Legislators Hope to Take On Pill Mills

We'd like to think of it as some sort of response to our extensive expose of South Florida vice, though maybe that's presumptuous. Either way, the "pain clinic" problem is simply too big for anyone with a conscience to ignore. A Florida Medical Examiners Commission report estimated that on average, six Floridians die every day from prescription drugs. One local doctor I spoke to said the number in South Florida is "probably closer to ten or 11 a day."

Now legislators across the state are gearing up to take a crack at the issue.

Prescription pills kill more than three times the number of people who die from all illegal drugs combined. On top of that, a BSO report from last year showed that drugs sold in South Florida pill mills are smuggled across the country and resold. One estimate has about half of the illegal prescription drugs in the country originating in South Florida.

Right now, these pill dispensaries essentially work like the cannibis clubs in California: A patient comes in complaining of pain, and a medical professional prescribes and dispenses drugs. The biggest difference, of course, is that pot doesn't kill anyone and pills kill a lot of people.

Broward County has nearly 150 such clinics, with almost 20 in Oakland Park alone. Palm Beach county has nearly 100. As of 2009, 33 of the nation's top 50 Oxycodone-dispensing doctors practiced in Broward. Virtually anyone can own and operate one of these dispensaries, and if the place doesn't take insurance, there is essentially no regulation.

Laws passed last year were supposed to establish a statewide database of addictive prescription drugs, to track who has been prescribed what. But that database does not exist yet. Other laws could require clinics to register with another database set up by a state agency, making it easier to track the operations of individual clinics. But that database hasn't been created either.

Several readers asked if a front-page story in last weekend's Palm Beach Post was inspired by our coverage. In the article, several lawmakers proposed very different approaches to what should certainly be considered a major public health issue.

State Sen. Dave Aronberg of Greenacres suggests restricting clinic ownership to only doctors in good standing and would require the doctors to be present anytime prescription pills are dispensed. Right now, clinics must have an association with a doctor or pharmacist (to approve each prescription, in theory), though there is no requirement that the doctor be there to dispense the "medication."

Sen. Dan Gelber of Miami Beach, who's running against Aronberg in the Democratic state attorney general primary, is proposing a bill that would prohibit anyone convicted of a felony from owning or operating a clinic. 

Rep. Kelly Skidmore of Boca Raton wants to require the Department of Health to register all pain management clinics, set universal standards for them, inspect each clinic every year, and revoke the permits of any owner convicted of a felony. Skidmore sponsored last year's (still unenforced) law requiring the reporting of prescription drug sales.

Rep. John Legg of Port Richey is proposing a bill that would prohibit doctors from prescribing more than 72 hours' worth of drugs. "That 72-hour dispensing ban cuts the head off the serpent," he told the Post. "If we want to do this, we need to do it and be serious about it. The regulation will make their lives miserable, but the 72-hour ban will shut them down."

But Legg's bill wouldn't affect the clinics that operate as pharmacies and don't hire doctors.

The truth is, no matter who owns these places or how much slow regulation is put to the industry, the problem is in the packaging. No, not the bright signs that make them look like a cross between an emergency room and a fast-food joint. I mean the pills themselves. In my experience dealing with South Florida pain clinics, the problem seems to be a bit semantical: Many of the addicts that frequent these clinics to get powerful drugs like Oxycontin and Roxycontin believe firmly that they're just medical patients receiving medication, not junkies looking for a fast fix.

When the public starts thinking of pills -- even if they come directly from a doctor -- as drugs that are just as serious as the more traditional dangerous narcotics, then maybe something will get done.

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Michael J. Mooney