By SCOTT SMITH
CNHI News Service
— When Indiana Attorney General Greg Zoeller talks about the prescription drug abuse epidemic in Indiana, he often mentions former Scott County Coroner Kevin Collins, who decided not to seek re-election last year.
“He just couldn’t take it anymore. He kept taking teenagers out of homes where they’d overdosed. In a short span he had 26 deaths, almost all of them young kids,” Zoeller said during an interview with the Kokomo Tribune this week.
For the past two years, Zoeller has been focused on a problem which now has overtaken car accidents as a leading cause of death for young people. He’s filed actions to revoke the state medical licenses of 14 doctors — including one in Jeffersonville — since the start of 2012. He’s trying to get the Indiana General Assembly to give him new authority to review medical records at pain management clinics across the state, and he’s lobbying federal officials to take a more aggressive role in combating the flood of narcotic pills.
“By the time the Centers for Disease Control lists it as an epidemic, it’s not just a loose term being used for description,” Zoeller said. “Each year, you can see this thing get worse and worse.”
For the past two decades, overdose fatalities have risen steadily. The death rate is now four times what it was 20 years ago. And Zoeller, whose authority is largely limited to asking the Medical Licensing Board of Indiana to revoke medical licenses, is seeking more weapons for his arsenal.
It appears he’s about to get them.
On Monday, the Indiana House passed a bill aimed at shutting down thinly regulated pain management clinics around the state. With the Senate expected to concur on slight changes made in the House, the bill appears headed to Indiana Gov. Mike Pence for a signature.
Authored by retired Jeffersonville pharmacist Republican State Sen. Ron Grooms, the bill also creates a process which allows the Indiana Attorney General’s office to ask the state medical licensing board for permission to inspect medical records at pain clinics.
Currently, the only way for the AG’s office to access those records is to wait for law enforcement to serve a search warrant as part of a criminal investigation. Once law enforcement gets the records, then Zoeller’s office can subpoena them.
Checking clinic records whenever Indiana’s electronic pharmacy tracking system sends up a red flag would be one way to get ahead of the curve and act against overprescribing doctors sooner, Zoeller explained.
“When you’re just waiting for deaths to occur ... there should be something prior to that,” Zoeller said. He’s selling the measure to doctors as a way to address the issue before seeking criminal prosecution.
“I don’t want to start off by accusing doctors of something that’s criminal, but if that’s what I’m left with, I’ll do what I have to do,” he said.
“This bill doesn’t fix everything, but it does give more agencies awareness, and it sends the message that Indiana’s going to pursue this and enforce every law we can,” Grooms said.
The bill, SB246, requires every pain management clinic in Indiana be owned and operated by someone who holds a valid registration to prescribe controlled substances.
“The bill restricts a person from just going and renting office space along U.S. 31 in Kokomo, hanging up a sign that says ‘Pain Management Clinic’ and hiring a doctor from South Bend to come down two days a week and write prescriptions,” he said.
Many of the abuses can be tied to the prescribing practices at a small minority of clinics, Grooms added.
Finally, the medical licensing board will be asked to begin work to establish standards of care so doctors have a clear definition of ”overprescribing.”
Indiana, Grooms, said, doesn’t have a set standard. That’s a problem in and of itself, he added.
“The [pain clinic that was shut down] in Jeffersonville was a pill mill for cash,” Zoeller said. “In the easiest cases, you’re not even talking about standards of care, you’re just talking about pushing pills onto people who will travel long distances to get them.”
Zoeller said the problem goes beyond the doctors who prescribe, and the state needs to take what steps it can.
“The whole issue of pain tolerance — sometimes I think we’ve just given up on it. I tell my kids if they say they’ve got a headache, go drink a glass of water and get over it. You don’t have to take a pill for everything,” he said.
— Scott Smith can be reached at firstname.lastname@example.org