JEFFERSON CITY — Missouri lawmakers on Thursday took a pivotal step toward becoming the final state to adopt a statewide prescription opioid tracking database, despite years of resistance to the idea by some Republicans.

State senators voted 21-10 to pass a House bill to create a database that provides physicians and pharmacists with patients' prescription histories so they can intervene with medical help for those who show signs of addiction. 

That's significant because opioid-tracking legislation has historically failed to pass the Missouri Senate, where some skeptical Republicans have raised concerns about patient privacy in a government database. 

Things could change this year. The measure needs another vote of approval from the state House, which House Speaker Elijah Haahr signaled is likely happen. 

"I have every reason to expect that the bill is going to pass the House and get to the governor's desk," said Parkville Republican Sen. Tony Luetkemeyer, who carried the House bill through the Senate. 

Missouri now is the only state without a database to track prescriptions, although St. Louis County created one after years of inaction by state lawmakers. At minimum, an estimated 85% of Missourians are already covered by the monitoring program run by St. Louis County and joined by numerous other counties across the state, according to the St. Louis County website. 

But Luetkemeyer described that as a "patchwork" system and said it lacks safeguards to protect patients' medical information. 

"There's really nothing that would prohibit St. Louis County from sharing that information, let's say with the FBI or the feds," he said. 

Former Republican state Sen. Rob Schaaf for years was seen as the main roadblock to enacting a drug database. Schaaf later agreed to support the proposal and has since left the Senate, but at least six members of the Senate's Conservative Caucus took his place in blocking the bill. 

Skeptics in the Senate eventually agreed to allow a vote on the bill after taking oversight of the program away from the health department and giving it to a task force of medical professionals. The task force would be responsible for picking an independent contractor to monitor the database. 

Sen. Cindy O'Laughlin, a Shelbina Republican and member of the Conservative Caucus, on Thursday flipped and voted for the program. She cited the task force as the main reason and said without the involvement of the health department, "it's not a government-monitored database."

"I'm not necessarily all on board with people looking at your records," O'Laughlin said. "But I think if there's anyone who should be able to see it and legitimately can use that, that it would be your doctor or pharmacist."

The bill also bans the data from being given to law enforcement or being used to take away firearms. 

Lawmakers have until mid-May to give the bill final approval and send it to Republican Gov. Mike Parson, who support s a prescription monitoring program.