Even as America reels from a wave of prescription drug abuse, largely involving opioids, that has reached epidemic levels, only one state continues to refuse to provide a prescription drug monitoring program (PMDP) — Missouri. And the reason could be traceable to the darkly Darwinian philosophy of a single Republican state senator.
"If they overdose and kill themselves, it just removes them from the gene pool," said State Senator Rob Schaaf in 2012 after successfully filibustering an earlier version of a bill to establish a prescription drug database.
Schaaf's threat to repeat his 2012 filibuster has thwarted attempts by other Missouri legislators to establish a monitoring program over the past six legislative sessions. Although Schaaf is a physician himself, he has opposed creating a PDMP by claiming that it would violate privacy rights. As recently as last year, Schaaf claimed that PDMPs "don’t work. And it’s an infringement upon people’s privacy. Most people don’t want the government to have that information and have it on a database in which many people can get it."
Instead, Schaff has proposed an alternative bill that would require doctors to send the names of patients who request painkillers to the state health department, which would in turn notify medical professionals of a history indicating abuse. This is in contrast to the databases in other states that provide medical professionals with direct access to each patient's narcotic history, which may explain why the Missouri State Medical Association opposes Schaaf's proposal.
Larry Pinson, a board member for the National Association of State Controlled Substances Authorities, told STAT News that Schaaf's plan winds up "charging [the bureau] with making a medical decision and that doesn’t make any sense to me. How are they going to know if there is a true medical reason for that patient to need a narcotic?"