Pill Mill

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A pill mill in Jasper, Alabama , 2015 DEA photo

The term Pill Mill (German: Pillenmühle or Pillenfabrik ) refers to illegal facilities, particularly in the United States , which are similar to regular pain clinics, but which usually prescribe prescription painkillers ( narcotics ) without adequate medical history , physical examination , diagnosis , medical supervision and documentation . As a rule, clients of these facilities can only get prescriptions for cash. Pill Mills are contributing to the US opioid crisis and are the subject of a number of federal legislative initiatives .

Business model and characteristics

Customers at a pill mill in Florida operated by Jeff and Chris George wait on the sidewalk for their turn. Palm Beach Sheriff's Office surveillance footage.

At Pill Mills, doctors or employees supervised by them prescribe opioids for non-existent or exaggerated pain. The primary intent behind this prescribing practice is not to relieve pain or to heal , but to achieve high profits. This makes Pill Mills a criminal enterprise.

Features of such facilities include that they are often owned by non-medical professionals, only cash is accepted (no credit cards or insurance payments ), long queues are visible in front of the facilities, parking spaces in front of or near the facility are heavily frequented, security guards or bouncers are employed be, medical records , results or X-rays are not needed any medical tests are carried out, or only pro forma , alternatives are not discussed for treatment with tablets, potent painkillers are formulated and recipes only at certain pharmacies to be redeemed.

According to information from investigating authorities and scientists, there are such facilities in different shapes and sizes, but what is important is the impression that they are independent pain treatment centers. To avoid law enforcement , Pill Mills officials tend to operate their facilities like pop-up stores with sudden pop- ups and shuts. Pill Mills clients are addicted to or trade their pills.

Origin and spread

David Herbert Procter (1951–2019) is considered the inventor of the pill mills. Born in Canada , he established a practice specializing in pain management in 1979 in South Shore, Kentucky near Portsmouth, Ohio . In the mid-1980s he was one of the first to prescribe painkillers containing opiates ; He also combined them with benzodiazepines ( tranquilizers ) such as Xanax . With the advent of OxyContin (active ingredient: oxycodone ), the blockbuster of the pharmaceutical company Purdue Pharma , its business expanded. He hired more doctors to run new practices. Some took over the business idea of ​​the “godfather of the pill mills” and later went into business for themselves.

Pill Mills subsequently spread to other states, such as West Virginia , Texas , New Mexico , and New York . They became particularly important in Florida . Chris George's Pill Mills had a prominent position here.

consequences

Easier access to strong painkillers promotes the opioid crisis in the USA, because clients who take these drugs over a long period of time get used to them and may need higher doses in order to achieve the same soothing or pleasant effect (development of tolerance with the following high dose dependency ). In addition, the opioids in these drugs are euphoric . With regular use, the exogenous opiates can replace the functions of the body's own endorphins , resulting in high addictive pressure . Drug abuse leads to increased casualties in emergency rooms , costly addiction treatments, and increased deaths from overdose .

The excessive prescribing practice, the careless and senseless practice management as well as the promotion of drug addiction and the illegal drug trade represent violations of medical professional rules and laws. For this reason, there were a large number of police operations, measures of the Drug Enforcement Administration (DEA) and closings of these facilities. Many perpetrators were convicted by court, up to the end of 2016 alone 378 medical professionals in Florida, 95 more were charged there up to this point.

In response to the growing problems with drug abuse, a number of states tightened their respective laws. For example, Kentucky introduced a law to improve the supervision of prescribing practice in 2012, known as the Pill Mill Bill . In 2012, 41 US states had implemented such monitoring programs; by 2019, all states except Missouri had implemented such programs. In the specialist literature it is discussed to what extent and to what extent the tightening of the narcotics laws allows addicts to resort to other addictive substances such as heroin ; in principle, many heroin addicts state that they had previously abused prescription opioids. Addicts also switched to fentanyl , often resulting in death.

Media adaptations

The OxyContin Express , a 2009 documentary by the Portuguese journalist Mariana van Zeller , which tracks Pill Mills' sales channels in Florida, received the Peabody Award (2010) and other awards and nominations for an Emmy . The American television series American Greed , which has dealt with white-collar crime since 2007 , featured Pill Mills in episodes 137 ( first broadcast : March 2017) and 152 (first broadcast: March 2018). Money laundering for a pill mill plays an important role in the TV series Claws (German-language broadcasts since October 2019). The film documentary The Apothecary , which was released on Netflix in 2020, shows how Dan Schneider uncovered a pill mill in St. Bernard Parish in Louisiana through private investigations .

literature

Web links

Commons : Pill Mill  - collection of pictures, videos and audio files

Individual evidence

  1. ↑ See Drug Enforcement Administration: Jasper Pain Clinic Physician Sentenced To Nearly Three Years In Prison For Illegally Dispensing Narcotics. In: dea.gov. April 8, 2016, accessed May 3, 2020 .
  2. ↑ Spectrum of Science: Spectrum Compact - Pain: New Paths out of Pein . Spectrum of Science, September 30, 2016, ISBN 978-3-95892-308-9 , p. 64.
  3. ^ A b William D. Moreto, Jacinta M. Gau, Erika J. Brooke: Pill mills, occupational offending, and situational crime prevention (...) (2019).
  4. ↑ a b Pia Malbran: What's A Pill Mill? In: CBS News . May 31, 2007, accessed May 2, 2020 .
  5. ^ A b c Judy McKee: “First, Do No Harm”: Criminal Prosecutions of Doctors for Distributing Controlled Substances Outside of Legitimate Medical Need . In: NAGTRI Journal . tape II , no. II , May 2017, p. 40-46 .
  6. ↑ Khary K. Rigg, Samantha J. March, James A. Inciardi: Prescription Drug Abuse & Diversion: Role of the Pain Clinic. In: J Drug Issues, Vol. 40 (2010), H. 3, pp. 681-702. 2010, accessed May 2, 2020 .
  7. ↑ Life data retrieved from free-website-translation.com , May 2, 2020.
  8. ↑ Philip Eil: The Pill Mill That Ravaged Portsmouth. In: Cincinnati Magazine. July 5, 2017, accessed May 2, 2020 .
  9. ↑ See Shraddha Chakradhar, Casey Ross: The history of OxyContin, told through unsealed Purdue documents. In: Stat. December 3, 2019, accessed May 2, 2020 .
  10. ↑ On Procter's importance in the 1990s, see Sam Quinones: Dreamland. The true tale of America's new opiate epidemic , pp. 23-27, p. 146, p. 155 and p. 160.
  11. ↑ 'Dreamland' Author Takes an Opioid Epidemic Trip - Investigative journalist Sam Quinones talks about the crisis. In: MedPage Today. November 26, 2016, accessed May 2, 2020 (Shannon Firth interview with Sam Quinones).
  12. ↑ Chronicle. In: Appalachian Journal , Vol. 43, No. 1/2 (autumn 2015 / winter 2016), pp. 136–139, here p. 137.
  13. ↑ See Dan Rather: Report on Pill Mills . YouTube , uploaded to the Dan Rather Reports channel , January 15, 2013.
  14. ^ Department of Justice. US Attorney's Office. District of New Mexico: Pawankumar Jain Pleads Guilty to Unlawfully Dispensing Prescription Painkillers and Health Care Fraud. In: justice.gov. February 11, 2016, accessed May 2, 2020 ( United States Department of Justice press release ).
  15. ^ Owen Dyer: Doctors in New York “pillmill” worked under daily threats, court hears . In: The BMJ , May 3, 2015.
  16. ↑ For the raised pill mills of the twin brothers Christopher and Jeffrey Georg see John Temple: American Pain. How a Young Felon and His Ring of Doctors Unleashed America's Deadliest Drug Epidemic . Lyons Press, Guilford (Connecticut) 2015, ISBN 978-1-4930-0738-7 . See also Felix Gillette: American Pain: The Largest US Pill Mill's Rise and Fall. In: Bloomberg News . June 6, 2012, accessed May 3, 2020 . See also United States Attorney's Office. Southern District of Florida: Thirty-two Indicted in Broward and Palm Beach Countries in Second Coordinated Pill Mill Takedown. In: www.justice.gov. August 23, 2011, accessed on May 8, 2020 (English, press release).
  17. ↑ Jennifer Chubinski, Sarah Walsh, Toby Sallee, Eric Rademacher: Painkiller Misuse among Appalachians and in Appalachian Counties in Kentucky . In: Journal of Appalachian Studies , Vol. 20, No. 2 (autumn 2014), pp. 154–169, here p. 155.
  18. ↑ For the Kentucky example, see Jennifer Chubinski, Sarah Walsh, Toby Sallee, Eric Rademacher: Painkiller Misuse among Appalachians and in Appalachian Counties in Kentucky . In: Journal of Appalachian Studies , Vol. 20, No. 2 (autumn 2014), pp. 154–169, here p. 158.
  19. ^ See for example:
    Chris McGreal: Why were millions of opioid pills sent to a West Virginia town of 3,000? In: The Guardian . October 2, 2019, accessed May 2, 2020 . Darryl Coote: Dozens arrested for running alleged Houston 'pill mill'. In: UPI . August 29, 2019, accessed May 2, 2020 . Woman at center of East Tennessee pill mill investigation found guilt. wvlt.t, February 14, 2020, accessed on May 3, 2020 .
  20. ↑ See the corresponding query on the DEA website, accessed on May 2, 2020.
  21. ↑ For example, around 400 pill mills in Florida were closed in 2010. See Lizette Alvarez: Florida Shutting 'Pill Mill' Clinics. In: The New York Times . August 31, 2011, accessed May 2, 2020 .
  22. ^ New Kentucky "Pill Mill Bill" Places New Restrictions on Pain Management Facilities and Controlled Substances Prescribing. In: taftlaw.com. May 8, 2012, accessed May 3, 2020 .
  23. ↑ Lauren Weber: Why Missouri's The Last Holdout On A Statewide Rx Monitoring Program. In: Kaiser Health News. May 20, 2019, accessed May 3, 2020 .
  24. ↑ Emily Rhodes, Maria Wilson, Alysia Robinson, Jill A. Hayden, Mark Asbridge: The effectiveness of prescription drug monitoring programs at reducing opioid-related harms and consequences: a systematic review. In: BMC Health Services Research. November 1, 2019, accessed May 3, 2020 .
  25. ↑ How is heroin linked to prescription drug abuse? In: National Institutes of Health . Archived from the original on February 28, 2014 ; accessed on May 3, 2020 .
  26. ^ Centers for Disease Control and Prevention : Understanding the Epidemic. In: cdc.gov. Retrieved May 3, 2020 .
  27. ^ The OxyContin Express. In: documentary.net. Retrieved May 3, 2020 .
  28. ↑ Current TV: Current TV's Documentary Series 'Vanguard' Receives 69th Annual Peabody Award and 2010 Television Academy Honor. In: prnewswire.com. April 7, 2010, accessed May 3, 2020 (press release). The OxyContin Express (Current TV). In: peabodyawards.com. Retrieved May 3, 2020 (recording of the honor). International Documentary Association. In: Internet Movie Database . Retrieved May 3, 2020 .
  29. ↑ American Greed (Season 11). In: tvguide.com. Retrieved May 3, 2020 .
  30. ↑ American Greed (Season 12). In: tvguide.com. Retrieved May 3, 2020 .
  31. ↑ Episode guide for the series on Fernsehserien.de , accessed on May 3, 2020.
  32. ↑ Darian Symoné Harvin: Nail Tips from 'Claws'. In: The New York Times. October 6, 2019, accessed May 3, 2020 (interview with Morgan Dixon, series chief manicurist ).
  33. ↑ Mahita Gajanan: Netflix's The Pharmacist Depicts the True Story of Grieving Father's Fight Against the Opioid Epidemic. In: www.time.com, February 6, 2020, accessed May 10, 2020.