1-1     By:  Hirschi (Senate Sponsor - Moncrief)               H.B. No. 120

 1-2           (In the Senate - Received from the House April 16, 1997;

 1-3     April 18, 1997, read first time and referred to Committee on Health

 1-4     and Human Services; May 1, 1997, reported favorably by the

 1-5     following vote:  Yeas 11, Nays 0; May 1, 1997, sent to printer.)

 1-6                            A BILL TO BE ENTITLED

 1-7                                   AN ACT

 1-8     relating to a physician's treatment of acute or chronic pain.

 1-9           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

1-10           SECTION 1.  Section 6, Article 4495c, Revised Statutes, is

1-11     amended to read as follows:

1-12           Sec. 6.  APPLICATION OF ACT TO CHEMICALLY DEPENDENT PERSONS.

1-13     (a)  Except as provided by Subsection (c) of this section, the

1-14     [The] provisions of this Act shall not apply to those persons being

1-15     treated by the physician for chemical dependency because of their

1-16     use of dangerous drugs or controlled substances.

1-17           (b)  The provisions of this Act provide no authority to a

1-18     physician to prescribe or administer dangerous drugs or controlled

1-19     substances to a person for other than legitimate medical purposes

1-20     as defined by the board and who the physician knows or should know

1-21     to be using drugs for nontherapeutic purposes.

1-22           (c)  The provisions of this Act authorize a physician to

1-23     treat a patient who develops an acute or chronic painful medical

1-24     condition with a  dangerous drug or a controlled substance to

1-25     relieve the patient's pain using appropriate doses, for an

1-26     appropriate length of time, and for as long as the pain persists.

1-27     A patient under this subsection includes a person who:

1-28                 (1)  is a current drug abuser;

1-29                 (2)  is not currently abusing drugs but has a history

1-30     of drug abuse; or

1-31                 (3)  lives in an environment that poses a risk for drug

1-32     misuse or diversion of the drug to illegitimate use.

1-33           (d)  A physician who treats a patient under Subsection (c) of

1-34     this section shall monitor the patient to ensure the prescribed

1-35     dangerous drug or controlled substance is used only for the

1-36     treatment of the patient's painful medical condition.  To ensure

1-37     that the prescribed dangerous drug or controlled substance is not

1-38     being diverted to another use and the appropriateness of  the

1-39     treatment of the patient's targeted symptoms, the physician shall:

1-40                 (1)  specifically document:

1-41                       (A)  the understanding between the physician and

1-42     patient about the patient's prescribed treatment;

1-43                       (B)  the name of the drug prescribed;

1-44                       (C)  the dosage and method of taking the

1-45     prescribed drug;

1-46                       (D)  the number of dose units prescribed; and

1-47                       (E)  the frequency of prescribing and dispensing

1-48     the drug; and

1-49                 (2)  consult with a psychologist, psychiatrist, expert

1-50     in the treatment of addictions, or other health care professional,

1-51     as appropriate.

1-52           SECTION 2.  Section 7, Article 4495c, Revised Statutes, is

1-53     amended to read as follows:

1-54           Sec. 7.  CANCELLATION, REVOCATION OR SUSPENSION OF

1-55     PHYSICIAN'S LICENSE.  Nothing in this Act shall deny the right of

1-56     the Texas State Board of Medical Examiners to cancel, revoke, or

1-57     suspend the license of any physician who:

1-58                 (1)  prescribes, [or] administers, or dispenses a drug

1-59     or treatment for other than legitimate medical purposes as defined

1-60     by the board and that is nontherapeutic in nature or nontherapeutic

1-61     in the manner the drug or treatment is administered or prescribed;

1-62                 (2)  fails to keep complete and accurate records of

1-63     purchases and disposals of drugs listed in the Texas Controlled

1-64     Substances Act (Chapter 481, Health and Safety Code), or of

 2-1     controlled substances scheduled in the federal Comprehensive Drug

 2-2     Abuse Prevention and Control Act of 1970, 21 U.S.C.A.  Section 801

 2-3     et seq. (Public Law 91-513), including records of:[.  A physician

 2-4     shall keep records of his purchases and disposals of these drugs to

 2-5     include]

 2-6                       (A)  the date of purchase;[,]

 2-7                       (B)  the sale or disposal of the drugs by the

 2-8     physician;[,]

 2-9                       (C)  the name and address of the person receiving

2-10     the drugs;[,] and

2-11                       (D)  the reason for the disposal of or the

2-12     dispensing of the drugs to the person;

2-13                 (3)  writes false or fictitious prescriptions for

2-14     dangerous drugs as defined by Chapter 483, Health and Safety Code,

2-15     for controlled substances scheduled in the Texas Controlled

2-16     Substances Act (Chapter 481, Health and Safety Code), or for

2-17     controlled substances scheduled in the federal Comprehensive Drug

2-18     Abuse Prevention and Control Act of 1970, 21 U.S.C.A.  Section 801

2-19     et seq. (Public Law 91-513); or

2-20                 (4)  prescribes, administers, or dispenses in a manner

2-21     not consistent with public health and welfare dangerous drugs as

2-22     defined by Chapter 483, Health and Safety Code, controlled

2-23     substances scheduled in the Texas Controlled Substances Act

2-24     (Chapter 481, Health and Safety Code), or controlled substances

2-25     scheduled in the federal Comprehensive Drug Abuse Prevention and

2-26     Control Act of 1970, 21 U.S.C.A. Section 801 et seq. (Public Law

2-27     91-513).

2-28           SECTION 3.  Article 4495c, Revised Statutes, is amended by

2-29     adding Section 8 to read as follows:

2-30           Sec. 8.  ILLEGAL SUBSTANCES.  This Act is not intended nor

2-31     shall it be interpreted to allow for the prescription of any

2-32     illegal substance to any patient or person at any time in violation

2-33     of federal law.

2-34           SECTION 4.  This Act takes effect September 1, 1997, and

2-35     applies only to a dangerous drug or controlled substance prescribed

2-36     by a physician on or after that date.  A dangerous drug or

2-37     controlled substance prescribed by a physician before the effective

2-38     date of this Act is governed by the law in effect on the date the

2-39     drug or controlled substance was prescribed, and the former law is

2-40     continued in effect for that purpose.

2-41           SECTION 5.  The importance of this legislation and the

2-42     crowded condition of the calendars in both houses create an

2-43     emergency and an imperative public necessity that the

2-44     constitutional rule requiring bills to be read on three several

2-45     days in each house be suspended, and this rule is hereby suspended.

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