Not hardly. “We’ve just taken baby steps,” admitted state Sen. Mike Fasano of New Port Richey. Fasano said it had taken him and a few stubborn colleagues nearly a decade just to get legislation passed stopping these clinics from doubling as pharmacies and peddling their pills on site. And a new law passed in 2009 finally barred convicted felons from operating pain clinics.
But the great triumph was supposed to have been a statewide database that tracked opiate and other controlled-drug prescriptions. Doctors and pharmacists, with a few strokes on their computer, could check a patient’s history of prescription controlled drugs and tell whether the patient had been doctor-shopping: going from clinic to clinic and collecting multiple pain prescriptions. Doctor shopping had become the great engine supplying America’s booming oxy street trade.
Except the database law failed to make the checks mandatory. An investigation last fall by the Tampa Bay Times looked at 48 million prescriptions for controlled drugs since the database was initiated in September 2011.
Only 2 percent of the prescribing doctors and 1.7 percent of the pharmacists had bothered to check their oxy patients against the prescription database.
State law, in an outrageous capitulation to anti-regulatory ideologues, also bans the use of public money to fund the database. Fasano and some other supporters formed a private foundation to find the $500,000 a year needed to keep the system operating, but it has been a constant scrounge for adequate funding. Fasano promised that he would file a bill that would allow for public funding and make database checks mandatory for doctors and pharmacists. But he’s up against a governor and some influential legislators apt to resist more regulation. Fasano, frustrated, said he wasn’t sure that the opposition to reforms had to do with ideology or the powerful lobbying interests backing the pharmaceutical industry.
But Palm Beach State Attorney Dave Aronberg, the former special statewide prosecutor for drug trafficking, suggested Friday that counties could plug the loopholes in the state law with their own tough pill mill ordinances. Manatee and Sarasota counties have both cracked down on pain clinics.
“It’s worked well,” he said. And he wants Broward and Palm Beach counties to follow suit.
Even the tepid steps Florida has taken toward regulation has had some notable effects. Most of the oxy tourism seems to have shifted to the more permissive regulatory environment in Georgia.
And some operators have switched to weight-loss or anti-aging clinics, where they’ve revived their cash-only, no-insurance business plan, selling their very profitable pharmaceuticals, various hormones and steroids, right on the premises.
The osteopath listed as owner of Professional Pain Management, for example, also runs a weight-loss clinic in Davie based on an expensive regime of treatments derived from a hormone produced by pregnant women. The FDA has not approved the hormone, known as HCG, for weight loss. Two states outlaw such uses of HCG, but in wide-open Florida, clinics can sell this stuff with little worry about regulations or oversight.
Anti-aging clinics are similarly selling treatments based on human growth hormone, building profitable businesses appealing to vanity or to athletes looking for performance enhancing drugs. Again, these uses were never approved by the FDA. There’s little medical proof of either long-range safety or effectiveness, but at least the bodies aren’t piling up.
Not yet anyway. “We know that these opiates are deadly,” Aronberg said. “With the human growth hormones, we may not know for years.”