Anatomy of a Pill Mill

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A report this month from MSNBC lays out the anatomy of the Florida based pill mill business. It follows the adventures of two brothers, Chris and Jeff George, who operated a chain of clinics with the express purpose of fueling the oxycodone epidemic for cash.

The brothers pleaded guilty recently and are now in prison, but the extent of their operation, and how patients were instructed to “keep a low profile” among other tips, is just now being exposed.

Obama drug czar, Gil Kerlikowske, is quoted as saying during the height of the Florida prescription drug problem, “The toll our nation’s prescription drug abuse epidemic has taken in communities nationwide is devastating, and Florida is ground zero.” Since last year, when he said this, Florida has tightened some of the rules in an attempt to reduce inappropriate prescriptions for heavy narcotics. At the time, the state was supplying neighboring states as dealers and users traveled hundreds of miles to take advantage of the lax regulations.

In fact, this was one of the tip-offs in the George brothers case. A car that was struck by a train had spread oxycodone tablets throughout the wreckage. The occupants were from Tennessee and in Florida to buy “legal” drugs by doctor and clinic hopping to get multiple prescriptions.

Although not licensed physicians themselves, the Georges were able to hire doctors who weren’t afraid to write lots of narcotic prescriptions. They advertised on Craig’s List for doctors – the main qualification was a license to prescribe narcotics in Florida. Without a narcotic tracking system in place (this has changed), the doctors were free to charge cash and give patients what they wanted. In essence, the practice became a legal way to deal drugs. And for those who had customers out of state, the “patients” would simply do a cash-and-carry back to their home markets.

The prosecution of this case outlined some of the bogus practices designed to meet medical standards of practice without actually interfering with the real business. For example, patients would be asked for a urine sample to detect whether they had an addiction problem, but the clinic would ignore the substitution of clean for dirty urine. Medical “exams” sometimes consisted of a glance at an X-ray and a three minute consultation.

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