Sunday, February 3, 2013

Georgia’s “Pill Mill” Problem

Some patients suffer from nearly constant intense pain. Pain management is complex enough that it has become a true medical specialty. Years of medical specialty training are required, culminating in certification by the American Board of Pain Medicine. Management of chronic pain requires a multi-faceted approach that includes careful medical evaluation after referral by a licensed physician; a full understanding of the source of the pain; attempts to reduce pain by non-narcotic means; and when all else fails, minimal doses of pain medications dispensed under strict medical supervision. Patients generally have insurance coverage because their pain has been properly diagnosed and is being legitimately treated.

Unfortunately, certain legitimate pain medications are also popular street drugs. And that has given rise to “pill mills” – medical clinics masquerading as pain management centers that are in reality just high-profit pain medication dispensaries. At pill mills, patients are prescribed unusually large doses of narcotics such as oxycodone, generally for cash and generally without extensive diagnosis or alternative treatment. Many of these pills are later sold for cash on the black market, rather than being used by the “patients” themselves.

According to the Wall Street Journal, the state of Georgia has developed a “pill mill” problem in the wake of an aggressive crackdown on such clinics in Florida. The clinics simply moved north, where current Georgia laws make it hard to prosecute such clinics effectively. Georgia, like most states, does not require medical clinics to be owned by a medical professional and does not track the number of prescriptions each clinic writes.

The state of Georgia will surely do something about its pill mill problem in due time. But until there’s a national solution or at least communication and coordination among the states, the pill mills are likely to just move elsewhere.

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