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Indiana board considers 1-year delay of patient tests

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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.

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  • Freedom is Good
    Mandatory testing of precious bodily fluids is an important and vital component of personal freedom. Also, it's better than asking dangerous questions like why some people are so unhappy that they are willing to risk injury, imprisonment, or death to escape from their miserable lives for a few hours. Those folks need to accept that they are losers and should be made to face their fate rather than avoiding it. All spoils to the victors and none to the losers - there is no greater moral imperative. All else is theft.

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  1. John, unfortunately CTRWD wants to put the tank(s) right next to a nature preserve and at the southern entrance to Carmel off of Keystone. Not exactly the kind of message you want to send to residents and visitors (come see our tanks as you enter our city and we build stuff in nature preserves...

  2. 85 feet for an ambitious project? I could shoot ej*culate farther than that.

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  4. Perhaps, but they've had a very active program to reduce rainwater/sump pump inflows for a number of years. But you are correct that controlling these peak flows will require spending more money - surge tanks, lines or removing storm water inflow at the source.

  5. All sewage goes to the Carmel treatment plant on the White River at 96th St. Rainfall should not affect sewage flows, but somehow it does - and the increased rate is more than the plant can handle a few times each year. One big source is typically homeowners who have their sump pumps connect into the sanitary sewer line rather than to the storm sewer line or yard. So we (Carmel and Clay Twp) need someway to hold the excess flow for a few days until the plant can process this material. Carmel wants the surge tank located at the treatment plant but than means an expensive underground line has to be installed through residential areas while CTRWD wants the surge tank located further 'upstream' from the treatment plant which costs less. Either solution works from an environmental control perspective. The less expensive solution means some people would likely have an unsightly tank near them. Carmel wants the more expensive solution - surprise!

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