The large billboards greet motorists traveling along Sunset Point Road in Clearwater and Gandy Boulevard in St. Petersburg with a bold message:
"We're Shutting Down Pill Mills in Pinellas County."
Wait. Is the county really declaring victory in the war against prescription drug abuse?
Not exactly, officials say.
Rather, the billboards are meant to warn prescription drug abusers that Pinellas is serious about curbing an epidemic that kills an average of about eight Floridians a day.
But the billboard campaign does happen to coincide with a possible sign of progress: In Pinellas, Hillsborough and Pasco counties last year, accidental overdose deaths caused by prescription drugs declined somewhat after years of increasing.
In 2010, Pinellas had 249 such deaths, one of the highest figures in the state. Bill Pellan, director of forensic investigations for the Pinellas-Pasco Medical Examiner's Office, said Friday the 2011 figure is 217, one fewer than the 2009's 218 deaths. That's a 13 percent drop over 2010.
Pasco County's decrease — 20 percent — was even steeper. There were 153 prescription drug-related deaths in 2010 and 122 last year.
"I think it's great news that we're seeing a reduction," Pellan said. "It's a compliment to those that deal with that on a daily basis."
In Hillsborough, accidental overdose deaths due to prescription drugs declined from 249 in 2010 to 226 last year.
But one year's decline isn't enough to declare a trend, officials say.
"There may be no explanation. It could be random scatter," said Hillsborough medical examiner Dr. Vernard Adams. "If it drops again, maybe it's real."
Paul Melton, an investigator with the Pinellas County Department of Justice and Consumer Services, agreed.
"I'm not sure that at this stage of the game that there is cause for celebration," he said. "We're not there yet."
Besides the large billboards on Sunset Point and Gandy, several smaller boards will be put up in the coming weeks. A billboard company is donating the space for the campaign, which is expected to last two months, Melton said.
Though the billboards may not be a "mission accomplished,'' businesses that call themselves pain clinics are on the decline, an apparent result of new state and local regulations.
Pinellas Sheriff Bob Gualtieri said that 18 months ago, there were 65 to 70 pain management clinics in the county. Now there are fewer than 20.
Hillsborough has "approximately 43" pain management clinics licensed under a county ordinance, sheriff's spokesman Larry McKinnon said, which is down from a peak before the regulations.
Melton said several efforts are making a difference.
Among them is a high-prescriber ordinance, passed last year in Pinellas County, that requires any health care facility in which physicians may prescribe 34 or more controlled substances in a single day to register with the county. Melton said the county has issued fines and warning letters to clinics that have not registered.
Several Tampa Bay area governments banned new pain management clinics and set stringent licensing requirements.
And statewide efforts may be having an effect as well — including a law that took effect last July that forbids doctors in most settings from dispensing many controlled substances, including addictive pain medications.
Florida now also has a prescription drug monitoring database that allows doctors and pharmacists to spot and stop people who try to obtain large quantities of drugs such as oxycodone and Xanax. Since its launch last fall, more than 35 million prescriptions have been loaded onto the database. Doctors and pharmacists have requested more than 838,000 patient reports as of March 28.
Though there are fewer pain clinics, and there is that encouraging one-year decline in deaths, law enforcement officials say that, at least in Pinellas, there appear to be just as many pills on local streets as a year ago.
Gualtieri pointed to the street price of an oxycodone pill (about $17), which has not changed in over a year.
"If the supply was being reduced, you'd see a price increase," Gualtieri said.
Hillsborough, however, has seen evidence of the opposite.
McKinnon said the street price of a 30 mg oxycodone tablet has increased by 30 to 50 percent.
He said the prescription drug monitoring database has made it easier to identify and arrest doctor shoppers, and addicts themselves know the risk of getting caught is higher than years past.
Still, officials say addiction-fueled crimes are hard to curb because they're always evolving. Addicts will do almost anything to get the drugs they crave.
For example, Gualtieri said, authorities may crack down on doctor shopping one month, then see a spike in fake prescriptions the next.
Shutting down the pill mills themselves is tough, too.
For instance, Whitney Enterprises in Palm Harbor was closed down in January — after a 20-month investigation.
Authorities also have seen pill mills close only to reopen under a new name. Some call themselves injury clinics, or even weight-loss clinics, but still operate much as they ever did, Gualtieri said.
Some, trying to project an air of legitimacy, require patients to have a cursory exam or present test results proving their need for drugs. Detectives have even come across addicts who have bought fake MRI results on the street to get their pills.
"I wouldn't declare any victory," Gualtieri said. "We still see the same stuff going on. We can go out and make these cases every day.
"We're making progress but we're also going in circles in some respects."
Richard Martin can be reached at email@example.com or (813) 226-3322. Kameel Stanley can be reached at firstname.lastname@example.org or (727) 893-8643.