Pubdate: Mon, 6 Apr 2009
Source: Miami Herald (FL)
Copyright: 2009 Miami Herald Media Co.
Contact:  http://www.miamiherald.com/
Details: http://www.mapinc.org/media/262
Author: Scott Hiaasen

PAIN PILLS FROM SOUTH FLORIDA FLOOD APPALACHIAN STATES

Parts of Rural Appalachia Are Awash in Prescription Drugs Delivered By
Car and Airplane From Broward County Pain Clinics

Dr. Roger Browne was once one of Kentucky's most popular pain
doctors.

His office, however, was 850 miles away, in Broward
County.

When federal agents raided Browne's Coral Springs clinic, Americare
Health and Rehabilitation, last year, they found medical files on
nearly 500 Kentucky residents who had received painkillers from the
doctor.

Browne was just one part of a vast pill-trafficking industry
stretching from Broward County through rural Kentucky, Tennessee, Ohio
and West Virginia.

Squads of traffickers dispatched from those states descend on the Fort
Lauderdale area almost daily to buy oxycodone, methadone and other
narcotics from doctors at local pain clinics and resell them in
Appalachia, according to interviews with police and court records.

Cars from Kentucky loaded with passengers can be seen clogging the
parking lots of some Broward clinics. One discount airline flying from
West Virginia to Fort Lauderdale is so popular with drug dealers that
police have dubbed it the "O.C. Express."

"We're inundated with it. Florida is killing us," said Sheriff Bill
Lewis of Lewis County, Ky., population 14,000. "There's a carload
that leaves here so often -- hell, every week or so -- to go to Florida."

In February, Lewis' deputies arrested four people returning to
Kentucky with almost 1,000 painkillers prescribed by Florida doctors.
And last Thursday, they arrested a suspected oxycodone trafficker
carrying the business card of a Hollywood pain doctor in his wallet.

The carloads are lured by Florida's growing number of storefront pain
clinics, where doctors can dispense pills to walk-in patients from
on-site pharmacies with little oversight -- exploiting lax state laws
and health regulations.

Broward County is now the epicenter of a prescription-drug epidemic
spreading across the eastern United States, with local doctors
dispensing 6.5 million oxycodone pills in the second half of last year
- -- far outpacing the rest of the country -- according to federal data
compiled by the Broward Sheriff's Office.

"Sometimes a doctor with a pen can be some of your biggest drug
dealers. It's called legal until you can prove it different," said
Sheriff Kent Harris of Unicoi County, Tenn. Last week, his deputies
arrested three men driving back from Florida with 1,000 pills stuffed
into the motor of their car.

The Pill Trail

Police in Appalachian states confiscate Florida pills almost daily,
prompting the U.S. Drug Enforcement Administration to ask police in
the region to track and log the Florida doctors whose prescriptions
they find. The Miami Herald has documented more than a dozen such
cases in rural parts of Kentucky, Ohio, West Virginia and Tennessee
this year.

The Florida pill pipeline has carved a depressing path through
Appalachia, already one of the poorest regions in the country.
Kentucky police call painkiller abuse an epidemic -- a far bigger
problem than cocaine, methamphetamine or other illegal drugs --
sparking burglaries and robberies, and ruining lives.

"We have families breaking up, and people dying and people losing
their jobs," said Sheriff Keith Cooper of Greenup County, Ky. "It's
sad now that it's so routine."

Just as routine are overdose deaths. In West Virginia, accidental
overdoses increased by 550 percent from 1999 to 2004 -- the biggest
increase in the country -- a spike attributed to prescription
painkillers, according to a recent report in the Journal of the
American Medical Association.

Last August, 38-year-old Timothy Hardin died of an overdose in a Fort
Lauderdale hotel room while "doctor-shopping" for pills with three
friends from Kentucky, according to a medical examiner's report.

Also dead: John White, 42, who overdosed in February hours after
flying back to Kentucky from Fort Lauderdale, according to police. His
wife told police he had come down for a doctor's appointment.

Sheriff Steve Burns of Greene County, Tenn., said he is investigating
the overdose of a teenager who died recently after returning from
Broward on a pill-buying mission.

"The problem I'm having is, they're either coming back and dying, or
they're coming back and selling them on the street," Burns said.
"It's a problem, even if they are getting them legally."

Once in South Florida, the traffickers are hardly subtle. While on a
fact-finding tour last month with Broward sheriff's detectives, two
local lawmakers say they found a traffic jam of cars with Kentucky
license plates outside one clinic.

"We saw cars filled with families," said Rep. Ari Porth of Coral
Springs, who is also a prosecutor with the Broward state attorney's
office. "I had to see it for myself to believe it."

More often, police say, pill carriers fly back and forth through
Knoxville, Lexington, Blountville, Tenn., and Huntington, W.Va. Police
say one airline's flight from Huntington to Fort Lauderdale -- with
rates as low as $29 one way -- is particularly popular with the pill
network.

"The flight is pretty much full of dopers," said Sheriff Cooper, a
former narcotics detective with the Kentucky State Police.

Many local clinics are aggressive in their advertising. "Out of State
Patients Welcome," blares a newspaper ad for A1 Pain, a new clinic on
Oakland Park Boulevard in Fort Lauderdale. Other clinics offer coupons
and discounts for patients who bring new referrals, or advertise their
price per pill.

'Doctor Shopping'

Whether by car or plane, Kentucky police say, the drug dealers
typically send groups of four to eight people to South Florida to buy
pills from unscrupulous or unwitting doctors -- a practice commonly
known as "doctor shopping."

The buyers can visit several clinics, often using forged or bogus
medical records or fake MRI results to justify the medications,
according to investigators in Florida and other states.

An anonymous tipster described the Kentucky-Florida pipeline in a note
left for the Lewis County sheriff in December at a dock along the Ohio
River: A Fort Lauderdale clinic "is giving anyone medicine all you have
to tell them is that you used to go to a pain doctor and your doctor has
moved," read the note, signed "Mr. X." "There is vehicles from
Kentucky there every day."

Some clinics sell the pills directly to the patients; others provide
prescriptions filled at pharmacies on the trip back north. Searching a
suspect's home last year, Cooper said he found a road map tracing a
route back from South Florida -- eight red circles marking stops in
Florida, Georgia and North Carolina.

The trail is well-worn. Last month, North Carolina's Board of Pharmacy
warned pharmacists to be wary of people from Kentucky, West Virginia,
Ohio and Tennessee with oxycodone prescriptions from Florida doctors.
"Many of the individual patients have been calling ahead, asking
pharmacists if they have oxycodone or roxicodone in stock," the alert
said.

These traveling bands of buyers are often drug addicts who split the
pills they collect with the main dealer, who typically covers the
travel expenses and sells the remaining pills, according to police and
court records. An oxycodone pill selling for $3 to $6 at a Broward
pain clinic could sell for as much as $30 on the black market in
Kentucky or Tennessee.

Doctors Helping Out

Sometimes, the local doctors are unwitting dupes in the scheme.
Others, like Browne, are knowing conspirators.

Browne, 53, teamed with a group of Kentucky drug dealers to provide
thousands of painkillers through phony prescriptions for at least a
year, court records show. DEA agents arrested Browne after one of his
Kentucky patients became an informant, secretly recording his meetings
with the doctor.

"My son's girlfriend is telling everyone that I am coming to Florida
to get pills," the informant told Browne in one meeting.

"What you need to do is not tell anybody that you come here," the
doctor replied.

Browne, of Pembroke Pines, was indicted along with 13 others in the
drug ring. The doctor -- who spent four years as a medic at Everglades
Correctional Institution in South Miami-Dade County before going into
pain management -- is now serving a 2 A 1/2-year prison term after
pleading guilty to conspiracy to distribute oxycodone.

Browne is the only South Florida doctor prosecuted as part of a
Kentucky drug ring -- although police say they can name several
doctors whose prescriptions routinely turn up in Kentucky
investigations.

"We need to start getting some of those doctors down there
arrested," said Cooper, the Greenup County sheriff. When he
interviews drug suspects, he said, "it's always the same story: It's
just easier to get them down there."

Prosecuting the pill buyers can be difficult. A prescription from a
doctor -- even a doctor in a far-away state -- creates an assumption
of legitimacy that's hard for police to disprove, law enforcement
agents say. Most successful prosecutions arise when a suspect is found
with only a few pills left on a fresh prescription -- suggesting the
missing pills were sold or traded -- or with pills prescribed to
someone else.

Florida emerged as the prime supplier of black-market pills after most
other states created computer monitoring systems, allowing police to
track patients receiving pills from multiple doctors. Kentucky was one
of the first states to pass such a law; Florida is one of 12 states
without a comparable program.

'Embarrassing'

"We are source-supplying many other states," said Sgt. Lisa
McElhaney of the Broward Sheriff's Office, who has spent years
investigating prescription drug fraud. "This is literally
embarrassing."

Last month, Kentucky's lieutenant governor wrote a letter to Florida
House Speaker Larry Cretul, urging the passage of a new bill creating
a monitoring program to help police track addicts and pill peddlers --
a proposal strangled in the Legislature for the past seven years.

Police in Appalachia say lawmakers must do something to stem the
pipeline from Florida.

"Until Florida itself gets off the pot and does something about this
problem -- they're just killing us all," said Terry Keelin, sheriff
of Boyd County, Ky. "They're killing our citizens. It's a mess."
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MAP posted-by: Richard Lake