Details of a recent $1.51 million federal court settlement involving a Creve Coeur pharmacy underscore why dithering and delaying by the Missouri Legislature over creating a prescription drug monitoring program contributed needlessly to addictions and possibly even deaths.

The pharmacy involved filled improper fentanyl-based painkiller prescriptions that helped feed the state’s deadly opioid epidemic. By the time Missouri’s drug-monitoring program went into effect recently, the damage was already done.

The U.S. Attorney’s Office for the Eastern District of Missouri announced last Monday that it had reached a civil settlement with pharmacy technician Irina Shlafshteyn and Olive Street Pharmacy related to the unlawful dispensing of controlled substances, including fentanyl. It appears some of the unlawfully dispensed drugs were billed to Medicare and Medicaid.

There were clear red flags that prescriptions were being abused to feed recreational users and addicts, but the pharmacy kept pumping out the pills.

It’s exactly this scenario that prescription drug monitoring programs around the country are designed to expose. But Missouri lawmakers insisted year after year on making this the only state in the country without a monitoring program.

A handful of lawmakers argued baselessly that such programs threaten patient privacy. Their dithering kept the door open for opioid addicts to hop from doctor to doctor in hopes of getting prescriptions filled to feed their habits, or for corrupt doctors and pharmacies to profit off others’ addictions.

In the Olive Street Pharmacy case, prosecutors argued, pharmacists should have recognized clear signs that prescriptions had been altered and that opioid prescriptions exceeded the federal dosage guidance by as much as 17.5 times.

One Missouri doctor mentioned in the case, Philip Dean, a Warrenton neurologist, repeatedly wrote prescriptions for women “whom he had lived (with) and with whom he had had personal relationships,” the U.S. Attorney’s Office stated.

Shlafshteyn and the Olive Street Pharmacy should have recognized the odd pattern exhibited by Dean’s behavior, yet they continued to fill his patients’ prescriptions.

Even though Missouri has been singled out for years as the only state without a prescription drug monitoring program, it wasn’t until last June that Gov. Mike Parson finally received a bill to create a statewide program. He signed it, and now, thankfully, it’s law.

But it never should have taken this long. Had the GOP-dominated legislature recognized the problem sooner and acted upon it, rather than waited for local governments such as St. Louis County to adopt their own programs, thousands of lives might not have been ruined by ongoing opioid abuse and addiction.

The heavy price now being paid by pharmaceutical professionals in Creve Coeur should serve notice to others that Missouri is no longer asleep at the wheel and that serious consequences could be in store for anyone contemplating generating storefront commerce off others’ addictions.

This was first published by the St. Louis Post-Dispatch and is reprinted with permission.


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