Pill Mills & The Endless Game of Whac-A-Mole

Friday, December 28th, 2012

I was troubled, but not surprised to read that the crackdown on ‘pill mills’ in my state of Florida has set off a boom in Georgia.  Now that Florida has established tougher regulations, ‘pill mill’ operators are simply opening businesses elsewhere—and taking customers with them.  As Ohio Senator Sherrod Brown put it, efforts to shut down sham pain clinics have “become like a game of Whac-A-Mole—as soon as one disappears, another one pops up.”

I couldn’t agree more.  While I’m proud that Florida, once a hotbed of these questionable clinics, has taken proactive steps to reduce prescription drug trafficking, the actions of any one state won’t be enough to solve this national crisis.  We need a set of federal regulations to prevent pill mill operators from moving on to the next state.  Developing a national prescription drug database, setting uniform standards for pain clinics, and investigating sketchy operations—these are efforts that require a coordinated, countrywide initiative.

But these tactics alone won’t provide the ultimate solution.  No doubt, we must attack the supply of prescription drugs in order to curb their abuse.  However, it is just as important, if not more, to address the demand for these drugs. More than 16,500 Americans die annually from opioid painkiller overdose, more than heroin and cocaine combined.  When a problem becomes this serious, we have to look at why so many people are becoming addicted to these painkillers in the first place—and what we can do about it.

One major reason painkiller addiction has soared in recent years is what I call our “culture of comfort.”  Today, many of us want to avoid any discomfort—and we tend to medicate every minor ache and pain.  That’s a heck of a lot of pills, many of which carry the potential for abuse. Of course, this doesn’t mean narcotic painkillers aren’t the right way to go when it comes to treating acute pain caused by severe injury or illness.  But I believe the over-prescription and usage of these drugs needs thorough examination.  If you’re regularly taking a narcotic painkiller like Oxycontin and you forget to bring it with you on a trip, you’ll find yourself in withdrawal. Unfortunately, far too few Americans understand that if they take narcotics over a period of time, they’ll become dependent and likely addicted.

So, what can we do?  For starters, both doctors and patients should be more educated about the risks—and they should consult addiction professionals.  I would even go so far as to suggest that every pain clinic should be required to have an addiction counselor on staff.  These counselors should talk to chronic pain patients before they start a narcotic and explain the dangers.

In addition, doctors should refer patients struggling with dependency or abuse to addiction treatment centers.  Southern Health, the Georgia clinic profiled in the Wall Street Journal, cited the fact that its doctors “tried to wean patients off high-dosage oxycodone” as evidence it was not operating a pill mill.  But the bottom line is that no pain clinic should be tapering down a medication, unless the staff includes someone trained in detoxification.  Detox should be left to addiction professionals who understand the entire realm of dependency.  Substance abuse requires specialized care, just like any other health condition; physicians who attempt to treat addiction without proper training are doing patients—and all of us—a disservice.

At the end of the day, we’ll never be able to conquer our country’s prescription drug abuse epidemic unless we take the wind out of its sails—and that can only happen through prevention, education, and treatment. Addicts will always find another way to get their fix—and dealers will always be ready and waiting to meet their demand.  If we focus solely on the newest ‘pill mill’ capital, this perpetual game of Whac-a-Mole will never end.

Jack Feinberg
VP & Clinical Director
Phoenix Houses of Florida


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1 Comment

  • Heather H

    In the mean time I can’t get anything stronger than Tramadol for my Cervical Osteoarthritis, Herniated Disc and 2 pinched nerves.

    What I did get was a referral to Pain Management, which I have to pay $250 for and I probably won’t walk out of that office with anything either.

    Why should I have to suffer because of this?