Prescriptions written for three addictive drugs linked to hundreds
of overdose deaths dropped by a dramatic 45 percent in the Houston
area during the first month that stricter state regulations took
effect.
In addition, the first suspected "pill mill" to be shut down
in Texas after the new law began Sept. 1 was in Houston.
Designed to stop the endless flow of black market prescriptions
for these drugs, the new law requires pain management clinics that
supply 50 percent of their patients with controlled substances to
register with the Texas Medical Board and be more highly regulated.
It was implemented after Houston was identified as one of three
major U.S. hubs where a high quantity of fraudulent prescriptions
were being written for the drug trio - hydrocodone (a narcotic),
alprazolam (an anti-anxiety drug) and carisoprodol (a muscle
relaxant). These drugs - known as the "Holy trinity" or "Houston
cocktail" - when taken together can produce a heroin high.
The prescription abuse and rogue clinics can be dangerous as
more than 1,200 accidental pill deaths were recorded in Harris
County since 2006, a Houston Chronicle review found.
The Texas Department of Public Safety's tracking system of the
drugs showed Houston-area doctors ranked first in the number of
prescriptions written for the trio during a 15-month period ending
in March. One Houston doctor alone was responsible for writing an
average of 3,000 prescriptions a month.
Yet in September, Houston-area doctors wrote 6,143 prescriptions
for the three drugs compared with 10,989 written during the same
period a year earlier.
While the majority of these prescriptions are written in Harris
County, the numbers plummeted statewide as well - 10,757 in
September, down from 19,040 for the same month in 2009.
While the data looks promising, Texas DPS authorities weren't
ready to say illicit clinics were voluntarily going out of
business.
"This is only a single month's worth of data. It could be an
anomaly," said DPS spokesman Tom Vinger. "We will better be able
to measure the law's impact when we can look at three or six
months."
Meanwhile, Better Life Clinic at 1013 Dairy Ashford - one of 293
clinics that have recently registered with the state medical board
- became the first to have its license suspended Oct. 21 after the
law went into effect.
The medical license of the clinic's owner and medical director,
Dr. David Joseph Shin, was suspended, as he and four other
employees now face state charges of engaging in organized crime.
"They committed fraud by knowingly delivering a prescription
for other than a valid medical purpose," said Assistant Harris
County District Attorney Donna Logan.
Shin, free on $20,000 bond, did not return phone calls for
comment. At the time of the doctor's arrest Oct. 15, he appeared
"filthy and emitted a strong odor" and was living in a squalid
apartment, a medical board report stated.
His cash-only clinic never authorized refills in order to create
a "monthly clientele or demand," Logan said.
Investigators allege the clinic's patients were seen by a
foreign medical student wearing a white coat but without legal
authority to practice medicine in Texas. After the exam, another
office worker used pads kept in an office safe to write
prescriptions for controlled substances for the patients, the
report said.
While Shin contended he was present for every examination, an
office security camera showed he was rarely there, authorities
said. In fact, the videotape captured an employee leaving to fetch
the doctor and then sneaking him in a back door as law enforcement
officers waited in the lobby to speak to him, Logan said.
The new state law stipulates only doctors can own these pain
clinics, and they must be present on the premises at least a third
of the clinic's operating hours. This is to eliminate lucrative
million-dollar enterprises in which absentee doctors had been
collecting fees from as many as 20 clinics that used blank
prescription forms that the doctors had pre-signed.
Since September, 11 physicians applying for pain clinic licenses
in Texas have withdrawn their application and another 12 had their
applications denied.
Another 85 applications for pain clinic licenses are still
pending.
Dr. C.M. Schade, past president of the Texas Pain Society, which
pushed for the law to eliminate the bogus clinics, hopes the new
regulations will make a difference, as happened in Louisiana three
years ago. Stricter laws forced illicit pill mills to close in
Louisiana and flood into Texas.
Houston police detective John Kowal hopes the "pill mills"
eventually move out of Texas. "But I'm a realist," Kowal said.
"We've been fighting this drug war a long time."
cindy.horswell@chron.com
c.2010 Houston Chronicle