Herald-Leader Editorial

Don't weaken the pill-mill bill

Legislature to tweak regulations

December 27, 2012 

It should come as no surprise to anyone that Kentucky is plagued by prescription drug abuse.

Still, a University of Kentucky study released last week must give us all pause.

It should also inform the medical community, the Kentucky Board of Medical Licensure and the General Assembly in the new year as they consider changes to regulations designed to assure that the most abused medications are prescribed only when they are medically appropriate.

The Kentucky Injury Prevention and Research Center studied 11 years (2000 to 2010, inclusive) of death certificate files, emergency department and hospital billing records, to assess the pattern of drug overdoses. Some of the findings:

■ Drug overdose deaths in Kentucky rose by 282 percent.

■ Drug overdose hospitalizations rose 68 percent.

In 2010 alone:

■ 53 percent of the overdose deaths involved prescription drugs.

■ Overdose-related inpatient hospitalization charges totaled $68.6 million. Emergency-room charges were another $9.6 million. Medicaid was charged $18.7 million for hospitalizations and $2.6 million for emergency-room care.

The investigators stated that they did not see any signs of a downturn in the numbers and that they believe the reports probably understate the actual overdose-related deaths and hospitalizations.

The study, for example, doesn't include Kentuckians treated in other states, and it's possible that some deaths may not be listed as overdoses even though they are.

Earlier this year, the General Assembly passed what's called the "pill-mill bill" aimed at closing down so-called pill mills where doctors write thousands of prescriptions for dangerous pain pills, often with cursory or no examination of patients.

It also authorized the KBML to write regulations to reduce the incidence of legitimate physicians incorrectly writing prescriptions for these dangerous drugs.

In regulations, the devil is always in the details. There has been significant push-back from the medical community and patient advocates about the regulations.

Specifically, regulations cover not just pain medications but also drugs used to treat ADHD and chronic illnesses in older people that require frequent urine tests.

This month, the KBML came back with modifications to address those and some other concerns. In January, a legislative committee will consider the revised regulations.

We applaud this collaborative process but caution all those concerned to keep in mind the findings released last week.

Each death, each hospitalization for a drug overdose is a tragedy that extends far beyond the person being treated. They also impose a huge cost on the families involved, and on taxpayers.

Watered-down regulations that impose only a minor inconvenience on physicians and accomplish little to stem this deadly tide will be worse than meaningless, they would be a disservice to the tens of thousands of Kentuckians who have lost parents, children, family members, friends and coworkers to prescription drug abuse.

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