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<TITLE>South Florida and Oxycodone: Invasion of the Pill Mills</TITLE>
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<P DIR=LTR><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" FACE="Times New Roman">More sources of meds to the public</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN></P>
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<P DIR=LTR><SPAN LANG="en-us"></SPAN><A HREF="http://www.time.com/time/nation/article/0,8599,1981582,00.html"><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><U><FONT COLOR="#0000FF" FACE="Times New Roman">http://www.time.com/time/nation/article/0,8599,1981582,00.html</FONT></U></SPAN><SPAN LANG="en-us"></SPAN></A><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><B></B></SPAN><SPAN LANG="en-us"><B><FONT COLOR="#000000" SIZE=2 FACE="Georgia">Tuesday, Apr. 13, 2010</FONT></B></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><B></B></SPAN><SPAN LANG="en-us"><B><FONT COLOR="#000000" SIZE=6 FACE="Arial">South Florida and Oxycodone: Invasion of the Pill Mills</FONT></B></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><B></B></SPAN><SPAN LANG="en-us"><B><FONT COLOR="#000000" SIZE=2 FACE="Georgia">By Thomas R. Collins / Fort Lauderdale</FONT></B></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT FACE="Georgia">It's only 8:45 a.m., but the storefront is already busy. Men and women in</FONT> <FONT FACE="Georgia">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.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT FACE="Georgia">The waiting room at Broward Pain Clinic is swarming. A woman begs a rece</FONT><FONT FACE="Georgia">ptionist, "There's no way he can squeeze me in?" "We're packed," the receptionist explains. "Packed, packed, packed."</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT FACE="Georgia">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</FONT> <FONT FACE="Georgia">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</FONT><FONT FACE="Georgia"></FONT> <FONT FACE="Georgia">go to a pharmacy. The business card of the Broward Pain Clinic announces, "Dispensing on Site!"</FONT> <FONT FACE="Georgia">—</FONT><FONT FACE="Georgia"> 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</FONT></SPAN><SPAN LANG="en-us"><I></I></SPAN><SPAN LANG="en-us"><I> <FONT FACE="Georgia">Miami Vice</FONT></I></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT FACE="Georgia"> era.</FONT> <FONT FACE="Georgia">Prescription oxycodone now reigns supreme.</FONT></SPAN><SPAN LANG="en-us"> </SPAN><A HREF="http://www.time.com/time/magazine/article/0,9171,986282,00.html"><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><U></U><U><FONT COLOR="#003366" FACE="Georgia">(See why people get addicted.)</FONT></U></SPAN><SPAN LANG="en-us"></SPAN></A><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT FACE="Georgia">The nation's top 25 oxycodone-dispensing doctors were all in Florida in the</FONT> <FONT FACE="Georgia">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</FONT> <FONT FACE="Georgia">—</FONT><FONT FACE="Georgia"> pill-shopping t</FONT><FONT FACE="Georgia">r</FONT><FONT FACE="Georgia">ips 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 fro</FONT><FONT FACE="Georgia">m</FONT><FONT FACE="Georgia"> Ohio, Tennessee and Kentucky as there are from Florida.</FONT></SPAN><SPAN LANG="en-us"> </SPAN><A HREF="http://www.time.com/time/photogallery/0,29307,1899641,00.html"><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><U></U><U><FONT COLOR="#003366" FACE="Georgia">(See pictures of America's cannabis culture.)</FONT></U></SPAN><SPAN LANG="en-us"></SPAN></A><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT FACE="Georgia">Broward County sheriff Al Lamberti says he isn't sure why his j</FONT><FONT FACE="Georgia">urisdiction 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."</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT FACE="Georgia">Meanwhile, deaths related to prescription-drug use in Florida rose from 2,780</FONT><FONT FACE="Georgia"> 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</FONT> <FONT FACE="Georgia">b</FONT><FONT FACE="Georgia">e a doctor to run a pain-management clinic, Lamberti says. "You need a background check to get a liquor license</FONT> <FONT FACE="Georgia">—</FONT><FONT FACE="Georgia"> you can't be a convicted felon and open up a bar</FONT> <FONT FACE="Georgia">—</FONT><FONT FACE="Georgia"> but you can be a convicted felon and open up a pain clinic."</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT FACE="Georgia">And so the clinics continue th</FONT><FONT FACE="Georgia">eir 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 c</FONT><FONT FACE="Georgia">l</FONT><FONT FACE="Georgia">inics, 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 requ</FONT><FONT FACE="Georgia">i</FONT><FONT FACE="Georgia">re patients to be fingerprinted when they pick up their pills, for better monitoring.</FONT></SPAN><SPAN LANG="en-us"> </SPAN><A HREF="http://www.time.com/time/specials/packages/article/0,28804,1903873_1903802,00.html"><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><U></U><U><FONT COLOR="#003366" FACE="Georgia">(See how to prevent illness at any age.)</FONT></U></SPAN><SPAN LANG="en-us"></SPAN></A><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT FACE="Georgia"> </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT FACE="Times New Roman">The clinics are c</FONT><FONT FACE="Times New Roman">oming under more fire than ever. Florida legislators have already passed a law that is supposed to create a database to track pain-pill purchases</FONT> <FONT FACE="Times New Roman">—</FONT><FONT FACE="Times New Roman"> as 38 other states already have. And there's more legislation in the pipeline this year, including laws tha</FONT><FONT FACE="Times New Roman">t</FONT><FONT FACE="Times New Roman"> 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. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT FACE="Georgia">But legislating good intentions is one thing. Real solutions ar</FONT><FONT FACE="Georgia">e harder to come by. Although the state has approved a database to track pill dispensing, there is no dedicated funding source</FONT> <FONT FACE="Georgia">—</FONT><FONT FACE="Georgia"> the legislation merely gave officials the ability to seek grants for it. The Broward County grand-jury report concluded that t</FONT><FONT FACE="Georgia">h</FONT><FONT FACE="Georgia">e 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.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT FACE="Georgia">State senator Dave Aronberg, who represents part of South Florida and is sponsoring anti-pill-</FONT><FONT FACE="Georgia">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 h</FONT><FONT FACE="Georgia">o</FONT><FONT FACE="Georgia">w easy it is to get pills. "I get all these stories</FONT> <FONT FACE="Georgia">—</FONT><FONT FACE="Georgia"> 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 tightr</FONT><FONT FACE="Georgia">o</FONT><FONT FACE="Georgia">pe, 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."</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT FACE="Georgia">Case in point: a man outside the Broward County clinic who says he makes the 11-hour dr</FONT><FONT FACE="Georgia">ive 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 ra</FONT><FONT FACE="Georgia">t</FONT><FONT FACE="Georgia">her 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 agree</FONT><FONT FACE="Georgia">s</FONT><FONT FACE="Georgia"> 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.</FONT><FONT FACE="Georgia">"</FONT></SPAN></P>
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<P DIR=LTR><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><A NAME=""><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">Deborah L. DeBiasi</FONT></SPAN></A><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" FACE="Arial"><BR>
</FONT></SPAN><SPAN LANG="en-us"><B></B></SPAN><SPAN LANG="en-us"><B></B></SPAN><B><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">Email: </FONT><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">Deborah.DeBiasi@deq.virginia.gov</FONT></SPAN></B><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" FACE="Arial"></FONT></SPAN><SPAN LANG="en-us"><B><I></I></B></SPAN><SPAN LANG="en-us"><B><I></I></B></SPAN><B><I><SPAN LANG="en-us"> <FONT COLOR="#FF0000" SIZE=2 FACE="Times New Roman">(NEW!)<BR>
</FONT></SPAN></I></B><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">WEB site address: www.deq.virginia.gov</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" FACE="Arial"><BR>
</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">Virginia Department of Environmental Quality</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" FACE="Arial"><BR>
</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">Office of Water Permit Programs</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" FACE="Arial"><BR>
</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">Industrial Pretreatment/Whole Effluent Toxicity (WET) Program</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" FACE="Arial"><BR>
</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">PPCPs, EDCs, and Microconstituent</FONT><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">s</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">www.deq.virginia.gov/vpdes/microconstituents.html</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" FACE="Arial"><BR>
</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">Mail: P.O. Box 1105, Richmond, VA 23218</FONT></SPAN><SPAN LANG="en-us"><B><I></I></B></SPAN><B><I><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" FACE="Arial"></FONT></SPAN></I></B><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><BR>
</SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">Location: 629 E. Main Street, Richmond, VA 23219</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" FACE="Arial"><BR>
</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">PH: 804-698-4028</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" FACE="Arial"><BR>
</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=2 FACE="Times New Roman">FAX: 804-698-4032</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080" FACE="Arial"> </FONT></SPAN></P>
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