At least, we’ve been spared the lowdown tourism attracted by the oxy mills. Parking lots outside anti-aging clinics aren’t filled by worn-out cars with Kentucky and West Virginia license tags. “Rejuvenation” operations aren’t thronged by hallow-eyed Appalachians with their suspect MRIs and feigned back injuries and addicts’ desperation, come to buy their quota of pain pills to carry back to the mountains.
The joints that peddle human growth hormone and steroids are a different kind of trouble. With a different kind of clientele.
“But it’s the same business model,” said Dr. Bernd Wollschlaeger of North Miami Beach. “It’s déjà vu.”
Wollschlaeger, former president of both the Florida Academy of Family Physicians and the Dade County Medical Association, was among the community leaders begging Tallahassee to intervene over the last decade, as pain pill merchants turned South Florida into an unfettered junkies’ bazaar.
By 2009, some 183 pain clinics were thriving in South Florida, most of them hawking oxycodone prescriptions with hardly a pretense of actual medical diagnosis. Florida could claim all of the nation’s top 50 most prolific physician prescribers of oxy. And 33 were from Broward County, many working out of shoddy storefront clinics.
Finally, as the mounting number of fatal overdoses traced back to Florida became a national disgrace, our reluctant legislature and governor approved regulations that tamped down on the worst of the pill mill abuses.
But opportunistic “bad operators,” as Wollschlaeger calls them, have adopted the old pain pill business plan to fit the “rejuvenation” racket. To great success. Suddenly, anti-aging clinics are proliferating like hamburger franchises. And, just like the pill mills, the shadiest of these operators accept only cash, carefully avoiding the unwanted scrutiny and state regulation that comes with accepting medical insurance.
Like pain clinics, the worst of the anti-aging operations are really about dispensing expensive pharmaceuticals right there on the premises. Actual doctoring tends to be scarce. Often, owners of the dodgier operations aren’t doctors but opportunistic entrepreneurs, who might keep a physician around to sign the scripts. But the object, once again, has little to do with dispensing medical advice and everything to do with dispensing wildly profitable doses of human growth hormone or steroids or testosterone or some amalgamation of those drugs, mixed right there on the premises.
South Florida offers them the perfect sucker clientele. We’ve got aging boomers in denial. We’ve got body builders and year-round weather to display their pumped up physiques. We’ve got an epidemic of silicone-inflated vanity. We’ve got a large colony of professional jocks who reside in South Florida, some of whom are desperate for a performance edge or the accelerated recovery from injuries that might come from injections of human growth hormone. Several names of major league baseball players bubbled up in the investigation of a BioGenesis of America, an anti-aging clinic on South Dixie Highway now under scrutiny from the U.S. Drug Enforcement Administration.
Of course, this is a national, even an international phenomenon. On Friday, Australia was stunned by what the Australian Advertiser called “sports darkest hour,” after the Australian Crime Commission released the findings of a 12-month investigation charging that “anti-aging clinics are marketing their services directly to athletes by offering services such as hormone profiling and hormone-based training regimes to enhance athletic performance." The Advertiser’s lead paragraph could have come from The Miami Herald. “Unethical doctors and pharmacists have been using athletes as human guinea pigs to test human growth hormones and other substances that have not been approved for human use, a shocking report into drugs in sport has found.”
Back here in sunny Florida, we harbor the kind of permissive state regulatory environment that all but encourages rogue medical pursuits.
Federal law prohibits the use of steroids as an athletic enhancement or a body building aid. And the FDA limits the use of human growth hormone (hGH) to a narrow range of medical issues. Yet aging clinics pump hGH into their patients for cosmetic reasons or to add lean muscle mass to their frames. Maybe it does both, though medical science has seen little evidence that hGH offers any long-term health benefits. But it’s the long-term side effects that worry Wollschlaeger.
“I’ve had to clean up the mess,” he said, describing patients who come to him after their so-called rejuvenation treatments. He said the anti-aging clinics often serve up a “devil’s brew,” mixing their own private recipes of high potency steroids and hGH, coming up with compounds never tested by medical science or authorized by the FDA. He talked about side effects of joint pain, soaring high blood pressure, anxiety attacks, irrational moodiness and sudden bursts of aggressive behavior. “They get quick results physically. They look good. It’s what’s happening to their brain that worries me.”
There’s another factor in the anti-aging phenomenon that might inhibit a crackdown on outlaw clinics. Body building drugs have been insinuated into law enforcement culture. In 2004, when the feds raided PowerMedica, an Internet steroid distributor based in Deerfield Beach, they discovered the names of eight Broward sheriff’s deputies, four Palm Beach County deputies, 13 West Palm Beach city cops and three Delray Beach policemen on the company’s list of regular customers. In 2006, the Department of Corrections busted a steroid-peddling ring run by a correction officer who was selling to his fellow prison guards. A 1991 FBI bulletin warned, “Anabolic steroid abuse by police officers is a serious problem.” Maybe that suggests something about law enforcement’s enthusiasm for investigating steroid and hGH mills.
Gov. Scott and other state officials managed to ignore the state’s pain pill scandal until the number of fatal ODs linked to Florida’s unscrupulous clinics caused a national uproar. Anti-aging pharmaceuticals don’t produce such obvious, dramatic tragedies, though Wollschlaeger worries that anti-aging merchants could be causing their patients serious, long-term damage. But there’s no body count to throw at a state leadership that loathes the very word “regulation.”
Even if the state and feds crack down on anti-aging clinics, Wollschlaeger suspects the cash-only business plan will simply be adopted to fit some other barely regulated, highly profitable, ethically questionable medical pursuit. “I don’t know what’s next,” he wondered. “Maybe gene therapy.”