Law may lack teeth to rein in pill mills

Todd E. Watson, owner of the South Florida Pain Relief & Injury Center, now resides in a cell at the Broward County Jail, a month after his arrest on charges of trafficking prescription painkillers.

But business continues to hum along at his Oakland Park pain clinic.

With state lawmakers poised to approve reforms to curb illegal pill trafficking through South Florida's pain clinics, Watson's case highlights the legal gaps that have allowed these clinics to proliferate with little scrutiny -- loopholes largely untouched by the new proposals.

South Florida -- and Broward County in particular -- has become the nation's chief supplier of black-market prescription narcotics, police and health officials say, a trend fueled by a cottage industry of storefront pain clinics that has grown from an estimated 60 to 150 clinics in the region in the past year alone.

Just 50 South Florida doctors dispensed nearly nine million pills of the dangerous painkiller oxycodone in a six-month span last year, according to the U.S. Drug Enforcement Administration.

Narcotics investigators say these clinics are feeding an epidemic of overdose deaths from Florida to Appalachia. The crisis prompted the Legislature -- after seven years of inaction -- to move forward on efforts to monitor and prevent prescription-pill abuse.

The Florida Senate on Friday passed a bill that would create a database to track narcotics prescriptions filled by doctors and pharmacists -- a tool to detect possible "doctor shopping" by drug addicts who seek pills from several doctors.


The Senate bill also requires pain clinics to register with the state and submit to annual inspections by the Department of Health. Currently, most pain clinics operate without the oversight or even the knowledge of state health agencies.

The state House of Representatives is expected to vote on the bill early this week.

But even if these reforms become law, many pain clinics will still operate with less oversight than many other healthcare providers.

For example, the Senate bill does not require criminal background checks for clinic owners or key personnel, which state law requires for workers at most other health facilities.

So the new reforms wouldn't touch people such as Watson, who continues to own -- and presumably profit from -- his pain clinic on East Commercial Boulevard, despite two recent felony arrests on drug charges.

Watson, 45, was arrested on Feb. 6 on charges of driving while intoxicated and illegal possession of oxycodone, after he drove his Mercedes-Benz up on a sidewalk to avoid a Broward sheriff's deputy who tried to pull him over for speeding, according to an arrest report. The deputy said he found 16 oxycodone pills in Watson's car, in a bottle labeled for a different medication.

On March 24, Watson -- who is not a doctor or licensed medical professional -- was arrested again on charges that he gave a bogus prescription to to a police informant to obtain oxycodone pills, court records show. Detectives arrested Watson after they watched him receive a bottle of pills from the informant in the parking lot of a Days Inn hotel, the records show.

Watson, of Cooper City, has pleaded not guilty in both cases. He remains in jail on $500,000 bail.

Watson has a criminal record including guilty pleas to battery and welfare fraud, court records show. He also attended two 30-day drug-treatment programs run by the Broward Sheriff's Office in 2005 and 2006.

Records show Watson opened his pain clinic last May. He once owned an MRI facility in Hallandale Beach.

Watson's lawyer, C. Craig Stella, said his client plans to fight the criminal charges vigorously. He stressed there are no allegations of wrongdoing at Watson's clinic.

"From my knowledge of the clinic, it is running in a lawful and legitimate fashion, " Stella said.

The osteopathic doctor who works at Watson's clinic, Dr. B. Marilee Glauser, was out of town last week and did not return phone calls seeking comment.

A Miami Herald review found six other owners or doctors at South Florida pain clinics with felony convictions.


In other types of health clinics in Florida, owners and employees must pass a criminal background check. Those found guilty of more than 40 different crimes, including felony drug offenses, are barred from working in these facilities under licensing rules enforced by the state's Agency for Health Care Administration.

AHCA also has broad authority to inspect clinics to ensure compliance with medical standards, said Dennis LaRosa, operations manager of AHCA's Health Care Clinic Unit. AHCA can suspend or revoke a clinic's license for rules violations and shut it down.

But under state law, AHCA only has authority over clinics that accept insurance -- and most pain clinics accept only cash. The bill passed by the Senate does not require pain clinics to be licensed by AHCA.

"Anybody dispensing narcotics should be subject to certain checks, " said Capt. Allen Siegel of the Hollywood Police Department, who leads a South Broward narcotics task force. "That's the big problem with these clinics, that you don't have to have any medical background whatsoever."

Police and healthcare advocates say the Senate bill contains the most important tool available to curb prescription fraud -- a database to monitor prescription sales.

Thirty-eight other states have similar programs to root out "doctor shopping, " and investigators believe the absence of a monitoring program has made Florida a magnet to addicts and pill dealers -- many from other states -- hoping to avoid detection.

Pill seekers from Kentucky, Tennessee and Ohio -- all states with monitoring programs -- routinely travel to Florida to buy painkillers at local clinics. But Florida doctors and police detectives now have no way to track patients receiving pills from several doctors.

"There are a lot of issues in the legislation that many of us feel are not being addressed. That being said, it's a very good start, " said Siegel. "It will give law enforcement a little bit of an opportunity to play catch up."

Some have criticized the Florida proposal as too relaxed, because it allows doctors to wait 15 days before submitting prescription information in the database. But other states have had a similar time lag.

Under Kentucky's monitoring program -- regarded as a national model -- doctors used to have 16 days to submit the information; now the law has an eight-day limit, and it will soon be reduced to seven days, said Dave Hopkins, who manages the program for Kentucky's Cabinet for Health and Family Services.

Hopkins said the database is most useful in detecting the frequency of prescription purchases over long periods, so the 15-day lag should not be a major concern.

"Florida just needs to bring a program up, " Hopkins said.

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