"Escalated without real thought"
Dr. Deborah McMahan, the Allen County Health Commissioner and task force chair, said the proposed rules will require doctors to take a "more thoughtful and intentional approach" to prescribing pain drugs.
"Doses (of pain drugs) are being escalated without any real thought," McMahan told the board.
The proposed rules are aimed at curbing dependence on pain-killing drugs and their illegal sale to drug abusers. They would only apply, for example, when a doctor writes a prescription for more than 60 opioid-containing pills in a month or a morphine-equivalent dose of 15 milligrams a day for three months.
The proposed rules would require doctors to do more screening of patients before prescribing the drugs, including the use of the state's online database that tracks prescriptions for controlled substances. It also requires patients undergo a urine or saliva drug-monitoring test before they get a prescription and additional drug tests while they're on the painkillers, to determine the presence of other prescription or illicit drugs.
During the board hearing, LaHood said a similar drug-monitoring test is already in place at a family practice clinic in Indianapolis, run by St. Vincent Health, for patients prescribed pain-killing drugs. The test results showed about half of those screened either had an additional pain-killing drug in their system, or showed that they weren't taking their prescribed pain medications at all.
McMahon and other task force members said the proposed rules intentionally exclude patients who are suffering from a terminal illness and receiving large doses of pain-killing medicine.
Some representatives of the state's nursing home industry asked that adoption of the prescribing rules be delayed, to give them time to figure out how they'd impact their patients. A representative from Indiana Academy of Family Physicians also asked for a delay until March to give doctors time to understand the new rules.
But Steve Huddleston, chairman of the Medical Licensing Board, indicated that a delay was unlikely.
"The legislature said this was an emergency," Huddleston said. "I don't see how we can duck that obligation."
Maureen Hayden covers the Statehouse for the CNHI newspapers in Indiana. She can be reached at firstname.lastname@example.org.