To address the growing number of unauthorized pain management clinics in South Florida, the Broward Board of County Commissioners created a Pain Management Clinic Task Force to review, research and make recommendations on how to address the problem of these clinics referred to as pill mills.
The eight-member Task Force first defined pill mills as medical facilities that appear to practice outside the normal course of professional medical practice by engaging in pain management treatment through the primary use of controlled substances for the majority of facility patients – many of whom frequently travel from outside Florida in search of controlled substances.
Dr. Sanford Silverman, a member of the Broward County Medical Association and a member of the Task Force, said the report the Task Force filed with the Broward Board of County Commissioners created a template on how to allow – or not allow – a new pain management clinic in cities and created the building blocks of an ordinance to monitor pain clinics.
“It’s a real blight for Florida to have these pill mills,” Silverman said. “It has gone a decade unchecked. However, most of the public and politicians think that all pain clinics are the same, and that’s a real tragedy.”
Silverman, a licensed and certified physician, said one of the responsibilities of the Task Force was to not only make recommendations to promote public health and safety but also to minimize any negative effects that may impede legitimate pain management clinic clientele from obtaining proper medical services. He said the main difference between legitimate pain clinics and pill mills is the doctors who treat patients. Pill mill doctors, he said, are not physicians, are not trained in pain medicine and only offer medication as a treatment for pain.
“The real bottom line is that people don’t know what to do when they’re in pain,” he said. “These pain clinics are not the way to go. These entities are cash driven, and they only offer one thing: pills. This can lead to chemical dependency.”
According to The Pain Truth, a website focused on educating Floridians about pain management and stopping prescription drug abuse, prescription drugs are responsible for killing at least seven Floridians a day, and Florida has the highest national rate of prescription drug abuse.
The Task Force, therefore, reviewed significant legislative actions that have passed and are pending implementation as well as local government ordinances to combat the problem.
Legislative action Chapter 2010-211, which took effect Oct. 1, now requires that pain clinics must register, must be owned by doctors or be state licensed, must examine patients before prescribing medication and must follow specific guidelines for dispensing medications. The Task Force supported the tougher restrictions, and in addition, they recommended that the County Commissioners support the ordinance’s implementation of the Department of Health’s Prescription Drug Monitoring Program, or PDMP, which would require a private vendor to house the database and receive the prescription information from pharmacies and dispensing practitioners throughout the state.
However, pending legal challenges to the implementation could potentially invalidate this important law, the Task Force stated in the report, which would hinder municipalities from curbing pill mills in their areas.
Another main goal of the Task Force was to look at the feasibility of a moratorium on the issuance of Business Tax Receipts (formerly Occupational Licenses) for certain businesses that dispense prescription drugs. The Broward Board of County Commissioners, for example, passed a 180-day moratorium on pain management clinics on June 8, 2010.
The Task Force stated in the report that “moratoria are only a temporary solution to postpone the growth of the problem while formulating a more permanent strategy. State and local regulations, ordinances, rules or permits must be developed to prevent further proliferation of pill mills,” which is why they support implementing the PDMP. Since many of the local moratoria are scheduled to expire in close proximity to the implementation dates of the legislative actions, timely implementation is key to preventing the creation of more pill mills.
Silverman said that managing pain clinics needs to be a joint effort between local, state and federal governments. Eliminating all pain clinics, he said, would be unconstitutional, so legislation for regulating legitimate pain clinics versus pill mills needs to pass.
“As long as pain clinics follow state laws, they shouldn’t have a problem,” Silverman said. “(And for people who need pain management), if you go to the right doctors, you’ll be taken care of.”
For more information about pain management clinics and qualified Florida pain management physicians, visit www.thepaintruth.org.
