Legislature passed pill law, but doctors wrote regulations

Legislation doesn't interfere with legitimate practice of medicine

October 15, 2012 

  • At issue: Sept. 28 Herald-Leader article, "Urine tests required by pill law at issue; patients decry cost, say all are treated like abusers"; Oct. 7 Herald-Leader editorial, "Pill-mill regs: A test too far? Prescription drug crisis demands delicate balance to protect Ky."

Earlier this year, the Kentucky General Assembly passed legislation to address prescription drug abuse that has become rampant throughout Kentucky.

Roughly 219 million doses of just one pain medication, hydrocodone, were dispensed in Kentucky in 2011.

That's nearly 51 doses for every man, woman and child in this state. While many Kentuckians have legitimate medical conditions that require treatment with prescription pain medicine, there are too many others who are not using those drugs for appropriate purposes.

The extent of the problem is sobering. Nearly 1,000 Kentuckians die of drug overdoses every year — more than are killed in car accidents. One in three Kentuckians has a friend or family member who is struggling with prescription drug addiction.

Obviously, prescription drug abuse has become an epidemic.

This epidemic is being fueled, in part, by the invasion of our communities by shady pain- management clinics or pill mills.

Pill mills are illegitimate operations, often owned by people without medical degrees who live out of state. They inappropriately prescribe large amounts of powerful narcotics to anyone willing to pay, often without a medical examination of any kind.

The primary goal of House Bill 1 was to identify pill mills and shut them down without hindering the important pain-management work done by law-abiding physicians.

To that end, HB 1 defines what pain-management clinics are and requires them to be owned and operated by licensed physicians with specialized pain-management training.

To ensure that pain clinics are legitimate medical facilities, they are required to accept health insurance and adopt payment practices that discourage dealers and drug seekers.

To be effective, some provisions of HB 1 had to address all doctors, not just pain clinics. This is because addicts and drug dealers often request pain medication from more than one doctor. HB 1 requires doctors to check an electronic system, KASPER, before prescribing or dispensing pain medications that are frequently abused. The average KASPER check takes five seconds.

Since the passage of the bill, there has been a flood of confusion and misinformation about what HB 1 does.

Many people mistakenly think the bill prohibits doctors from prescribing pain medication or requires that pain medication be prescribed only by a pain clinic.

The reality is that the bill does not prohibit any doctor from prescribing anything. It does require doctors to look and see what a patient is already taking before prescribing potentially addictive medications.

Doctors are also required to physically examine a patient before initially prescribing those same medicines. These are common-sense precautions, not radical interventions into how doctors practice medicine.

The task force created to oversee the implementation of HB 1 has been flooded with criticism from the medical community.

Much of that criticism is directed at administrative regulations drafted after the bill was passed. It is important to note that those administrative regulations were drafted by doctors and other practitioners, not the legislature.

Medical professionals were given the job of establishing prescribing standards because they did not want them imposed by the General Assembly. Those same professionals are now complaining about the content of regulations they wrote.

The good news is that those regulations are not final and can be amended in a way that will implement HB 1 and address the concerns of the medical community.

HB 1 is a good piece of legislation that is attempting to address a scourge that threatens every Kentuckian. Lawmakers did the right thing by passing it.

Now we need the medical community to do its part.

Lexington Herald-Leader is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

Commenting FAQs | Terms of Service