The Worldwide Pill Mill

Thursday, December 8th, 2011


Blog Editor’s Note: The following post was originally published by Hickory Wind Ranch, a sober living community in Austin, Texas.

In 2001, a California teenager named Ryan Haight bought Vicodin over the internet and fatally overdosed; he had no prescription, and had never consulted with a doctor about the drug. The 2008 Ryan Haight Act was meant to prevent additional overdose tragedies by prohibiting the online sale of narcotics without a prescription—but has it worked?

As The Palm Beach Post points out this week, the crackdown on pill mills here in Florida has caused folks to start searching for other, easier ways to get high. That’s where the internet comes in—over the past year we’ve seen a continuous rise in internet narcotics purchases in the state and elsewhere. The Post report is unfortunately correct in saying that “internet pill peddlers never had it so good.” These illegal vendors work through a combination of legal loopholes (including an online questionnaire that will purportedly be reviewed by a physician) and geographical confusion (offshore locations linked to multiple untraceable contacts) to sell deadly prescription pills to the next generation of Ryan Haights. They’re even using social media tools like Twitter and Facebook to reach a wider – and largely younger – audience. This renewed accessibility of medications is especially troubling given recent statistics about the prescription addiction epidemic: as of this year, drug deaths outnumber traffic fatalities, with prescription overdoses accounting for more deaths than heroin and cocaine combined.

We knew that something like the resurgence of internet “pill mills” would happen; personally, I was predicting that people would turn to heroin when the brick-and-mortar pill mills shut down, but the internet makes even more sense—it’s the ideal anonymous shopping mall, and it delivers to your door. The pill mills had to be addressed first because they were the biggest source, and now we’ll have to tackle the internet as well. But this changeover proves what most of us have known for some time: we can’t just fight supply. Shutting down the local pill mills only feeds the digital ones. The demand for drugs in this country is so strong that people will always find a new way to get high—but that doesn’t mean that we should let things slide. We know from studying drug legalization in other countries that “just letting it slide” will only lead to more problems.

It always comes back to the same thing—we need to make more help available to more people. And not just people at the end of their rope. People with substance abuse problems face a number of crossroads long before they hit a dead end, and if there were more treatment options available at each of those crossroads, more people would get the help they need. Programs like Phoenix House’s SBIRT (Screening, Brief Intervention, and Referral to Treatment) initiative, based in medical clinics, schools, and physician’s offices, help those folks who are still functional but whose drug use is negatively affecting vital aspects of their lives.

Perhaps an even better tool is social media—the very instrument that digital pill mills are using to advertise and support their illegal drug sales. Phoenix House is part of a growing online community of forward-thinking organizations (such as the Partnership at, The Fix, and others) that offer aid and insight for people affected by substance abuse and addiction. With our platforms on Facebook, Twitter, Tumblr, and elsewhere, we’re sparking dialogues, increasing awareness, and showing folks how and where to get help. We’re presenting healthy options in places where people can simply stumble across them—the very same places they might stumble across internet pill peddlers.

If we could only accomplish one thing in Florida, it should be to increase the awareness, availability, and accessibility of treatment at different levels and locations (physical and digital) throughout the state. Reigning in the pill mill supply was definitely the right first step, but prescription addiction, like any addiction, is a much bigger problem that needs to be addressed from all angles—otherwise, we’re just going to keep losing lives.

Jack M. Feinberg, LMHC, CAP
Vice President and Clinical Director
Phoenix Houses of Florida


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  • I agree that, “It always comes back to the same thing — we need to make more help available to more people.”

    Polls show that the more people understand that addiction is a biological brain disease, the more they support treatment. Thus, one of the key components of getting more help to more people is education about the nature of the disease: what part of the brain malfunctions; how those malfunctions play out behaviorally; why some get addicted while others don’t; why treatment works; etc. For a website that addresses these issues, please check out

  • Bob Denson

    Yes, I totally agree because the War on Drugs is not leading to any problems whatsoever. Just because the all out anarchy, death, corruption and daily reminders of the hacked up limbs courtesy of the Sinaloa Cartel aren’t happening in your neighborhood, does not mean that they do not matter!!!!!!! Screw you stupid retards that say rehab is the only way, you know nothing of the human spirit. I was a monster addict, and I mean a monster freaking addict that blacked out and freaked out 6 out of 7 nights of the week for 9 years. Guess what. All I needed was some inspiration, it took a baby boy. My baby boy. But I also had to be ready to quit. Your stupid billion dollar industry is taking peoples money ever so happily by not letting them know these two things first hand. Because those two requirements are common to ALL ADDICTS because the disease is so goddamn strong!!! Your multimillion (or is it billion?) dollar industry is corrupted, and I am here to expose you with devastating consequences. Deep down if not consciously you know what I say is true. So keep fighting the war on drugs, keep lobbying for more guns, more siezures, and let the drug war evolve and escalate. It sure is good for business, eh?

  • alharris

    Bob – Thank you for your comment. You’re right that the disease of addiction is strong and that there are flaws in our country’s current approach to the “War on Drugs.” Phoenix House supports changes in our approach, including decriminalizing drugs and increasing access to treatment.

    You’re also correct that there are many paths to recovery, and there is no “one size fits all” cure to the disease of drug addiction. Over the years, however, the scientific and addiction treatment communities have developed research-tested methods proven to be helpful to people struggling with addiction. We provide support through services like individual and group counseling, treatment for co-occurring conditions, family therapy, and medical stabilization to ease withdrawal symptoms. Many people share your concerns about the cost and the effectiveness of treatment, so we’ve addressed a few of those concerns in our blog posts. Here are a couple of links if you’re interested in reading further:

    Thank you for dialoguing with us, and congratulations on your recovery.