Florida's "pill mills"

There have been a few discussion threads addressing the "pill mills" in Florida and the consequences for legitimate patients, including the extreme shortages of oxycodone in some parts of the state.

So, here's a news story that may interest folks:

http://www.nytimes.com/2011/02/24/us/24drugs.html?emc=eta1

Excerpt: " Mr. Trouville said that since the operation began a year ago, a task force had taken action against 66 doctors at 83 locations and seized more than $25 million worth of property. "

Thank you for sharing this info with us. I just read the artlicle and it's horrible that they clinics are giving drugs like this. It's just making it harder for those of us with cp to get our legitimate medications. It makes me sick.

Dani
thank you for sharing even more information. wow. they have long laws or whatever they are i can't remember, don't they? This is so serious.

people are dying and i'm sure these pill mills couldn't give a crap.

love and hugs
Loretta

These pill mills make it harder for us legitimate pain patients...but I think we need to go after the crooked docs rather than punishing the patients. I don't want any of my meds in a database with our government...not my psych meds, not my thyroid meds and not my pain meds. We've seen how well our government can protect it's classified info, how well are they gonna protect my classified info? Something needs to be done here in Florida b/c it's bad. But the fact of the matter is that people who want to abuse drugs are going to do so and if we take the pills away they will jsut find something else. We need to help the drug addicts get off drugs and close the pain management clinics that hand this stuff out like skittles but I don't want "Big Brother" knowing what I consider my personal business.

Just my 2 cents as a Florida resident who has had my pain management care impacted by this issue.

Also, our govoner recently decided he wasn't going to support the database with gov't funding.

I agree. I don't want my "personal business" on the government database either. I don't trust them on bit. Who knows what would happen it that came to fruition (sp?) It's scary. They do need to take care of the people that are addicted like that so we can have peace that we can get our meds and not have to worry about it.

love and hugs
Loretta

Just FYI,  MN already tracks how many narcotics physician's write RX for and if they are suspicious they are investigated.  Thus physicians are leary of writing scripts for pain meds.

Kitt

I agree with each and every poster on this topic. It's hard enough being a pain patient without all the crap that is out there. I've witnessed so much horror in my years of being a pain patient and it scares me that people are out there doing this.

I've seen deals going down in parking lots, had my son stealing my medications and witnessed people in full withdrawls mode cause they can't control their urges to steal pain meds and get "high". Out of all of it....only one really got to me....my youngest was a senior in hs and got hooked, via one of his friends, on my pain medications. I don't know how long he had been stealing from me and I really didn't want to know. But, when I did find out it scared the hell out of me and I can honestly say that I feared for the kids life.

I had mixed emotions at that point. I was furios, scared to death, felt like I had been stabbed in the heart and totally depressed. Of course he had the gaul to deny everything, but I had him red handed and told him I would let this one slide. Kicked him out of the house and told him that if he ever stoled from me again I would turn him into the police.

Anyway, my point is.....that for some unknown reason my son was drawn to this. I don't understand it but I don't have to watch while he ruined his life either. These people are the worst of the worst.

Anyway, hard to trust him again.

Hugs

Scarred

Thanks for the articles.... I am a south FL resident and I always have had a problem filling my scripts....

Just last week my primary Dr. put my back on Oxycodone.... I got the script drove right to the pharmacy handed them the script and was told they couldn't take the script... because.... the date was not spelled out... the date was on there but was like this: 10/6/11.... the word October was not spelled out...

I had to drive 20 minutes back to my Dr's office to have the problem corrected... she was angry.... apparently there is yet another law that the date must be spelled out and the # of pills must be written out and also in # form....

It should be: sixty and 60.

So crazy... but again... it's always something!

Honestly, part of the solution is research into safer narcotics and ofcourse to make existing narcotics less abusable through other means outside of adding APAP to it (or other substances that can cause real damage to the body).

The biggest issue with safer narcotics is that sometimes the "safety" mechanism cause them to work improperly when following the tradtional prescribing profile. For example, there was a morphine pill that was supposed to be tamper resistant but there were complaints it did not digest and break down properly in the system. Hopefully, that ones been fixed.

The second idea is more research into safer new narcotics. The thing is the opioid pathway remains one of the most effective ways to treat pain. As science is discovering over time, there are several sets of receptors. More recent medications use multiple pathways, which can have opioid sparing effects. Bustran is a pretty good example of this, as its not new in existance, but new for chronic pain management, and its method of delivery makes it difficult to abuse. Like Tramadol and Tapentadol, it also works on the norephedrine system for addition pain relief action.

Demoral was one of the first to have multiple mechanisms of action. However it was toxic and too short lasting, but for nuero pain it worked very well. I think science has realized multi action medications which could utilize weaker opioids IF properly adjuvanted is the best path forward. However, it took years to see the Bustran patch, 25 years to advance from tramadol to tapentadol, and there were newer medications talked about that have yet to make it into phase III trails. Also, to have less addictive medications like Bustran patch (enter as Schedule III) and tapentadol (enter as Schedule II) really hurt the industry since tramadol was unschedule (and still is federally) and marketed as less addictive. All evidence indicates that thought tramadol can be abused and is, its still less abused and addictive than other opioids. That has to be partially attributed to its multiple mechanisms of action and it seems we've hit a stumbling block here with anti depressants being now labelled addictive by some within the medical community. Hopefully anti depressants will surive the scrutiny.

The DEAs current policies are well supported by politicians on both sides of the spectrum. Those policies are in need of revamping, but unfortunately the conservatives feel this is an area where big government is needed and liberals feel everything must be regulated (generalizations, no offense to anyone :)  Until politicians on both sides can realize that government protection/regulation is just as important as proper health treatment in society and can balance the 2 out, the DEA regulation will remain unchanged. This is sad because the DEA is for the benefit of Americans not the disbenefit, and therefore a system with disbenefit like this isn't properly serving the government or people of the unites states :/

Re-hi, I think the New York Times article confirms the Cato Institute article in one paragraph here: “This is a completely profit-driven operation that has no medical regard for anyone,” Mark R. Trouville, the special agent in charge of the Miami field office for the D.E.A., said in an interview. “These clinics have nothing to do with the welfare of the community.”

Imme

I think the government/dea intervention is rediculous.

I have very liberterian views though. If someone decides to use hard drugs, then ruins their lives and their families lives. Then so be it. Moral and drug issues should not be the governments business. I'm ok with using some tax dollars for real drug education as opposed to the bullcrap propoganda they've been using since the 70's but that is as far as they should go with my money. Create jobs, fix infrastructure and leave the morals or lack there of to parents. Some people just turn out bad regardless. Such is life. A Utopia will not be created, our rights wil just be lost trying. Rant over :)

I don't think the AMA, the DEA, and the FDA are doing this to reduce drug related deaths. That's just what they say in order to do what they do. It's about money as always. The profits law enforcement reaps from arresting medical professionals is nothing to sneeze at. I don't just mean pill mills but rather medical professionals as a whole. And there's nothing wrong in my book with doctors who actually do make money as long as it's legal.

But what is wrong is that law enforcement organizations divide all profits, (assets) they seize *during* arrest and not after conviction between their organizations. That way doctors have no resources to defend themselves in court, and end up plea bargaining down to a lessor crime and or jail time. That's why all anyone reads in the news that so and so doctor was found guilty of "x".

It blows my mind that this kind of thing is even happening in America. But it's all on the Internet for people to read, they just need to dig just a little deeper than front page news and or Fox TV. Of course the people who need to know these things won't be bothered, it's so much easier to point the finger and blame someone else for our societies problems.

Google Dr. Scott Fishman for one example. You may already know of him for his relentless advocacy of quality pain care and compassionate treatment of chronic pain patients.

Dr. Fishman was arrested and had to move back home to live with his parents because all of his assets were seized at the time of arrest. But he would not plea bargain and 5 years later all charges against him were dropped. He lost everything he had worked for. I found this information by going to the Cato Institute website.

One more thing that really disturbs me is that Florida law now states that the DEA must be allowed access to all patient records if requested, no warrant is needed.

Imme

I used to and still do volunteer in local law enforcement and have gone on quite a few traffic stops. Its disgusting the amount of narcotics officers pull of people of EVERY age. I'm serious too. Its a pretty wealthy area too with plenty of respectable physicians. But when I was in high school the given was talk about ADHD stimulants as I think about %70 of kids had a valid script...I would go into the nurses office and they had a cabinet chalked full of bottles labeled "CONTROLLED SUBSTANCE". Then I would hear tons of talk about OxyContin, Vicodin, etc. Most kids didn't know much about it but boy allot of people seamed to have it and use it. It always bothered me because kids would get stupid large amounts of it. (Edited for language) One girl about 17 had a 20mg 2x a day OxyContin script for fibromyalgia she had for a year...she was started on OxyContin from the start and even admitted she didn't need it but it was "like her antidepressants" in a semi-sarcastic tone. Only reason I know the details is because she came in pissed one day when her new doctor refused to write for it and wanted to switch her to Tylenol #3. Then of course allot of football players would talk about Vicodin and what not but thats a given if you look at the entire NFL's narcotics use statistics. I heard about a few kids with pain problems but becoming addicted and having there parents basically lock there pain killers away and manage the whole issue. There were also allot of the druggies who would take Vicodin in really unsafe amounts not understanding that 2000mg of tylenol at once is not good for you.

Over all I can't comment on "pill mills" but I can say doctors need to (Edited for language) learn how to manage pain. I do not think everyone needs to go to a pain specialist; I mean come on an Internist; the type of doctor allot of people see as their primary s job is "to diagnose, treat and manage chronic diseases and ailments of the body with a focus on general medicine". I think once you have a diagnoses and a pain specialist has ruled out other treatments there should be no issues with an Internist or whoever you see as a primary, prescribing opiates should not be an issue if the doctor has any sense of good judgement...anyways that's just my opinion.


(Edited for language)
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Post Edited By Moderator (Screaming Eagle) : 10/13/2011 4:04:20 PM (GMT-6)

I'm in canada ,and its much the same here !I wish there was a patch to wear that would kill the pain .I try to be so careful with meds as narcotics are not good for the body ,yet so necessary for helping ease CP.I too blame the media for the hype. Its sad the abuse of pain meds and people making money from illegal sales and not caring about consequences.