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St. Louis County expands prescription drug monitoring resources

Opioid epidemic

A man addicted to opioids suffers from painful withdrawal symptoms in the waiting room on Friday, Jan. 3, 2020, at the Assisted Recovery Centers of America, or ARCA, clinic in downtown St. Louis. Photo by Laurie Skrivan, 

BERKELEY − St. Louis County’s prescription drug monitoring program has been expanded to help physicians evaluate how often they prescribe opioid painkillers compared to best practices and also identify and access resources for addicts.

“We really want the opportunity to use this information at the point of decision-making to help providers who are partners in the PDMP to continue to make good choices about their care,” Spring Schmidt, director of the St. Louis County Department of Public Health, said Wednesday at a press conference.

The program is a database used by doctors and pharmacists to help ensure that somebody isn’t shopping around for addictive opioid painkillers, such as oxycodone and hydrocodone.

Though it’s been debated for years, Missouri is the only state in the country that doesn’t have a statewide monitoring program. St. Louis County started its program in 2017. With 75 jurisdictions in Missouri choosing to participate, the county’s program now covers about 85% of the state’s population and 94% of providers, officials said.

One of them is Evan Schwarz, an emergency room physician at Barnes-Jewish Hospital who attended the press conference. He said the database helped him identify “easily more than 100” patients who showed red flags for opioid use disorder.

“It let me have that conversation with the patient and be very objective and say this is what I see and this is why I am concerned,” Schwarz said. “Beforehand, I would kind of have to guess and draw conclusions based on behavior, which may or may not be correct.”

He said new information added to the database will help him find places to refer patients in the community for additional treatment. But access to care is still a challenge.

“Even though that’s gotten better with some of the tools we have in the St. Louis area, not everybody has access to get people into treatment within two to three days,” he said.

Ben Westhoff, a local author of “Fentanyl, Inc.,” a new book about the synthetic opioid at the center of the epidemic, said it’s good that the county expanded its monitoring program but the overprescription of painkillers is no longer driving the crisis.

“The opioid crisis is increasingly being fueled by fentanyl, which is being cut into drugs like heroin, black market prescription pills, meth, cocaine,” he said.

St. Louis County had 307 opioid-related deaths in 2018, up from 236 the previous year. St. Louis city had 315 deaths in 2018, up from 254.

In 2018, there were about 300 nonfatal overdoses reported each month in St. Louis and St. Louis County, which public health officials say is a good predictor for mortality. Next month, St. Louis County will begin tracking people who were treated in the emergency room for overdose.

St. Louis County Executive Sam Page said a caseworker will try to offer them the help they need, such as naloxone, the overdose reversing drug commonly sold as Narcan.

“Getting Narcan in the hands of family members of someone who is likely to overdose is the single best thing you can do,” Page said. “And then getting them referred to treatment.”

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