Ideas for fixing pill-mill law's overreach
John Cheves' excellent article explaining the problems created by House Bill 1 (the pill mill bill) should be required reading for every citizen in Kentucky. It clearly spells out the legislature's overreach and its costly consequences to patients in the form of money, time and dignity. My hope is that Frankfort will recognize the unintended aftermath of its efforts to curb prescription drug abuse, and make necessary revisions.
As Cheves points out, patients receiving many medicines for pain, sleep, anxiety, neurologic and psychiatric disorders are now, under the new law, required to have urine drug screens, computer inquiries of all their controlled drug prescriptions, frequent doctor visits and examinations as well as investigations of personal and family histories of alcohol and drug use.
I wish the state would ask those of us prescribing these medicines what suggestions we have, but I am still waiting. If I were asked, I would make these suggestions to improve HB 1:
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■ Remove many of the specifics regarding patient histories and examinations.
■ Remove certain low abuse potential drugs from the list of monitored drugs. These include tramadol, zolpidem, clonazepam and several others.
■ Put a trigger for monitoring (urine drug screens, etc.) based on the quantity of the drug dispensed.
As a citizen, I applaud the state's attempt to rein in prescription drug abuse, even if it imposes some measure of burden to physicians and patients, but I also wish our politicians would use informed thought and restraint.
Gary Margolies, M.D.
Law ignores root causes
It has become apparent to the offices of the attorney general and governor and to the legislature that HB 1 (the prescription drug bill) is having a lot of unintended consequences — consequences that the news media and attorney general demonized the Kentucky Medical Association for trying to point out. Though the legislature had good intentions and certainly curtailed some of the illicit abuse of prescription medication by so-called pill mills, this could have been addressed effectively by giving the Kentucky Board of Medical Licensure more resources and power to act.
Unfortunately, most of the prescription drugs still come from sources outside Kentucky's control. Equally unfortunately, we have not addressed the problem of why people take drugs and why they modify prescription drugs for illicit use. This is a harder, multifaceted problem not easily addressed and not addressed by HB 1. There is little legislative effort or money to treat addiction or solve the root of addiction. Instead an easy solution was to blame doctors, the KMA and the Board of Medical Licensure for all these problems. Attorney General Jack Conway now says he is willing to work with doctors because of the unintended consequences that interfere with medical care, while he still demonizes the KMA for its previous well-founded concerns.
Meanwhile the partially closed door on prescription medication has unfortunately pushed open the door to other addictive drugs, such as heroin.
John Moore, M.D.
Obstacles to reforesting
I applaud any efforts to get our returning veterans gainful employment, as you suggest in the Sept. 16 editorial ("Honor our vets with jobs bill: Reforesting Appalachia could be one of the shovel-ready projects"), but you have also hit on another real problem in the mountains — erosion of what hillside soil is left to properly grow any kind of useful vegetation.
Several years ago, the University of Kentucky finally filled a vacancy in the county's Extension Service in the area where I lived. At the first meeting with citizens it was suggested to the agent that a great need might be to replant the fallow and eroded hillsides with trees. The use of the Extension Service, with its research arm at UK, could enlist foresters and lead important, real long-range planning in land use for the area. The use of hillsides for growing corn and pasture had declined since the 1950s-60s to almost nothing. We were told it could not be done as the land was not public land. Later the same idea was broached with the local forester, with the same answer.
So now your paper suggests help for our returning veterans by having them reclaim and replant the mountains with trees. I do hope our leaders will at least consider the idea before discovering obstacles that, at first glance, may appear impossible to overcome. Somehow, I have the idea that real leaders are those who find a way to overcome obstacles and convince others to follow.
John K. Pitts
Why not polygamy?
The Rev. Marsha J. Charles' commentary, "Marriage is a basic right that should not be denied," got me thinking. Having been married for approaching 50 years, I thought I knew a thing or two about the subject. But, alas, perhaps I have been wrong. There are, of course, some things that would tend to argue for the continued definition of marriage as between one man and one woman. That definition has worked fairly well for a tolerable long time and has well served a lot of folks, including George Washington, Martin Luther King and others, including me.
But perhaps it is time for a change in definition. Who knows, I just might be persuaded to support a change. First, however, someone will have to clear up one point that bedevils me. If, indeed, the definition of marriage should be changed to include committed, loving unions between one man and one man or between one woman and one woman, why should it not include unions between say, one man and two women? Perhaps those people also long for that life, liberty and pursuit of happiness stuff to apply to them.
Well, I'm trying to maintain an open mind, but I am struggling with this one point. I discussed this one man, two women thing with my wife but she really wasn't attracted to the concept.
Children need marriage
The issue of redefining marriage may be new to Kentucky, so it is important for your readers to understand the sleight of hand proffered by Marsha Charles in her commentary, "Marriage is a basic human right." She argues that same-sex couples should be permitted to marry because she thinks marriage is merely an institution for "choosing to whom one can convey civil responsibilities and with whom one can legally proclaim a life of mutual love and care." That is not what marriage is.
In order to accommodate same-sex couples, marriage would have to be redefined to make it gender neutral with the consequence of eliminating from the law the only civil institution that unites kids with their moms and dads. There would no longer be any authority for the state to promote it. The state, schools and other public and private institutions would be prohibited from promoting the unique value of men and women marrying before having children.
The consequences of redefining marriage are too great, unless Charles and her peers can make an argument for why there is no longer a need for any public institution that unites kids with their moms and dads.
William B. May
President, Catholics for the Common Good
San Francisco, Calif.
Is this sarcasm?
Kentucky Wildcat fans, you gave us all we could handle. Great job. You need to give Joker at least five years. He's a class guy and a very good coach. He'll make you proud. Stand behind him and your players. Great game.
Get real about coal
Does anyone really care if Heath Lovell is a coal miner? I certainly don't. How many TV ads do we have to be subjected to on this subject? What a waste of campaign funds.
Andy Barr and Ben Chandler, we've had enough already. If you want to talk about coal in your ads, try a discussion about the current low cost of cleaner natural gas in the U.S. or the environmental impact that a dirty fuel like coal poses. Those are the real reasons for the reduction of jobs in the industry.
In the meantime, my mute button is working overtime.
Party contrast telling
Who truly doubts that presidential debates are anything short of theater? Does anyone really believe voters are influenced one way or another? After all of the discussions of winners and losers, let us not forget that the candidates are representatives of their party.
Jim Lehrer kept asking for contrast between the two. The contrast undecided voters should look at is not between the men, but the core beliefs that separate the two parties.
The driving belief of the Republican Party is that any American, regardless of situation, can make it if they only work hard enough. National government has no obligation to the individual and should get out of the way and let free enterprise rule the land. Amassing great quantities of money and wealth is an American right.
The Democratic Party's platform is grounded in the belief that having more money than one could possibly spend in several generations is more of a privilege. We all have a responsibility for each other. The working poor don't choose to live in poverty. The federal government's role is not to move out of the way, but to step up and try to even the playing field for everybody. "We the people of the United States, in order to form a more perfect Union, establish justice, ........promote the general Welfare, ...". Not welfare as in handing out something for nothing, but welfare as in making it possible for everyone to have their basic needs met.