According to the National Institute on Drug Abuse (NIDA), there were more than 70,200 drug overdose deaths in the U.S. in 2017, with more than half involving opioids. NIDA also found that Florida physicians wrote 60.9 opioid prescriptions for every 100 people in 2017, above the national average of 58.7 prescriptions per 100. In response to the high rate of overdose deaths from prescription drugs, the Florida Legislature has enacted new prescribing guidelines for controlled substances, as well as other measures to combat drug abuse. Yet issues with so-called “pill mills” and treatment center fraud remain a challenge for the state. Let’s review some recent headlines below.
Governor DeSantis re-establishes the Office of Drug Control
As we previously reported, earlier this year Florida Governor Ron DeSantis announced his plan to re-establish the Office of Drug Control, which had been eliminated by previous governor Rick Scott. Governor DeSantis is also creating a task force to determine how best to combat the opioid epidemic in Florida.
The Herald Tribune also added that Florida “received $26 million in federal funding for Florida’s State Opioid Response Project” under Governor DeSantis.
Florida’s prescribing guidelines for controlled substances: HB-21
Florida’s new law on Controlled Substance Prescribing Provisions (HB-21) went into effect on July 1, 2018, with strict prescribing guidelines for controlled substances, especially schedule II opioids for acute pain. The law does not apply to pain medications prescribed for cancer pain, terminal pain, palliative care, or severe traumatic injury.
Highlights of the law include:
- Florida licensed doctors must have completed a mandatory 2-hour controlled substance prescribing course prior to January 31, 2019.
- Doctors cannot prescribe schedule II opioids for acute pain for more than a 3-day supply, unless physicians document an exception on the prescription and in the patient record.
- Before prescribing a controlled substance, the physician must first review the patient’s controlled substance dispensing history in the E-FORCSE (Electronic-Florida Online Reporting of Controlled Substance Evaluation Program) database. If database can’t be accessed, the patient’s supply is limited to 3 days.
The Department of Health continues to oversee the Florida Prescription Drug Monitoring Program (PDMP) and maintain E-FORCSE, an electronic system that collects and stores controlled substance dispensing information. The Florida Legislature created E-FORCSE in 2009 as part of an initiative to encourage safer prescribing of controlled substances and to reduce drug abuse and diversion within Florida.
HB-21 does require some changes regarding the database, most notably that the prescribing doctor “must consult the database to review a patient’s controlled substance dispensing history before prescribing or dispensing a controlled substance for a patient who is 16 years of age or older.” The law also stresses that this requirement applies to all controlled substances, not just opioids.
According to the Orlando Sentinel, Florida joins twenty four other states that have put laws on their books to control opioid prescriptions.
The bill can be read in its entirety on the Florida House of Representatives site.
“Pill mills” continue to flood Florida with opioids
Pill mills refer to clinics, often focused on pain management, that caters to people abusing and diverting prescription drugs. In recent years, disreputable Florida doctors at these clinics gained notoriety for supplying cheap opioids with little due diligence. In fact, earlier this year, the Washington Post reported that at their peak, around 2010, “90 of the nation’s top 100 opioid prescribers were Florida doctors, according to federal officials, and 85 percent of the nation’s oxycodone was prescribed in the state.” Today, Florida still has a lasting opioid problem, with the second-highest number of opioid-related overdose deaths in the nation.
In July 2019, the Miami Herald reported that over 5 billion hydrocodone and oxycodone pills had poured into Florida over a 7-year time period. While many of these drugs came to Florida via “pill mills,” many others came through legitimate sources, including well-known pharmacies. According to this article, “one Walgreens in Port Richey alone received an average 74,706 pills per month. The city’s population is 2,831.”
Kickbacks for urine samples
In July, the Miami Herald also reported on charges against the owner of a substance abuse treatment center for sending patient urine samples to certain labs in exchange for large kickbacks. The article quoted Florida Attorney General Ashley Moody as saying, “In recent years, Florida has seen an increasing number of fraud cases in the substance abuse and recovery industry. It is appalling that anyone would take advantage of people trying to break the grip of addiction, especially amid this national opioid crisis that is claiming 17 lives a day in Florida.”
Hope for the future
There is some reason for optimism in Florida’s fight against addiction. Palm Beach County State Attorney Dave Aronberg told radio station WJNO that the rate of fatal overdoses had fallen in his county, a decline he attributed in part to a crackdown on illegal fentanyl and insurance fraud among treatment centers. Aronberg cited statistics that showed a 40% drop in fatal overdoses in Palm Beach County in 2018.
In national news, the Washington Post reported on findings from the Centers for Disease Control and Prevention that “the total number of drug overdose deaths in the United States declined in 2018, by 5.1%, the first annual decline in nearly three decades.”
Turning Point of Tampa’s goal is to always provide a safe environment and a solid foundation in 12-Step recovery, in tandem with quality individual therapy and groups. We have been offering Licensed Residential Treatment for Substance Abuse, Eating Disorders and Dual Diagnosis in Tampa since 1987.