Indiana board considers 1-year delay of patient tests

Indiana's Medical Licensing Board is considering delaying for one year a proposed new rule that would require physicians to conduct annual toxicology tests on some patients as part of a larger state effort to crack down on prescription drug abuse.

Board members on Thursday discussed the pros and cons of making the drug-testing requirement a recommendation for the first year before it would become mandatory in 2015.

Some board members said they were concerned that physicians might need the extra time to adjust to the proposed emergency rules the panel must adopt as part of a state law passed this year calling for standards for prescribing potent medications such as painkillers.

"The market needs to know what we are going to require as part of this testing," said board member Bharat Barai, a physician in the northern Indiana city of Merrillville.

Board Chairman Stephen Huddleston questioned whether delaying the proposed mandatory urine or saliva tests for some patients to detect potent painkillers would satisfy the Legislature's instructions that the panel draft emergency rules to help curtail rampant prescription drug abuse.

Prescription drugs were blamed for 718 overdose deaths in Indiana in 2011, a nearly 10-percent increase from 2010's 654 deaths.

The results of the drug tests would determine if a patient is actually taking their prescribed medications or possibly selling them illegally to people hooked on those drugs.

"That was a big piece of the Legislature's concerns, that we have people out there selling this stuff," Huddleston told the board. "We've had dramatic testimony from a nurse who watched the patient go into the parking lot to sell the drugs he'd just gotten. And then he came back the next month and the physician gave him another prescription."

Board member John McGoff, an Indianapolis physician, said doctors who've already adopted best practices for spotting patients who might be selling their medications already perform periodic tests on patients and wouldn't be affected by the new rules.

"They aren't going to see a change. They've worked it out and it's part of their overhead," he said.

Huddleston said the panel, which also discussed other issues Thursday related to the proposed rules, would hold a public hearing in September on those rules and likely vote during its October meeting on adopting them.

The state law passed earlier this year requires the board to adopt temporary emergency rules by Nov. 1, and have permanent ones in place by November 2014.

State Attorney General Greg Zoeller said last week that more people in Indiana now abuse prescription drugs than abuse cocaine, heroin, hallucinogens and inhalants combined.

The new rules will be part of a state prescription drug crackdown that's also targeting so-called "pill mills," where doctors churn out prescriptions to addicted patients.

Zoeller said his office has taken action against more than 15 doctors since January 2012 for prescribing addictive painkillers for purposes not considered medically appropriate.