Legislation Aims to Cure Doc Shop, Pill Pop Life
By Paul S. Martinez, The Beaumont Enterprise, Texas
Apr. 1–A local state senator’s bill in the state Legislature could help law enforcement combat prescription drug abuse in the form of doctor shopping and pill mills.
Prescription drug abuse is one of the biggest problems in Southeast Texas, Orange County Sheriff Mike White said.
“We are having massive amounts of overdose deaths due to prescription drugs,” White said.
Prescription drug abuse in Texas is abetted by lax reporting laws, which enable doctor shopping and pill mills.
Doctor shopping is when a patient goes to different doctors to get multiple prescriptions for narcotics, White said.
Pill mills are unscrupulous medical practices that prescribe narcotics irresponsibly, according to the Texas Medical Board.
The drugs being abused are Xanax, Soma, Lorcet and Vicatin, according to law enforcement.
These drugs are classified as Schedule III. Currently, doctors and pharmacists are not required to report these prescriptions to the Texas Department of Public Safety.
“Currently, the State of Texas only monitors Schedule II drugs, which are your strongest drugs like morphine,” said Johnny Hatcher, the manager of the DPS narcotic regulatory programs.
Senate Bill 1879, authored by state Sen. Tommy Williams, R-The Woodlands, would require the reporting of Schedule III drugs. Williams developed the legislation after consultations with White.
“There is not a database in the state that pharmacists and doctors can check to see if patients are going around doctor shopping,” White said. “That’s what this bill is for.”
Pill mills and pain management clinics
There was a startling increase in prescription drug abuse in Orange when several pain management clinics began operations three years ago, White said.
“Obviously, there is something there,” Orange County District Attorney John Kimbrough said. “But the police can’t substitute our judgment for a medical judgment, and that’s why I think the burden just falls on the Texas Medical Board.”
The TMB does investigate pill mills, which usually open under the guise of a pain management clinic, spokeswoman Jill Wiggins said.
In January, the TMB suspended the medical license of Dr. Carlos Domingo Cunado, an area doctor whose practice embodied all the pill mill criteria, Wiggins said.
Cunado prescribed the same combination of Xanax, Soma and Lorcet to 800 patients in a seven-month period, according to the TMB.
“(Pill mill doctors) just kind of churn patients through — many, many patients a day,” Wiggins said. “And each patient pretty much gets the same pain cocktail.”
Cunado originally was being investigated by the TMB for poor record-keeping.
“Another flag is not keeping adequate records,” she said. “They’ll just write ‘back pain’ without any indication of how they determined the diagnosis.”
Cunado only accepted cash.
“They usually don’t work through insurance,” Wiggins said. “They are usually given a day to come back for a refill. They work more on a time basis rather than a need basis.”
Pill mill doctors also usually open multiple locations with the assistance of nurse practitioners or physician assistants who are allowed to prescribe medicine under the supervision of a doctor.
Pain management is a bona fide medical specialty and the vast majority of practitioners are legitimate, Kimbrough said.
“The problem is there are pain management clinics in this area and across the state that are not legitimate operations,” the Orange County attorney said. “Every sheriff and police chief knows it; it’s a huge problem.”
Prosecuting
It will always be difficult to prosecute a doctor for prescribing irresponsibly because only another doctor can challenge a doctor’s opinion, Kimbrough said.
Doctors are protected by laws which shield them from testifying in cases, Hatcher said.
“There are specific statutes. They don’t have to give up any information,” Hatcher said. “These aren’t simple investigations.”
What the law would do for law enforcement is give them one centralized database from which they could access prescription histories, and in turn, file a complaint with TMB to initiate an investigation.
The law also would take away any excuses unscrupulous doctors might have, White said.
“Right now, a doctor can say they didn’t know their patient had another doctor,” White said. “With this law in place, they have access and an obligation to look under their Hippocratic Oath.”
SB 1879 was introduced March 9. On March 22, went to committee, where it now awaits attention.
paulsmartinez@beaumontenterprise.com
(409) 880-0737
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Copyright (c) 2007, The Beaumont Enterprise, Texas
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