Florida Legislation Helps Reduce the Number of “Pill Mills”

Florida is one of the states that has been hardest hit by the prescription drug abuse epidemic. In 2010, more people died in Florida from opioids than from cocaine. In the same year, prescription drugs were associated with 81 percent of all drug-related or drug-caused deaths, excluding those caused by alcohol. The next year, that percentage was even higher.

Florida’s state legislature has attempted to address the epidemic with a series of laws aimed at reducing the number of so-called “pill mills” — clinics that fuel the drug trade by prescribing large amounts of opioid drugs. Researchers funded by NIJ studied the effects of these laws and found that they did indeed help reduce the number of clinics. Through interviews with law enforcement officers, the researchers learned about the complexities of making a case against a pill mill and how the legislation helped. The study is part of an NIJ effort to understand the different ways in which states and local governments can work on disrupting the illegal market in prescription drugs.

The researchers, from the University of Central Florida’s Department of Criminal Justice, studied the impact of three laws passed in 2010 and 2011 that defined and regulated pain management clinics and set up a prescription drug monitoring program. The “pill mill law,” passed in 2011, banned pain management clinics from dispensing drugs and established requirements for medical examinations and follow-ups before and after prescribing opioids for chronic pain, among other new requirements, with the intent of reducing the number of pill mills.

Over the next three years, the number of pain clinics in Florida dropped. The first year that pain management clinics had to register, the 2009-2010 fiscal year, there were more than 900 clinics. By 2013-2014, that number had fallen by 60 percent, to 371. The researchers also examined geographical data and found that pain clinics tend to operate in areas where homicide, rape, burglary, and other serious crimes are common. However, the data cannot show the nature of the connection — whether pain clinics are drawn to high-crime areas, whether they increase the risk of crime, or whether there is some other reason entirely why pain clinics are in high-crime areas.

In interviews, law enforcement officers said that making a case against an illegal pain clinic is very difficult. Pill mills are lucrative businesses: A physician prescribing opioids can make thousands of dollars a day, often in cash, and owners and physicians can afford expensive defense attorneys. For that reason, some officers said that laws that allow law enforcement to seize assets were very helpful. In one investigation, officers found more than $30 million in cash; a single house had more than $1 million in the attic.

The officers also said that successful investigations depend on a collaborative approach, with a prosecutor involved from the beginning. Investigations can be expensive; undercover visits to buy pills alone require a lot of cash, and investigators also need money for surveillance equipment and overtime.

About This Article

The research described in this article was supported by NIJ grant number 2012-r2-cx-0006, awarded to the University of Central Florida. This article was based on the NIJ grant final report “Non-Medical Use of Prescription Drugs: Policy Change, Law Enforcement Activity, and Diversion Tactics” (pdf, 22 pages).

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