Florida's pain management industry is starting to feel the effects of a new law that limits who can own pain clinics, part of an effort to stop unscrupulous operators notorious for dispensing huge amounts of prescription narcotics.
State health records suggest that about three dozen pain clinics have had their licenses revoked or have closed since officials started enforcing the law that took effect in October.
Supporters praised the actions as progress in efforts to curb a prescription drug epidemic killing an average of seven Floridians a day. Still, the long-term impact of the enforcement is uncertain, and many are frustrated that other key reforms have been sidelined by long delays.
And pain clinic owners who say they want to help solve the prescription drug crisis worry that it may become harder for patients with legitimate pain problems to get treatment.
"This was the Wild, Wild West. It was a completely unregulated field and everything was out of control," said Paul Sloan, who owns pain clinics in Venice and Fort Myers and is the president of the Florida Society of Pain Management Providers. "We've gone from being completely unregulated to being completely over regulated."
Under legislation passed last spring, state health officials have sent letters to 204 pain clinics since September, warning their licenses were in danger. Of those, state documents indicate three dozen have lost their licenses or closed, according to Greg Giordano, chief legislative assistant to state Sen. Mike Fasano, R-New Port Richey, who sponsored the law.
Health officials did not respond to requests for additional information Tuesday afternoon.
In the past, anybody could own a pain clinic. Now, the clinics must show that they are owned by state-licensed doctors, or meet rigorous licensing standards through the state agency that regulates hospitals.
"I think this is a giant step," said Dr. Fred Bearison, a Valrico internist and member of the Board of Medicine, which has been working on its own regulations for the physicians working in pain clinics. "Two years ago, the pain clinics didn't even have to be licensed. Now they're licensed and the licenses are being scrutinized."
Most of the 204 clinics that received warnings appear to have resolved their issues. For Tampa Pain Clinic on Fletcher Avenue, it was just a matter of removing the physician's daughter, Ashley VanDercar, from the ownership records since she is not a doctor.
The practice stayed open during the transition. VanDercar, a lawyer and risk manager for the practice, said the hassle was justified by the need to rein in illegitimate pain practices. But she and others acknowledged that unscrupulous practices could make phony ownership changes to get around the law.
And even the pain clinics that were shut down may not be out of business permanently.
In Tampa, health records show that Health & Pain Center's license was revoked. Owner Nicholas Lacarrubba said the police even came out to close him down. But the acupuncturist blames administrative errors for the problems and says his Waters Avenue clinic meets the legal requirements. He's applied to have his pain clinic license restored.
Until then, the physician who used to work at his center is seeing patients at another pain clinic that is licensed. Lacarrubba, whose office is still open for acupuncture, says the ordeal has cost him at least $50,000.
"Good things have happened from the change in the law. All of these dirt-bag, out-of-state pain clinics are getting shut down," said Lacarrubba, adding that regulators then became overzealous. "Our right to do this was summarily taken away."
Fasano said he was pleased to see the law that he spearheaded being enforced. But he also is frustrated over a recent spate of setbacks in the efforts to fight prescription drug abuse.
• This month, Gov. Rick Scott shut down Florida's office of drug control, which had led the various agencies concerned with prescription drug abuse.
• The Board of Medicine's rules for medical doctors who work in pain clinics have been stalled by legislators and Scott, who all want more scrutiny on costly agency regulations.
• And there's been another delay in a prescription drug database program that will allow physicians to see when patients are doctor-shopping to obtain narcotic painkillers. Supposed to go online last month, it now isn't expected to be running until the late spring or summer.
"It's just going to take longer to get this crisis under control," Fasano said.
Times researcher Carolyn Edds contributed to this report. Letitia Stein can be reached at firstname.lastname@example.org or (813) 226-3322.