[Pharmwaste] South Florida and Oxycodone: Invasion of the Pill Mills

Wed Apr 14 09:36:41 EDT 2010

More sources of meds to the public

http://www.time.com/time/nation/article/0,8599,1981582,00.html

Tuesday, Apr. 13, 2010
South Florida and Oxycodone: Invasion of the Pill Mills
By Thomas R. Collins / Fort Lauderdale
It's only 8:45 a.m., but the storefront is already busy. Men and women
in jeans, baseball hats and leather jackets keep the tinted door
swinging open and closed. But this is not a retail outlet. It's a
pain-management clinic. The people have come for pills.
The waiting room at Broward Pain Clinic is swarming. A woman begs a
receptionist, "There's no way he can squeeze me in?" "We're packed," the
receptionist explains. "Packed, packed, packed."
There are more of these pain clinics here in Broward County than there
are McDonald's restaurants: 115 so-called pill mills, vs. about 70 of
the burger franchises. And that profusion contributes to one big
problem: there is no tracking system to prevent patients from getting
multiple pill prescriptions at once and immediately, because the clinics
hand out the pills rather than making people go to a pharmacy. The
business card of the Broward Pain Clinic announces, "Dispensing on
Site!" - a service that's also trumpeted by dozens of other clinics.
Because of that, cocaine is no longer king in South Florida, as it was
during the Miami Vice era. Prescription oxycodone now reigns supreme.
(See why people get addicted.)
<http://www.time.com/time/magazine/article/0,9171,986282,00.html> 
The nation's top 25 oxycodone-dispensing doctors were all in Florida in
the first half of 2008; 18 of them were in Broward County, according to
a Broward County state attorney grand-jury report. In South Florida
overall, there were 176 pill mills, up from 66 just 14 months before.
This has contributed to tourism - pill-shopping trips to the Sunshine
State from Tennessee and Kentucky, where authorities have cracked down
hard on similar clinics, seem to be as common as Disney vacations
nowadays. In the parking lot of the Broward Pain Clinic, there are just
as many license plates from Ohio, Tennessee and Kentucky as there are
from Florida. (See pictures of America's cannabis culture.)
<http://www.time.com/time/photogallery/0,29307,1899641,00.html> 
Broward County sheriff Al Lamberti says he isn't sure why his
jurisdiction has become the hotbed. "There's no reasonable explanation,"
he says. "It seems like it's just happened. I don't know why. Maybe we
have better beaches, I don't know."
Meanwhile, deaths related to prescription-drug use in Florida rose from
2,780 in 2006 to 3,317 in 2007, and then to 3,750 in 2008. The last
figure is equivalent to about 10 reported deaths a day. That's more than
the number of fatalities from street drugs like cocaine and heroin. It
doesn't help that in Florida, you don't need to be a doctor to run a
pain-management clinic, Lamberti says. "You need a background check to
get a liquor license - you can't be a convicted felon and open up a bar
- but you can be a convicted felon and open up a pain clinic."
And so the clinics continue their march northward. The latest front line
is Palm Beach County, just north of Broward County. That county had 372
suspected overdose deaths from legal pain pills in 2009, up from 248 in
2005, according to published reports. Alarmed by the spread of the
clinics, Palm Beach County commissioners just passed a moratorium to
keep new clinics from opening while officials try to hammer out a
solution. Other local governments are passing similar moratoriums. A
commissioner in one city, Delray Beach, wants to require patients to be
fingerprinted when they pick up their pills, for better monitoring. (See
how to prevent illness at any age.)
<http://www.time.com/time/specials/packages/article/0,28804,1903873_1903
802,00.html>  
The clinics are coming under more fire than ever. Florida legislators
have already passed a law that is supposed to create a database to track
pain-pill purchases - as 38 other states already have. And there's more
legislation in the pipeline this year, including laws that would make it
illegal for anyone other than a doctor in good standing to run one of
the clinics, ban advertising by the clinics and limit how much pain
medicine can be dispensed at one time. 
But legislating good intentions is one thing. Real solutions are harder
to come by. Although the state has approved a database to track pill
dispensing, there is no dedicated funding source - the legislation
merely gave officials the ability to seek grants for it. The Broward
County grand-jury report concluded that the monitoring program should be
"swiftly implemented and adequately funded, by any means necessary." But
that's a tall order in a state hard hit by the recession.
State senator Dave Aronberg, who represents part of South Florida and is
sponsoring anti-pill-mill legislation, acknowledged that money is an
unsolved matter. "There are grants to get it going. Then we have to
figure out a recurring funding mechanism," he says. Action must be
taken, he says, because anyone can end up ensnared by addiction, given
how easy it is to get pills. "I get all these stories - people telling
me about their brother dying, their sister dying," he says. "These are
heads of families who end up in a terrible situation because of a
workplace injury." But it's like walking a tightrope, he adds: "It's a
delicate balance here. You want to stop the pill mills. At the same
time, you don't want to stop legitimate patients from getting pain
management."
Case in point: a man outside the Broward County clinic who says he makes
the 11-hour drive from Tennessee every month just to get his medication.
He says he is prescribed medicine for chronic neck pain stemming from a
forklift injury but cannot get the medicine he needs anywhere near his
home. He won't divulge what he is prescribed. "I'd rather not say, but
it's helping me," he says. "I'm not a junkie." The medicine allows him
to keep working as an excavator, he says. "They help people that can't
get medication that they need," he says. "Thank God there are places
like this." Though he agrees that some people take advantage of the
clinics, efforts to shut them down are misguided, he says, and pain
medication is essential. "It's everybody's constitutional right."

Deborah L. DeBiasi 
Email:   Deborah.DeBiasi at deq.virginia.gov (NEW!)
WEB site address:  www.deq.virginia.gov 
Virginia Department of Environmental Quality 
Office of Water Permit Programs 
Industrial Pretreatment/Whole Effluent Toxicity (WET) Program 
PPCPs, EDCs, and Microconstituents
www.deq.virginia.gov/vpdes/microconstituents.html 
Mail:          P.O. Box 1105, Richmond, VA  23218 
Location:  629 E. Main Street, Richmond, VA  23219 
PH:         804-698-4028 
FAX:      804-698-4032 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20100414/eb6902a2/attachment.htm