THE PILL MILL INITIATIVE: ARE WE DOING ENOUGH?

courtesy : FDLE

Until a short time ago, Florida was known for a few things: sun, beaches, fishing and pill mills.

Amidst the stunning beauty of the state, settled very many pharmacies and unscrupulous doctors, who together conspired to create a wide and intensive network of distribution of pain killing medication that created a huge wave of illicit drug trafficking and drug abuse.

The reason for the sudden growth of pain management clinics and the pharmacies that operated with them, was a giant loophole in the Florida law.  Florida did not require a licensed doctor to own a pain management clinic, and there was no system that tracked the pharmaceuticals from the manufacturer all the way to its ultimate user.

This created a tremendous opportunity for people who knew how to exploit the system and sell prescriptions at prohibitive costs, and were then aided by pharmacies, who in turn charged a premium for the medications and closed both eyes to both the quantities in the prescriptions and the number of prescriptions presented.

In the course of a few years Florida transformed into a drug addict and dealer haven.  

Open air clinics and pharmacies were visited by an endless stream of drug dealers and addicts who traveled from as far as Washington state, but who mainly came from the rural midwest. 

Many of the clinics employed private security, often visible from the road.  Often long-strech limos would pull up.  Other times, drug addicts could be seen crushing and smoking or injecting the pharmaceuticals in the parking lot of the clinic.

For a long while, nothing could be done.  It was all legal.  The then Governor of the state of Florida did not respond to numerous pleas to pass legislation that would halt the existance of pill mills.  

Until 2012 that is.  The Attorney General of Florida launched an initiative to investigate and close pill mills, using a bill passed just to combat the scourge.

At the height of the epidemic the number of deaths by overdose topped seven per day. 

However, as the Florida authorities cracked down on the pill mills in their state, the people who owned them packed up tent and pitched it in neighboring Georgia, who sadly enough also has inadequate laws to stop the pill mills.

This sudden exodus from Florida and the settling of new business in Georgia shows how quickly these people can relocate and how elusive a victory against prescription drug abuse can be.  

The uptick in Georgia has already been registered: the clinics that dole out painkillers have gone from 10 in 2010 for the entire state to 125 in just two years.    

Per capita prescription sales of the pharmaceuticals in the pill mill business has tripled in two years.

But Georgia has tried to cut the bud before it gets out of hand.  

But if they are kicked out of Georgia, the pill mill owners will just settle into another 'friendlier' state.  

But what is the cause of this problem?  One of the causes as observed by independent studies is the abuse of drugs like oxycodone by the general population.  There has also been a substantial uptick of legal and legitimate prescriptions of oxycodone and related compounds to the general population.  

Some have argued that such widespread, and arguably unnecessary, use of the medicine might be creating a generation of drug addicts and that there should be less willingness by doctors to prescribe the medicine for less severe cases.  Oxycodone is considered to be one of the most addictive prescription medications on the market. Some contend that the medications are too easily prescribed and often for complaints that might not be true, or for symptoms easily manageable with over the counter medications.  

Why then are doctors prescribing so many of these painkillers?  Some sources point to the intransigence of some patients who want a medication that is fast and effective, others instead look towards the fact that some doctors only see their patients for a very short time and sometimes fail to detect a patient who is 'fishing' for prescription of the medication to which they might be now addicted.

Cracking down on the dispensation of such medication, on the other hand, could spell trouble for legitimate patients, who would have to be screened and scrutinized before obtaining their medication.

Another problem is that different legislation on the regulation of prescriptions and dispensation of such drugs exist in each state.  Each state enacts different legislation in an attempt to invite business to their state.  However, this checkerboard of different legislation plays in the hand of savvy drug dealers and pill mill owners who know all too well how to take advantage of them.  A push to increase regulation is often met with resistance by the states, who prefer free market practices to favor businesses that operate within their state. 

Law enforcement then, is fighting a losing battle.  It's like a 'game of Whack a Mole" said recently one law enforcement official.                

 Source: Wall Street Journal/Office of the Attorney General of Florida/FDLE