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Florida's War Against Pain Clinics And Opioids: Is It Really A War Or Is It A Trojan Horse?

Effective July 1, 2018, via amendment to Controlled Substances Prescribing [Act], Florida Statutes 456.44(5), Florida pain management physician's are only permitted to prescribe a 3 day supply of opioid pain medications to patients for acute pain, or up to a 7 day supply where 'medical necessity' for the increased opioid supply is documented in the patient's file, as necessary to treat an 'acute medical condition', and the physical prescription issued is marked "Acute Pain Exception" so the pharmacy can document the physician's statement. This will of course make it easier for the DEA to track for dispensing abuses. That is a far cry from a prescription for 120- 30 mg oxycodone pills with a refill. There are also new patient file documentation requirements, DOH oversight requirements, and other requirements that tend to spotlight anybody issuing prescriptions for opioids in Florida.

This new legislation will surely mark the end of pill mills in Florida, the availability of opioid pain medications from pharmacies in Florida that are completely pulling out from dispensing certain opioids; and should be a wake up call for pain management physicians in Florida to find other work. You might ask why? The reason why is because a handful of pain management physicians went to prison for drug trafficking in the past few years for allegedly not prescribing in "good faith", placing them within the purview of Florida's drug trafficking statutes.

Band-Aide On A Sucking Chest Wound:

Although Florida Governor Rick Scott wanted accolade for pushing forward the recent 2018 opioid prescribing supply limit legislation to help curtail the opioid epidemic in Florida, the fact remains that 24 other States enacted similar legislation before Florida did. See Florida House Of Representatives Final Bill Analysis HB 21 March 20, 2018 Here. Why was Florida so late to enact opioid physician prescribing limitations when the opioid pill mill crackdown commenced in 2011, and the opioid user pandemic began at least 10 years earlier? [The dramatic rise in prescription opioid abuse began in the 1990's at about the same time that opioid analgesics assumed a greater role in the management of chronic pain in the United States (Kuehn, 2007). HHS, Prescription Drug Abuse & Diversion: Role of the Pain Clinic, January 28, 2011] [Prior to the 2011 crackdown Florida became the unofficial pill mill capital of the United States with 93 of the top 100 oxycodone prescribing physicians located in Florida.]

Why Florida's Pill Mill Legislation Will Prove Meaningless Toward Curbing The Opioid Epidemic:

Florida's 2018 legislation closes the barn door to an empty barn. It's too little too late to be meaningful to curb any perceived opioid epidemic in Florida.

The inability of opioid addicts to obtain oxycodone from Florida pill mills in recent years has lead to a new and growing market in Florida, and across the United States, for synthetic opioids being produced in China that have easily infiltrated the United States. The Fentanyl network of importers and traffickers are firmly entrenched across the United States at this point. Florida's 2018 opioid supply limit legislation may very well increase the number of opioid deaths in Florida, because oxycodone addicts will seek substitute opioids and will find Fentanyl, the elephant tranquilizer, either wittingly or unwittingly, and it will increase the likelihood that they die from an opioid overdose. [Where Oxycodone is about 50% stronger than Morphine, Fentanyl is 50 to 100 times more potent than Morphine. Source The Washington Post, Article by Dan Keating and Samuel Granados, titled "See how deadly street opioids like elephant tranquilizer have become" found here.] Anyone that believes that an opioid epidemic is cured by limiting a physician's prescription for oxycodone is naïve. At least oxycodone is the devil that we all knew. It is the unknown devil that will ramp up deaths across the United States. [The San Diego Union Tribune reported on June 17, 2018, that in 2016 there were 20,000 reported Fentanyl overdose deaths in the United States, restating statistics from The Centers For Disease Control And Prevention. Id., Article by Kristina Davis and Sandra Dibble, titled "Fentanyl Has Taken Over America's Drug Market. Where Is It Coming From?" See full article here.] As it were, the musician Prince's death in 2016 was also linked to Fentanyl.

Fentanyl Drug Smuggling Route Map Courtesy Of The San Diego Union Tribune, June 17, 2018

Apparently one can still illegally purchase Fentanyl online Chinese Fentanyl Labs and have the drug mailed directly to them via the postal service. Because Fentanyl is unregulated by the Chinese government, none of the Fentanyl chemists, manufacturers, or distributors got into trouble in China, thus far, notwithstanding that the United States Indicted many of these Chinese nationals as being international Fentanyl Kingpins. After taking office in 2017 President Trump immediately engaged the Chinese government relative to making Fentanyl a controlled substance regulated by the Chinese government. Those initial efforts are continuing now through the Trump Administration.


These are the two questions that should be asked:

1. Why did the Florida Legislature wait until 2018 to regulate opioid quantities, when the opioid epidemic in Florida existed since the year 2000 or earlier?

2. Why didn't the United States government attempt to prevent Fentanyl, and Fentanyl derivatives, from infiltrating the United States, and becoming a separate trafficking network prior to 2017?

The Author would like to believe that the War on Drugs is actually a War that the State Of Florida and the United States is trying to win, however, if that were the case, why are we in an "opioid epidemic" state here in 2018. It is not as though we did not have notice that these things were occurring, but somehow we let them happen anyway and now we are in a crisis state. Why?


This article is for informational and educational purposes only and should not be construed as constituting legal advice. It is intended to provoke critical thinking related to the issues presented. The opinions rendered are the opinions of the Author, a non attorney. Nothing presented in this Article should be interpreted as legal advice as any such interpretation is unintended. In fact it is not legal advice and was written by a non-attorney. You should consult with your attorney to determine the best course of action to take on your case.

Copyright 2018 All Right Reserved, by Joseph J. Pappacoda, JD, Senior Litigation Paralegal, GhostWriter Paralegal, Chartered, Fort Lauderdale, Florida

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