Prescription drug traffickers in Georgia may run into some new roadblocks.
The Cobb County government and all of its cities either have adopted or are considering measures to prevent new pain clinics from opening for up to a year. The moratoriums are a pre-emptive strike against "pill mills" --- clinics that are not affiliated with local hospitals, drug treatment centers or hospices, and that move in and dole out prescriptions with little screening of patients.
At the state level, the House is considering a bill that would create a prescription drug monitoring program under the Georgia State Board of Pharmacy. The program would create an electronic database that tracks the dispensing of prescriptions. The measure passed in the Senate last month.
Proponents say the bill would help prevent patients from doctor-shopping and help track doctors who are over-prescribing. Opponents say the program would violate patients' privacy.
Abuse of prescription painkillers ranks second behind marijuana as the nation's most prevalent drug problem, according to the Office of National Drug Control Policy.
Police say pill mills are a popular supplier for prescription drug traffickers. Unlike legitimate pain clinics that are affiliated with hospitals and employ legitimate pain management practices, they typically do not accept insurance and take only cash payments. Often they treat a large number of patients from out of state.
Oxycodone pills obtained legally in Georgia for $3 to $4 each can fetch up to $60 each in neighboring states, where the drug is sometimes referred to as "hillbilly heroin," Lt. Craig Graydon of the Kennesaw Police Department said.
A proliferation of pill mills ushered in an epidemic of prescription drug abuse in South Florida beginning around 2007, according to a Broward County grand jury convened to investigate pain clinics.
Operatives from drug trafficking rings also traveled from as far away as Tennessee, Kentucky and West Virginia to visit the Florida pill mills, creating a pipeline for popular painkillers like oxycodone.
Between 2007 and 2009, the number of pain clinics skyrocketed throughout South Florida. In Broward County alone, the number jumped from four to 115 in that period.
Florida and other states surrounding Georgia have cracked down by developing prescription drug monitoring programs. That makes Georgia a "doughnut hole" susceptible to being exploited by criminal entrepreneurs, said Rick Allen, deputy director for the Georgia Drug and Narcotics Agency.
One suspected pill mill, the Pain Express clinic in Kennesaw, opened last month in Cobb County. It was shut down within weeks after federal authorities raided three locations operated in Florida by the same owners.
There are signs that similar pill-peddlers could be in the offing. Small roadside signs like those used to advertise yard sales have been sprouting in Cherokee County. The signs raise suspicion because they tout a pain clinic that's accepting new patients and provide a phone number but no business name or address, said Lt. Tommy Pinyan, a drug investigator for the Cherokee County Sheriff's Office.
Pinyan said there are no pending investigations in Cherokee County involving pill mills, but authorities are on the lookout for them.
The Georgia Drug and Narcotics Agency, which is tasked with enforcing the laws against diverting prescription drugs, reports it is keeping an eye on five to 10 suspected pill mills across the state. However, it's impossible to know exactly how many are operating. The clinics are unlicensed, and do not come to the attention of investigators unless someone makes a complaint, Allen said.
Not everyone is in favor of creating a prescription drug monitoring program. Some believe it would trample patient privacy rights.
Former congressman Bob Barr, in a March 25 opinion column in The Atlanta Journal-Constitution, said the proposed program "sweeps far too broadly and raises serious privacy concerns."
"The solution being touted by the federal Drug Enforcement Administration [DEA], by the Georgia Drug and Narcotics Agency, and by similar agencies across the country, is the typical one preferred by government --- monitor everybody in order to catch the [relatively] few abusers," Barr wrote.
Republican state Sen. Buddy Carter, a freshman lawmaker from Savannah who spearheaded the bill, said the only way law enforcement access the database is by obtaining a subpoena.
Carter, who is also a pharmacist, said that under the measure being considered in Georgia, he would have to file a weekly report about any prescriptions for controlled substances he filled. He could check the database before dispensing drugs to make sure a patient had no suspicious activity on file, but he would not be required to do so. Doctors and pharmacists are bound by federal patient privacy laws not to reveal that information to anyone outside the patient's health care network. Anyone caught surfing the database without a legitimate purpose would be subject to a $250,000 fine and two to 10 years in prison, Carter said.
South Carolina's prescription monitoring database got up and running in January 2008. Since then, the state has seen a 45 percent increase in the number of investigations into prescription drug abuse, said Thom Berry, spokesman for the South Carolina Department of Health and Environmental Control.
"We believe it is working," Berry said.
Kentucky Attorney General Jack Conway said his state's prescription monitoring database drove suppliers out of the state after it was implemented in the late 1990s.
"That's why it's important for other states to adopt prescription monitoring systems," Conway said. "With Kentucky bordering seven other states, it makes it hard to keep all the pills out."
Copyright 2010 The Atlanta Journal-Constitution