After years of notoriety for a rapid increase in prescription opioid abuse and overdose deaths, Florida is now a “success story,” demonstrating that state government action can reverse such trends, according to a study presented at PAINWeek.
It was estimated that 732 “pill mills”—pain clinics that inappropriately prescribe and dispense a high volume of opioids—existed in Florida in 2009.
Decisive steps were put into effect in 2010 to fight the rampant abuse:
- Pain clinics were required to register with the state; Schedule II or III substances could be prescribed but no longer dispensed from offices;
- a prescription drug monitoring program and mandatory dispenser reporting was put into effect; and
- pill mills were raided and their assets seized.
From 2010 to 2013, all 98 high-volume oxycodone-dispensing clinics were shut down, 250 pill mills closed and peak prescription drug overdose deaths decreased from 2,722 in 2010 to 2,116 in 2012.
Florida’s lax policy was really contributing to a lot of the diversion of medications from medically appropriate channels into illegal ones.
If Florida was the main problem, and that is now being solved, why are patients everywhere else being harassed as well? The problem prescribers were extreme outliers and easy to pick off, so it seems a waste of effort to question every prescription from every doctor for every pain patient. (See ProPublica online tool, Prescriber Checkup, to search for individual providers and see which drugs they prescribe.)
“The big concern I have with all of these studies, and the prescription monitoring programs that almost every state has adopted now, is whether legitimate patients are in some way being deprived of medications. … The worry is that we’re going to make it so difficult for some legitimate patients to get pain medication that we will cut into the appropriate therapeutic use of these drugs.”
When asked whether it will be harder for legitimate pain patients to get the prescription drugs they need, Dr. Pergolizzi said, “We don’t know. I tend to think not if the patient’s going to a pain specialist. There may be some hesitancy by primary care doctors that may have led them to potentially underprescribe or avoid prescribing an opioid.”
The only way he could not know that patients are having a hard time getting their medicines is if he is deliberately looking away.