Monday, July 25, 2011

‘Pill mill’ clinics spread in ’burbs

“Pill Mills” Illegally Sell Prescription Drugs

The Atlanta Journal-Constitution

A worrisome new kind of drug dealer is gaining a toehold in Georgia after fleeing crackdowns in surrounding states, setting up in bedroom communities northwest of Atlanta along I-75 to serve customers near and far.

So-called “pill mills” are illegally selling prescription drugs in Georgia. Police say it’s no coincidence that the first bust of a suspected pill mill — the kind of illicit pain clinics that have proliferated in South Florida — occurred last month in Cartersville, the seat of Bartow County. Nor that a Cherokee County house served as a distribution site for a counterfeit prescription drug operation.

The counties are along the superhighway that brings drug seekers in droves from Kentucky, Tennessee, West Virginia and Ohio to pill mills in Florida along a route that has come to be known as the “Oxy Express,” after the powerful and highly addictive prescription painkiller oxycodone. Oxycodone and its brand names OxyContin and Roxycodone are sometimes called “hillbilly heroin” because of their popularity in Appalachian states.

Georgia lawmakers have been slower than neighboring states to try to deter prescription drug abuse through means such as a statewide database to track prescriptions or tough regulations for pain clinics. As a result, recent high-profile indictments and arrests illustrate the extent to which prescription forgery rings, counterfeit prescription pushers and illicit pain clinics have sprung up in the Peach State.

● In May, 11 people were indicted on federal charges of conspiring to forge oxycodone prescriptions and trafficking in oxycodone. The alleged ringleader, Kristen Noelle Goduto, 27, of Marietta, and alleged conspirators from Acworth, Canton and Braselton manufactured prescriptions and recruited others to pass them at pharmacies across metro Atlanta. The ring obtained more than 10,000 tablets they intended to sell on the streets, according to the federal indictment.

● Federal, state and local authorities raided Atlanta Medical Group clinic in Cartersville a month ago in the first takedown of a suspected pill mill in Georgia. A few weeks later on June 29, the clinic financiers, who are from Vero Beach, Fla., were arrested on federal drug and money laundering charges. Federal agents removed close to $600,000 in cash from two homes in Florida as part of the raid.

Cherokee County drug investigators searched a house in Woodstock in January 2010 and seized 100,000 prescription pills including the anti-anxiety drug Xanax, the erectile dysfunction drugs Viagra and Cialis and the diet drug phentermine. Many were counterfeit drugs imported from China. The resident, Robyn Phillip Henderson, 34, has pleaded guilty to charges related drug trafficking in federal court.

Combating prescription drug abuse has become a top priority for the office of Sally Quillian Yates, U.S. attorney for the Northern District of Georgia.

“As shown by last week’s federal indictment charging the owners and staff of a pill mill in Cartersville, our drug prosecutors are bringing larger and more sophisticated cases to focus on the largest sources of abused painkillers, and we’ll continue to bring these cases until the epidemic subsides,” Yates said.

Phillip Price, who heads the Cherokee Multi-Agency Narcotics Squad, shifted two of his 10 detectives to prescription drug investigations last year after observing the uptick in those cases. When one of them, Investigator Nate Luca, began introducing himself to local pharmacies, he was startled at how much prescription forgery was going unreported. Pharmacists handed over folders of information on suspicious customers they had been collecting for months.

“Every pharmacy had a folder that was 2 inches thick,” he said.

There is little to prevent patients who are doctor-shopping or forging prescriptions from going from pharmacy to pharmacy to score drugs. Georgia lawmakers this year passed a law to create a prescription drug monitoring program, an electronic database that would track how prescriptions are dispensed, but no funding was allocated.

Rick Allen, director of the Georgia Drugs and Narcotics Agency, said he has applied for a federal grant to fund the database, which would cost between $400,000 and $1.2 million. Even if the state gets the grant, it will probably be 2013 or later before the database is online.

Prescription medications can be more deadly than heroin, meth and cocaine when abused. Nationally, there has been a tenfold increase in prescription drug-related deaths over the past four decades, according to the Centers for Disease Control and Prevention. In Georgia, six times more people died from prescription drug overdoses in 2009 than from all other illegal drugs, accounting for 87 percent of drug-related deaths.

Among the people who suffered untimely deaths was Brandi Lynn Kanthak, 24, of Cartersville, who died Feb. 25, 2010, from an overdose of the painkiller Demerol. Unbeknownst to her parents and husband, she would crush the pills to negate the time-release formula and inject them, said her mother, Barbara Pruitt. The once-promising nursing student who worked at a medical clinic went into respiratory failure one day and never revived.

“She had so much ahead of her,” Pruitt said. “And she was so smart, and she could do anything. It’s just a sad thing.”

“Doctor-shopping” and forging prescriptions are prime ways people get their fix. Another avenue is pill mills, such as the one raided in Cartersville last month. Unlike legitimate pain clinics, they prescribe large doses of painkillers with little to no screening of patients.

Allen used to keep a count of how many pain clinics were operating in the state. The tally went from about five last year to about 50 earlier this year. But within the past few months, there have been two to three new ones opening each week.

“They are all over the place,” Allen said. “We can’t even keep up with them anymore. We quit trying.”

There are at least 10 pain clinics currently operating in Cherokee County, according to Price. Five years ago, the county didn’t have any.

Now as many as five to six calls per day come in to Mid-City Pharmacy in Canton from people asking whether it fills oxycodone prescriptions, owner and pharmacist Billy Cagle said. Many of the requests are coming from out-of-state customers and unfamiliar clinics.

“The pain clinics that we are familiar with that are local, we take care of,” Cagle said. “But you’ve got some people coming from Tennessee and from Florida, and from some of the pain clinics we are not familiar with. We turn them down.”

Pill mills are likely to keep moving into Georgia because it has no operational prescription drug monitoring database, unlike its neighbors. And new legislation in Tennessee and Florida that took effect July 1 is aimed at making it more difficult for pain clinics to operate in those states. The new laws state only doctors can own pain clinics. They require the physicians to be board-certified in pain management. And they prohibit convicted felons from ownership.

All of which are “no-brainers” to Rusty Grant, who supervises the Canton Regional Drug Enforcement Office of the Georgia Bureau of Investigation. And yet, according to law enforcement officials, no state legislators have proposed similar measures in Georgia.

Grant said pain clinics with Florida owners started moving into his 28-county region in northwest Georgia more than a year ago in anticipation of the crackdown in the Sunshine State.

“They didn’t wait for July 1,” Grant said. “They went ahead and made the move to get up here as quickly as they could.”