Members of the Senate Health Policy Committee discussed a 2011 law designed to crack down on illicit painkiller prescriptions through “pill mills,” which Chairman Aaron Bean said has sent “the pendulum from one direction to the other.”
The law, HB 7095, was spearheaded by a newly elected Attorney General Pam Bondi and then-state Sen. Mike Fasano in the midst of a widespread painkiller abuse epidemic that earned Florida the title of “pill mill capital of the U.S.”
A pair of experts corroborated accounts senators said they have heard from constituents that the crackdown, however, has prevented suffering patients from receiving legitimate care.
Division Director of Medical Quality Assurance Lucy Gee of the state’s health department told the panel that back in 2010, Florida was home to 921 pain management clinics and 90 of the nation’s top 100 purchasers of OxyCodone, a powerful, widely abused opiate. Orders from the state accounted for nearly 89 percent of the nation’s purchases.
Since then, however, state-level legislative and enforcement moves have dropped those excessive numbers precipitously, leading to a 63 percent drop in Floridians “doctor shopping” for painkillers and a 65 percent drop in OxyCodone-driven deaths, according to Gee.
In other words, “it’s working.” Perhaps a little too well.
“The system for delivering needed medications to Florida’s patients has eroded by a lack of confidence and trust” in the wake of the 2011 reforms, said Gee.
Toward that end, Gee said the DOH is working with the Florida Board of Pharmacy — a state board of pharmaceutical industry and drug dispensary stakeholders and consumers — to eliminate fear and confusion among pharmacists, who dread losing their license and livelihood over new drug limits and regulations.
Gee suggested the board’s rules be tweaked to move the focus away from “red flags” toward a renewed presumption in favor of filling prescriptions, along with a comprehensive education program for pharmacists and wholesalers alike.
Michael Jackson, CEO of the Florida Pharmacy Association, testified about the 2011 bill, saying “things did get a little out of balance,” creating a “fear factor” among pharmacists.
During the hearing committee member state Sen. Don Gaetz wondered aloud to Gee whether an increase in street drug use could be attributed to the state crackdown. He also suggested a more holistic approach to the problem, including considering medical marijuana as an alternative to prescriptions painkillers.
“I’m not trying to sell anything here, I’m just trying to suggest that it may be necessary in both discussing what’s appropriate for dealing with pain management… to know what the Department of Health thinks about the best ways to deal with pain and noxious symptom management,” said Gaetz.
Gee replied that her discussions with the board were limited to painkillers.
“Most respectfully,” said Gaetz, “I would suggest that your discussions ought to be how to ensure that patients who have chronic pain receive the best treatment.”