Florida closes pill mills, and curbs painkiller abuse

Washington PostJuly 8, 2014 

Prescription opioids enable millions of Americans to overcome what might otherwise be agonizing, crippling pain. Yet, each year, those same wonder drugs sicken, addict and even kill thousands of others. Public- and private-sector officials were slow to respond to this public health crisis, but there are signs that new measures designed to curb the illicit flow of painkillers are producing lifesaving results.

A report released Tuesday by the Centers for Disease Control and Prevention (CDC) shows that overdose deaths in Florida — one of the states hit hardest by painkiller abuse — fell by 17 percent between 2010 and 2012, from 3,201 to 2,666. Incremental as that decrease may seem, it stands in blessed contrast to the 2003-2010 period, in which deaths rose 75 percent, from 1,829 to 3,201.

As the CDC notes, the data suggest that most of the decline is due to fewer prescription opioid overdoses — and that, in turn, reflects policy changes that shut down 250 of the state’s notorious “pill mills,” as high-volume pain-medication dispensaries are known. Once home to 98 high-volume prescribers, Florida now has no such doctors.

The United States remains far and away the world’s largest user of prescription opioids. A separate CDC report showed that prescription rates vary widely among states. The range is so wide — prescriptions for oxymorphone were 22 times more frequent in Tennessee than in Minnesota, for example — that it is difficult to account for it through any legitimate medical explanation. The five highest prescribing jurisdictions remain a handful of Southern states where the epidemic of prescription opioid abuse began: Alabama, Tennessee, West Virginia, Kentucky and Oklahoma.

The Florida numbers demonstrate that the epidemic can be curbed, even where it seems unstoppable. Additionally, Florida has not seen the same rise in heroin abuse that has accompanied prescription opioid crackdowns elsewhere, and which has caused some critics to argue that government was merely shifting addicts into an even more dangerous source of supply.

The CDC figures show that heroin-related deaths rose by only 60 in Florida between 2010 and 2012: troubling but not outside the range of normal fluctuations prior to the prescription opioid crackdown, and that number was far outweighed by the decline in prescription drug-related deaths. The data, in short, send a clear policy message: Tougher regulation of prescription opioid distribution saves lives. More states need to follow Florida’s example.

Washington Post

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