TAMPA — Superior Injury Center was shut down last year as an illegal pain clinic. But police say the many people who flocked there for prescription narcotics soon returned.
They gathered down the block, in a walled-off breezeway behind a brown brick building with a sign that says United American Finance.
There, they waited to be summoned in small groups to another unlicensed pain clinic a few miles away from this bleak stretch of W Hillsborough Avenue. This way, there were no tell-tale parking lots full of waiting drug-seekers, a signature of Florida's pill mill epidemic.
As governors testify on Capitol Hill and legislators wrangle in Tallahassee over the crisis, police and consumer protection officials around the Tampa Bay area say that every day they see pain clinic operators and prescription drug diverters employ ever more creative ways to continue their lucrative — and deadly — trade.
In the years since Florida gained a reputation as pain pill capital of the nation, and deaths from prescription drugs kept rising, state and local governments have created rules meant to shut down problem clinics.
But police say many of them quickly relocate — to another city, or just down the block. They might use words like "wellness'' or "auto injury'' rather than "pain'' in their names to avoid detection.
Some pay recruiters to import clients from states that have tougher regulations, or to bring in homeless people who will fill illicit prescriptions.
The clientele are getting smarter about concealing their actions, even using tactics associated with the cocaine trafficking of decades past.
Tampa police caught a half-dozen people from Tennessee in a scheme to hide drugs in condoms they planned to swallow, just in case they got stopped by police on their way home.
"If you can find a way to divert, it's being done," said Sgt. Dan Zsido of the Pinellas County Sheriff's Office.
Officials say they see the same operators showing up, time and again.
"A select group of offenders is behind many of these clinics," said Tampa police investigator Kenny Morman. "And they know how to keep the shell game going, day in and day out."
What's more, the new rules and laws, officials say, aren't strong enough.
"As long as there are loopholes — as long as there are exceptions in place — there's always a new angle," said Tim Burns, Pinellas County director of justice and consumer services.
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What remains in the breezeway behind the Hillsborough Avenue office — aside from graffiti and a plastic bucket full of cigarette butts — are worn chairs, an outdoor water fountain and a lab drop box for fluid samples.
Tampa police say that dozens of people a day waited for the summons to the Habana Spine and Medical Clinic, just across a parking lot from St. Joseph's Hospital.
The clinic was run by Warren Gold, 52, who in just four months had moved his operation from Ellenton to Lakeland to Tampa, running afoul of licensing rules in each location. His wife owns the property that police say was used as a staging area.
Habana Spine would call over patients in groups of five to 12 to avoid crowds in its parking lot.
Clients paid $340 in cash — insurance was not accepted — for a first visit and $200 for each follow-up visit. Doctors saw between 70 to 150 patients a day, employees estimated. Two-thirds of the patients came from out-of-state, an employee told police.
On Dec. 22, Tampa police shut down the clinic for operating without a permit, arresting Gold and two physicians working there.
Gold's attorney, Dale Sisco, questioned police priorities.
"Frankly it's my opinion, based upon what I've seen, that the (police) marching orders are simply: 'The only good pain management clinic is a closed pain management clinic.' "
Meanwhile, the remote waiting room system is catching on.
"These waiting areas are showing up in other parts of Hillsborough County. In fact, we recently got a call about one on Dale Mabry," said Kevin Jackson, chief investigator for the county's Consumer Protection Agency.
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In October, Tampa police shut down a pain clinic at 4707 Gandy Blvd. after a receiving an unusual tip: Six people from Tennessee and one from Ohio had been caught shoplifting condoms from a nearby Family Dollar Store.
They planned to fill the condoms with oxycodone pills and swallow them in order to smuggle the drugs back home.
The condom incident tipped off an undercover agent to a familiar Gandy clinic, one that Tampa police closed down when it was operating a few blocks away. They arrested clinic owner Kevin O'Malley and the doctor working there, charging them with operating an unlicensed pain clinic. But prosecutors say the misdemeanor charges were dropped when both agreed not to operate or practice at a pain clinic in Tampa again.
"This was a false arrest. They had no reason to arrest us whatsoever," O'Malley said this week.
Police said 1st Medical Group, a pain clinic at 2316 Dale Mabry Highway, gave free prescriptions and office visits to recruiters who brought in out-of-state clients and homeless people.
An undercover agent posing as a pain patient was given a ticket with a number, deli line style. He was told he would get a call on his cell phone when it was his turn to get his oxycodone and Xanax prescriptions — another technique to avoid creating parking lot crowds. He was also told he could jump the line for a fee — on top of the $400 cash he paid up front for the appointment.
Police closed the clinic and arrested owner Jorge Gonzalez-Betancourt. 50. He was charged, along with his wife, Michele Gonzalez, 34, and one of the clinic's doctors, with racketeering and drug-trafficking.
Police allege that at least five people died of overdoses from pills obtained with prescriptions from 1st Medical, accused of prescribing 2.4 million pain pills in the first seven months of 2010. Authorities suggested there could be more charges, but Gonzalez-Betancourt's lawyer noted there haven't been, and the arrest was months ago.
"As much as they (police) would like to suggest that all kinds of nefarious conduct was occurring, I could draw some conclusions from the fact that nothing's happened," said attorney Sisco, who also represents Warren Gold.
Officials say enforcing pill mill laws is time consuming and difficult.
"For us to connect the dots takes a lot of investigative work, which makes it especially frustrating when the arrests don't amount to much," said Morman.
Meanwhile, neighbors who had complained about the goings-on at Habana Spine now have a new grievance. They say dazed patients in cars with Ohio and Kentucky license plates are arriving at a new clinic in the same complex.
Times researcher Caryn Baird contributed to this report. Meg Laughlin can be reached at email@example.com. Letitia Stein can be reached at firstname.lastname@example.org.