There seems to be no disagreement that Camden County is experiencing an opioid crisis. Where the disagreement comes into play, is what to do about it.

There seems to be no disagreement that Camden County is experiencing an opioid crisis. Where the disagreement comes into play, is what to do about it.

Some support Camden County taking part in the St. Louis County Prescription Drug Monitoring program that many counties across the state have joined.

Others, worried about privacy issues and citing a lack of effectiveness in PDMP’s would advocate waiting on the Missouri legislature to take some action.

A PDMP is an electronic data base that tracks who opioids are being prescribed to and how frequently.

According to information from from the National Institute on Drug Abuse, opioids are a class of drugs that include the illegal drug heroin, synthetic opioids, such as fentanyl, and pain relievers available legally by prescription such as oxycodone, hydrocodone, codeine, morphine and others.

Opioid pain relievers are generally safe with taken for a short time and as prescribed by a doctor but because they produce euphoria in addition to pain relief, they are easily misused. Regular use, even as prescribed by a doctor can lead to dependence and, when misused, can lead to addiction, overdoses and deaths.

Camden County Sheriff Tony Helms said the opioid problem continues to grow. The department has recently move forward with a plan to equip their road deputies with Narcan, a drug to combat overdoses. The Camden County Commission had been considering the PDMP but withdrew from discussions after running into opposition from some residents who are not in favor of a monitoring program.

Camdenton and Sunrise Beach have already passed an ordinance to participate. Osage Beach and Lake Ozark were discussing the PDMP. However, to enter the program, there has to be a county-wide ordinance. Without the county ordinance, any action by the municipalities is a mute point. Missouri is the only state in the nation without a drug monitoring program.

Although the effectiveness of the programs varies, they all require doctors and pharmacies to enter prescriptions into a database. The monitoring programs are intended to stop patients from being able to doctor sip by bouncing from one prescriber to another to get painkillers.

St. Louis County established a regional drug monitoring program in 2016. A growing number of counties have joined St. Louis County’s program.

Following a town hall meeting late last week, the commission is not planning on taking any action at this time.

According to Presiding Commissioner Greg Hasty, after listening to the presentations made during the town hall meeting by lake area resident and realtor Stacy Shore and Missouri State Rep. Keith Frederick, R-Rolla, who has sponsored a bill aimed at curbing the opioid issue, the county will wait to see what happens in the state legislature.

Based on the information provided by Frederick, Hasty said it appears the issue is being addressed at the state level at this time.

“We need to see what the Missouri state legislature does,” Hasty said.

However, time is running out for the legislature. The legislature adjourns at the end of this week and the funding for the bill was not included in the state’s budget that has been approved by the House and Senate.

Frederick, a physician and former pharmacist, introduced House Bill 2105, that would, among other provisions, put a 7-day limit on new opioid prescriptions, increases awareness with a voluntary pledge for physicians, improves access to treatment for addicts and expand drug take back efforts.

The bill, House Bill 2105, passed the Missouri House and is currently in the Senate. The legislature adjourns at the end of this week. If the bill were to pass the Senate, it would still face the challenge of funding. The bill carries a price tag of approximately $33 million. The informal town hall meeting last week at the Camden County Courthouse drew a crowd of about 60. The audience was a mixture of residents, local officials, law enforcement and health providers who spoke openly about their feelings of proposed prescription drug monitoring.

Of those in attendance, it was clear that healthcare professionals and law enforcement officers who see the effects of the drug crisis each day, were strongly in favor of the monitoring.

Lake Regional Health System CEO Dane Henry and a group of physicians voiced their advocacy of such monitoring, citing overdoses and how the issue makes it harder for the hospital to recruit.

Among the physicians who spoke was Lake Regional’s Becky Watson, who has been an OBGYN for 25 years. She said 25% of her female patients come up with a positive drug screening. Many are using altering drugs and having unplanned pregnancies, due to opioid use.

Watson said that she and her staff spend 9 months working to help these women and there being born with withdrawal symptoms. The babies spend their first weeks of life addicted. Watson would like the ability to see if her patients are getting prescriptions from different sources as it would be helpful in treating not only the women, but the babies they are carrying.

Camden County resident Ike Skelton spoke in opposition. Skelton said it is not the government’s responsibility to “protect me from me.” He compared PDMP to gun control. And, he talked about privacy and having information that could be hacked.

The opposition of the monitoring focused on their fear of invasion of privacy and possible violation of their rights.

Shore and Frederick both gave detailed presentations opposing the program.

Shore's presentation included references to the 4th Amendment of the United States Constitution and the 19th Amendment of the Missouri Constitution.

Representative Dr. Frederick, focused on speaking about his house bill 2105 and why he no longer supports the drug monitoring program. Frederick's slide show presentation drew some questions from Lake Regional physicians. Frederick is currently running for the state senate seat being vacated by Dan Brown.

Following the forum, Henry said "As the largest provider of health care services in the area that also works collaboratively with other health care providers, public health, law enforcement and emergency management services, we support a prescription drug monitoring program for Camden County.”

“Collectively, we are facing a devastating public health and safety crisis that daily impacts our ability to advance the health and well-being of our patients and the quality of life in this community. Nationwide, PDMPs are supporting patient and health care worker safety and helping to ensure clinically appropriate prescribing. City leaders within Camden County recognize this, and we appreciate their support."

According to Lake Regional Emergency Department statistics, in 2017 there were 107 overdoes-related deaths. So far, in 2018 there have been 28 overdose-related deaths.

It’s also a workforce issue that impacts economic development in the region. Lake Regional Occupational Medicine serves area businesses and is the largest provider of pre-employment drug testing in the area.Currently, 1 in 10 individuals fail pre-employment drug screens and this number does not include individuals with valid prescriptions.

According to a recent report by the Associated Press and St. Louis Post Dispatch, St. Louis County's program launched last year to track prescriptions of opioid painkillers, muscle relaxants, stimulants and other legal drugs with a potential for abuse. Nearly 60 other Missouri cities and counties have since joined the program.

More than 6,600 doctors and pharmacists are registered to access the database of patients' prescription drug histories, but county officials said that's fewer than half the physicians and pharmacies statewide.

The program has flagged nearly 14,000 instances in which someone filled three different prescriptions at three different pharmacies in a span of six months. Officials said the alerts indicate possible doctor-shopping and drug abuse.

Pharmacists and doctors can look up a patient's history to check for the drugs prescribed, by which provider and in what amounts over a certain time period. Doctors can also check their own records to find any fraudulent prescribing under their names.

The most frequently prescribed opioids are hydrocodone, oxycodone and tramadol. The drugs are prescribed in the county for an average of 16 days, according to county officials.

Between 700 and 800 people died in the St. Louis area last year from opioid overdoses, officials said.