacists can also see a patient’s drug history.
All three pharmacies in McDonald County are outfitted with the software that deposits prescription information into the database.
On a regular day, Kirk said his pharmacy dispenses 120 to 130 prescriptions. Having the program helps him be sure he is not serving a pharmacy hopper.
Two days earlier, Kirk said he searched the database for a customer who visited his pharmacy from a different county.
“I didn’t find anything,” Kirk said.
The frustrating part of the search was that Kirk couldn’t see if the customer had filled a prescription in any of the surrounding counties.
Though residents in Newton County pushed for the program, the Newton County Health Board of Trustees put the brakes on the program until a lawsuit filed in St. Charles County is resolved. Jasper County and the city of Joplin have authorized joining the St. Louis County prescription drug monitoring program in the last month, but their programs won’t go live until 2018.
Although other states share database information with each other, St. Louis County’s program has yet to partner with surrounding states. Kirk said he applied to the Arkansas Board of Pharmacy to access to its database but was denied because he didn’t have an Arkansas license.
“The sad thing is that we are in the corner of the state and we are 6 miles from Oklahoma and Arkansas, too,” Kirk said. “We don’t have access to any of their information.”
Paige Behm, McDonald County Health Department administrator, said a statewide program is sorely needed.
“Maybe through all of this, our legislators will come back and look at the need for it,” Behm said.
Every Thursday, Behm talks with other county health department administrators who are part of the program. Among those who have launched the program, Behm said, there are 1,200 patient searches a day on average and 17,000 controlled substances dispensed per day. Behm said the program was too new in McDonald County to generate any statistics.
With less opioids on the street, the use of illegal substances like heroin could rise, Behm said. Currently, abuse of either isn’t as bad as in more densely populated areas in Missouri, she added. In 2015, 34 individuals in the county were admitted into substance abuse treatment programs, though only five admissions were prescription drug-related.
One issue for the county could be the lack of an addiction treatment center, Behm said. The McDonald County Health Department refers those who need treatment to rehab centers in Joplin.
“We make the referrals, but the distance can be a hindrance to assistance,” Behm said.
Forty-eight counties and cities have passed measures to join the prescription drug monitoring program. Counties in Southwest Missouri include Vernon, Greene and Jasper. The cities of Joplin and Springfield have passed measures as well.