For most of the last decade, millions of Americans have fallen victim to an epidemic of opioid addiction. Florida is one of the states that have been hardest hit by opioids. The state is both the source of much of the pill supply and the home to many opioid users.
The effects have been devastating on ordinary Floridian communities. Thousands of people have lost their jobs and homes because of crippling opioid addictions. Many families and children have suffered.
In 2013, an average of five Floridians died every day from opioid overdoses.
Opioid use in Florida is widespread. According to the Centers for Disease Control and Prevention, around 1.27 million Floridians received prescriptions for high-dosage painkillers in 2012. In 2015, nonheroin opiate dependencies resulted in 6,180 Floridians being admitted to rehab.
That’s more than 20 percent of all rehab admissions. That year, nonheroin opiates were the most common addictive substance, other than alcohol, for which Floridians sought treatment. There are undoubtedly more people who have not sought treatment. Indeed, some never will because of fatal overdoses.
In 2013, an average of five Floridians died every day from opioid overdoses. That’s actually down from 2009, when seven Floridians died every day. That year, opioids accounted for one in eight deaths in Florida from unnatural causes.
According to federal estimates, in 2011 at least 775,000 Floridians used opioids recreationally. The problem has become extremely, heartbreakingly common.
Opioids are a dangerous group of drugs. They’re also one of the easiest to obtain because their production is legal. They’re marketed under familiar brand names such as OxyContin, Percocet and Vicodin and are routinely prescribed by doctors for serious cases of chronic or acute pain.
Opioids are a class of synthetic opiates that produce effects and dependency similar to the effects of naturally sourced opiates, such as heroin, morphine and opium. Unlike those drugs, which rightfully have a sinister reputation, opioids are thought of as everyday commercial products. After all, opioids are frequently prescribed by surgeons and primary care physicians.
Still, as many can attest, opioids can be just as dangerous as their better-known cousins. Opioids are frequently prescribed by reputable doctors in large quantities for legitimate reasons.
Many of those addicted to opioids began using the drugs after sustaining a major injury or undergoing surgery. Doctors tend to prescribe more opioids to their patients than they might need. That leaves patients with a large supply of powerful drugs.
Some patients, unfortunately, develop a dependency on the drugs or sell them. Street dealers have been known to buy or steal surplus opioids from legitimate pain patients.
But that doesn’t explain how Florida became ground zero for the crisis. In fact, Florida was the center of an entire opioid industry. Florida’s pill mills produced a massive, dangerous supply of black-market opiates that expanded the crisis to the entire Eastern United States.
Opioids became widely prescribed in the 1990s, but opioid addiction became a crisis in recent years. This was in part due to Florida’s pill mills.
Pill mills are storefronts, run by medical professionals, that provide prescriptions in exchange for cash. Doctors and other professionals who can write prescriptions will sometimes abandon legitimate practice and open these unethical operations.
In Florida’s pill mill heyday, anyone could get a prescription for vast quantities of opioids just by visiting one of these shops. Any person could arrange a “consultation” with the pill mill’s practitioner and, in exchange for a fee, walk out with months’ worth of opioids. Customers wouldn’t even need a legitimate medical reason for the drugs. Money was all that was needed.
Florida’s pill mill industry was the largest in the country at its peak in 2005. According to the Miami Herald, Miami-area Broward County was “ground zero, home to more than 150 storefront pain clinics” and “the painkiller capital of America.” According to the Miami New Times, “doctors in Florida prescribed ten times more oxycodone pills than in every other state in the country combined.”
The primary goal for people with a substance use disorder is finding their next fix. Access to their substance becomes the most important thing in their lives. And it was shockingly easy to get powerful opioids in Florida.
Easier, in fact, than obtaining these drugs in almost any other state. People would travel from all over the Eastern United States to enter the South Florida pill scene. According to the Herald, opioid users moved to Florida from as far as Ohio and West Virginia.
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The pill mill industry attracted criminals. One former street drug dealer, Christian Valdez, worked for a pill mill at the height of the crisis. Valdez says that, not long after he started working at his clinic, he realized he was doing the same job he had done on the corner.
“It dawned on me why I got my job,” Valdez told the Miami New Times in 2015. “It was actually because I was a drug dealer.” When Valdez started, he thought he would be his clinic’s office manager.
In reality, Valdez was an enforcer and money man. When opioid addicts couldn’t pay, he was responsible for scaring them off—sometimes with force, such as the time he pistol-whipped a patient.
That sort of outlaw behavior was typical of pill mill staff. Doctors should have put a stop to the outrageous excesses of their employees. Instead, they ignored the medical profession’s ethics. Valdez’s clinic, in Oakland Park, was run in part by one of South Florida’s most infamous pill mill doctors, Thomas J. Weed.
According to the New Times, Dr. Weed was the quintessential pill mill doctor. Dr. Weed appeared in commercials for the clinic in which he touted how easily patients could obtain opioids from him. Dr. Weed often saw patients for fewer than five minutes, and would often see more than seventy patients per day.
The DEA eventually raided the Oakland Park clinic. Florida’s medical licensing board investigated Dr. Weed, and he eventually gave up his license.
Government oversight became more common in the early 2010s, when the state of Florida and federal law enforcement cracked down on pill mills. Law enforcement prosecuted the most flagrant offenders, including Dr. Weed. According to the DEA, opioids are now harder to get.
The state government also took action. In 2011, the legislature passed a law that limited the amount of opioids individual patients could receive. Before 2011, crooked doctors routinely sold blank prescriptions to opioid users and street dealers. With the new personal limits, pharmacies can’t dispense outrageous amounts of opioids anymore.
Enforcement has also been stepped up. When patients are prescribed opioids now, their doctor has to check a statewide database that tracks how many opioids any person has been prescribed. Law enforcement can now keep tabs on and arrest flagrant pill pushers.
The crackdown has succeeded. Pill mills have closed down statewide. The number of new opioid prescriptions has gone down. Public health officials believe that opioids are no longer gaining hard-core users as quickly as they were.
Still, the crackdown couldn’t help those who were already addicted to opioids. The restriction on the pill supply also had a horrible unintended consequence. Because the crackdown so severely limited supplies, many opioid addicts developed a heroin addiction.
For people already addicted to opioids, their chemical dependency didn’t disappear just because the pill mills did. Because heroin has a chemical structure to similar that of opioids, some started using the far more dangerous drug as a result of the pill mill crackdown.
Heroin can be bought in any town or city in the United States from street dealers. Obviously, dealers care even less than pill mill doctors about medical ethics. They don’t have databases, and they don’t make any pretense of cooperation with law enforcement. As a result, heroin users are even more vulnerable than opioid users to exploitation and violence.
The drug itself is more dangerous than opioids. Heroin is manufactured and transported by criminals, not pharmacists. Opioids have FDA-mandated quality and safety standards. Heroin, on the other hand, is manufactured illegally from start to finish.
As a result, heroin users cannot be sure of the purity of the drug they consume. Street heroin dealers often mix or replace their product with other drugs, such as fentanyl or morphine, without saying so to their customers. A heroin user could accidentally ingest a substitute drug and fatally overdose. One South Florida woman overdosed on heroin mixed with fentanyl and passed out while driving. She very narrowly avoided a fatal collision.
The vast range of purity in heroin is also dangerous. Even heroin users with a high tolerance can easily overdose on the drug if their dealer starts providing them with a higher-grade drug from a new source. A person could shoot the same physical amount of heroin that he always does and overdose. The higher purity would be too much for his system to handle and could kill him.
Seeking compassion and assistance at a residential treatment center may help people addicted to opioids free themselves from the drug before they wind up turning to more dangerous substances, such as heroin.