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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  1. Bravo for taking on a very real problem that seems to be getting bigger due to the profit motive as you so rightly point out along with lack of social support mechanisms for younger adults. Thanks for tackling these types of issues and reporting on real social problems and not just celebrity gossip.

    1. Prior to covering this public hearing, I had no idea the problem was this extensive. It doesn’t surprise me, though.

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