CARTHAGE, Mo. — Jasper County could become the latest local government in Missouri to take the threat of opioid abuse into its own hands.
Members of the Jasper County Commission expressed support on Tuesday for a prescription-drug monitoring program, an electronic records-sharing system that would make it more difficult for patients to obtain extra opioid medications by jumping from doctor to doctor, a practice known as “doctor shopping.”
The PDMP would flag patients who attempt to fill at least three prescriptions for controlled drugs, such as oxycodone and fentanyl, in three months.
A growing number of cities and counties in Missouri are taking an end run around the state Legislature, the only one in the country that has not adopted the a statewide PDMP. The 28 local governments that currently monitor drug prescriptions form a belt stretching across the middle of Missouri and into the boot heel. As a border county, and one of the most populous in Southwest Missouri, Jasper County would be a significant prize for PDMP advocates.
Commissioners said it would be a boon for the county, which has seen 85 deaths from opioid overdoses since 2009, according to the county coroner.
“I’d like us to keep pressing forward,” said Darieus Adams, western district commissioner. John Bartosh, presiding commissioner, also voiced support.
County officials now must hammer out the details of the policy. It will be reviewed first by the county prosecutor, who would be responsible for enforcement if the final ordinance includes a fine for pharmacists who fail to submit prescription data.
If adopted, the PDMP wouldn’t be activated until late this year, according to Tony Moehr, director of the Jasper County Health Department. It would become part of a patchwork system that began with St. Louis County, which left the door open for other local governments when it started its PDMP in 2016.
The cost to join would be $5,180 for Jasper County, compared to $445 for Newton County, based on the number of prescribers living within their county borders. Like the Missouri counties that have already joined, Jasper County would use software produced by Aperis, which runs PDMPs across the country.
Tom Flanigan, eastern district commissioner, spent the last eight years in the state legislature as a state representative. A supporter of a statewide PDMP, he says the policy stands a better chance of passage next year, particularly if more local governments adopt it on their own.
“As more support for that type of ordinance comes about, it’ll put pressure on the Legislature,” he said.
Opposition in the Missouri statehouse has stemmed largely from concerns that the program would create a database of medical information that posed a threat to privacy.
Moehr says the data used by the PDMP is already stored in the patient’s medical records, and would still be subject to laws limiting the disclosure of information about the health of individual patients.
Jasper County Sheriff Kaiser told commissioners on Tuesday that he supports the drug monitoring program, saying most of the overdoses he’s seen during more than two decades in law enforcement have been caused by prescription drugs.
“Anything we can do to stem the tide (of prescription drug abuse) is worth doing,” he said. “I think it’s a minimal intrusion.”
Neighboring states have complained that the Legislature’s inaction has made it easy for doctor shoppers to fill illicit prescriptions across the border in Missouri.
Sarah Baker, a pharmacist at Pronto Pharmacy in Webb City, says she regularly turns away customers from Arkansas and Kansas who have come to the Joplin area to fill a third or fourth prescription. As a licensed pharmacist in those states, she can access their prescription databases. But she doubts other pharmacists can do the same.
“I’m sure they’re going to different places in Missouri,” she said. “We just can’t track it.”
She says a prescription drug monitoring program in Jasper County “would be very helpful,” and that she had not had any trouble using systems from other states.
Support for the policy has grown in Joplin area in recent months. Health officials from St. Louis County visited Newton County last month to discuss it, and officials there are preparing to vote on an ordinance.
In Joplin, a citizen planning commission recently included a municipal PDMP among its recommendations to the City Council.
Jasper County officials discussed the possibility of a cost-sharing agreement with Joplin, which holds over a third of the county’s population. A county PDMP would cover all cities within the county, including most of Joplin, as well as unincorporated areas.
Dan Pekarek, director of the Joplin Health Department, said the city is still exploring the policy. No city ordinance has yet been introduced, and Pekarek said it is too early to know if the council would be open to a cost-sharing agreement.
More people died from drug overdoses in 2014 than in any year on record, and the majority of drug overdose deaths (more than six out of 10) involved an opioid, according to the U.S. Department of Health and Human Services. Since 1999, the rate of overdose deaths involving opioids — including prescription opioid pain relievers and heroin — has nearly quadrupled, and over 165,000 people have died from prescription opioid overdoses.