The Medical Licensing Board of Indiana is considering emergency rules related to opioid prescribing as mandated by the state’s “pill mill bill” (SB 246), which was signed into law by Governor Mike Pence in May 2013. The emergency rules would go into effect in December 2013, and would likely form the basis of more permanent changes. According to the current draft of these rules (PDF), certain patients taking opioids would be required to:
- Agree to toxicology screenings and random pill counts, and
- Sign an agreement not to share pills.
Prescribers would be required to:
- Discuss potential risks and benefits of opioid treatment, as well as proper medication use,>
- Inform patients about alternative forms of pain treatment,
- Run patients’ names through the state’s prescription monitoring program at least once per year,
- Conduct saliva and urine tests to ensure patients are taking the drugs they’ve been prescribed, and
- See pain patients at least once every four months.
In order to fully assess the impact, the board is considering making annual saliva and urine tests a recommendation instead of a requirement for the first year. These rules would pertain to patients who are prescribed more than 60 opioid-containing pills a month, or a morphine equivalent dose of more than 15 milligrams per day for more than three consecutive months.
According to a report in the Indianapolis Star, critics of these rules worry it will make it harder to treat patients suffering from chronic pain. While the emergency rules allow exceptions for terminal patients, critics believe other chronic pain sufferers may have a harder time finding doctors willing to prescribe CS painkillers. Supporters argue that prescribers turn to these medications too readily, and that these new measures will help ensure that patients are informed and that doctors only prescribe opioid painkillers when necessary.