According to the federal government, there were 420,000,000 oxycodone pills dispensed in Florida in 2008. The population of the state was 18,750,483. That works out to 22 oxycodone pills for every man, woman and child in the state that year.
Do we really have that much pain?
Of course not. But that statistic, for just one type of highly addictive prescription pain medication, demonstrates the enormity of Florida's problem with "pill mills." Yet at Tuesday's Pinellas County Commission meeting, Commissioner Nancy Bostock seemed uncomfortable about slamming the door quite so hard on pain management clinics.
The commission was discussing extending its six-month moratorium on new pain clinics another two years until Oct. 1, 2012, and also was considering adding a few requirements that pain clinics must meet to operate here.
In May, the commission had been urged by law enforcement and tearful family members of pain pill addicts to stop the onslaught of new Pinellas pain clinics and their customers, who are flocking here from all over the country to obtain legal narcotics handed out like candy from clinic dispensaries. The commission unanimously approved a six-month moratorium, designed to last until the Legislature acted to control the problem, and also created a registration requirement for pain management clinics.
Tuesday, the county staff urged commissioners to extend the moratorium for two years and add some tougher requirements on clinic operators. In addition to registering, they would have to provide a floor plan, submit to inspections, supply a list of employees and pay fees totalling $3,000 to cover the cost of the county doing background checks and inspections and issuing permits.
"I certainly understand the importance of this item," she said, but she was concerned about causing problems for legitimate clinics and doctors while going after the bad guys. She called for a moratorium extension of one year, not two, "to not be over reaching."
Bostock also was worried about a proposed requirement that pain clinics must have equipment for diagnosing and treating chronic pain. Seems logical, but Bostock feared clinics would have to close if they didn't have expensive MRI and X-ray machines. She remained concerned even after the county staff explained that wasn't the intent. They said some pain clinics here don't even have a stethoscope on site, just a doctor sitting at a table with a stack of prescription pads. "I just want to make sure this isn't overly broad," she fretted.
Bostock also questioned the $3,000 fee, wondering if it really costs that much for the county to monitor the clinics and issue permits. And she wanted the county to issue permits only 15 days after the county received a completed application, rather than the 30 days the staff sought.
Fortunately, most other commissioners weren't swayed to ease off. They argued for the two-year moratorium because they aren't confident the Florida Legislature will take strong enough steps to stop the spread of pill mills. They pointed out that if the state does act, the commission can just sunset the moratorium.
Though Commissioner Neil Brickfield seconded Bostock's motion for a one-year moratorium, the motion failed. The commission approved a two-year moratorium extension along with the other new requirements.
The extension gives the new Pinellas County Pain Management Task Force more time to figure out how to permanently address the problem of pill mills and gather input from medical practitioners and residents.
When you go to war, you want to have all the weapons needed to successfully complete the mission. And there is no doubt that Pinellas is in a war, one the public and officials are only now beginning to understand. The commission needed to take a tough stance to stop the influx of pain clinics while it works on long-term solutions.
If only the medical profession were moving that aggressively to police its own. Doctors handing bags of addictive narcotics to patients without properly diagnosing their problems or first trying alternative therapies are nothing more than drug pushers.
Diane Steinle can be reached at firstname.lastname@example.org.