Jackson County will start a prescription drug database in an attempt to limit the abuse of opioids such as Oxycodone.
County legislators unanimously approved the measure Monday. It takes effect Jan. 1.
Forty-nine states have such a database, so doctors and pharmacists can see all the medications a patient is on, but Missouri does not. The Missouri General Assembly has repeatedly rejected attempts to create one. The county is hiring a vendor to put in place a system to monitor the dispensing of controlled substances.
“So really what the vendor is doing is just pulling data that’s already out there,” said Dr. Sarah Martin-Anderson, professor of health services administration at the University of Missouri-Kansas City and manager of community engagement, policy and accountability with the Kansas City Health Department.
The database would help pharmacists, for instance, spot red flags indicating that patient is doctor shopping to get several opioid prescriptions.
County Legislature Chair Crystal Williams, D-Kansas City, said she expects the county will only have to run the program for a year or two. St. Louis and St. Louis County both have such databases.
“I have faith the state’s going to come forward and do the right thing,” she said.
The county is working with Independence and Kansas City, which have their own health departments, to get the database up and running, though it’s at county expense. Kansas City is on board, and Independence Mayor Eileen Weir said city officials are still getting answers to their questions. The issue has not yet gone to the City Council.
Williams said the program will help medical professionals provide better care. She put the cost to the county at less than $150,000 a year.
There are about 26,000 opioid addicts in Jackson County, and a database would cut that by about 5 percent, said Martin-Anderson.
“That means a PDMD (prescription drug monitoring program) is not a silver bullet to end the opioid crisis,” she said.
But, she added, at 5 percent, that’s 1,500 people in the county who are steered away from addiction each year. Treating an addict can cost $10,000 a year, she said, some of that borne by the public if, for instance, the addict is on Medicaid.
As Martin-Anderson put it, the county is spending $150,000 a year to save $13 million a year in treatment – not to mention the effects that opioid addiction has on crime and worker productivity.
“That’s certainly something I would invest in,” she said.
Martin-Anderson stressed that the database will not interfere with the doctor-patient relationship, a point picked up by Dr. Bridget McCandless, president and CEO of the Health Care Foundation of Greater Kansas City. She noted that many patients get meds from more than one doctor, so a doctor looking at pain medication generally won’t have the whole picture and, out of caution, can be likely to underprescribe pain medication dosages.
Dr. Stephen Glenski, a Kansas City pharmacist, agreed.
“We (patients) could be seeing a lot of different people as well as our primary care” doctor, he said.
Dr. Diane Peterson, Jackson County’s chief medical examiner, said about 100 people a year die in Jackson County from prescription drugs – about 70 of them from opioids.
“So it is significant,” she said.
That’s 13 percent of non-natural deaths in the county, the same number as traffic fatalities, though she noted traffic fatalities get a good deal more media attention. About 16 percent of non-natural deaths are homicides.
The No. 1 opioid concern, she said, is Oxycodone, followed by heroin, hydrocodone and methadone. The biggest number are from ages 46 to 60, and most are men.
“These are adults who have become either addicted or take more than they should,” she said.
After the Legislature approved the database, Williams asked Legislator Dan Tarwater, D-Kansas City, if he wanted to speak about the issue personally. Tarwater lost his brother, Brian, last month.
He choked up but pushed through it and described the toll drugs took on his brother.
“He abused opioids for about 13 years,” he said.
He also said his brother’s death was the type that won’t appear in drug-death statistics because he had recently been clean but the drugs took their toll. The listed cause of death was a heart attack but, Tarwater stressed, it was really about drugs.
“Would this (database) have a made a difference? I don’t know,” he said. “It’s a start.”