By Hirschi                                             H.B. No. 120

      75R518 MLR-D                           

                                A BILL TO BE ENTITLED

 1-1                                   AN ACT

 1-2     relating to a physician's treatment of acute or chronic pain.

 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-4           SECTION 1.  Section 6, Article 4495c, Revised Statutes, is

 1-5     amended to read as follows:

 1-6           Sec. 6.  APPLICATION OF ACT TO CHEMICALLY DEPENDENT PERSONS.

 1-7     (a)  Except as provided by Subsection (c), the [The] provisions of

 1-8     this Act shall not apply to those persons being treated by the

 1-9     physician for chemical dependency because of their use of dangerous

1-10     drugs or controlled substances.

1-11           (b)  The provisions of this Act provide no authority to a

1-12     physician to prescribe or administer dangerous drugs or controlled

1-13     substances to a person for other than legitimate medical purposes

1-14     as defined by the board [the physician knows or should know  to be

1-15     using drugs for nontherapeutic purposes].

1-16           (c)  The provisions of this Act authorize a physician to

1-17     treat a patient who develops an acute or chronic painful medical

1-18     condition with a  dangerous drug or a controlled substance to

1-19     relieve the patient's pain using appropriate doses, for an

1-20     appropriate length of time, and for as long as the pain persists.

1-21     A patient under this subsection includes a person who:

1-22                 (1)  is a current drug abuser;

1-23                 (2)  is not currently abusing drugs but has a history

1-24     of drug abuse; or

 2-1                 (3)  lives in an environment that poses a risk for drug

 2-2     misuse or diversion of the drug to illegitimate use.

 2-3           (d)  A physician who treats a patient under Subsection (c) of

 2-4     this section shall monitor the patient to ensure the prescribed

 2-5     dangerous drug or controlled substance is used only for the

 2-6     treatment of the patient's painful medical condition.  To ensure

 2-7     that the prescribed dangerous drug or controlled substance is not

 2-8     being diverted to another use and the appropriateness of  the

 2-9     treatment of the patient's targeted symptoms, the physician shall:

2-10                 (1)  specifically document:

2-11                       (A)  the understanding between the physician and

2-12     patient about the patient's prescribed treatment;

2-13                       (B)  the name of the drug prescribed;

2-14                       (C)  the dosage and method of taking the

2-15     prescribed drug;

2-16                       (D)  the number of dose units prescribed; and

2-17                       (E)  the frequency of prescribing and dispensing

2-18     the drug; and

2-19                 (2)  consult with a psychologist, psychiatrist, expert

2-20     in the treatment of addictions, or other health care professional,

2-21     as appropriate.

2-22           SECTION 2.  Section 7, Article 4495c, Revised Statutes, is

2-23     amended to read as follows:

2-24           Sec. 7.  CANCELLATION, REVOCATION OR SUSPENSION OF

2-25     PHYSICIAN'S LICENSE.  Nothing in this Act shall deny the right of

2-26     the Texas State Board of Medical Examiners to cancel, revoke, or

2-27     suspend the license of any physician who:

 3-1                 (1)  prescribes, [or] administers, or dispenses a drug

 3-2     or treatment for other than legitimate medical purposes as defined

 3-3     by the board [that is nontherapeutic in nature or nontherapeutic in

 3-4     the manner the drug or treatment is administered or prescribed];

 3-5                 (2)  fails to keep complete and accurate records of

 3-6     purchases and disposals of drugs listed in the Texas Controlled

 3-7     Substances Act (Chapter 481, Health and Safety Code), or of

 3-8     controlled substances scheduled in the federal Comprehensive Drug

 3-9     Abuse Prevention and Control Act of 1970, 21 U.S.C.A.  Section 801

3-10     et seq. (Public Law 91-513), including records of:[.  A physician

3-11     shall keep records of his purchases and disposals of these drugs to

3-12     include]

3-13                       (A)  the date of purchase;[,]

3-14                       (B)  the sale or disposal of the drugs by the

3-15     physician;[,]

3-16                       (C)  the name and address of the person receiving

3-17     the drugs;[,] and

3-18                       (D)  the reason for the disposal of or the

3-19     dispensing of the drugs to the person; or

3-20                 (3)  writes false or fictitious prescriptions for

3-21     dangerous drugs as defined by Chapter 483, Health and Safety Code,

3-22     for controlled substances scheduled in the Texas Controlled

3-23     Substances Act (Chapter 481, Health and Safety Code), or for

3-24     controlled substances scheduled in the federal Comprehensive Drug

3-25     Abuse Prevention and Control Act of 1970, 21 U.S.C.A.  Section 801

3-26     et seq. (Public Law 91-513)[; or]

3-27                 [(4)  prescribes, administers, or dispenses in a manner

 4-1     not consistent with public health and welfare dangerous drugs as

 4-2     defined by Chapter 483, Health and Safety Code, controlled

 4-3     substances scheduled in the Texas Controlled Substances Act

 4-4     (Chapter 481, Health and Safety Code), or controlled substances

 4-5     scheduled in the federal Comprehensive Drug Abuse Prevention and

 4-6     Control Act of 1970, 21 U.S.C.A. Section 801 et seq. (Public Law

 4-7     91-513)].

 4-8           SECTION 3.  This Act takes effect September 1, 1997, and

 4-9     applies only to a dangerous drug or controlled substance prescribed

4-10     by a physician on or after that date.  A dangerous drug or

4-11     controlled substance prescribed by a physician before the effective

4-12     date of this Act is governed by the law in effect on the date the

4-13     drug or controlled substance was prescribed, and the former law is

4-14     continued in effect for that purpose.

4-15           SECTION 4.  The importance of this legislation and the

4-16     crowded condition of the calendars in both houses create an

4-17     emergency and an imperative public necessity that the

4-18     constitutional rule requiring bills to be read on three several

4-19     days in each house be suspended, and this rule is hereby suspended.