Pubdate: Sun, 03 Dec 2006
Source: Sun-Sentinel (Fort Lauderdale, FL)
Copyright: 2006 Sun-Sentinel Company
Contact:  http://www.sun-sentinel.com/
Details: http://www.mapinc.org/media/159
Author: Vanessa Blum, South Florida Sun-Sentinel
Bookmark: http://www.mapinc.org/find?232 (Chronic Pain)
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/find?136 (Methadone)
Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone)

ALARM IN SOUTH FLORIDA OVER PRESCRIPTION DRUG TRADE

Deaths Skyrocket As Dealers and Addicts Flock to S.
Florida.

Out-of-state drug dealers and addicts are traveling long distances to
visit Florida pain clinics, targeting the state because its lax
oversight of prescription drugs makes scoring pills easier.

The unwanted tourism alarms state officials who have watched deaths
from prescription pain medication skyrocket in recent years. In 2005,
such prescription drugs as hydrocodone, methadone and oxycodone
contributed to more overdose deaths than all other narcotics combined,
according to Florida medical examiners.

Despite the known dangers, Florida lacks a system for tracking
prescription drugs. That, according to law enforcement officials,
makes it a haven for addicts and "pill mills," where doctors churn out
prescriptions without thoroughly examining patients.

The problem was noted in a national drug threat assessment released
Nov. 15 by the U.S.Department of Justice. The report outlined the
"drug run" phenomenon in South Florida, saying residents of states
with prescription monitoring "have in some cases turned to traveling
to nearby states ... to illegally obtain pharmaceuticals."

That was the case for more than two dozen people from Kentucky who
drove 1,000 miles each way to see doctors in Palm Beach County and
Fort Lauderdale. They came by the van-load throughout 2005 and early
2006, returning with doses of OxyContin, Endocet, Percocet, Methadose
- -- drugs that were more difficult to get at home, according to federal
prosecutors.

Eight people involved in the trips pleaded guilty to drug-trafficking
charges in Palm Beach federal court, and several more are being tried
in Kentucky state courts for alleged drug-related crimes.

The Fort Lauderdale medical office that supplied some of their
prescriptions also is being investigated.

Drugs prescribed by Florida doctors caused the deaths of five people
in Kentucky, according to prosecutors. One man died from a fatal
overdose during the 18-hour drive home.

"We've seen people coming from all over the Southeast United States,"
said Rick Zenuch, an agent with the Florida Department of Law
Enforcement who monitors drug-related trends. "The fact is, illicit
drug traffickers don't see state lines as any boundary."

As of June, 32 states had adopted prescription-tracking programs to
curb problems such as those in Florida, the most populous state
without such a law.

While each system follows slightly different rules, their primary goal
is to identify forged prescriptions and to expose so-called doctor
shoppers who visit multiple physicians and pharmacies seeking drugs.

The programs generally require doctors to submit information on
prescriptions to a centralized database. When an order is filled, the
pharmacist also sends an electronic record.

If a doctor or pharmacist were to notice anything amiss in a patient's
file, they could contact law enforcement or state health officers.

Kentucky's system is a model for other jurisdictions. Its
effectiveness drove illicit drug seekers to surrounding states like
Indiana, Ohio, Virginia and West Virginia. Each, in turn, created
tracking programs, said Danna Droz, a former administrator of
Kentucky's system.

In 2004, Florida's Legislature seemed poised to jump on the bandwagon.
OxyContin manufacturer Purdue Pharma agreed to pay the state $2
million to cover start-up costs. But key legislators blocked a vote on
the proposal citing its annual $2.8 million price tag and patient
privacy considerations.

Dr. Rafael Miguel, a professor of pain medicine at the University of
South Florida, called the inaction "infuriating and
depressing."

"You have to provide Florida doctors with tools so they can safely
prescribe these medications and know they're in the right hands,"
Miguel said. "Right now doctors are being made unwilling and unknowing
participants in the drug trade."

A similar proposal languished and died this year as the legislature
focused on other issues. Drug enforcers like Bill Janes, director of
the Florida Office of Drug Control, vow to continue their push. Janes
said working with lawmakers to pass a prescription-tracking program is
his top priority for the new legislative session.

Soon legislators may have no choice. Under a federal law passed in
2006, states that do not implement prescription-tracking within three
years will take a backseat for federal funding of drug-related programs.

A prescription tracking system is not a cure-all, Janes said, but
could help prevent doctors and pharmacists from unwittingly aiding
addicts and drug dealers. Moreover, if criminal activity were
suspected, police could get evidence much more quickly.

"It would be a first step," Janes said. "Certainly the opportunity to
obtain illegal drugs is much higher if you don't have this."

Maureen Barrett of Fort Lauderdale will support those efforts. She
lost her son to a painkiller overdose in 2002 and thinks prescription
monitoring might have saved his life.

Drew Parkinson, a student at Florida Atlantic University, received
prescriptions for 1,455 pills in 57 days. He died at 25, two days
after picking up his final doses.

"Somewhere along the line, a red flag should have come up so they
wouldn't have kept giving him the pills," Barrett said.

Privacy concerns cited by opponents are overblown, she
added.

"If you go to CVS or Walgreens they have a complete list of all the
medicine you've gotten," Barrett said. "We have laws in place to make
sure that information is not disseminated."

Dr. Robert Yezierski, director of University of Florida's
Comprehensive Center for Pain Research, isn't convinced. He said
prescription-tracking is "a good idea in theory," but people who want
to abuse the system will find a way.

"What we don't want to do is deny treatment to people who legitimately
need pain medication," Yezierski said.

Pain relievers such as methadone and oxycodone -- both chemically
altered opioids similar to heroin -- are among the most commonly
abused prescription drugs. According to a report published by the
Florida Department of Law Enforcement, methadone caused 620 Florida
deaths in 2005 -- either alone or in combination with other drugs. The
report listed oxycodone as the cause of 340 fatal overdoses.

Used at recommended doses, oxycodone is a powerful treatment for pain
and is often prescribed to cancer patients. The drug also is highly
addictive and dangerous when taken in large quantities or mixed with
alcohol.

Oxycodone tablets sell on the street for about $1 per milligram --
almost 10 times what they cost at a pharmacy.

The Kentucky group frequented clinics in Broward and Palm Beach
counties. Some pills went to feed their own addictions, prosecutors
and law enforcement say. Others they sold on the street or to friends
and neighbors in their small towns near Lexington.

Kentucky law enforcement alerted the Drug Enforcement Administration
after a number of overdoses were linked to Florida prescriptions. The
individuals charged in federal court range in age from 21 to 64 and
face sentences of about four to nine years.

So far, no physicians have been charged in the connection with the
case.

In May, federal agents raided the offices of a Fort Lauderdale pain
clinic where some Kentucky travelers received prescriptions.

Kentucky grandmother Jewel Padgett, 64, was among those prescribed
pills by physicians at the AMMA Pain Care Center in Fort Lauderdale,
according to her attorney.

She pleaded guilty to four felonies connected to her Florida trips,
including conspiracy to distribute controlled substances and traveling
across state lines to promote drug trafficking.

Government lawyers contend Padgett organized and paid for many of the
trips from Kentucky in exchange for a portion of the others' pills,
earning roughly $30,000.

Padgett's son said his mother went to Florida because she couldn't
find a doctor in Kentucky willing to treat neck and back pain caused
by a 1998 car accident.

"They wouldn't give her medication she needed," said Don Padgett.
"They're scared up here. They got them so restricted."

Fort Lauderdale attorney Theresa Van Vliet, who represents AMMA, said
her client supports prescription monitoring and hired a Tallahassee
lobbyist earlier this year to push the measure.

"They think it's a good thing," Van Vliet said of her clients. "Pain
management is a very new medical field and it is one that clearly can
be manipulated."

Van Vliet declined to discuss the Kentucky cases, citing medical
privacy laws.

She said AMMA physicians are told to verify medical reports before
prescribing pain medication and discouraged from treating out-of-state
patients. "It's not foolproof," Van Vliet said, "but nothing is
foolproof." 
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MAP posted-by: Richard Lake