Last month, Gov. Eric Greitens issued an executive order to create a statewide prescription drug monitoring program-or PDMP. Missouri is the last state to establish one, but it’s not for a lack of trying. For years State Rep. Holly Rehder pushed for legislation to create one, but her attempts fell short. Rehder says while there is still room to improve the program, it’s a necessary step in the right direction. KRCU’s Marissanne Lewis-Thompson spoke with Rehder about it.
On her reaction to Gov. Eric Greitens executive to create a prescription drug monitoring program
Rehder: I was very excited that we are focusing on the issue. That we have an executive branch who cares about this epidemic, a governor who wants to do something--to not wait and wait and wait. Because we tried to get this through the legislative process. It is very different than the bill that I've been pushing and the program that I've been pushing. In that this is an additional layer. It's not a substitute for the program that I've been working on. And what this attacks is--is it looks at the prescriber. So something that's very much out of the box thinking--very new. I don't know that there's another state doing this, and I've been working with all the states for this. [It] is my fifth year now. So, what it does is it's going to look at the pharmacies. It's going to look at the prescribers, the physicians and that way they'll be able to detect where the pill mills are. Where scripts [prescriptions] are being egregiously written and passed out. And so, then that can be handled from [the] board getting someone regarding their license to prescribe. So that's an area that we haven't looked at. Definitely needs to be looked at. Pill mills are very difficult for those with addictions, because it is easier for you to go there and get those medications. Not all pain clinics are pill mills. There are many pain clinics in our state that are very helpful, very cautious with their patients, very caring with them. But we do have pill mills and even in the Bootheel we have pill mills that people, you know, stand in line for hours to get their medication--to get their scripts. Those do need to be controlled. They need to be looked at and brought to justice and so that is very important. That is what the governor's executive order will do. So it's a wonderful additional layer--a cross check to the traditional PDMP. But the traditional PDMP, the one that I've been fighting for and will continue to fight for is a clinical tool. It allows the physician and the pharmacist to actually see their patients narcotic information.
On why prescription drug abuse hits home for her
Rehder: I was raised very poor on welfare. Lots of men in and out of the home. But one of my stepdads was a dealer. And my sister was an addict by the time she was 16. She married a dealer at 16. My cousin died at 39 from long term opioid abuse. That was common place in my life. I grew up around drugs. It was common place. I didn't do them. I was afraid of them, because I wanted to be very conscious of everything going on around me as a child to be able to protect myself. But I had to quit school at 15 to help take care of my family. And by the time I was 16, I was married, pregnant and a high school dropout. And so, you know I looked at my life and said I want to do something different. I don't want to raise this child in the same atmosphere that I grew up in. And so, I raised her in church. I went to work. I worked hard--multiple jobs and got my GED. Started taking college classes at night and on the weekends and I raised my kids in church. You know two parent home. Mom up in their business all the time. That knows what addiction looks like. I know what drugs look like. And you know, I'm that crazy mom that has my kids when they come in at night they have to come in and wake me up and kiss me goodnight just so I can smell and see if they have alcohol on their breath. I do random drug testing in my house.
And at 17, my daughter cut her thumb open at work opening a bag of okra. [She was a] hard worker. She was already accepted into SLU's [University of Missouri-St. Louis] physical therapy program. I mean bright child. And went to the emergency room to get it stitched up and they gave her a script of Lorcets. Now I don't know when they quit giving Tylenol three’s or you know those kinds of things that it seems like now it's so easy to get a script of pain killer. Anyways, she's 31 now. She was 17. So it's been years ago. And when she finished that bottle, and scientifically it is proven now that someone that had [a] substance use disorder can become addicted within 1-7 days of being on an opioid. So when she finished her prescription she just started purchasing them at work. And then when she got to where she was taking so many she couldn't afford them anymore, she switched to meth. And so, we went through 13 years of in and out of rehabs, prison, my grandson being born with opioids in his system and me having custody of him.
I spent many weeks not knowing if my child was alive. Because of course they don't come home anymore. They stop coming home and they live in God only knows what. And as a mom, you're wondering 'what did I do wrong?' I tried to do all of these things. But after all these years, I've studied this for so long now and working so closely with the medical community and the mental health community. My mother struggled with mental health my whole life and so I'd been around that, but I never really realized that it's a brain disease. And so, it's scientifically proven now that addiction is. It's no different than if you have heart disease and you insist on still being a smoker. That's an addiction and it's harming you. But there's so much stigma around drug addiction that you know there's so many parents that worry and wonder 'well what did I do wrong.' And they're embarrassed. They don't want to reach out for help and then a lot of times it really separates them and their child, because they think that their child is doing this against them. You know they're going against how they were raised. My daughter was certainly going against how she was raised. But I know now that their body begins becoming very sick and it's very hard to get through that clean phase. But then once they get clean, there's all of these mental triggers--emotional triggers that move them back into drugs. We get Rachel [her daughter] clean many times. But without the mental health component to that they don't learn how to manage it. And so they go back into it. And she's been clean for just over three years now. And what we did differently was we were able to get her into a longer term treatment that had that mental health component with it, which is so important.
On why the prescription drug monitoring program is not the end all to the problem
Rehder: The most important aspect of a PDMP is for that physician to be able to see what is going on in their patients narcotic history. You need to have those conversations with your physician whom you trust in your physician's office. They can help point you to places to get help. To me that's the most important part. Our physicians must have access to their patients information. So, while this is wonderful and I cannot thank the governor enough for stepping forward and doing something and saying 'okay this is something we can do. Let's take this first step.' We definitely must continue with the county effort giving our physicians-- our medical community the information that they need to make these important clinical decisions. Without that we're not going to pull those drugs back off the streets, and law enforcement is still going to be completely underwater when it comes to trying to get the drugs off the street. So this is allowing physicians to have access [to me] is the cornerstone in my opinion.