Most of us in North Carolina believe in a simple principle: people should be able to make informed decisions about their own health care. That belief is rooted in personal responsibility, transparency, and respect for individual liberty. But those values break down when patients are not given the information they need to make a real choice.
That is exactly what is happening with a class of antibiotics called fluoroquinolones, sold under names like Cipro and Levaquin. These drugs carry multiple FDA black‑box warnings — the strongest safety alerts the federal government issues — because they can cause tendon ruptures, nerve damage, central nervous system effects, aortic aneurysm, and other serious, sometimes permanent injuries. They are meant to be used sparingly, and only when safer antibiotics will not work.
Yet in North Carolina, fluoroquinolones are still prescribed routinely for common infections like sinusitis, bronchitis, and uncomplicated urinary tract infections. Many patients never receive meaningful disclosure of the risks. And when injuries occur, the consequences fall squarely on individuals and families — not on the system that allowed the harm.
I know this because I lived it. In 2023, I was prescribed Cipro for an infection I did not have. The adverse reaction left me permanently disabled. Taking Ciprofloxacin made me develop debilitating fatigue and weakness, painful nerve damage in my hands and feet (peripheral neuropathy), and cognitive impairment. The traumatic nature of the injuries severely affected my mental health. I was forced to resign from my teaching position, and now struggle to take care of myself and two young children.
My story is not unique. Across our state, people are being harmed by medications they never should have received in the first place.
This is not a partisan issue. It is a market‑failure issue, and one that the North Carolina General Assembly is uniquely positioned to address with targeted, conservative, common‑sense reforms.
A functioning market depends on informed consumers, but when a patient is handed a prescription without being told that the drug carries multiple black‑box warnings and risk of permanent disability, the consumer cannot make a rational choice.
That is why North Carolina needs three specific, actionable reforms that restore transparency and protect both patients and taxpayers.
First, the legislature should enact a statutory requirement for written informed consent before prescribing fluoroquinolones in non‑emergency situations. This would require prescribers to provide patients with a one‑page, standardized disclosure outlining the FDA black‑box warnings and explaining that safer alternatives often exist. The patient would sign it before receiving the prescription. This is not burdensome regulation. It is the same principle we already apply to opioids and other high‑risk medications. It restores consumer choice, prevents hidden risk‑shifting onto families and taxpayers, and ensures that patients — not institutions — control their own medical decisions.
Second, lawmakers should direct the Department of Health and Human Services to issue statewide prescribing rules that reserve fluoroquinolones as last‑line antibiotics. This directive would require DHHS to publish clear, enforceable prescribing rules stating that fluoroquinolones should only be used when culture results, allergies, or clinical circumstances rule out safer options. This is not a ban, and it does not interfere with FDA approval. It simply aligns state practice with existing federal warnings and reduces avoidable injuries that drive up Medicaid spending, disability claims, and insurance costs. Smart guardrails protect both patients and the state budget.
Third, the General Assembly should establish a formal legislative study committee to quantify fluoroquinolone‑associated disability in North Carolina. Right now, the state has no mechanism to track these injuries. A study committee would gather data from hospitals, insurers, workers’ compensation claims, and patient reports to determine how often these injuries occur, what they cost the state, whether certain prescribing patterns are driving harm, and what targeted reforms would be most effective. Lawmakers cannot craft efficient, limited regulation without accurate data. This is the fiscally conservative first step.
The goal is not to regulate more — it is to regulate smarter. When a high‑risk drug is prescribed casually, without proper disclosure, the downstream costs don’t disappear. They show up as lost productivity, long‑term disability, higher insurance premiums, increased strain on Medicaid, and families pushed into financial crisis. Those costs are ultimately borne by taxpayers, employers, and the state. That is the opposite of fiscal responsibility. Everyone benefits when high‑risk medications are used safely and responsibly.
The General Assembly has the authority — and the responsibility — to fix this. Requiring written informed consent, issuing statewide prescribing rules, and establishing a study committee are modest, reasonable steps that respect both patient autonomy and the free‑market principles our state values.
North Carolinians deserve a health care system that is transparent, accountable, and safe. It’s time for the legislature to act.