Florida Pain Clinic Society: Pain Clinics & McDonald's™; What's Up With That?

TALLAHASSEE, Fla., March 5, 2011 /PRNewswire-USNewswire/ -- The Florida Society of Pain Management Providers (www.Flspmp.org) urges all to cease with the ridiculous comparisons of pain clinics to McDonald's™ and work to solve the issue of Rx diversion without resorting to such tactics. To make McDonald's™ comparisons to pain management clinics where the vast majority are staffed with (or operated by) respectable, well trained physicians who provide necessary and legitimate care to those suffering with chronic pain is completely inappropriate.

Facts as of lately seem to have become the greatest casualty in the war on pain clinics:

Facts ~v~ Fiction; Just in the past two weeks alone:

Statement:  Florida has more pain clinics than McDonald's (1200 vs. 860)

Florida has 1300 pill mills.

Fact: On February 24^th Larry McPherson Executive Director of the Florida Board of Medicine appeared before the Florida House Committee on Health and Human Services and testified that there were 860 registered pain clinics. The Board of Medicine handles all pain clinic registrations and they should be the only source quoted. That included the 11 clinics shut down by Law enforcement and DOH thus we are at 849.

Fact: The 860 number is a 30% reduction in the number of pain clinic from the high in 2010.

Statement: Florida prescribed 10 times more oxycodone than the rest of U.S. combined in first 6 month of 2010: Florida 41.2 million tabs, U.S. (excluding FL) 4.8 million tabs.

Fact: Based on DEA annual quota (published publicly) it is estimated that 3.5 billion tablets containing oxycodone were dispensed in the U.S. as a whole last year. That would average 9.5 million tablets per day. The 2011 U.S. annual quota for Oxycodone base is currently set at 105 million grams. http://www.deadiversion.usdoj.gov/fed_regs/quotas/2010/fr1220_2.htm

Fact: In December 2010 the St. Petersburg Times Florida reported: "According to the federal government, there were 420,000,000 oxycodone pills dispensed in Florida in 2008".

Fact: DEA Report for 2006 (http://www.deadiversion.usdoj.gov/arcos/retail_drug_summary/index.html )

Note: 30/ 15mg tab translation examples are for comparison purposes only as oxycodone base is used in several varieties of pain medication: oxycontin, oxycodone, endocet, percocet, percodan, etc.

Florida's 2006 annual dispensing of 3,958,797 grams of Oxycodone would translate into approximately 132 million tabs of oxycodone 30mg. (or 262 million 15mg tabs).

U.S. 2006 annual dispensing of 37,034,220 grams of Oxycodone would translate into approximately 1.3 billion tabs of oxycodone 30mg (2.3 billion 15mg tabs).

Statement: Ohio was number two behind Florida with 1 million tabs in the first 6 months of 2010.

Fact: Hard to believe when in 2008 one county in Ohio prescribed 35 million tablets of oxycodone which was the medication the story was referencing: "...in this Appalachian county along the banks of the Ohio River, a handful of licensed doctors pump out prescriptions for an estimated 35 million pain pills a year…" 2/26/11 Cleveland Pain Dealer online.

Fact: DEA YEAR 2006 dispensing of Oxycodone  http://www.deadiversion.usdoj.gov/arcos/retail_drug_summary/2006/06_rpt4.pdf

For the many that toss pain clinic numbers around and make McDonald's™ comparisons, just one question. What number of pain clinics is acceptable in Florida?

And just for context Florida has 1362 orthopedic surgeons and a conservative estimate of 4,000,000 residents with chronic pain. Additionally, approximately 4,000,000 Floridians are uninsured or under-insured and must pay cash for medical care.

THE FORGOTTEN FACT IN THE WAR ON PAIN CLINICS:

Florida has a problem with an extremely small percentage of bad clinics but they are not the primary source of abused medication.

In an August 20, 2010 editorial by Bruce Grant; Director Governors Office of Drug Control stated: "But don't be fooled. Pill mills are not the major source of prescription drug diversion and abuse. According to the 2008 National Survey on Drug Use and Health, 70 percent of those who use prescription drugs non-medically get their drugs from friends and family. Patients receiving medications from a single doctor is the next most frequent source, followed by 'doctor shoppers' visiting multiple doctors to receive pain killers." Report at:  http://www.oas.samhsa.gov/nsduh/2k8nsduh/2k8results.cfm

Florida has a problem with the diversion and abuse of pain medication (just as we do with Sudafed) yet there must be a balanced approach in finding a solution so as not to affect the care of the legitimate pain patient and the ability of the principled, well trained physician to treat them.

That balanced approach; 4 weapons:

1. Board of Medicine rules for standards of care in pain clinics including registration and inspections. (effective March 2011).
2. Agency for Health Care Administration (AHCA) licensing for non-physician owned clinics which bars felons and includes additional controls and inspections. (effective 10/1/2010).
3. The Prescription Drug Monitoring Program (effective late spring 2011).
4. Remove the cash exemption in AHCA HealthCare Clinic definition so there can be no loop holes (in 2011 legislation).

Now all we need to do is to let these items begin to work and "Pill Mills" will come to an end. There is no single "silver bullet" and remember we've already see a 30% reduction in pain clinics!

SOURCE Florida Society of Pain Management Providers