News From Terre Haute, Indiana

Local & Bistate

November 4, 2013

A pharmacist in the State House

Republican legislator leads push for tighter drug regulations

INDIANAPOLIS — In January, on his first day in office, Indiana Gov. Mike Pence called for a moratorium on state regulations, saying fewer government rules would help spur job creation across the Hoosier state.

State Sen. Ron Grooms, a conservative Republican from Jeffersonville, applauded the general notion of “less government intrusion” but decided the health of Hoosiers trumped ideology. During the 2013 session, he authored legislation to impose sweeping new regulations on the providers of prescription painkillers. His intent: to turn back the wave of misuse, abuse and addiction associated with the most frequently prescribed drugs in the U.S.

How did Grooms come to that decision? Through his personal experience as a pharmacist in Floyd County, where he’d witnessed the rise of suspicious pain management clinics, better known as “pill mills.”

In a recent interview, Grooms recalled how he could track the rise in prescriptions for drugs containing hydrocodone — the chemical derivative of opium — just by tracking his orders.

In the early 1990s, as those drugs were hitting the market, Grooms needed only one bottle of 100 pills each week to fill the hydrocodone prescriptions that came into his pharmacy. By the mid-1990s, he needed to buy one bottle of 500 pills a week to keep up with the demand. By 2006, when he retired, he was ordering 20 bottles of 500 pills each week.

What he saw in his drug store was happening across the nation. The number of prescriptions for hydrocodone-containing medications like Lortab, Vicodin and their generic equivalents — all marketed as safe, cheap, and effective — was skyrocketing. In 2011, according to federal government estimates, about 131 million prescriptions for hydrocodone-containing medications were written for about 47 million patients. That comes out to about five billion pills.

“We’d become a society where everything is supposed to be easy and uncomplicated,” Grooms said. And pain treatment was no different: “Treating pain is uncomplicated. You just write a prescription.”

Also happening: An alarming number of patients were becoming addicted to their narcotic painkillers and developing what’s called a “narcotic tolerance” — meaning they had to increase their dosage to get the same pain relief.

The consequences have been deadly: More people are now dying from overdosing on their prescription painkillers than overdosing on heroin or cocaine. In October, a study released by Trust for America’s Health found Indiana had the country’s 17th highest rate of drug overdose deaths, with most of those deaths from prescription painkillers.

Grooms came into the 2013 session believing the best way to put a big dent in those numbers was to impose more regulations on the people writing the prescriptions. The legislation he introduced was much tougher than what was passed, having met significant opposition from the medical community. He understood their argument: “Doctors didn’t want legislators telling them how to practice medicine,” Grooms said.

Still, with help from a fellow pharmacist, Republican Rep. Steve Davisson of Salem, he got a bill passed that gave the state Medical Licensing Board what Grooms called “tremendous power and authority” to impose new regulations on painkiller-prescribing doctors.

Pence signed the bill. And last week the board passed emergency rules — clearing the way for permanent rules to come — that mandate drug testing of pain-medication patients and much closer monitoring of patients by doctors to detect drug addiction and abuse.

Grooms is a classic small-government Republican who characterizes the regulation-wary Indiana General Assembly. As a pharmacist, he had the right to refuse to fill a painkiller prescription of someone he thought was abusing the drug. But more intervention is needed, he said, when there are critical public health issues at stake.

“The rest of the story is: What we do with these people who are addicted? How do we treat them? What are we going to do in 10 years and they’re still addicted?” Grooms said. “Look at the cost to society and the loss of productivity. … We’ve got a huge problem we need to address.”

Maureen Hayden covers the Statehouse for CNHI, the Tribune-Star’s parent company. She can be reached at maureen.hayden@indianamediagroup.com.

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