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'Pill mills' targeted in Florida legislature

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By Carl  Orth | The Suncoast News

Published: October 24, 2009

PORT RICHEY - Abuses of prescription painkillers is a hard pill for state lawmakers to swallow.

So-called "pill mills" have transformed much of Florida into "the painkiller capital of the United States, the notorious home to a cottage industry of storefront pain clinics selling alarming numbers of narcotics and feeding a brazen black market," state Rep. John Legg said in a press release.

In the last six months of 2008, South Florida pain clinics alone handed out more than 6.5 million pills of the potent narcotic painkiller oxycodone to walk-in patients, Legg laments.

Legg, R-Port Richey, wants to do something about it by filing House Bill 225 with more restrictions on dispensing of controlled substances. He hopes other lawmakers will come on board to pass the legislation in 2010.

It took six years for state Sen. Mike Fasano, R-New Port Richey, to shepherd a prescription drug monitoring database into becoming law this year.

Fasano's target also has been the pill mills. The new law will help close a loophole, according to Greg Giordano, his chief legislative assistant. People paying cash to bypass medical plans are the target of this monitoring bill.

The other thrust of the bill is to prevent "doctor shopping," in which patients use multiple prescriptions to trick doctors, Giordano elaborated. Doctor shopping is a third-degree felony.

A task force is still ironing out the details on how to set up the drug monitoring system, Giordano said. Some of the task force recommendations are expected by the end of the year. The database could be up and running perhaps by late in 2010, according to Giordano.

Legg hopes to take regulations a step farther.

The pill mills have popped up at strip malls and nondescript office parks - some with armed guards stationed by the clinic, Legg complains.

Many Florida pain doctors can dispense narcotics directly to patients without a pharmacist, even doctors with disciplinary or criminal records, Legg elaborates.

More oxycodone is distributed in Florida than in any other state - 40 percent more than in second-ranked California in 2006, according to DEA data.

Legg's proposal would limit physician controlled substance dispensing to a 72-hour supply. He believes this could effectively eliminate abusive pain clinics, which make money from volume dispensing, not physician visits or prescribing.

The legislation would not interfere with the doctor-patient relationship, Legg argues. Physicians can still prescribe any drug and in any amount they deem necessary.

Patients requiring more than a 72-hour dose of a controlled substance must go to a licensed pharmacy to fill their prescriptions, instead of getting the drugs directly from their doctor's office.

Pharmacies have automatic, real-time access to patient drug history information, Legg observed.

"We must face the prescription drug abuse epidemic head on," Legg said. "It is my hope that we if we can cut off the supply we can subsequently reduce the demand for these widely abused pain medications that are tearing apart the lives and families of so many Floridians."

While it remains to be seen how much support Legg's bill will garner, plans are proceeding for the new Florida tracking system to monitor for possible abuse of prescription drugs.

Oddly enough, the law to create the tracking system was signed by Gov. Charlie Crist on June 18, only one week before the death of singer Michael Jackson who reportedly used powerful prescription drugs.

Statistics can be rather startling from the Florida Medical Examiners report released in June.

Deaths from the painkiller oxycodone increased significantly in 2008 statewide.

In drug overdose cases, only heroin and methadone were more lethal than products with oxycodone. Overdoses with synthetic opiate oxycodone were fatal nearly 60 percent of the time.

Oxycodone accounted for the highest number of drug deaths in Florida in 2008, with 941 in all. Misuse of alprazolam, the anti-anxiety drug better known under the brand name Xanax, led to 705 other deaths.

The death rate from the misuse of legal drugs here is three times the death rate attributed to illegal drugs, statistics from the medical examiners' report indicate.

So law enforcement agencies have been "highly supportive" of Fasano's drug monitoring bill, Giordano added.

Carl Orth can be reached at 727-815-1068 or corth@suncoastnews.com.

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