Orange County commissioners target ‘Pill Mills’

Orange County commissioners are worried about the use of pain medications sold at so-called Pill Mills

ORLANDO – Dr. Jan Garavaglia has seen a lot of deaths by accidental overdose in her position as Orange County’s medical examiner, but what’s starting to change is what the victims are overdosing on.

“Usually what we see in Orange County are the heroin and cocaine deaths,” said Garavaglia. Today, though, more people are being brought into her morgue because they were using prescribed drugs – not illegal ones.

 “The number of accidental deaths from prescription drugs continues to accelerate alarmingly,” Garavaglia said. “In 2010, we’re going to equal or surpass 2009 for accidental prescription drug deaths. These are not intentional deaths by suicide. These are people trying to get high. One pill is good, two is better, three is even better.”

And while there are deaths among young people in their teens, twenties and thirties using these drugs, Garavaglia added that “I’m seeing older people dying from it, and I don’t think these people know they’re addicted to it.”

On Nov. 9, Garavaglia took part in a workshop organized by Orange County Mayor Rich Crotty, to focus on the growing problem of so-called “pill mills,” where doctors write prescriptions for pain killing medications that in some cases can be highly addictive.

“The abuse of prescription drugs is our country’s fastest growing drug problem,” said Lin Lindsey, director of the Center for Drug Free Living Addictions Receiving Facility. “We’re seeing this increase at all of our drug prevention programs.”

Lindsey noted during the workshop, held at the Orange County Board of Commissioners office in downtown Orlando, that addictions to heroin recently made up 47 percent of the patient base at her forty-bed inpatient detoxification stabilization facility, while “the pharmaceuticals – and that included all the pain pills – was 50 percent, with Methadone at 3 percent.

“This past October, we jumped to 83 percent for pain pills, 15 percent for heroin and 2 percent for Methadone,” she added.

Dr. Charles Chase, vice president of the Florida Society of Anesthesiologists, said these pill mills often set up shop near bars, hoping to find people who want to get high.

“These are clinics that primarily engage in treatment of chronic pain,” he said. “Often times these pain clinics will stay open late to accommodate people coming out of the local bars.”

Carol Burkett, director of the Orange County Drug Free Living Coalition, said adults 50 and older are increasingly at risk for becoming victims of pain medications.

“Two million older adults use prescription drugs non-medically,” she said, adding that they typically get their pills in one of five ways: from family and friends, doctor shopping, at pill mills, from street dealers, or through theft, usually by stealing prescription drug pads from their doctor’s office.

“Pill Mills, which are considered pseudo-pain clinics, may ask very few questions, if any,” Burkett said. “Pill mills can bring in $25,000 a day. Broward and Palm Beach counties have 200 known pill mills. There are some that say ‘No wait, walk in’s welcome for chronic pain.’ “

The pain medication Oxycodone is particularly troubling, Burkett said, adding, “Florida led the nation in dispensing Oxycodone, more than any other state.”

Equally troublesome, she said, is that there are 61 pain management clinics in Orange County alone.

“We have more pain management clinics in Orange County than we do Burger Kings,” she said.

Crotty said he organized the workshop because he wants county government to limit the number of pain-management clinics and their hours of operation.

“The problem isn’t granny dying from cancer and needing pain relief,” he said. “It’s about young people.”

Garavaglia said in many of the cases she’s worked on, parents are shocked to learn their children had access to legally prescribed drugs.

“I’ve talked to parents and they’re so angry that their children can get access to these medications for nebulous pain,” she said.

In some instances, she said, it’s the parents themselves who are prescribed the pills. They wind up not using them, but they also don’t throw out the pills.

“They can be very expensive,” Garavaglia said of the medications. “People don’t want to get rid of them because they say ‘Someday I might have pain,’ but they do get stolen.”

Crotty – who did not seek re-election this year and will be replaced by Teresa Jacobs – said he hopes fellow commissioners act on this problem.

“I think you’ve got a pretty angry mayor – and a pretty angry commission, too,” Crotty said.

As she was getting ready to leave the workshop, Garavaglia noted that “I have seven bodies — and one appears to be a prescription drug death – waiting for me.”

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Words take on evolving meanings, Mensa board member says

COCOA BEACH – Words are supposed to be clear and obvious, and so are the laws that guide society. But these days, how we use words – and, likewise, how we interpret the law – can be very ambiguous and open to wide interpretation.

Or, as Mel Dahl noted, “It depends on what the meaning of “is” is.”

In the field of law, this has become a hotly debated topic: does the law mean what it plainly seems to say? Or does the law change with the times, following altering public attitudes, making it more of an evolving document than one set in stone?

It could be, as Dahl noted, “using language to achieve a desired result. How do you say, ‘Well, this does not mean what it plainly says it means,’ and how do you get around that.”
Dahl knows something about the law – and about the intellectual challenges that the law as an evolving document pose — and not just for the legal system. A former trail attorney and legal writer, Dahl is also the Region 10 Vice Chairman for Mensa, the largest and oldest high-IQ society in the world, for people who score at the 98th percentile or higher on Mensa’s intelligence admissions test. Region 10 covers Florida and parts of south Georgia.

Dahl was a guest speaker during the Space Coast Area Mensa chapter’s “SCAM-O-WEEN 2010” regional gathering at the Comfort Inn and Suites hotel at Cocoa Beach, held over the Halloween weekend. In addition to hosting a costume contest and handing out awards for the best male, female, group and themed costumes, Mensans also devoted the weekend to debating issues like …. It depends on what the meaning of ‘Is’ is.

As Dahl noted, courts have always interpreted the law in different ways. As an example, he noted a recent decision by the U.S. Court of Appeals on whether the U.S. Constitution allows private gun ownership.

“The court ruled there is no private right to gun ownership,” Dahl said, an opinion later overturned by the U.S. Supreme Court. In a 5-4 vote in June, the Supreme Court declared for the first time that the Second Amendment to the Constitution guarantees the right of individual Americans to keep and bear arms. Gun ownership, the court declared, is an individual right and not one connected with military service.

Mel Dahl says how we interpret the law often depends on what the definition of "is" is

“Whether you believe in private gun ownership or don’t believe in private gun ownership isn’t the issue,” Dahl said. The bigger question is why two separate courts reached the exact opposite conclusion – one viewing the law very broadly, the other narrowing it in scope. Why?

“Whether we interpret something very broadly or very narrowly depends on what we think of the right being debated,” he said. It also depends, Dahl said, on whether the justices believe one or more rights are in conflict with one another.

He cited as an example the arrest of potential terrorist suspects, who claim their religion is a motivating factor in their desire to bomb American government buildings. What if a Holy War against the United States was their motive?

“Suppose that all the hijackers had been caught and put on trial,” Dahl said. “Suppose they had said they had a right to practice their religion?”

The courts, he added, could counter that freedom to practice one’s religion doesn’t trump laws protecting people from violence and bodily injury.

“How do you reconcile what seems to be a clear text, if your right to do something is in conflict with someone else’s?” Dahl asked. “How do you get past the written page? The courts have said you can practice your religion as you want, but freedom of religion gives you the right to belief – not to act.”

He cited the 8th Amendment to the U.S. Constitution, which bans cruel and unusual punishment.  How exactly are those terms defined?

Mel Dahl is a former trail attorney and Region 10 Vice Chairman of Mensa

“Is it the definition at the time it was written, or what we consider cruel and unusual punishment today?” Dahl asked.

Other members of Mensa seemed to agree there should be no set rule for how the law can be applied in any given case.

“The interpretation of practicing your religion is as long as you’re not hurting someone else,” said Nora Foust of Orlando. “People who read the Koran say there is no provision in it to justify what the terrorists did on 9-11.”

Another Mensan from Orlando, Maggie Truelove, added, “Just as our Constitution changes with the times, so the definition of cruel and unusual punishment should change with the times as well.”

Another example that Dahl cited: what if the Constitution leaves out crucial information?

“Articles 2 of the Constitution says the president of the United States is the commander and chief of the Army and Navy, but it says nothing about the Air Force,” Dahl said. “Well, there was no real Air Force in 1789.”

Another example: how does inflation impact on the law?

“The 7th Amendment provides that you have the right to a jury trial for any dispute of $20 or more,” Dahl said. But while $20 may have been a lot of money in 1789, it’s not much to quarrel over today.

“Should they have the right to take six people away from their busy lives, and a judge away for half a day, to deal with a $20 dispute?” he asked. “The practical problem is that sometimes laws are badly written. Sometimes laws are in conflict with one another. Some of the time if we like the right we’re talking about, we want a very broad jurisprudence and want the courts to put shackles on government officials who think otherwise.”

The bottom line, Dahl said, is that how laws are defined will likely continue to change and evolve – and then evolve some more.

“Language basically means what you can get over, around, under or through to get a desired result,” Dahl said.

Mensa has its own admissions exam, and Mensa International consists of more than 110,000 members in 50 national groups. The two largest are American Mensa, with more than 56,000 members, and British Mensa, with 23,500 members.

What keeps people in the organization?

“Mensa is a fun group of diverse people,” said Brian Reeves of Palm Beach. “The only thing they all have in common is the ability to take a test well. When Mensans get together — as many do several times a year — it is like a family get together. There are lots of laughter, good stories, interesting conversation … and even an weird uncle or two.”

“I’ve been a member of Mensa for 27 years, and I’ve met hundreds, if not thousands, of members over that time, from all over the world,” said Stacey Kirsch of Chicago. “I may not like every single member I meet, but I can say that I like many more than not. All of them are interesting in one way or another — some in many ways — and I have learned something from each and every person I’ve met in the organization.
”One thing that Mensa has that is rare these days is a sense of tolerance,” she added. “Most behavior or beliefs, no matter how bizarre or outré they would appear to normal society, are tolerated and sometimes even encouraged in Mensa. Most people in the group approach most situations and topics with a desire to learn more, and people can discuss things largely without becoming strident. In these days of the dueling talking heads on TV, it’s a refreshing change of pace to be in a group that promotes tolerance.”

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A true Peter Pan

Peter Pan flies over the Downtown Disney Marketplace, representing all boys who never want to grow up. For one former Fort Lauderdale adult, though, wanting to stay a boy meant he paid a high price.

ODESS, TEXAS – Peter Pan spoke about never growing up. And apparently some take that a little too far.

Consider the case of one “kid” from Florida who really didn’t want to grow up.

Starting in February 2009, a 22-year-old named Guerdich Montimere started posing as a 15-year-old high schooler named “Jerry Joseph.” Why? In order to play high school basketball, it seems.

Montimere, a 2007 Fort Lauderdale graduate, had been living in Odessa, Texas while attending Permian High School, and lived with Permian basketball coach Danny Wright – all the while posing as Joseph, a “Haitian orphan.”

School officials and the local media received anonymous tips in April 2010 of his true identity, and an investigation was opened up. Since his initial arrest earlier this spring for providing fake information to police – on which he bonded out – he got arrested again the next day for tampering with government records and bonded out again for $7,500. He was again arrested the following day for engaging in sexual relations with a minor, and bond was set at $50,000.

He faces up to 20 years if convicted.

Apparently a student had come forward stating that Montimere had had a sexual relationship with her while posing as Johnson, portraying himself as being just 15 years old. He was, in reality, seven years old.

I guess he truly was a Peter Pan fan.

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