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Florida pain clinics – Too much or too little regulation?

Florida’s got a new type of tourist: the pill popping day tripper. In fact, Florida seems to be the Marakesh of our time, with easier access than ever to pain numbing medication – for legitimate or illegitimate use. But what is the current state of affairs? And how is the state government reacting to this new problem?

In the past few years, pain clinics in Florida have burst on to the scene. In 2008, Broward County was leading the pack with one new pain clinic opening each week. Likewise, the top 25 physicians prescribing oxycontin the United States were also located in Broward County.  I spoke this week with Sue Jahn, owner of halfway house Sober Living in Delray Beach, FL who says, “It seemed like every time there was an empty store front in a strip mall, a new pain clinic would pop up. They were everywhere.”

Although some pain clinics in Florida legitimately serve the needs of patients in chronic pain, many were making fast bucks and peddling analgesics like candy to babies.  But “pill mills” can be used legitimately for people with mobility issues. Patients using pain medications properly claim that the process of seeing a doctor, getting a prescription and filling them at pharmacies is difficult. Instead, people in chronic pain prefer doctors who provide controlled substances out of an office for convenience. But cutting out the pharmacies opens up the trade for misuse and abuse.

To respond to the fast paced explosion of drug tourism, Florida’s state government has made some hasty changes to its laws. Although the standards of practice for physicians practicing in pain management are still in draft, Rule 64B8-9.0131 is constantly be updated. So while the pain clinic bill is getting passed from the House to the Senate, what are lawmakers discussing? At the moment, he folks in Tallahassee have drafted, proposed and even passed some of the the following into law:

1. Registration
As of January 4, 2010 Pain clinics must register their practices with Florida’s Board of Medicine.

2. Inspection
The Department of Health must inspect clinics and review patient records at least once a year. Inspections include medical histories of drug or alcohol abuse, treatment plans and the effect of physical pain on psychological and physical function)

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3. Dispensing
Only licensed physicians or pharmacists can dispense pain management medications on the premises of pain clinics. Additionally, Pain clinic patients who pay with cash, checks or credit cards (not via insurance, Social Security, Medicare/Medicaid) cannot obtain more than a three-day supply of pain medications.

4. No advertising
Pain clinics cannot advertise or promote the use and sale of controlled substances.

5. Ownership
Pain clinics cannot be owned by former felons. Additionally, pain clinics can only be owned and operated by medical physicians with a clear and active license to practice medicine in Florida.
What do you think? Is government response meeting public need, or making the lives of legitimate patients more difficult? Will government law always favor the buddies and/or interests of government officials? What other ideas might lawmakers consider?  How can Florida make it less easy to board a plane, drop in to the sunny south for the afternoon and leave with a bag full of legal drugs to either use or distribute at home?

Also, FYI search for Florida State Medical Licensees here.

Reference sources:

2010 HOUSE BILL
HB 373 Pain Management Clinics
2009 FLORIDA STATUTES
Sections 458.309(4)-(6)
section 459.005(3)-(5)

2009 BOARD AND DEPARTMENT RULES
Florida Administrative Code Chapter 6488-9
Florida Administrative CodeChapter 65815-14
Florida Administrative Code Chapter 648-4

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7 Responses to “Florida pain clinics – Too much or too little regulation?
Jennifer Bunch
2:03 pm August 31st, 2010

” 3. Dispensing
Only licensed physicians or pharmacists can dispense pain management medications on the premises of pain clinics. Additionally, Pain clinic patients who pay with cash, checks or credit cards (not via insurance, Social Security, Medicare/Medicaid) cannot obtain more than a three-day supply of pain medications. ”

How will this work when most pain clinics do not take insurance? Close? I don’t see how they will stay in business writing only 3 days worth of medication for people who are coming from several hours away.

thailand
2:05 pm October 4th, 2010

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mt airy
8:48 am October 8th, 2010

This might not be the right post, but I am looking for some neck help here.

3:31 pm October 8th, 2010

For neck pain, I suggest that you look into american associations for pain medicine.

Drug Rehab
8:42 am October 12th, 2010

Hi there, I have been reading the website only a few days and simply wanted to state your way of writing is fantastic and just wanted to let you know what a great learning resource I think you have going here, carry on the nice work. Best wishes.

2:05 pm October 13th, 2010

Thanks (*blush*).

Also, Jennifer…I have been thinking about your comment. I think that legit pain clinics WOULD and SHOULD carry insurance, shouldn’t they. If a pain clinic in Florida DOES NOT carry health insurance, it is just another sign to me of fraudulent practice.

Ashburn VA
11:52 pm October 24th, 2010

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