·        Rules are tightened for writing prescriptions and plans for pain treatment.

·        Doctors who over-prescribe painkillers are penalized with minimum $10,000 fines and six-month suspensions.

·        Doctors are now required to use electronic or counterfeit-proof prescription pads purchased from state Health Department-approved vendors. Vendors are required to report monthly sales of these pads to state officials.

·        Mandatory buy-back program established for doctors to transfer narcotics back to distributors.

·        If a pharmacist knowingly fails to report an attempt to purchase drugs fraudulently to police, it’s now a first-degree misdemeanor.

·        Pharmacies now have seven days to report prescription information into the state drug database, shortened from the previous 15-day time limit.

·        Pharmaceutical companies are prohibited from providing funds for the database operation.

·        Wholesalers who sell controlled substances are required to report distribution data to the state.

·        Doctors are required to tell the state when they begin and stop working at pain management clinics.

·        Law enforcement officers are allowed to review or copy pain clinic records without a search warrant.

·        Provides $3 million to support law enforcement efforts and state prosecutors.

Not only does the new law impose tighter regulations on doctors and pharmacies, it also includes using a strike force to crack down on the notorious pill mills.

There’s good reason for the crackdown on Florida’s pill mills. An estimated nine people per day in the state die from abuse of prescription drugs, mostly through overdose. In 2007, an estimated 11,000 people died from prescription drug abuse in the country. Long considered the epicenter of the problem, Florida has had the dubious distinction of prescribing 86 percent of the oxycodone in the country, according to estimates by the federal government. One Florida doctor was reported to have prescribed more oxy pills than were prescribed in the entire state of California last year.

Broward County is the nation’s pill-mill capital, according to the Miami Herald  (http://www.miamiherald.com/2011/06/03/2249936/scott-signs-pill-mill-bill-into.html), with 130 pain clinics in operation. In Broward alone, say law enforcement authorities, more than one million oxycodone tablets are prescribed every month.

It isn’t just Florida residents that have had easy access to the pill mills, however. The state’s reputation as “Oxy Express” has attracted addicts and dealers from across the country. States north of Florida have applauded the Florida law and crackdown. Kentucky Governor Steve Beshear called the “choking off of the pill pipeline from Florida” a key element in that state’s strategy to curb rampant prescription drug trafficking and abuse.

The law enforcement crackdown on Florida pill mills is also starting to have an impact. In late August, federal investigators busted the nation’s largest pill mill crime enterprise operation in South Florida, a narcotics network that churned out more than $40 million in profits from more than 20 million oxycodone pills.

Defendants Christopher and Jeffrey George have been portrayed as the twin kingpins of the South Florida prescription drug market, with their network of storefront pain clinics across the state. But their reach extended far beyond Florida, with drug couriers coming from as far away as Appalachia, Mexico and Turkey. In the indictment, some 32 people were charged for their involvement with the pill mills, the result of a three-year criminal investigation.

After the law went into effect July 1st, there was an immediate furor raised by patients who were afraid they’d be unable to get their legitimate prescriptions filled because there was a shortage of state Health Department-approved prescription pads. As a result of the uproar, State Surgeon General Frank Farmer suspended the requirement until August 29.

The department estimates that approximately 50,000 licensed physicians in Florida prescribe controlled substances to treat the medical needs of their patients.

Governor Rick Scott said in a statement, “Earlier this year, I made a promise to crack down on pill mills and stomp this scourge out of our state. By shutting down pill mills, we are saving lives and making our communities safer places to live.”

Although the road to getting the new law passed and into effect was a long one, what with the Florida governor initially against and then for the provisions, once it passed, drug treatment centers in the state began to gear up for the influx of new patients seeking help to overcome their addiction to various prescription drugs. That’s according to a story in the Sun Sentinel (http://articles.sun-sentinel.com/2011-07-09/news/fl-next-for-pill-mills-20110709_1_pain-clinics-prescription-drug-monitoring-program-pill-mill-law) in early July.

As drug treatment experts will tell you, once the supply of a prescription drug is no longer available, you can’t just go off the drug cold turkey without some potentially serious consequences. Most addicts who go off a drug need to safely detox and most probably require treatment. At the time of the bill’s passing, the state’s treatment facilities were said to be full. So, meeting the challenge was seen as one that would be difficult.

Public facilities were already maxed out, while private treatment facilities were also experiencing demand that often exceeded availability. The Florida Department of Children and Families (DCF), which funds a number of locally-based drug programs across the state, has tried to maintain its funding for substance abuse programs despite budget shortfalls. Reports say that although its total annual budget for drug- and alcohol abuse treatment programs has hovered around $215M for the past few years, now increased demand for treatment may outpace the amount of funds available for the purpose.

A report by the DCF ranked Florida number 35 out of 50 states in 2009 for per-capita spending on programs for substance abuse and addiction. The sponsor of the pill-mill legislation, State Sen. Mike Fasano, R-New Port Richey, said that the Legislature needs to track the ongoing fight against prescription drug abuse to determine whether dealers are finding a way around the law. After the bill went into effect July 1, 2011, Fasano said his focus was on whether treatment centers would be able to provide detox and treatment to all those who need it.

“You’re going to have a big problem…a situation where many addicts thankfully will not be able to get their fix, and we’re going to need to assist those individuals in any way we can so they don’t commit crimes,” Fasano said.

One thing is certain. In the continuing fight to eradicate the pill mills in Florida, it will take a coordinated and concerted effort by all concerned: law enforcement, pharmacists, doctors, drug treatment facilities, and concerned citizens alike. Ridding the state of its “Oxy Express” image won’t happen overnight. In that regard, it’s much like addiction. There’s a lot of hard work that needs to be done and will continue to be required in order to beat it.

Attitudes toward drug and alcohol addiction have evolved over the years in society as a whole. While addicts and users used to be seen strictly as criminals, education and outreach programs have taught us that addiction is a disease. The treatment of addicts and alcoholics in state courts has also evolved over time. Florida has lead the way in this regard, establishing the first Drug Court and, more recently, applying the Drug Court model to habitual driving under the influence (DUI) offenders. Drug crimes are the most common type of case coming before Florida’s criminal judges today. Further, roughly 60% of those arrested are either under the influence of drugs or alcohol or have committed a crime to get drugs or alcohol.Drug Abuse

Florida’s drug court diversion program first came on the scene in Miami-Dade county in 1989. Judicial officers and court personnel had noticed an alarming rise in the number of drug offenders who where re-appearing in court for new drug-related crimes. It became clear that placing these criminals in jail was not helping with their underlying drug addiction issues. Instead, certain drug addicted criminals are offered the chance to successfully complete a drug treatment program to avoid a criminal conviction. Today, there are over 100 drug courts throughout Florida.

Florida’s drug court diversion program is codified in Florida State Law, section 948.08(6)(a). Drug addicts charged with purchasing a controlled substance, possessing a controlled substance, prostitution, tampering with evidence, solicitation for purchasing a controlled substance or obtaining a prescription by fraud all may be eligible for the pretrial program. Successfully completing the program means that the charges will be dropped and will not appear on the person’s criminal record. However, a small number of courts follow a post-conviction model instead.

If charged with a crime that is eligible for the diversion program, a defendant asks the court to be admitted to the program. If the district attorney agrees, the final admission decision is made by the judge. Certain prior convictions or the commission of violent crimes will make someone ineligible. Also, admission will be denied if the person is found to have been dealing or selling controlled substances.

The diversion program lasts for a minimum of one year and includes substance abuse treatment, case management, drug testing, monitoring and court appearances. The program also provides structured sanctions and incentives to participants. Certain violations will generate sanctions such as community service, probation or even jail time. Should one fail to complete the program, he or she may be offered the chance to repeat it or may be tried for the original crime.

The program itself is very structured and has three phases. In Phase I, the drug abuser enters detox in a county treatment clinic for up to two weeks to get clean. While there, they begin the group and individual counseling, 12 step meetings and drug tests that will be required throughout the program. The county also offers acupuncture to help with withdrawal symptoms. Phase II, stabilization, lasts for up to four months and focuses on helping the addict stay clean. Participants are now required to start attending court sessions. Phase III, after care, lasts up to 9 months and adds education and vocation classes to participants.

Alcohol Abuse

Florida has the third highest rate of motor vehicle fatalities due to alcohol use. However, alcoholics are treated much more harshly in criminal court than drug addicts. Once charged with a DUI, it is not likely that a person addicted to alcohol will walk away from it with treatment instead of a criminal conviction. A first DUI offense carries with it up to six months in jail, a $500 fine, six months license suspension, 10 days of loss of vehicle, 12 hours of DUI school, 1 year probation and 50 hours of community service. It is possible to get a first DUI charge reduced to either reckless driving or careless driving, a civil citation. However, the most treatment a first offense DUI defendant will be ordered to complete is 12 hours of “DUI school”. Compare this to the 12-month treatment program offered to certain drug offenders through the drug diversion program.

A few Florida counties are beginning to offer DUI Court, a program which offers probation and treatment as an alternative to serving time in jail. However, as opposed to successful participants in the drug diversion program, DUI Court participants will not have their convictions dropped after treatment. Sarasota County started its DUI Court program in 2008 and serves those who have been convicted of DUI two or more times. The phases of the program are similar to those of the drug diversion program.

Millie Anne Cavanaugh is an attorney licensed to practice law in California & Massachusetts and is a former insurance defense lawyer. The information contained herein is provided for informational purposes only, and should not be construed as a solicitation for your business or as legal advice on any subject matter. You should not act or refrain from acting on the basis of this information without seeking independent legal advice.