In a process authorized by the Colorado State Administrative Procedure Act (APA) that provides for legislative oversight of executive branch rulemaking the Office of Legislative Services voted 8-0 to ask the Colorado Legislature to repeal Chiropractic Board Rule 7c that gives chiropractors the authority to administer non-FDA approved compounds by injection according to a news release from the Colorado Medical Society. The Colorado Legislature is scheduled now to vote on the repeal of the rule in its upcoming session as part of the Committee's rule review bill.

In Colorado executive branch agencies must submit new or amended rules to the Office of Legislative Legal Services (OLLS) and the statute directs OLLS staff to review the rules to determine whether they are within the agency's rulemaking authority.

On November 15, 2012 the Colorado Board of Chiropractic Passed Rule 7 C allowing for the administration and injection of legend drugs.

Proposed Rule 7 (C) provides for chiropractors, who have completed a 24 hour course of instruction, to administer a variety of legend (prescription) drugs by injection.  Colorado Revised Statutes expressly prohibit chiropractors from prescribing, compounding, or administering drugs.  All injectables for human use are prescription drugs.  The Board of Chiropractic Examiners may only promulgate rules that are “not inconsistent with the law.”  Proposed Rule 7 (C) exceeds the statutory scope of practice for chiropractors in Colorado, and is therefore unlawful.

That Rule then went on to the Attorney General of the State of Colorado who opined on December 5, 2012 that Rules 6 and 29 were acceptable but that Rule 7 exceeded the legislative scope of authority of the chiropractic board.

Then in an unprecedented move 13 medical organizations filed a complaint to prevent “irreparable injury and for judicial review of agency action.”  The Plaintiff’s also filed a motion for immediate injunctive relief. The Plaintiff’s are led by the Colorado Medical Society which has 7000 members. The Complaint argues that the adoption of Rule 7(c) exceeds the statutory authority of the chiropractic board and is an “intrusion on the practice of medicine” that “threatens irreparable injury to the public welfare and the safety of the patients Plaintiffs’ members serve to protect.”  

The Committee for the Office of Legislative Services heard a range of testimony in opposition to Rule 7c, including:

• Jan Kief MD - Colorado Medical Society President
• Susan Koontz JD - Colorado Medical Society General Counsel
• Marschall Smith - Program Director of the Colorado Medical Board
• Dr. Ken Spresser - a practicing chiropractor in Colorado

According to Dr. Kief:

"In December, three members of the Chiropractic Board approved a rule that allows chiropractors who complete a 24-hour course to perform injections of non-FDA approved substances as well as to administer them topically and through inhalation. The rule does not restrict the medical conditions to be treated or where in the human body the injections can be administered. This leaves open to individual interpretation the disease to be treated, the substance they want to inject and the site in which they choose to inject it."

CLICK HERE TO READ Dr. Kief's complete testimony

The testimony by Dr. Spresser was even more to the point: “Please protect the public from this small interest group and the Chiropractic Board of Examiners that only wants to make more money by exceeding their statutory boundaries."

CLICK HERE TO READ Dr. Spresser’s complete testimony
 
In a move clearly made to protect Colorado chiropractors from prosecution should they go ahead and start injecting drugs into their patients in defiance of the Attorney General, the Colorado Board of Chiropractic Examiners approved an emergency rule effective December 31, 2012 to delay the implementation of the addition of Rule 7(C) regarding injectables. According to an announcement on the Board website, the delay in the effective date of the rule from January 15, 2013, to April 30, 2013, is to allow the legislature an opportunity to rule on whether the rule is proper.

Emergency Rule Announcement on Board Website

Copy of Board Emergency Rule

Dr. Kief closed her testimony with perhaps the most logical statements uttered since the whole drug issue in Colorado surfaced:

“Pharmacology and injection therapy are areas that cannot be learned in 24 hours.  Physicians study and practice this over years to know drug interactions, liver and kidney metabolism, how the entire body will respond to substances, etc.  For example, I would never be able to do spine manipulation.  The chiropractors are very skilled at this and it takes years and I refer my patients to them for this treatment.”

Click Here to Read the Complete Colorado Medical Society News Release