Pain Clinics: Immediate Action Required

Attached two recent articles from the Miami Herald and Sun Sentinel highlighting the continuous and growing problem with pain clinics in South Florida.
I also witnessed a new phenomenon: one pain clinic in my area was finally shut down but reopened several days later calling itself "MedClinic" offering ALL medical services INCLUDING pain management. That means they will restart the SAME activities with the SAME management!! Its really frustrating! We have to focus on promoting tough measures as outlined in the grand jury recommendations. Therefore, I ask FSAM to issue a press release supporting the following recommendations and to contact the legislators asking them for their support.

The grand jury recommended to the Legislature 18 new reforms to curb the pain-clinic problem, including closing several loopholes the new state law failed to address. They include:

• Preventing pain clinics from distributing drugs on site until the state database is up and running next year.


• Limiting prescriptions from pain clinics to no more than a three-day supply.


Looking forward to your comments.
Yours
Bernd


Bernd Wollschlager,MD,FAAFP,FASAM
Member of the PRESCRIPTION DRUG MONITORING PROGRAM IMPLEMENTATION AND OVERSIGHT TASK FORCE





Posted on Fri, Nov. 20, 2009
Broward grand jury recommends pain clinic reforms

BY SCOTT HIAASEN
shiaasen@MiamiHerald.com

A Broward County grand jury issued a damning report Thursday bemoaning the explosion of illegal painkillers sold through Broward pain clinics -- and warning that reforms passed by the Legislature may not be enough.
Echoing a Miami Herald investigation earlier this year, the report details how lax state laws spawned a cottage industry of storefront pain clinics across South Florida, which have become the primary source of illegal painkillers in the eastern United States.

In just the past two years, the number of pain clinics in Broward County grew from four to 115, the grand jury found. In one six-month span, Broward pain-clinic doctors dispensed more than 9 million tablets of oxycodone, one of the most powerful and dangerous painkillers on the market -- far more than any other part of the country.

Addicts and drug peddlers routinely hop from clinic to clinic using bogus medical records to pass off fake injuries and obtain prescriptions -- a practice known as ``doctor shopping,'' the grand jury found. The proliferation of clinics attracts carloads of illegal drug buyers from other states, notably Kentucky, Ohio, West Virginia and Tennessee.

While some pain clinics offer legitimate medical services, most are ``rogue clinics putting out pills for cash,'' the report found.

``By the time law enforcement initiates and completes a successful investigation leading to the arrest of a doctor, user or dealer, several new clinics have opened,'' the report said.

WEAKNESSES

In response to the growing problem, state lawmakers approved a new law this spring placing pain clinics under greater scrutiny, and creating a database of prescription drugs sold, so prescribing doctors can better detect ``doctor shopping'' patients.

But the grand jury highlighted weaknesses in the law -- most notably, that the database program has no dedicated source of funding. State officials plan to seek grants to pay for the $4 million program.

The grand jury also criticized a section of the law that allows doctors to record prescriptions in the database within 15 days of their distribution. The grand jurors said drug traffickers could have come and gone by the time their prescriptions are recorded.

CLOSING LOOPHOLES

The grand jury recommended to the Legislature 18 new reforms to curb the pain-clinic problem, including closing several loopholes the new state law failed to address. They include:

• Preventing pain clinics from distributing drugs on site until the state database is up and running next year.

Many clinics advertise that they both prescribe and sell pills on site to attract clients -- another practice the grand jury would ban.

• Limiting prescriptions from pain clinics to no more than a three-day supply.

Clients at pain clinics typically receive a 30-day supply of drugs -- 150 to 240 tablets of oxycodone, often coupled with the painkiller roxycodone and anti-anxiety drugs such as Xanax -- after only one doctor's visit.

CRIMINAL RECORDS

• Barring people with criminal records from owning pain clinics. The Miami Herald investigation found several examples of clinic owners with criminal records, including the owner of a Boca Raton pain clinic who once pleaded guilty to possession of steroids with intent to sell.

• Limiting the number of pain-relief patients to 100 per clinic, and placing limits on the number of out-of-state patients a clinic may have.

Narcotics investigators have said that some pain clinics have as many as 65 patients per day. One Coral Springs doctor indicted on trafficking charges last year had nearly 500 patients from Kentucky.


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sun-sentinel.com/news/broward/flgrand-jury-pill-mill-20091119,0,1892598.story

South Florida Sun-Sentinel.com

Grand jury recommends pill mill cleanup

In two years, number in Broward jumped from four to 115, panel finds

By Scott Hiaasen, The Miami Herald

November 19, 2009


A Broward County grand jury issued a damning report Thursday bemoaning the explosion of illegal painkillers sold through Broward pain clinics — and warning that reforms passed by the Legislature may not be enough.

Echoing a Miami Herald investigation earlier this year, the report details how lax state laws spawned a cottage industry of storefront pain clinics across South Florida, which have become the primary source of illegal painkillers in the eastern United States.

In just the past two years, the number of pain clinics in Broward County grew from four to 115, the grand jury found. In one six-month span, Broward pain-clinic doctors dispensed more than 9 million tablets of oxycodone, one of the most powerful and dangerous painkillers on the market — far more than any other part of the country.

Addicts and drug peddlers routinely hop from clinic to clinic using bogus medical records to pass off fake injuries and obtain prescriptions — a practice known as "doctor shopping," the grand jury found. The proliferation of clinics attracts carloads of illegal drug buyers from other states, notably Kentucky, Ohio, West Virginia and Tennessee.

While some pain clinics offer legitimate medical services, most are "rogue clinics putting out pills for cash," according to the report.

"By the time law enforcement initiates and completes a successful investigation leading to the arrest of a doctor, user or dealer, several new clinics have opened," the report said.

In response to the growing problem, state lawmakers approved a new law this spring placing pain clinics under greater state scrutiny, and creating a database of prescription drugs sold, so prescribing doctors can better detect "doctor shopping" patients.

But the grand jury highlighted weaknesses in the law — most notably, that the database program has no dedicated source of funding. State officials plan to seek grants to pay for the $4 million program.

The grand jury also criticized a section of the law that allows doctors to record prescriptions in the database within 15 days of their distribution. The grand jurors said drug traffickers could have come and gone by the time their prescriptions are recorded.

The grand jury recommended to the Legislature 18 new reforms to curb the pain-clinic problem, including closing several loopholes the new state law failed to address. They include:

Preventing pain clinics from distributing drugs on site until the state database is up and running next year. Many clinics advertise that they both prescribe and sell pills on site to attract clients — another practice the grand jury would ban.

Limiting prescriptions from pain clinics to no more than a three-day supply. Clients at pain clinics typically receive a 30-day supply of drugs — 150 to 240 tablets of oxycodone, often coupled with the painkiller roxycodone and anti-anxiety drugs such as Xanax — after only one doctor's visit.

Barring people with criminal records from owning pain clinics. The Miami Herald investigation found several examples of clinic owners with criminal records, including the owner of a Boca Raton pain clinic who once pleaded guilty to possession of steroids with intent to sell.

Limiting the number of pain-relief patients to 100 per clinic, and placing limits on the number of out-of-state patients a clinic may have. Narcotics investigators have said that some pain clinics have as many as 65 patients per day. One Coral Springs doctor indicted on trafficking charges last year had nearly 500 patients from Kentucky.