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Research Topic: Illegal Prescription Pill Diversion

Focusing Statement: Throughout the United States, the abuse of Prescription pills is a controversy
that is steady growing. In order to understand why the death toll and abuse numbers are rising, one
must discover the link(s) in which these pills can be obtained.

Essential Background Information for Introduction:Prescription pill mills (or typically known as
pain management clinics) can be found right in Philadelphia, but are vast in numbers in places such
as Texas or Florida. It is there that dealers from all across the country travel and complain of a
simple pain, and leave with overwhelming amounts of pills to deal back to the abusers on the
streets. Whether the diversion is occurring through doctor shopping, pill mills, parents cabinets and
pharm parties, and ‘bad’ doctors. In attempt the crackdown on the pill mills, and also to rid itself of
the nickname the “Oxy Express”, Florida just recently created the Prescription Pill Monitoring
Program, which isn’t mandatory for all doctors to register their patients until 2012.

Potential Hook/Grabber (Story, anecdote, quote about your issue):“Everyday, nearly 7 Florida
residents die from a prescription drug overdose, leaving more dying than any other drug in the
state. Ironically, Florida doctors bought 89% of the oxycodone made in the country in 2010”.

Topic 1: The ‘Problem’


Explanation                                         In a study done by the Substance Abuse and Mental
                                                    Health Services Adminstration, people ages 12 to
Prescription Pill abuse is a rapidly growing        25 who were new abusers of prescription drugs
epidemic. Although common mostly in young           rose rapidly from 400,000 in the mid-’80s to 2
people, it is also evident in the older             million in 2000.
generation. The most common type of
prescription pills that are being abused are        “The growing population of aging Baby Boomers
opioids. Many people are beginning to abuse         are also prime candidates for prescription drug
these pills because of the ‘perception’ that they   abuse, intentional or not, as are the elderly. Once
are safer than regular street drugs whilst some     someone begins taking a number of pills for things
simply become addicted after taking the             like managing blood pressure and cholesterol, it
medicine for a surgery.                             becomes easier to take narcotic pain killers,
                                                    prescription sleep aids and other, more addictive
                                                    drugs”. “In 2000, about 43 percent of hospital
                                                   emergency admissions for drug overdoses (nearly
                                                   500,000 people) happened because of misused
                                                   prescription drugs. This type of drug abuse is
                                                   increasing partially because of the availability of
                                                   drugs, including online pharmacies that make it
                                                   easier to get the drugs without a prescription, even
                                                   for minors.” --"Prescription Drug Abuse Info."

                                                   “96.6 percent increase in drug-related deaths in a
                                                   five-year period from 2005 to 2010 has occurred with
                                                   the main cause being prescription pills. Doctor
                                                   shopping, pharm parties, and ‘bad’ doctors have also
                                                   resulted in the spread of abuse.”"According to the
                                                   2006 Monitoring the Future study, prescription
                                                   drug use among teenagers is second only to
                                                   marijuana, and is second to none among 12- and
                                                   13-year olds. Every day, an estimated 2,500
                                                   teenagers abuse a pain reliever for the first time." -
                                                   -"Prescription Drug Abuse Info."

Why do people abuse prescription pills?
Common misperception that the pills will
provide them with the same feeling as being
high, without the negative effects of a typical    Adderall, a common prescription pill abused
street drug, hopes that it will help them lose     among college and high school students that is said
weight, or study more effectively. People also     to make students more efficient when studying is
take the drugs with the idea that because the      estimated to have had frequented over 20% of
pills themselves aren’t illegal, obtaining and     college students on multiple occasions and while
taking a pill without a prescription IS illegal.   there is no true statistic on how many of those
                                                   frequent abusers turned addictions, the number is
                                                   estimated to be “shockingly high”.

                                                   Adderall is a stimulant that speeds up the body
                                                   processes, and in turn when the body is not getting
                                                 the 'upper' it is used to, it begins to crave it, just
                                                 like any other prescription drug.

                                                 "In one 2008 study of 1,200 college freshmen done
                                                 by the Center for Substance Abuse Research,
                                                 researchers found that Adderall was the most
                                                 popular drug used to enhance mental performance,
                                                 and that many professors were abusing stimulants
                                                 for the same reason. Allure magazine and other
                                                 media have reported that Adderall abuse is
                                                 increasing as a trend among women who want to
                                                 lose weight and stay slim; a study from the
                                                 University of Iowa indicates that 46% of stimulant
                                                 abusers are females." --

                                                 "Prescription Drug Abuse - Adderall.

                                                 Prescription pill diversion is a "$25 billion dollar
                                                 industry". "Seppala"

Topic 2: Prescription Pill Mills
                                   National Survey of Drug Use and Health reported that an estimated
                                   5.2 million Americans (age 1 2 or older) reported using prescription
Explanation                        opioids non-medically in the past month (Summer 2010). “Opioid
                                   abuse is so widespread that it accounts for 75% of all prescription
                                   drug abuse in the U.S.In fact, opioid analgesics reportedly cause more
Typically, a ‘Pill Mill”
                                   deaths nationwide than either heroin or cocaine estimate that the
                                   abuse of prescription opioids costs the U.S. $9.5 billion in 2005,
Is a pain management clinic        leading some researchers to refer to this problem as a "national
                                   epidemic”. – Rigg, Incardi, March
Is said to give out dozen’s of
                                   Oxycodone, hydrocodone, and methadone are implicated in the
Pills to any patient just at the   majority of opioid poisonings nationwide and are also known as the
                                   commonly prescriped pills by pill mills. –Rigg, March , Incari
Slightest complaint of pain,
making it an easy option for
Pill mills provide one of the most simple ways from prescription
drug dealers to obtain their prescription pills in vast amounts.
The pill mills, as reported by news stations like MSNBC and ABC
alike are accredited towards the ‘prescription pill epidemic’.

"Pill mill" clinics are also known as private pain-management
centers. They often open and shut down quickly in order hide
their operations from law enforcement, the highest amount of pill
mills can be found in Florida and Texas.


 Accept cash only

 No physical exam is given

 No medical records or x-rays are needed

 You get to pick your own medicine, no questions asked

 You are directed to "their" pharmac

 They treat pain with pills only

 You get a set number of pills and they tell you a specific date to
come back for more

 They have security guards
                                       There may be huge crowds of people waiting to see the doctor”


Explanation                           Evidence/Quotes:In documentaries, the camera men capture the
                                      license plates I nthe parking lots which range from KY, VA to WA
Florida’s pill mills are so bad, it   and MI. People come to Florida and hop around from clinic to
gained the nickname the “Oxy          clinic to be able to bring back the pills to sell on their own.
Express” Florida, being the state
with the most pill mills, has the     "Pill Mills".
highest prescription pill death
rate.                                 Everyday, 7 florida residents die from a prescription pill
                                      overdose. 89% of all the Oxycodone made in the US was
                                      purchased by the doctors of Florida.-Van Way
                                      Evidence /Quotes:

                                      Just by complaining of simple pain almost everyone, including a
                                      homeless man was able to obtain over 200 pills on his first visit
                                      by paying just a small few and the price for pills. "Prescription
                                      Opioid Abuse and Diversion in an Urban Community: The Results of
                                      an Ultra- Rapid Assessment”


Pill mills fuel the users habits by
providing easy access for the
frequent abusers
                                      "Pill mill' is a slang expression used mostly by investigators to
                                      explain a doctor, clinic or pharmacy that is prescribing or
                                      dispensing powerful narcotics, such as the common oxy’s, roxy’s,
                                      etc. inappropriately. - Malbran

Topic 2: Pharm Parties

-Pharm parties gained their nickname after having a rule that you could only enter the party if you
carried prescription pills on you. These pills would then be dumped into a bowl that resembled a
candy dish, also known as Trail Mix.
                            Evidence/Quotes:For the kids, because sometimes obtaining the pills
                            can be more difficult, steal them from their parents cabinets and bring
Most Pharm parties are
                            whatever they can get to be able to enter these “Pharm Parties” and
held by young kids who live
                            create the deadly trail mix. --" Teen Prescription Drug Abuse On the
with their parents

                               Evidence/Quotes:Each kid who enters a pharm party bring their own
                               pills to be able to enter and they place them into a bowl. Then they
                               grab a handful of pills that everyone has placed into the bowl and take
Trail Mix at pharm parties     whatever they get." Teen Prescription Drug Abuse On the Rise
are possibly one of the
most deadly drug

                              Evidence /Quotes:“Every pharm party I went to, I planned on blacking
Along with the pills that are out. I’d chase the pills with beer because being around my friends you
being taken at the parties, were a ‘champ’ if you blacked out, especially if you woke up the next
the kids chase the pills with morning” – Recovering addict from ABC interview.

Topic 3: Parents Cabinets / Surgery
                                  Evidence/Quotes:Because the pills are in their own homes, the
Many parents get surgery and
                                  kids are tempted to take the medicine that their parents have,
obtain the pain pills afterwards,
                                  and if they do they can distribute to friends or at Pharm parties.
enabling the kids to be tempted
with the pills
Explanation                       Evidence/Quotes:

Surgery allows an opportunity       Often those people begin to use the pills and discover they enjoy
for people to use the pain pills,   how they relieve the pain, or give them a feeling they simply
often times those people are new    aren't accustomed to. Most people with addictive personalities
to the effects a pill can have      have a higher chance in becoming addicted.

                                    Evidence /Quotes:Because the pills that the parents are abusing
                                    are located in the home, the kids have access to the pills and
                                    become interested in how they will make them feel.
Many children see the side
effects the pills place on their
parents, which is often a
tempting view for them

Topic 4: Doctor Shopping
                                   Evidence/Quotes:Doctor shopping is when someone bounces
                                   around from doctor to doctor complaining of a different pain or
In states that do not have the
                                   need that would call for the prescription pills. The states that do
Prescription Drug Monitoring
                                   not have the database have no way of knowing what pills the
program, it is quite easy to
                                   patient has already been prescribed.
doctor shop
                                    Evidence/Quotes:In one county in Florida named Broward, there
Pill Mills/ clinics are so          is 165 clinics. In the state of Florida there is more than 1000. -
widespread that in one day, a       Alvarez
regular person hired for ABC's
documentary could recieve over
1,000 pills
                                    Evidence /Quotes:
Most doctor shopping can also be
linked to normal everyday
doctors who are unaware that
their patients are involved in this There was a 154% increase in opoid prescriptions from 1992 to
doctor shopping                     2002, compared to a 54% increase in general prescriptions.--

 Evidence /Quotes:

Topic 5: Prescription Drug Monitoring Program
Explanation                       In the state of Florida, there is over 1,000 pain management
                                  clinics, and not until now was a monitoring program put into
Doctors in Florida, as well as    action. Doctor shopping was simple for most people because there
others states who already have was no true was to see who are what the patient had already seen
the program installed willbe      and been prescribed.
able to track down the patients
prescription history in their own
                                    Evidence shows that over 80 doctors have seen their licenses
                                    suspended for prescribing large amounts of pills for to a patient
                                    with no true apparent need. As a result of the new laws in Florida,
                                    doctors purchasing, which was at 32 billion of Oxycodone in 2010,
                                    fell recently by 97%. Although this may leave the pills harder to
                                    obtain, they're still on the streets of Florida while it's taking police
                                    a decent amount of time to hit over 1,000 of Florida's pain clinics.
                                    The pills have increased in price from 8 to 15$. -- Alvarez
                                Evidence/Quotes:With fear of bad doctors, loopholes in the
Many law makers are worried
                                database may cause doctor shopping to still exist seeing as sadly
that 'bad' doctors won't comply
                                most pain management clinics are in it for the money, as
with the program, and that it
                                displayed in the documentaries from ABC and NBC
needs to become a country-wide

Alvarez, Lizette. "Florida Laws Shutting 'Pill Mills'" NY Times. 31 Aug. 2011. Web. 19 Oct. 2012.

"Pharm Parties." ASK - Adolescent Substance Abuse Knowledge Base - Teenage Drug Abuse.
CRC Health Group, 2007. Web. 8 Nov. 2011. <http://www.adolescent-substance->.

" PILL MILLS - ABC NEWS."YouTube - Broadcast Yourself.. N.p., n.d. Web. 7 Oct. 2011.

"Prescription Drug Abuse - Adderall." Prescription Drug Abuse - Home. CRC Health Group,
2011. Web. 7 Nov. 2011. <>.

"Prescription Drug Abuse Info." Prescription Drug Abuse Information | Drug Rehab Programs.
2009. Web. 7 Nov. 2011. <>.

"Prescription Opioid Abuse and Diversion in an Urban Community: The Results of an Ultra- Rapid
Assessment." National Center for Biotechnology Information. N.p., n.d. Web. 13 Oct. 2011.

Rigg, Khary, Samantha J. March, and James Inciardi. "PRESCRIPTION DRUG ABUSE & DIVERSION."
ProQuest AP Science. Proquest, Summer 2010. Web. 03 Oct. 2011.
Seppala, Marvin. Prescription Pain Killers. Center City, MN: Hazelden, 2010. Google Books. 2010. Web. 6
Oct. 2011. <>.

" Teen Prescription Drug Abuse On the Rise - YouTube ." YouTube - Broadcast Yourself. . ABC NEWS, n.d.
Web. 13 Oct. 2011. <>.

Van Way, Kan. "Florida Attempts to Crack Down on Pill Mills : Pill Mill Monitor." Pill Mill
Monitor : Personal Injury Lawyer & Attorney : Kay Van Wey Law Firm : Prescription Drug
Overdoses & Pharmaceutical Abuse. N.p., n.d. Web. 25 Oct. 2011.

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