Greitens signs executive order establishing prescription drug monitoring program for Missouri

(From Gov. Eric Greitens)

Today, Governor Eric Greitens signed an executive order directing the Missouri Department of Health and Senior Services to begin work creating a Prescription Drug Monitoring Program. Through partnerships with private sector leaders, the state will be able to monitor prescribers and dispensers to find and eliminate bad actors in the system.

"We need to be honest and clear about the scale of what we are up against: Opioids are a modern plague," said Governor Greitens. "Like the plague, opioids kill the young, the old, the healthy, the sick, the virtuous and the sinful. There's not a corner of our state that hasn't been visited by this curse. There is no single program, or law, or executive order that can fix this crisis. This program is a step—and it's a big step. Throughout this week, we will outline the other steps we will take to address the opioid crisis. The only thing we won't do is wait. We won’t wait for this problem to get worse. That's not an option.”

More details about the Governor's actions to combat the opioid crisis will be available throughout the week. That schedule is below. This executive order has garnered praise from national leaders.

“I’m glad to see Missouri is launching its statewide prescription drug monitoring program,” Richard Baum, Acting Director of National Drug Control Policy, said. “In the context of both the ongoing opioid epidemic and the health of Missourians, it’s vital to have safeguards in place to make sure that doctors aren’t overprescribing opioids that can be misused and patients aren’t doctor-shopping for multiple prescriptions that could be misused or diverted.”

"I commend Missouri Governor Eric Greitens for taking a strong step in fighting the opioid epidemic by joining other states in establishing a Prescription Drug Monitoring Program (PDMP),” said Secretary Tom Price of the U.S. Department of Health and Human Services. “I commend Governor Greitens for his leadership in Missouri as we all work to detect and deter the abuse of prescription drugs.”

This Prescription Drug Monitoring Program will utilize de-identified data from private sector partners to specifically target "pill mills" that pump out prescription drugs at dangerous and unlawful levels. It will also enable the Department of Health and Senior Services to better inform doctors, nurses, pharmacists, other healthcare providers, and patients and their families about best practices in pain management to decrease over prescriptions of opioids.

Text of Executive Order 17-18 is included below.

Tuesday, July 18—Preventing Overdose Deaths
9:30 AM
​NCADA
9355 Olive Blvd,
St. Louis, MO 63132
Media should RSVP to parker.briden@governor.mo.gov

Wednesday, July 19—Combating Drug Traffickers
1:30 PM
Cape Girardeau Regional Airport
860 Limbaugh Drive,
Cape Girardeau, MO 63701
Media should RSVP to parker.briden@governor.mo.gov

Thursday, July 20—Opioid Summit: Treating Addiction in Rural Missouri
8:00 AM
John A. & Genny Morris Conservation Center, White Room,
600 W Sunshine Street,
Springfield, MO 65807
Media should RSVP to parker.briden@governor.mo.gov. Additional details on the Opioid Summit will be available from the Department of Health and Senior Services soon.

Friday, July 21—Treating Addiction in our Cities
The Governor will be in the Kansas City region on Friday, July 22 to discuss the impact of drug courts on addiction treatment. Details on this event are forthcoming.

EXECUTIVE ORDER

17-18

WHEREAS, the Centers for Disease Control and Prevention has declared a national opioid epidemic, which poses a grave danger to Missouri; and

WHEREAS, Missouri is facing a public health crisis of epidemic proportions from the unlawful distribution and misuse of opioids (“Opioid Public Health Crisis”); and

WHEREAS, one cause of Missouri’s Opioid Public Health Crisis is the overabundance of prescription opioids, with evidence showing that at least half of opioid overdose deaths involve prescription opioids.  In Missouri, there are approximately 89,000 prescriptions for narcotics for every 100,000 Missourians; and

WHEREAS, Missouri’s Opioid Public Health Crisis is impacting Missouri families and communities every day.  It is estimated that two Missourians die from narcotic overdose and two babies are born with narcotic withdrawal every day somewhere in Missouri; and

WHEREAS, in 2016, more than 900 Missourians died from an opioid overdose; and

WHEREAS, deaths that are the result of opioid overdose are preventable; and

WHEREAS, Missouri’s Opioid Public Health Crisis is overwhelming law enforcement, health care, and social services providers; and

WHEREAS, Missouri is the only State in the country that does not have a system to monitor prescription drug activity; and

WHEREAS, despite Missouri’s Opioid Public Health Crisis, the 99^th General Assembly failed to pass legislation instituting a prescription drug monitoring program; and

WHEREAS, Missouri’s Opioid Public Health Crisis necessitates the marshalling of all appropriate resources to combat the harmful effects of opioids on Missouri families and communities.

NOW THEREFORE, I, ERIC R. GREITENS, GOVERNOR OF THE STATE OF MISSOURI, by virtue of the authority vested in me by the Constitution and laws of the State of Missouri, hereby declare, order, and direct the following:

1.     The Department of Health and Senior Services (“DHSS”) shall implement a multi-phase prescription drug monitoring program (“PDMP”). 

2.     To implement the first phase of the PDMP, DHSS shall enter into contracts with pharmacy benefit management organizations to analyze prescriber and pharmacy prescription and dispensing data for schedule II-IV controlled substances, which includes opioids. 

a.      DHSS shall use the analyses for the purpose of identifying activity indicating that controlled substances are being inappropriately  prescribed, dispensed, or obtained; investigating such activity; and making referrals regarding such activity to appropriate government officials, including law enforcement and professional licensing boards. 

b.     Prescription and dispensation information received by DHSS shall be confidential and shall be disclosed only as provided by section 195.042, RSMo.

3.     For the second phase of the PDMP, DHSS shall promulgate a rule pursuant to Chapter 195, RSMo, requiring dispensers to submit controlled substance prescription and dispensation information to DHSS or its designee for the purpose of identifying activity indicating that controlled substances are being inappropriately obtained, prescribed, or dispensed; investigating such activity; and making referrals regarding such activity to appropriate government officials, including law enforcement and professional licensing boards.  Prescription and dispensation information shall be confidential and shall be disclosed only as provided by section 195.042, RSMo.

4.     Finally, DHSS shall work with private companies, government entities, or others to purchase and utilize innovative technology and software to effectively and efficiently monitor controlled substance prescription information sent to DHSS or its designee under a prescription drug monitoring program.  Prescription and dispensation information shall be confidential and shall be disclosed only as provided by section 195.042, RSMo.