WHAT OTHERS SAY: State needs to end reputation as pill-pushers' paradise

Tuesday, August 5, 2014 | 10:24 a.m. CDT

Missouri’s status as the only state in the nation without a prescription drug database continues to make the state a rich target for pill-mill operators, corrupt doctors and painkiller addicts.

A recent front-page story in The New York Times drew attention to the issue, which was on a back burner after legislation to set up a database was filibustered to death by state Sen. Rob Schaaf, R-St. Joseph, two years ago.

This year, a bill to create a database that would be managed by the Department of Health and Senior Services to monitor prescribed drugs such as OxyContin, Vicodin and Xanax didn’t make it out of the Missouri House.

The Times’ Alan Schwarz wrote that new data suggest Missouri is being targeted by out-of-state drug seekers and sellers who want to buy and sell prescription painkillers without having to mess with a state monitoring system.

Express Scripts, the giant St. Louis-based pharmacy benefit manager, reports that visitors to Missouri get prescriptions filled here far more frequently than Missourians get their prescriptions filled in states that do drug-monitoring, Mr. Schwarz wrote.

As Bob Twillman, deputy executive director of the American Academy of Pain Management said, “I’ve told legislators that I know they want to increase tourism, but not this kind of tourism.”

Missouri can, and should, do better.

More women overdose

Prescription drug addictions destroy families. The number of painkiller prescriptions is off the charts, due in large part to persuasive marketing by the large pharmaceutical companies. The Centers for Disease Control and Prevention said that “enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for a month.”

The drugs are heavy-duty respiratory depressants that make it difficult for the respiratory system to function adequately. The result is that it’s easy to accidentally overdose on prescription painkillers.

They are also highly addictive. The National Institute on Drug Abuse says painkillers can be as addictive as heroin, particularly when smoked or injected. The institute says more people overdose on painkillers every year than on heroin and cocaine combined. It’s a tough addiction to kick, even with professional treatment.

The overdose death rate from prescription painkillers is rising fastest among middle-aged women, the CDC says.

In the past, men killed by heroin or cocaine accounted for most overdose deaths in the United States. But by 2010, middle-aged women taking prescription painkillers accounted for 40 percent of drug overdose deaths.

The rise in female overdose death rates parallels the skyrocketing use of prescribed painkillers. Women’s deaths were about five times greater in 2010 than in 1999, compared to 3 1/2 times greater for men during that same time.

Research shows that women have more chronic pain than men and are more likely to be prescribed higher doses of painkillers and to use them longer.

Doctor shopping

Women are also more likely than men to “doctor shop,” obtaining prescriptions for pain medication from multiple physicians, the CDC says. Doctors have been slow to recognize the problem, continuing to think of drug abuse primarily as a male problem.

The most effective way to stop doctor-shopping and pill-mill exploitation is also the best way to help keep middle-aged women from dying from painkiller abuse: Set up a prescription drug database.

Sen. Schaaf, a family practice physician, said his opposition to the database is about freedom. The drug database would infringe on patients’ personal liberty, he says.

Of course, his opposition makes life easier for greedy doctors and unscrupulous pill-pushers, and more dangerous for drug addicts.

Dr. Schaaf is not opposed to all databases or impinging on the freedom of poor people. He voted in favor of legislation in 2011 that required the state Department of Social Services to set up a database to screen some welfare recipients for drug use.

He also voted last session for a bill that would have required the state Division of Workers’ Compensation to develop and maintain a database allowing employers access to workers’ compensation records.

So much for freedom, eh, Dr. Schaaf?

Missouri doesn’t need the reputation as a pill-pusher’s paradise. It’s time to enact a prescription drug database.

Copyright St. Louis Post-Dispatch. Reprinted with permission.

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