About 15 miles southwest of St. Louis, is Fenton City Park. It’s pretty unremarkable, with picnic shelters, softball fields, and flags waving gently from a memorial to fallen soldiers. It's also where Kevin Mullane sought refuge as he struggled with an opioid addiction.
"Anybody that knew Kevin knew he loved Fenton Park," Kevin's mother Kathi Arbini said, recounting how her song became increasingly isolated. Mullane turned to prescription opioids to deal with depression. He eventually started stealing medications from friends and family members, and doctor-shopping for more.
Arbini said, "He went to this doctor for back ache, and then he went to this doctor for foot ache, and then he went to this doctor because he was depressed, so he had all these doctors working against each other."
In November of 2009, at the age of 21, Mullane died of a heroin overdose in a friend’s basement. Arbini later found out, at the time, he had nine prescriptions from different doctors. But there was no state-wide prescription drug monitoring program or PDMP, then to keep track. And there still isn’t: Missouri is the only state in the country without a state-wide PDMP.
At the state capitol, which is currently under renovation, House Bill 188 is the latest effort to create a state-wide program. It’s sponsored by Republican state representative Holly Rehder, and it’s her sixth attempt. Rehder said, "I’m absolutely concerned that it might not make it through this year, but I’m more hopeful than ever."
In the past, the main opposition has come from within Rehder’s own party, and one man in particular. Senator Rob Schaaf filibustered the bills, saying they infringed on patients’ privacy rights. "I’m someone who’s very concerned about privacy as well, and I don’t like government databases, but this is very much different from that, it’s a medical tool."
But Schaaf ran up against a term limit last year, and the man who replaced him is now set to carry the bill through the senate. Supporters also hope to get some leverage from a drug monitoring program St. Louis County started in 2017. It was largely created to sidestep the years of gridlock in the Senate. More than 70 jurisdictions have joined, but it does not reach more than 50 others.
Family-owned Sam’s Health Mart is in Randolph county – one of the places that hasn’t joined the St. Louis County program. That means pharmacist Annie Eisenbeis has to take matters into her own hands. "If I suspect that somebody is abusing or misusing the medication, I will call all of the neighboring pharmacies," Eisenbeis said. "So in Moberly specifically we have five different pharmacies but then we’ll call other counties just to check."
Eisenbeis said a state-wide program wouldn’t single-handedly solve Missouri’s opioid problem, but it would help. She said someone came to her recently with almost identical prescriptions from two different doctors. "Luckily, he handed them both to me at the pharmacy and I was like, these are the same thing, if you take both of them you’re going to overdose," Eisenbeis recounted.
Still, research on PDMPs in other states shows that the effectiveness of these databases can vary. Some states require providers to check the database before issuing new prescriptions. But others don’t -- and the Missouri PDMP program wouldn’t, either.
Some researchers say the monitoring can have a chilling effect on providers, leading them to prescribe fewer opioids -- and pushing people towards more dangerous options like heroin. Arbini remains a supporter. After Kevin died, she became an activist and testified before the legislature on the database bills. She’d like to open a treatment clinic, and has a reason to keep pushing for a solution: Kevin’s 9-year-old son. Her grandson.
"He looks like our son, and he acts like him, and I’ll be honest that scares me. But his mom is aware of it- we’re very close, and we watch him and hopefully he won’t go down that same path."