The term “pill mills” is the nickname given for the innumerous illegitimate pain clinics that have sprung up in strip malls and nondescript office parks nationwide over the past few years. These alleged pain management centers tend to occupy unmarked office spaces or storefronts, or may display a misleading or false business name, and have armed security guards patrolling the clinic’s lobby. These clinics are employed by shady or unlicensed doctors who prescribe massive amounts of powerful narcotic medications to anyone who walks into the clinic off the street. Although they exist nationwide, most pill mills are located in Texas and Florida due to the states' looser restrictions on prescription drug monitoring.
Unlike the other 34 states in the U.S. that implement a mandatory prescription drug monitoring program (PDMP), Florida has yet to enact a strategic method for guarding the amount of prescription drugs sold with its state boundaries. A PDMP helps doctors, pharmacists, and medical professionals remain aware of patients’ prescription drug history to allow them to administer proper medicinal care, prevent doctor shopping dealers from scoring pills for illegitimate reasons, and prevent drug trafficking. A PMDP includes a statewide database that both medical practitioners and law enforcement can immediately access to review individuals’ controlled-substances records and assist efforts to combat prescription drug diversions. With prescription drug overdose deaths quickly becoming the leading cause of accidental death in multiple states, law enforcement and health professionals are calling prescription drug abuse and drug trafficking a national epidemic. Florida’s state officials are currently seeking legislation to crack down on the ever-growing amount of pill mills that are operating throughout the state, mostly in South Florida. Over 200 known pill mills are currently operating in Florida’s Broward and Palm Beach counties alone. These clinics have become the sites of felons, addicts, and dealers who contribute to the exponential boom in prescription drug-related deaths; yet not enough legislation exists to prosecute those responsible, and these pain clinics have been able to remain under the legal radar.
At Florida pill mills, cars flood the small strip mall parking lots and patients are lined up outside the doors, with several visitors from out-of-state. Doctors or employees posing as doctors illegally dispense potent prescription painkillers, anti-anxiety drugs, and antidepressants such as OxyContin, Vicodin, Lorcet, Darvon, Xanax, Roxicodones, Soma, Carisoprodol, and hydrocodone to patients on demand for non-medical related purposes. Dealers can come to these phony pain clinics, purchase narcotics for $5 a pill, and return to their home states and sell the pills on the street for $80 per pill. These "pain clinics" are merely a front for the immense drug-dealing operation taking place behind their doors. Investigators have discovered that the more prescription medications these doctors sell, the more they get paid. Patients can directly obtain a 30-day supply of narcotics from these pain clinics or their affiliated pharmacy and return each month to continue feeding their drug habit. The idea is to get patients hooked on these drugs to ensure the sale of more drugs and help physicians quickly profit. One patient can obtain as much as 120 pills at one time; clinics are dispensing millions of pills each month with practically no supervision.
All pill mills are operated in the same fashion: no medical records, x-rays, or examinations are needed; pain is treated only with prescription medication; patients can request whatever medication they want with no questions asked; only cash is accepted; prescriptions can only be retrieved from their pharmacy; patients must return on a specific date to obtain more prescriptions; and they tend to shut down and open up in new locations to avoid getting caught by law enforcement and face legal prosecution. By law, it is illegal to prescribe pain medications without a viable medical purpose or physical examination; a legitimate pain management doctor would most likely recommend other therapeutic methods such as physical therapy, exercise, lifestyle adjustments, and/or stress management, and would limit and monitor patient intake of prescription drug medication. It is always illegal to prescribe medication without a medical license. Doctors may face felony charges for prescribing medications without a valid purpose, which is considered to be a form of drug trafficking. Pill mill owners are hard to trace since clinics are registered with absent doctors or stolen identities, and are employed by individuals not of the medical profession. Felons even have the ability to open these pain clinic businesses and avoid prosecution.
The U.S. Centers for Disease Control and Prevention (CDC) has recognized a 96 percent increase in drug-related deaths within the U.S. Florida alone has seen a 107 percent increase in oxycodone overdose deaths. Interstate drug dealing has gained the House and Senate’s attention and who are currently working to increase penalties for drug-related crimes such as trafficking of out-of-state drugs. Ninety-eight percent of illegal narcotic medications are believed to come out of Florida; states such as Kentucky, Tennessee, West Virginia, Ohio, New York, and Illinois have experienced prosecution and major drug busts for drug trafficking and distribution of narcotics obtained from Florida pill mills. Texas runs an operational PDMP, but law enforcement has had most difficulty tracing the sale of controlled substances at the retail/consumer level. The program was expanded in 2008 to include the monitoring of Schedule III–V controlled-substance prescriptions. Texas, however, remains a well-known source of pill mills and illegal distribution of prescription medications for out-of-state dealers.