TAMPA — Outside a pain clinic in Tampa, a bare chested man sprawled face down on the hood of a white sedan. Four people piled out of a Winnebago from Ohio. A woman in a tank top left her dog panting in a hot car. Seventy cars crammed the parking lot, carrying license plates from Kentucky, Michigan, Colorado, Illinois.
Throngs of people milled around waiting, sometimes all day, for an appointment with the doctor inside. He is their connection to highly addictive and lucrative drugs — primarily the painkiller OxyContin and the anti-anxiety medication Xanax.
Cpl. P.K. Williams, an undercover detective with the Hillsborough County Sheriff's Office, watched all this from his car in the parking lot.
"This is the land of zombies," he said. "We had no idea it was this bad."
In the past month, Williams and two dozen other Hillsborough County undercover officers infiltrated pain clinics like this one. They bought prescription drugs from dozens of pain clinic patrons.
The investigation revealed a subculture of people from all over the country attempting to capitalize on Florida's lax prescription drug monitoring.
"With all of the overdose deaths — three to nine a week in Hillsborough County — it hit us that we needed to do something to stop this," he said. "The problem has all of a sudden gotten out of control."
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Today, Hillsborough County investigators will ask the County Commission to pass a temporary ban on new pain clinics. This follows a similar effort in Pinellas County, which earlier this month agreed to a moratorium.
While making a case for the ban in Pinellas, Sgt. Dan Zsido told county commissioners if he could deputize everyone in the crowded room, he could give them each 20 cases.
"It's beyond epic proportions," Zsido said. "Every 35 hours in Pinellas County, someone dies of an accidental drug overdose."
Hillsborough County put more than two dozen officers on its four-week undercover operation. A year ago, Pinellas County had just three investigators devoted to prescription drug fraud and trafficking. Now they have 16.
The scrutiny is leading to arrests. Twins in Treasure Island were charged with creating fake prescriptions for oxycodone and sending "runners" to pharmacies around the county. A doctor in Hillsborough County was charged with prescribing painkillers without medical necessity. A group of 23 in Hernando County was accused this past week of prescription fraud.
Florida legislators have already passed a law to track prescription drug dispensing. It would not go into effect until later this year, and money has not been set aside to fund it.
Meanwhile, Florida is the largest of the dozen or so states without a monitoring system. And of the nation's top 100 doctors who dispense oxycodone, 92 are in Florida, according to the Drug Enforcement Administration.
The result: a caravan of addicts traveling to Florida for prescription drugs.
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Williams, the undercover officer from Hillsborough County, listened as employees of a dry cleaner described what they had seen outside of a different pain clinic, M.D. & More on W Hillsborough Avenue: people throwing up in the parking lot, loitering, exchanging pills. Williams nodded.
Hillsborough County's four-week undercover operation resulted in 87 arrests. Most of the clinics targeted were associated with deaths from overdose.
"We're doing something about it ma'am," Williams told the woman. "I can tell you things will change."
In the past few weeks, Hillsborough County arrested a couple from Mississippi who had appointments with 12 different doctors in Florida. They watched a box truck from Kentucky pull up to one pain clinic. A half dozen people spilled out and sat with Icehouse beers waiting for their appointments. Another group pulled up with a barbecue grill.
Some of the clinics see 200 plus patients a day at $250 a visit, $100 for return patients. Many of the patients return monthly to renew prescriptions of oxycodone. Doctors commonly prescribe 240 pills per month, or eight pills a day.
The couple from Mississippi admitted paying about $1 a pill in pharmacies here and taking the pills back home, where they sold them for $30 a pill.
"They've been getting away with this and turning it into a massive business," Williams said.
As he spoke, the parking lot was in a constant state of flux with people walking to and from the M.D. & More pain clinic, which offers an on-site pharmacy.
Dale Sisco, attorney for M.D. & More, said the clinic has done a lot to curb the "diversion" of prescription drugs. It no longer takes out-of-state customers unless they are on vacation or working here temporarily. They require urine tests of patients to see if they're on the drugs before they prescribe them.
"Obviously the clinic can't control what people do once they leave the clinic," he said.
Investigators say it's harder to make cases against the doctors at the clinics. But those arrests are coming, Williams said. And if police don't stop them, the state's pain monitoring system should at least expose them.
"Their days are numbered," he said.
Times researcher Carolyn Edds contributed to this report. Leonora LaPeter Anton can be reached at firstname.lastname@example.org or 727-893-8640.