Florida Law Attempts to Reign in Pain Clinics

Nearly two years ago, a post here discussed the growing problem of unregulated pain-management clinics, so-called “pill mills,” and how South Florida – Broward County in particular – was ground zero.

According to the Centers for Disease Control, overdose deaths from painkillers are rivaling the No. 1 killer, traffic accidents. It attributes much of the increase to the overuse of prescription opiates such as OxyContin and Vicodin. In Florida, deaths from prescription-drug use rose from 2,780 in 2006 to 3,750 in 2008 – more than cocaine, according to the Florida Medical Examiners Commission.

You don’t even have to be a doctor to run a pain-management clinic. “You need a background check to get a liquor license — you can’t be a convicted felon and open up a bar — but you can be a convicted felon and open up a pain clinic,” says Broward Sheriff Al Lamberti.

Fort Lauderdale Drug Trafficking Attorney at Law

But starting Oct. 1, 2010, a new law will go into effect that takes steps to regulate the clinics and punish offending doctors, although some think it isn’t far-reaching enough.

“No bill is perfect, but this lets the Department of Health and the police regulate, inspect, shut down and discipline [clinics and doctors] operating blatantly outside the legitimate practice of medicine,” says Bruce D. Grant, director of the Florida Office of Drug Control.

The law allows police to inspect patient files for violations without a warrant and enforces penalties for doctors, who can be charged with third-degree felonies and fined up to $5,000 a day of violations. Every clinic must be directed by a doctor with a clean record.

In addition, clinics are limited to selling patients only three days of pills at a time, making it more difficult for dealers who pay patients to buy drugs (however, clinics can get around the rule by charging more for an office visit and giving the pills away, skeptics point out). In 2009, members of the Bonanno crime family were charged with using pain clinics to distribute prescription drugs.

Still, the bill does not require the clinics to do criminal background checks on owners and employees, as other health clinics must.

And although the state has approved a database to track pill dispensing, there is no dedicated, ongoing funding source. Bruce Grant said that more than $500,000 in donations has been raised to pay for the prescription-tracking program, with three months to go in the campaign. The goal is to raise $1 million.

Laws for drug possession and abuse have grown progressively harsher, while the source has not been adequately addressed; according to an FBI report, 82.3 percent of all drug arrests in 2008 were for possession.

Now South Florida’s nearly 200 pain clinics and dozens of OxyContin-dispensing doctors, which have operated with no legal scrutiny, will face some accountability.

The Dude Dean says:

September 28, 2010 at 9:54 pm

My only question is why did this take so long to happen? Its about time.

Leland E. Garvin says:

October 6, 2010 at 2:18 pm

I recently was asked a question about this new law by a local doctor who was worried that his practice (or him personally) might fall within the law. I will include my response to his question below:

It looks like they are defining a pain management clinic as “All privately owned pain-management clinics, facilities, or offices, hereinafter referred to as “clinics,” which advertise in any medium for any type of pain-management services, or employ a physician who is primarily engaged in the treatment of pain by prescribing or dispensing controlled substance medications, must register with the department”

The same statute also states A physician is primarily engaged in the treatment of pain by prescribing or dispensing controlled substance medications when the majority of the patients seen are prescribed or dispensed controlled substance medications for the treatment of chronic nonmalignant pain. Chronic nonmalignant pain is pain unrelated to cancer which persists beyond the usual course of the disease or the injury that is the cause of the pain or more than 90 days after surgery.

Here is Fla. Stat 458.3265 http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0458/Sections/0458.3265.html

Take a look at that statute (if you haven’t already)

Being extra cautious you should look at (2)(c) below and go the extra step and document the patients record as to the reason for prescribing more than 72 hrs. worth of meds. (even though it doesn’t seem like your practice, or you personally fall within the definitions above)

458.3265(2) (c) states that: A physician must perform a physical examination of a patient on the same day that he or she dispenses or prescribes a controlled substance to a patient at a pain-management clinic. If the physician prescribes or dispenses more than a 72-hour dose of controlled substances for the treatment of chronic nonmalignant pain, the physician must document in the patient’s record the reason for prescribing or dispensing that quantity.