Kokomo Tribune; Kokomo, Indiana

May 14, 2013

Zoeller credits Legislature for action

Pill mill bill aids prescription drug fight.

By Scott Smith
Tribune staff writer

— Indiana Attorney General Greg Zoeller’s crackdown on the state’s prescription drug epidemic got a boost last month when the Indiana General Assembly passed a “pill mill” bill with little opposition.

Now it’s up to Zoeller, who has called prescription drug abuse the state’s biggest drug problem, to follow through.

“I’m always sensitive to not get more authority than I can actually use,” Zoeller said during an interview Monday. “People complain about Internet spam. [The Legislature] has tried to put that on me a couple of times. ... Of course there’s nothing I can do about it.”

Zoeller does, however, think the new law can make an impact on the growing pill problem, which has seen the number of annual overdose victims quadruple since the early 1990s.

Thanks to the legislation, Zoeller hopes he’ll be able to start reviewing medical records of patients whose doctors are suspected of overprescribing narcotics.

Under the new law, the Medical Licensing Board of Indiana can now grant the attorney general’s office permission to conduct “administrative reviews” of medical records.

That’s a big change, considering that until now, the AG’s office has had to seek criminal search warrants against doctors.

Zoeller said the Indiana Medical Association was initially against administrative reviews, but relented after he brought licensing actions against more than a dozen doctors in the past two years.

Zoeller will still have to get permission to conduct any reviews, and the fact he’s seeking to review records will remain confidential unless and until he files a licensing action against a doctor.

The other piece of the legislation seeks to address the fact Indiana is one of a handful of states without a clear definition of “overprescribing.”

Both the medical licensing board and the Indiana Pharmacy Board have been asked to arrive at standards of care, which doctors and pharmacists will be able to refer to when prescribing or filling prescriptions.

In some cases, Zoeller said, doctors could have used care standards to provide guidance.

At the same time, “If you can’t say ‘no’ to a drug addict, you shouldn’t be prescribing,” he said. “And that’s giving some [doctors] the benefit of the doubt.”

The true pill mills, the cash-and-carry, cash-for-meds businesses, need to be shut down immediately, he added.

“Those places are basically legalized drug dealers. These have to go away right now.”

To aid that effort, the law requires pain clinic owners to hold an Indiana Controlled Substance Registration for each facility they own in Indiana. The medical licensing board has authority to approve or reject any new applications.

That ends the ability of unscrupulous individuals to simply rent office space, hang up a sign, and hire a doctor to write prescriptions.

Zoeller said he’s still unhappy the U.S. Drug Enforcement Agency isn’t doing more to revoke the DEA registration numbers of overprescribing doctors.

Of the 14 doctors Zoeller has filed state licensing actions against, only two have had their DEA registrations revoked. He’s careful not to say too much on the subject, other than to say he’s seeking to meet with DEA officials in Washington, D.C., about the issue.

Zoeller’s office and local law enforcement have worked closely with the DEA to build the cases against four doctors associated with the Wagoner Medical Center clinics in Burlington and Kokomo.

All four of the Wagoner doctors — who are each facing felony drug dealing charges — are now barred from prescribing narcotics and state officials are proceeding with formal complaints which could result in all four doctors’ state licenses being revoked. The medical licensing board is scheduled to have a formal hearing for doctors Don and Marilyn Wagoner on June 27, Dr. William Terpstra will appear July 25 and Dr. Robert Brewer’s case will be heard Oct. 25.

Zoeller declined to discuss the cases while they’re pending, but did say he wasn’t surprised at the criminal charges being filed against the doctors.

In the wake of the Wagoner clinics being shut down, Zoeller said he expects to see a local increase in the number of people being arrested with controlled substances in their possession, as drug dealers seek to supply addicts.

He said pharmacy robberies are always a concern in Indiana, adding the state has one of the highest rate of pharmacy robberies in the country.

Those concerns point to the next step Zoeller said the state needs to take against the prescription drug epidemic.

“The next big problem we’re going to have to address is the lack of addiction services,” he said.

Scott Smith can be reached at 765-454-8569 or at scott.smith@kokomotribune.com