Some doctors find law to fight pill mills confusing and overreaching, and some say they will stop writing prescriptions

Dr. Kathy Nieder, with patient charts
(C-J photo by Michael Clevenger)

Dr. Ralph Alvarado’s medical practice in Winchester has prescribed controlled substances to 1,800 patients in Central Kentucky over the past three years. But he and other doctors in the practice decided to put down their pens four weeks ago. That’s because, Mike Wynn of The Courier-Journal reports, "The standards imposed under a new Kentucky law designed to crack down on prescription drug abuse are so strict and complex that he would go bankrupt in a month -- or worse -- if he were to continue prescribing controlled substances."

Alvarado, who has made two unsuccessful campaigns for the state Senate, told Wynn, "I’m not going to be threatened with jail time or criminal charges and lose my career." He said he would refer patients to specialists to get pain-pill prescriptions.

Proponents argue that the new prescribing standards in House Bill 1, passed by the 2012 General Assembly "in hopes of combating an epidemic of drug abuse that kills nearly 1,000 Kentuckians each year were intended only to root out pill mills and crooked doctors and should not hamper legitimate physicians or prevent patients from receiving needed drugs," Wynn writes. However, "Some doctors contend the legislation is excessive, confusing and time-consuming, and across Kentucky, many have been seeking advice from attorneys about following the law, and warning patients about potential cutbacks to common drugs for pain, anxiety and other conditions. Some doctors are even talking about leaving the state. . . . Others say they have sent patients home in tears or in pain because they lack the time and resources to comply with the law."

"Patients who have never been a problem are bound up in all of this," Greg Hood, Kentucky chapter governor of the American College of Physicians, told Wynn. "There are so many unintended consequences." Hood's group and the Kentucky Medical Association are trying to determine how many clinics are declining to write prescriptions, but neither is advocating that approach. According to state offices of the Drug Enforcement Administration, only three in-state doctors have voluntarily surrendered their DEA registration — required for prescribing controlled substances — in recent weeks for reasons related to the new law. Still, the Greater Louisville Medical Society held a meeting with about 200 members recently in which attorneys tried to explain the law’s details. Doctors cited nearly two dozen areas of concern stemming from what they call vague and ambiguous legal language, the group reported. (Read more)