Texas seeks to eliminate so-called "pill mills," which sell powerful narcotics to patients without first giving them an exam, say officials from the Texas Medical Association.
If the Texas Medical Board becomes aware "of a pain management clinic that is doing business after Sept. 1 without a certificate, we will take action to shut the clinic down until it can meet the requirements of the law," said Mari Robinson, an attorney and TMB's executive officer, in an interview with the association's magazine Texas Medicine.
Physicians say that currently, the storefronts, which will now have to be certified under Texas law, "give legitimate pain management clinics and physicians a bad name, and put patients at risk."
Chris Shade, MD, a pain medicine specialist and past president of the Texas Pain Society, told the magazine that such pill mills are insulting to legitimate pain clinics. He said the storefronts in question commonly accept only cash, have only a storefront, no medical equipment, aren't owned by a doctor, don't conduct any medical procedures, don't keep patient records and often have crowds waiting to see the doctor.
According to the article, the new law applies to clinics that issue prescriptions for opioids, benzodiazepines, barbiturates, or carisoprodol on a monthly basis for at least 50% of their patients. It allows medial board officials to inspect any pain management clinic to determine they are operating legally.
It also requires that legal clinics must be owned by Texas physicians, and that non-physician owners will have to sell those clinics to licensed physicians who meet criteria.
That criteria include never having been disciplined by a licensing entity for inappropriately prescribing, dispensing, administering, supplying, or selling a controlled substance. Also, physician owners of such clinics must be on-site at least 33% of the clinic's operating hours and review at least 33% of the patient files, including those of a clinic employee or contractor who has the authority to care for patients.
Some of the clinics in question have been or are operated by physicians who have restricted licenses.
The Texas physician association magazine article says that Texas, and the nation, are in the midst of a prescription drug abuse "crisis," especially with hydrocodone products and pseudoephedrine. Forged prescriptions, pharmacy theft, Internet sales and doctor shopping are all illegal activities linked to these pill clinics that the new certification process seeks to stop.