Phila. anti-'pill mill' legislation advances

Posted: June 12, 2014

Last summer, at a subdued doctor's office near 12th and Fitzgerald Streets in South Philadelphia, patients would line up 20 or 30 at once, at 11 on weekday mornings.

Somehow, they knew where to be, just days after the psychiatric medical office, which bore no visible name outside, had opened, said City Councilman Mark Squilla.

An armed guard hired by the psychiatric office stood watch at the front door, and patients who emerged with prescriptions would often fill them at a local pharmacy. Then, they would round back to the doctor's office, where they would loiter outside, and quietly sell the pills to others.

It was, Squilla says, a "pill mill" - a small medical office, typically run by a licensed physician, that dishes out reams of prescriptions to addicts or dealers under the guise of necessary prescriptions.

At a City Hall hearing on Tuesday, the Council's Public Health and Human Services Committee approved a bill, sponsored by Squilla, that would give the Department of Public Health the power to pinpoint, target, and shut down "pill mills." It faces a vote of the full Council on June 19. If approved, it will then land on the desk of Mayor Nutter, who could make it law.

According to Squilla, state and federal investigations of doctors who illegally prescribe and profit from Oxycodone or other potentially addictive medications can take years - and lots of resources. His bill, which appears to have the mayor's support, is focused on allowing the Health Department and the Department of Licenses and Inspections to quickly close pill mills under their power to regulate public nuisances.

The doctors and office workers would not be arrested, and the physician would not lose his license, but the illicit business would be knocked from the neighborhood.

Both Squilla and Nan Feyler, the city health commissioner's chief of staff, said they knew of no other municipalities or states that have tried to empower a health department to go after medical offices, clinics, and doctors handing out illegal prescriptions. Squilla's bill, they say, could offer a way for other areas caught in the grip of what officials say is a growing national and state problem to deal with the matter.

"I hope the [mill] operators will recognize we have this authority and will use it, and it works as a deterrent," Feyler, who testified in favor of the bill, said after the hearing.

Squilla said he was aware of at least four suspected pill mills in his district, which covers portions of Center City and South Philly, including the one at 12th and Fitzgerald, which went away on its own last summer after the surrounding middle-class neighborhood banded together. He added that across the city dozens operate each day.

"They actually would be outside protesting the business," he recalled of residents last June near 12th and Fitzgerald, which he described as a small street dotted with rowhouses. "They had a rally one night, over 100 people, and neighbors would picket it."

He added, "The residents were saying to me, 'We asked them [the doctor's office] why they need an armed guard, and they would say to protect their workers from their clients, because it's a cash business.' "

Among the drugs doled out for several weeks, before the office closed, Squilla said, were Suboxone, a brand-name medication that can help fight heroin or other opioid addiction, along with various antianxiety meds and pain-management drugs such as Oxycodone and Percocet.

Mill operators "come in the guise like they're going to help the people in need," Squilla said, "but what they're actually doing is preying on these people. What we realized is that, they are actually making money off the people who need the most help."

One telltale sign for the office at 12th and Fitzgerald, Squilla recalled, was their special cash sale last June: It was dubbed, he said, the "Suboxone Summer Special."

Councilwoman Maria Quiñones-Sánchez, who was at Tuesday's hearing, also called on state authorities to help the city and other municipalities go after pill mills.

For instance, according to Sánchez, the state has access to records on Medicaid and Medicare patients that lists the prescription drugs they get and from where. Therefore, she said in a phone interview, state officials may be able to help trace patients to pill mills. In her district, she also noted, one stretch alone has up to a dozen pharmacies that are small and not associated with major companies.

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