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Florida pain clinics

How cracking down on prescription peddling pain clinics created an even more devastating epidemic that remains ongoing and growing to this day: an eruption of widespread heroin addiction

Crooked doctors and ‘Pill Mills’

Florida, USA, also known as the “sunshine state” has revealed a darker side, after being labelled by some as the prescription drug capital of America. Over the past two decades, Florida has fallen prey to a heaving prescription drug epidemic, which at its height saw more than 90% of all the prescription opioids dispensed by doctors in the US being sold there. In 2010,

Florida took action, passing two new laws which attempted to stem the flow of readily available prescription painkillers being peddled by crooked doctors from ‘pill mills’ across the state. However in doing so, they created a further, perhaps more devastating epidemic that remains ongoing and growing to this day; an eruption of widespread heroin addiction.

Florida’s downfall began in 1996, with the manufacture of OxyContin – an opioid pain medication, recommended for use around the clock to treat moderate to severe pain – by pharmaceutical company Purdue Pharma. At the time, medical authorities were pushing doctors to pay greater attention to medicating chronic pain, and so OxyContin was quickly picked up as a miracle cure drug – strengthened by a staggering marketing campaign by Purdue Pharma, which involved the gifting of OxyContin-branded merchandise to physicians, and fabricated ‘real-life’ stories of patients whose lives had been vastly improved by the drug.

Prior to this, the medical community was wary in their prescription of painkillers, even to patients with incredibly debilitating illnesses such as cancer – something that might seem alien to society’s liberal attitudes today. The ideological shift in addressing pain was attributed in part to Purdue’s marketing campaign.

With few laws in place to stop them, and lax enforcement of those that did exist, pain clinics began to pop up in Florida and within a few years they were widespread throughout the state. These clinics were usually owned by businessmen and run by the doctors they hired. An example of one of the earliest and biggest was American Pain – opened in late 2007 by Chris George, a 27-year-old former convict with no medical training, and aided by his twin brother Jeff. It would become the largest illegal prescription drug ring in the US. The clinic experienced booming success, often seeing thousands of patients a day. The doctors were paid per patient – incentivising them to prescribe liberally and recklessly, both to those with valid need and those without.

American Pain ran for two years, amassing a prescription rate of almost 20 million pills and earning an estimated $43 million during that time. In 2010 it was shut down in an FBI raid and the George twins were imprisoned. In court, prosecutors said it was responsible for at least 50 overdose deaths in Florida alone – around one every fortnight for the time it was open.

New laws were introduced, thwarting the pill mills, and deaths from OxyContin in Florida dropped dramatically, by around 69% in the five years following 2010. But during that same time, the clampdown left thousands of addicts cut off cold turkey and forced to desperately look elsewhere for their fix. With the pill mills gone, supplies dwindled and demand skyrocketed – forcing up street prices. Heroin, around eight times cheaper for the same hit, was more readily available, and tragically became many user’s alternative. By 2014, Heroin deaths in Florida had doubled, and by 2016, had tripled nationwide. Florida’s attempts to curb one epidemic only made another worse.

Research has found that 9 out of 10 heroin users start with prescription opiates. Over the past few years, the Journal of the American Medical Association Psychiatry noted a trend towards greater heroin usage in white people from affluent backgrounds, most of whom said they were drawn to the drug after becoming addicted to opioid painkillers. In 2007, Purdue Pharma paid a $634m penalty for misrepresenting OxyContin’s addictiveness. A small price to pay, some might say, for a misrepresentation that caused such crippling damage that the US is still feeling the ramifications of it twenty years later. An entire generation has been lost to OxyContin, and who can say how many lives the subsequent heroin crisis will claim.

City Addictions, March 24, 2017

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