CDC report lauds Florida for crackdown on 'pill mills'

A federal report released Tuesday says Florida became the first state to make a significant dent in prescription drug overdose deaths when it cracked down on pill mills and shady doctors four years ago.

A report released Tuesday by the Centers for Disease Control and Prevention announced a 23 percent reduction in prescription drug deaths in Florida from 2010 to 2012.

In the years prior, Florida was considered the nation's medicine cabinet because pill mills ran rampant and people from out of state drove here to load up their cars with pills. In addition, people were fatally overdosing at an alarming rate — at one point at least seven people a day were dying.

The CDC report indicates Florida may have shown the rest of the country how to reverse that trend when it passed tougher laws in 2010 that have been expanded in the years since.

Pinellas County, which was home in recent years to about 65 "pill mills" where doctors prescribed drugs illegally, has now seen unscrupulous pain clinics nearly wiped out, said Sheriff Bob Gualtieri.

"Through concerted enforcement efforts we really have eradicated them down to one or two," Gualtieri said. "So you don't really have drug dealers in white coats unscrupulously pushing their poison."

The problem of prescription drug mortality had been building for decades. Before the crackdown took effect, overdose deaths in the United States had more than tripled since 1990, the CDC reported.

From 2003 to 2009, annual drug overdose deaths in Florida increased 61 percent, the report said, from 1,804 to 2,905. The largest increases were caused by opioid painkillers like oxycodone and anti-anxiety drugs like Xanax.

But from 2010 to 2012, overdose deaths decreased nearly 17 percent, with overall prescription drug deaths dropping 23 percent.

"It's good news," said Dr. Steven Rosenberg, a West Palm Beach dermatologist and member of the Florida Board of Medicine. "Finally the Legislature has given us the opportunity to develop rules to basically get rid of the drug dealers who just happen to have an 'M.D.' after their name."

Rosenberg sat on a joint committee that wrote the rules to crack down on pill mills and "doctor shoppers" (people who buy pain medications simultaneously from multiple physicians), which the Legislature used in drafting the laws beginning in January 2010. That month, new laws required pain clinics to register with the state. In 2011, a prescription drug monitoring program, in which doctors could check whether a patient was doctor shopping, went into effect.

"When we first got started, we heard reports that seven people per day were dying of (prescription) drug overdoses in Florida," Rosenberg said. "Then it went up to around nine. Then there were reports of 11 per day just prior to the legislation being enacted."

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The subsequent drop in deaths, he said, "corresponds basically with the elimination of the pill mills."

At their peak several years ago, Florida was home to 98 of the 100 physicians in the country who dispensed the highest quantity of oxycodone directly from their offices. The state became a magnet for what Rosenberg called "narco tourists," buyers from other states who found pain management clinics advertised on billboards and bought thousands of dollars worth of prescriptions.

Then pain management clinics were raided, their inventory confiscated and doctors put out of business. About 250 clinics were shuttered. By last year, none of the nation's top 100 prescribers of oxycodone were in Florida.

"That's really what has made the difference is getting the illegitimate physicians closed down," said Christopher Wittmann, a physicians's assistant who owns Trinity Pain Center in Pasco County. "People who practice legitimate medicine have not really changed what they do at all."

The prescription drug overdose death rate has since fallen to its lowest level since 2007, the report said. Deaths related to oxycodone, methadone and hydrocodone have all decreased.

Despite the encouraging news, some former pill abusers are migrating to heroin. In the first six months of last year, 68 people fatally overdosed on heroin in Florida — more than double the same period in 2012.

Gualtieri said heroin arrests through the first half of 2014 are running at nearly double the rate of last year.

"We're kind of able to choke off the (pharmaceutical) supply," Gualtieri said. "But the only way you get to the core is through prevention, education and treatment."

Contact Andrew Meacham at ameacham@tampabay.com or (727) 892-2248. Follow @torch437.