Audrain County Health Department Advocates New PDMP

To help fight a nationwide epidemic in the abuse of addictive pain medications, the Audrain County Health Department (ACHD) recently began the process of establishing a computerized PDMP ordinance-based system to monitor the sale of certain prescription drugs. Currently, Missouri is the only state in the U.S. without a Prescription Drug Monitoring Program (PDMP). The drugs to be included in the database range from highly addictive painkillers, such as oxycodone and morphine, to less harmful drugs like diazepam, more commonly known by the brand name Valium.
Audrain County Ordinance No. 1332-030817 establishes and authorizes the operation of a Prescription Drug Monitoring Program, with Audrain as a subscribing county of the Saint Louis County Department of Public Health’s (DPH) State database. The Audrain County Prescription Drug Monitoring Program (or PDMP), monitors the prescribing and dispensing of Schedule II through IV controlled substances to assist in the identification and prevention of prescription drug misuse and abuse.

“The program’s goals are to, one, improve controlled substance prescribing by providing critical information regarding a patient’s controlled substance prescription history, two, inform clinical practice by identifying patients at high-risk who would benefit from early interventions, and, three, reduce the number of people who misuse, abuse, or overdose while making sure patients have access to safe, effective treatment”, states ACHD & PDMP Administrator Sandra Hewlett.

ACHD Board of Health Chair Faye Fairchild says the ordinance will allow pharmacists to help stop doctor-shopping.
“Under the Audrain County PDMP, pharmacists will be able to access the St. Louis County Department of Health’s PDMP database for the State of Missouri,” she said. “The pharmacist will use specialized software to ensure it is appropriate to fill prescriptions for Schedule II, III, and IV controlled substances, or the pharmacist will contact the prescribing physician if he/she has a concern.”
Drug overdose deaths and opioid-involved deaths continue to increase in the U.S., and account for 91 opioid deaths each day, according to the Centers for Disease Control. CDC officials also say the majority of drug overdose deaths (more than six out of 10) involve an opioid. The data also points out that since 1999, the number of overdose deaths involving opioids (including prescription opioids and heroin) has quadrupled, and from 2000 to 2015, more than half a million people died from drug overdoses (CDC, 2017).

Pharmacists and physicians will use the database to determine whether patients are getting multiple prescriptions to supply a drug habit.
Mexico Orthopedic Surgeon Doctor Kathleen Weaver, who is also a member of the Audrain County Health Board, says an ordinance such as this is a stride to improving the community as a whole.

“I’m happy to see the health department is going to tackle a true public health problem with this piece of legislation,” she said. “This program will help improve the public’s safety.”

Eighteen counties have now passed health department-driven PDMP ordinances with several dozen more county health departments in Missouri moving forward with PDMP ordinances. Repeated efforts to establish a statewide registry in Missouri have failed to pass the General Assembly for more than a decade, although all of the other 49 states have already passed PDMP laws.

“We’d like to recognize public health for putting together this ordinance,” Audrain County Presiding Commissioner Steve Hobbs said. “We would have liked to have seen it taken care of at the state level, but their inaction led to public health agencies getting involved and getting these ordinances passed (at the local level) to help protect the citizens of the county.”

The Audrain County Health Department’s PDMP received broad support from physicians, pharmacists, SSM St. Mary’s Audrain clinicians and leaders, law enforcement, and many other groups, as the opioid drug epidemic is having an adverse impact on Audrain County, too. The Audrain County Board of Health approved the PDMP ordinance proposed by the Audrain County Health Department on Wednesday, April 12, 2017, after an Open Town Hall Meeting was held. The PDMP ordinance was then forwarded to the County Commissioners for their review and approval. The County Commissioners unanimously approved the ACHD-proposed PDMP ordinance on Thursday, April 20, 2017. The PDMP will become effective in Audrain County on July 1, 2017, in Audrain County. The annual PDMP program cost is nominal and will be covered by the ACHD. The PDMP specialized software is currently being used by several of the 49 states with statewide monitoring programs.

If you have any questions or for more information, contact Hewlett at the ACHD at 573-581-1332.