"[Illegal prescription drugs] are generally transported as anything else, in whatever is available -- trucks, cars, etc," Cartersville Police Chief Thomas Culpepper said. "The transportation of drugs tends to bring out the 'creative' nature of people. Anything is possible when conducting an illegal enterprise. I am sure that any and all measures are taken to evade law enforcement."
Considering this, several reports have been brought to light over a "pipeline" of trafficking drugs from pain management clinics in south Florida to users in Georgia, Kentucky, West Virginia and Ohio.
A "pill mill" is a business that staffs a legitimate doctor and dispenses prescription medications outside the realm of medical standards. Meaning, prescriptions are often times handed out without a medical examination in exchange for cash instead of accepting health insurance, credit or debit cards, or checks.
In an effort to combat this issue locally, Culpepper will be presenting an ordinance to the Cartersville City Council tonight that would "make it unlawful for any person to operate a medical establishment or pharmacy without having first complied with the provisions" of the chapter.
Pain clinics operating as "pill mills" are described in the ordinance as having "little or no interest in treating pain or the symptom of the pain, but is interested in only dispensing prescription pain medication with little or no diagnosis of the 'patient.'"
"[The ordinance] does not apply to legitimate medical operations and facilities," Culpepper said. "[It] only [applies to] the 'convenience store-grade' pill dispensaries. A medical establishment must be able to demonstrate that they are operating with a legitimate medical purpose (legitimate doctors office, hospital, clinic, etc.).
"None of the physicians in this area delivering proper medical services based on the standard of care have anything to worry about, only those that would seek to violate the law. It would also control any new establishments that would fall in the category of 'pill mill.'"
Under the decree, new establishments must submit to a questionnaire and any misrepresentation will cause enforcement action and penalties.
During summer 2011, authorities from local, state and federal agencies busted a "pill mill" at Atlanta Medical Group on Collins Drive in Cartersville. The raid was the result of a yearlong investigation, and in April 2011, the Cartersville City Council passed a "pill mill" resolution that would impose a one-year moratorium on any establishment that came into the community and an evaluation of those establishments would be completed at the end of that year. The moratorium was issued to conduct the proper research and vetting to create the ordinance.
"We are not the first city to look to pass this type of ordinance," Culpepper said. "If we can implement an ordinance that will prevent the 'pill mills,' then our medical community and other health providers will not have to deal with the problems caused by the added abuse of pain medication."
According to the ordinance, "Since the 1990's, the abuse of prescription opioids has risen dramatically, due in large part to the increase in the use of these analgesics to manage pain. Opioids are prescribed to alleviate pain ranging from moderate to severe, as described by the patient. These analgesics principally affect the nervous system, suppressing the signals of pain sent to the brain; examples of these medications can include, but not be limited to, morphine, codeine, oxycodone (e.g., OxyContin, Percodan, Percocet) and related drugs. As opioids 'block the perception of pain' they also have the affect of creating a state of euphoria, which may be heightened when abused. Side effects can include drowsiness, nausea, constipation and respiratory constraint."
Bartow-Cartersville Drug Task Force Commander Capt. Mark Mayton commended the city's move, calling the ordinance a "positive" measure.
"It's a step in the right direction, and there is hope for a county resolution of the same nature in the near future," he said. "The next step is working with our lawmakers to create laws with teeth that give law enforcement the tools to aggressively target these type organizations."
The ordinance continues to say that increased security measures due to the terrorist attacks of Sept. 11, 2001, may be to blame for the diversion of legal prescription drugs growth. The ordinance states, "Amplified security has effectively reduced the supply of illegal drugs, traditional smuggled by the drug trade, necessitating the need to find alternative methods of supplying drugs to users; consequently, legal prescription drugs are now being diverted to illegal uses."
To assist with detailing the need for the ordinance and the problems "pill mills" cause for communities, the ordinance pulls information from the Broward County Florida Grand Jury Report. That report compares deaths detected that were caused by lethal doses of prescription drugs over three years, showing a steady increase from seven deaths per day to 10 deaths per day.
"Both Lt. [Leslie] Cheek, who is assigned to the drug task force and I have studied the Broward County report, as well as others," Culpepper said. "Kennesaw also used the Broward report as their basis. This report was the first of its kind to shed light on the growing prescription use problem."
Tuesday, the Federal Bureau of Investigations released a statement regarding a "pill mill" in Broward County. In the news release, the FBI announced the sentencing of additional defendants in connection with charges stemming from Florida's Operation Oxy Alley, an investigation into "pill mills" in Broward and Palm Beach counties. The FBI's release states, "According to the indictment and statements made in court from 2008 to early 2010, these 'pill mills' distributed approximately 20 million oxycodone pills and made more than $40 million from the illegal sales of controlled substances. Thirteen of the 32 defendants were doctors."
As the deadline approaches for the moratorium's end, Culpepper said is no time like the present to establish the rule.
"Quite often problems are identified by an agency that has the fastest growth rate of the particular problem," Culpepper said. "The Miami area has long suffered from the illegal drug trade. We have even seen incidents in this area of death caused by the abuse prescription medication.
"It is my hope that we can eliminate the type of businesses that would prey on the vulnerable. These 'pill mills' are little more than outlets for the sale of pain killers and are skirting the law. It is my obligation as the chief of police in the city of Cartersville to do all I can to improve the quality of life.
"This is an area that can be improved by this type of ordinance. Personally, I believe that the medical community has enough to deal with without having to combat the illegal distribution of pain killers to people that may not need them for medical purposes."