For the past year, federal agents say, David Kidd and Christopher Grigg traveled almost weekly from their homes in Ohio to Florida, where they — and others working for them — doctor-shopped throughout the state, buying thousands of prescription pills during each visit.
The group is suspected of taking at least 50,000 powerful prescription pills, which have a street value of more than $1.5.million, back to Ohio and West Virginia.
But their business venture ended in March, when a Volusia County deputy pulled 42-year-old Kidd and 24-year-old Grigg over as they headed to Orlando International Airport. Deputies found about 7,000 pills and about $14,000 in cash in their rental car, and they were charged with several federal crimes, including conspiracy to distribute controlled substances.
The case is emblematic of Florida's prescription-drug epidemic. With its lax laws and proliferation of pain clinics, the Sunshine State is hospitable to drug addicts and dealers looking to buy up lots of pills and turn them around for profit on the streets of Florida and other states throughout the South, East and parts of the Midwest.
In fact, 90 of the top 100 oxycodone-purchasing physicians in the nation last year were from Florida, according to federal records.
Local and state leaders, and even the White House and Drug Enforcement Administration, point to Florida as a top source for prescription drugs. Yet politicians, law enforcement, health officials and others can't seem to get their arms around the problem.
Years of weak regulation, a lack of legislation and no prescription-drug-monitoring program — combined with doctors who liberally prescribe narcotics — helped make Florida the poster child for the prescription-drug epidemic.
•No one at the state or federal level tracks what types — or how many — of these drugs Florida doctors prescribe. In the 35 states with operational monitoring programs, prescribing doctors and patients are tracked. After much political wrangling, Florida's system is expected to be up and running in the fall.
•Even after doctors are charged with illegally prescribing medicine or are linked to overdoses, the state Department of Health doesn't automatically suspend or revoke their licenses.
•Not all doctors who run "pill mills" are registered as pain-management clinics, so new regulations targeting such practices don't affect them.
Meanwhile, prescription drugs kill thousands in Florida each year — nearly seven people a day.
"If there were seven people dying a day from salmonella … don't you think something would be done?" said Sue League, an Orlando mother and grandmother whose 32-year-old son died of a prescription-drug overdose in January 2010.
James "Jimmy" League became addicted to prescription drugs after obtaining a legitimate prescription — he fell down a flight of stairs about 10 years ago, broke both heels and then underwent surgery.
Sue League, like many who have lost loved ones to prescription-drug overdoses, is critical of the state's lack of pain-clinic oversight.
"There are people who need the drugs for a legitimate injury or surgery who got addicted to the drugs and couldn't get off of them," League said. "And ultimately, like our son, the more you take them, the more you need … and you have an accidental overdose."
'Failed to enact proper controls'
What about Florida makes access to powerful, addictive prescription drugs so seemingly simple?
"We failed to enact proper controls and procedures that would keep this from getting out of hand," said Bruce Grant, the state's former drug czar.
Grant, who was appointed director of the Office of Drug Control in 2009 by Gov. Charlie Crist and held that role until Gov. Rick Scott abolished the department in January, said he and other public officials failed to convince lawmakers years ago that prescription-drug abuse was reaching epidemic levels.
What started as a South Florida problem extended northward as doctors and entrepreneurs realized running pill mills could be lucrative.
Not only were Floridians willing to pay cash for office visits and prescriptions, but the customer base extended throughout the South and East. Users and dealers from Kentucky, Ohio and West Virginia — which have monitoring programs that track prescriptions — would simply drive or fly to Florida for easy access.
And so the number of pain clinics, often nothing but fronts for pill mills, began to skyrocket.
In South Florida, the number of pain clinics went from 66 in August 2008 to 176 by November 2009, according to a 2009 Broward County grand-jury report.
InOrange County today, there are about 80 pain-management clinics. Statewide, there are more than 800, according to the best estimates.
It's also impossible to know which are legitimate pain clinics and which are fronts for pill mills, because there is little regulation — either on the local or state level. So law enforcement concentrates on stings and other operations to bust crooked doctors and shut down their clinics, one at a time.
"In years past, Florida had little oversight of pain clinics," Florida Attorney General Pam Bondi said. "Florida is the epicenter of the pill-mill crisis because of our lack of tough regulations and laws."
Only recently did state leaders take action by creating a Prescription Drug Monitoring Program similar to one found in dozens of other states.
This month, Scott signed legislation that toughens criminal and administrative penalties against doctors and clinics engaged in prescription-drug trafficking. When it takes effect July 1, the bill also will ban doctors from selling pills at clinics or their offices, and punish pharmacies and drug wholesalers if they don't report suspicious prescriptions.
In Central Florida, law enforcers are attacking the problem from all angles: They are arresting dealers, abusers and the doctors who dole out the addictive drugs. And they strongly encouraged state leaders to get the monitoring program up and running.
In the past two years, at least five Central Florida doctors have been arrested in multiagency investigations, each accused of running pill mills. Some of those doctors have been linked to overdoses.
Criminal cases against doctors are complicated, time-consuming and require much greater resources than typical drug investigations. Prescription drugs are, after all, legal. And doctors arrested say they were prescribing the drugs in good faith, based on a patient's complaint of pain, and cannot control whether a patient doctor-shops to get multiple prescriptions.
Earlier this month, dozens of drug agents raided the pain-clinic offices of Dr. Riyaz Jummani and took records and evidence as part of a yearlong ongoing investigation.
Jummani and his associates were not arrested, but several clients at his Pro Relief Center just south of downtown Orlando on South Orange Avenue were arrested on drug-related charges.
Since 2007, the Orange County Sheriff's Office has doubled its arrests for pharmaceutical-related cases. And in Orange, the number of hydrocodone- and oxycodone-trafficking charges filed by prosecutors has increased nearly 800 percent from 2005, when prosecutors filed 17 such cases, to 2010, when there were 151.
"It is a significant problem for us in the law-enforcement community, primarily because what we're dealing with are drugs that are legal in most cases to possess," said Orange County Sheriff Jerry Demings. "What unscrupulous individuals are doing at that point are simply trying to take legal medications and distribute them illegally."
Despite law-enforcement efforts, the death toll continues to climb.
During the first half of 2010 — the most recent period for which statewide data are available — 1,268 people died in Florida with at least one prescription drug in their system that the medical examiner determined caused their death.
In Orange and Osceola counties, 147 people died from an accidental prescription-drug overdose in 2010, an increase of more than 30 percent from the year prior. The five-county medical examiner's district that includes Lake and Marion experienced a similar increase — jumping from 120 accidental prescription-drug overdoses in 2009 to 160 in 2010.
And this year's death toll shows no sign of slowing, said Orange-Osceola Medical Examiner Dr. Jan Garavaglia.
"It's just frustrating because the tide isn't stopping," she said. "I have to call the families up, tell them why their loved one died, and they just are so angry that something more isn't done."
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