As a New York Times article highlighted this week, Missouri is the only state without a prescription drug monitoring program (PDMP), but not everyone agrees on how big a problem that is.

Senator Claire McCaskill (D) calls it embarrassing that Missouri doesn’t maintain a database of the prescription drugs Missourians buy, a database that doctors, hospitals, pharmacists and others could access. Proponents say such a program could help identify individuals who “doctor shop,” and stockpile prescription medications to sell illegally.

She says Missouri has now become, “a Mecca for opiate dealers all over the country. Every opiate dealer in the country knows they can come to Missouri and avoid detection.”

Some opponents of such a program say the database it would create could be abused or hacked into.

Representative Kevin Engler (R-Farmington) says those arguments are weakened by the lack of problems in the 49 states that have a monitoring program.

“You’ve had years of experience from these other states that have not resulted in a breach of security on the database, or [a registry] hasn’t been shown to be the way police are going after people or going after doctors,” says Engler. “It’s simply used to try to stop, at the start of the process, the abuse of legal drugs.”

However, Senator Rob Schaaf (R-St. Joseph) says other states have had problems.

“The database has been hacked in five states; in Florida, Virginia, Colorado, Utah and Washington,” says Schaaf.

Schaaf also points to stories of abuse of a database, such as that of a police officer in Utah who used the registry to go into a couple’s home and take their prescription pills, and of a Utah man who says immediately after his wife died of cancer, police showed up at his home asking to confiscate her pain medication.

Schaaf says there are also questions about the effectiveness of a monitoring program. He says studies of monitoring programs, “do not consistently show that they reduce deaths from opioid overdose, and at least one shows that when the PDMP is enacted, heroin use actually increases.”

Schaaf thinks a database would violate Missourians’ liberty, and says they should ask themselves whether they want the government to know what prescriptions they are taking. Still, he’s proposed versions of a registry and says he’s willing to compromise.

McCaskill believes a registry will fight prescription drug abuse, and hopes state lawmakers “wake up” about the issue soon.

“We’re killing Missourians by not doing this database,” says McCaskill.