JEFFERSON CITY — Thursday brought the latest chapter in a long history of attempts to track and reduce opioid abuse in Missouri.

Sen. Holly Rehder, R-Sikeston, brought a bill before the Committee on Fiscal Oversight that would create a Prescription Drug Monitoring Plan, or PDMP. Missouri is the only state in the U.S. not to have a statewide program monitoring prescription drug use.

Rehder repeatedly pushed for a PDMP program in her eight years as a member of the state House of Representatives. This is her first term in the Senate.

In 2019 a PDMP bill sponsored by Rehder passed in the House, but the bill failed to pass the Senate after being filibustered by the chamber’s conservative caucus. Another version of Rehder’s bill passed the House in 2020, but once again did not pass the Senate in a session shortened by COVID-19.

Rehder has made changes to the proposed PDMP in hopes that it will make the program more palatable for some Senate conservatives.

Unlike previous versions of the program, Senate Bill 63 would not be a tool for law enforcement. And the bill specifically attempts to protect the gun possession rights of those in the opioid databases.

Rather than helping law enforcement, the PDMP would allow doctors and an oversight board to view prescription records of their patients. Proponents hope this would prevent patients from “doctor shopping,” where a patient goes to multiple doctors in the hopes of maximizing the amount of opioids they are prescribed.

“Information is only utilized by medical professional and patients, not law enforcement,” Rehder said.

While this change may end up garnering support for the program from some members of the conservative caucus, other Republicans wished the bill had not been changed.

“I still prefer a law enforcement tool,” Sen. Bill White, R-Joplin, said.

White added that he wished the program monitored all prescriptions, rather than just opioids.

Rehder also removed a harsh fentanyl abuse penalty, as a similar penalty was passed in a separate bill in 2020.

It is unclear what impact these changes will have on the positions of senators who have historically opposed a PDMP.

When he was a member of the House, Sen. Mike Moon, R-Ash Grove, objected to the program over database security concerns.

“They want to risk the data of all our Missourians?” Moon said in 2019. “I call that a load of male bovine feces.”

Sen. Bob Onder, R-Lake St. Louis, has long expressed doubts about the effectiveness of a PDMP.

“An opioid could be prescribed entirely appropriately but stolen from Grandma or Mom or Dad’s medicine cabinet,” Onder said in 2020. “PDMP is not going to stop that.”

Onder was unavailable for comment on Rehder’s newest bill.

While Missouri does not have a statewide PDMP in place, Rehder noted the success of a PDMP program run by St. Louis County. According to previous Missourian reporting, 75 jurisdictions in the state have joined that program, encompassing 85% of the state population. Columbia is in that program.

“The question is no longer should we have a PDMP in Missouri because we do have one, the St. Louis County program,” Rehder said. “We will keep going until all counties are covered.”

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  • Engagement and outreach, Fall 2021. State Government Reporter, Fall 2020 and Spring 2021. Reach me at, or in the newsroom at 573-882-5700

  • Mark Horvit is the state government editor. Call me at 817-726-1621 with story ideas, tips or complaints.

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