Calling it "a modern plague," Missouri Gov. Eric Greitens implemented a prescription drug monitoring program by executive order Monday, bypassing the legislative process.

The order aims to help address the opioid epidemic that killed more than 900 Missourians last year.

The monitoring program could be operating within a month, Missouri Department of Health and Senior Services director Randall Williams told The Associated Press.

State Rep. Holly Rehder, R-Sikeston, called it "really innovative," but added it won't replace the need for a comprehensive drug monitoring program such as the one she has proposed.

Holly Rehder

Rehder said the governor's program will analyze prescription and dispensing data but will not provide a database doctors can check to see whether patients are "pill shopping" and have obtained prescription painkillers from several doctors.

Doctors need to see a patient's narcotics history to combat addiction as with other states, she said.

Rehder said the governor's program also will not replace the St. Louis County-directed monitoring program that has been joined by several other counties and cities. That program provides a prescription database that encompasses about 60 percent of Missouri's population, Rehder said.

Greitens signed the order after a news conference at Express Scripts, the St. Louis-based online pharmacy benefits manager that will help provide data analytics, The AP reported.

According to a news release from the governor's office, the Health and Senior Services department will use the analyses to identify whether controlled substances are being inappropriately prescribed, dispensed or obtained.

The agency will investigate such activity and make referrals to "appropriate government officials including law enforcement and professional licensing boards."

For many years, Missouri has been the lone holdout without a statewide program that tracks prescription drug scripts.

The announcement surprised lawmakers who failed to send the governor legislation this year to implement such a program.

Democrats questioned whether the order goes far enough while some Republicans expressed concerns about privacy, according to The AP.

State Reps. Kathy Swan and Donna Lichtenegger also questioned the governor's action.

Every other state in the nation has a statewide prescription drug database, but that has not stopped the drug epidemic in those states, Lichtenegger, R-Jackson, said.

Donna Lichtenegger

Lichtenegger voiced concern about creating another government program, suggesting she would prefer to let pharmacy associations police the matter.

"I am all about smaller government," she said.

She blamed insurance policies for part of the opioid problem, contending such policies often lead doctors to prescribe painkillers for a longer period of time than they otherwise would.

Swan, R-Cape Girardeau, said a prescription database "has its limitations."

Kathy Swan

It may prevent some people from obtaining addicting painkillers, but in doing so, it will lead to more addicts using heroin, Swan said.

"It is strictly a tool, but a tool without action," Swan said of the governor's proposal to establish a database.

Swan said she has pushed for several years now for the state to adequately fund the Bureau of Narcotics and Dangerous Drugs to enforce existing drug laws.

About 30,000 pharmacists, veterinarians and doctors who deal with prescription narcotics pay an annual fee designed to fund the bureau, she said.

The state collects $870,000 a year from the fee, Swan said. But the bureau has seen its number of investigators decrease from nine to two and its budget drop to $200,000, she said.

Swan said she doesn't know what the rest of the fee revenue is spent on.

Swan said she has been pushing to strengthen the bureau for two or three years, without success.

Reducing the supply and demand for addicting painkillers is essential to addressing the opioid problem, Swan said.

mbliss@semissourian.com

(573) 388-3641