2. What is Driving the Growth?

According to the Office of National Drug Control Policy, individuals illegally obtain opioids through a variety of means, such as:

  • Doctor shopping or other prescription fraud
  • Illegal online pharmacies
  • Theft and burglary (from residences, pharmacies, etc.)
  • Receiving/purchasing from an unlicensed third party, such as a friend, family member or dealer
  • Overprescribing (negligent or occasionally even intentional overprescribing by physicians or other prescribers)

Additionally, a major factor in the increase of opioid abuse is the alarming rise of “pill mills,” which often operate under the title “pain clinic.” There are many outstanding legitimate pain management providers and clinics that do incredible work with patients who have legitimate pain. Pills mills, however, are illegitimate sources for medication, which illegally offer extremely potent drugs to patients with little or no examination. Common signs of a pill mill are:

  • The physician has minimal to no training in pain management
  • Cursory or no patient exam given
  • Large volume of patients seen daily (100 +)
  • Patients drive long distances, often from other states
  • In many cases patients carpool
  • Clinic owners are not health care providers and have no medical training-they are typically from out of state (some clinic owners are unscrupulous and have shady backgrounds)
  • Clinic is run on a cash only basis
  • Same prescription “cocktail” for each patient
  • Drugs are dispensed onsite (patient pays for office visit then pays for the drugs)
  • Security guards are employed by the clinic
  • Clinics advertise in small papers and Craigslist
  • All patient MRI’s come from the same imaging facility
  • The clinics are set up to make large sums of money
  • Unscrupulous clinic owners convince the physician that the clinic is operating legally

Next: Part 3: Red Flags for Physicians