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Subject: Texas State Board of Medical Examiners Proposed Change of Rule Chapter 170. Authority of Physician to Prescribe for the Treatment of Pain

Dear Colleagues,

I am a Past President of the Texas Pain Society and currently on the Board of Directors, and President of the Texas Cancer Pain Initiative. As you may know the TSBME has proposed a change in Rule, Chapter 170. Authority of a Physician to Prescribe for the Treatment of Pain. The original Chapter 170 was adopted by the Board in 1995. There is nothing wrong with the current rule. Unfortunately, the Board has ignored it and disciplined physicians as they pleased, unencumbered by any guidelines. The only reason I can think of for this change is my opinion that Dr. Patrick's ambition is to intimidate physicians in the use of opioids. This was articulated in an article he co-authored (with an addictionologist and a psychologist) in the June 2004 issue of Pain Practice. If a physician takes this rule, as proposed, and the DEA's Interim Policy Statement, published in the November 16, 2004 issue of the Federal Register, and continues to prescribe opioids, he/she should have his/her head examined.

The proposed rule was published in the December 31st issue of the Texas Register. That means that the Board is likely to adopt the rule at their Feb 3-4th meeting. There is a 30 day period in which comments can be submitted to the Board. We are in that period now. If any of you would like to comment, and I would encourage it, the person and address to send them to is in the attachment. The comments should be numbered and formally stated. They should be sent asap. Theoretically, the Board is required to respond to the comments under the requirements of the Administrative Procedure Act. They are very sly and good at getting around this requirement. However, I believe if enough comments are sent in they cannot ignore them.

If you have any questions I would be happy to try to answer them.

C. Stratton Hill, Jr.

Read proposed change in Rule, Chapter 170