‘Pill mill pipeline’ creeping into rural Georgia

WASHINGTON -- It’s called the “pill mill pipeline” -- an underground prescription drug network that weaves its way up from pain clinics on Florida’s sunny shores to the Appalachian mountain communities and is now seeping into rural Georgia enclaves and towns just outside of larger cities.

The selling of what is known as “hillbilly heroin,” or OxyContin, has spread rapidly in part because of the fact that Georgia is the only Southern state that has not yet enacted legislation for a prescription drug monitoring program to track the drugs, according to the Alliance of States with Prescription Monitoring Programs, but is one of seven states that has such legislation pending.

Florida is one of seven states nationally that have enacted prescription drug monitoring legislation but don’t have the programs operational yet.

In some cases, prescriptions are being written by doctors in places such as Middle Georgia and filled in Alabama and South Carolina, said John Horn, first assistant U.S. attorney in Atlanta.

“Our office is absolutely concerned that Georgia is seeing an increase in pill mills, and we do believe the increase is tied to the fact that our neighboring states have monitoring programs,” Horn said. “A monitoring program is a way to identify where to address the problems, but it also has a deterrent effect on those who would come to Georgia to obtain drugs illegally.”

There are several measures in the state Legislature to create a monitoring system, and the Georgia Senate recently voted to create a database that would flag patients who “doctor shop” by trying to get multiple prescriptions for pain pills and also flag the doctors and pharmacists who repeatedly fill those requests.

Lawmakers in other states hope Georgia officials take heed.

Kentucky officials consider their state a cautionary tale of sorts. Kentucky Rep. Hal Rogers’ voice grows tight with frustration whenever he talks about the prescription drug epidemic that’s gripped Appalachia for more than a decade.

“Crook doctors operating these pill mills” in Florida are running rampant and are fueling the flow of illegally obtained prescription drugs to states like Kentucky, Rogers told Attorney General Eric Holder during a recent hearing.

“My people are dying,” the chairman of the House Appropriations Committee said.

For Kentucky lawmakers such as Rogers, who’ve long been on the front lines battling an epidemic of pain-pill abuse, the battle feels personal.

While Rogers appreciates the administration’s current efforts, he says the problem was ignored for far too long on the federal level. More needs to be done, he says.

The White House “has got to act,” Rogers said. “We’ve got more people dying of prescription drug overdoses than car accidents.”

The Obama administration counters that it is the first to publicly call the prescription drug abuse problem an epidemic and says it has stepped up drugs busts and directed millions in funding to state-operated prescription monitoring programs.

White House drug czar Gil Kerlikowske called Thursday for a multi-pronged approach to fight the problem.

Kerlikowske spoke to members of the Congressional Caucus on Prescription Pill Abuse and stressed the need for stronger law enforcement, education and prescription drug monitoring to help combat abuse.

In the meantime, Rogers hopes legislation he’s co-sponsoring with Rep. Vern Buchanan, R-Fla., calling for a tougher federal crackdown on pain clinics that dispense prescription drugs will help stem the flow of drugs across all state lines.

The measure includes provisions to support state-based prescription drug monitoring programs; to use the money from seized illicit operations for drug treatment; to strengthen prescription standards for certain addictive pain drugs; and to toughen prison terms and fines for pill mill operators. As of Friday, Buchanan’s staff was reaching out to Georgia lawmakers and others to co-sponsor the bill.

The measure comes on the heels of Florida Gov. Rick Scott’s calls to repeal a monitoring program designed to stem interstate prescription drug trafficking -- a move White House officials say will stymie efforts to curb the problem.

Scott has cited concerns about costs and patient privacy rights and has since turned down a $1 million donation from pharmaceutical giant Purdue Pharma, the maker of OxyContin, to help pay for a prescription database to combat Florida’s illegal trade in painkillers. Despite some success, including several high-profile drug busts and the adoption of prescription drug monitoring programs in 43 states, the problem is now so entrenched that the cheap flights and van rentals drug traffickers use to travel from Florida, through Georgia and up the East Coast to peddle “hillbilly heroin” are nicknamed the “OxyContin Express.”

During the past decade, the study by the Substance Abuse and Mental Health Services Administration found a fourfold increase nationally in treatment admissions for prescription pain pill abuse. The increase spans every age, gender, race, ethnicity, education, employment level and region.

The study also shows a tripling of pain pill abuse among patients who needed treatment for opioid dependence.

“The extent of the problem is statewide,” Horn said. When we see “prescriptions being written by a doctor in Georgia and filled in Alabama and South Carolina, the inference is that there are doctors in places like the Macon and Columbus (metropolitan areas who) are writing those prescriptions.”

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