About a decade ago, Florida leaders watched as prescription drugs began to wreak havoc across the country.
Drugs prescribed to treat pain became known as "hillbilly heroin," and in a matter of years, the epidemic found its way to the Sunshine State.
Prescription drugs began to kill thousands of Floridians, thousands of babies were born addicted to drugs, and Florida doctors became the most prevalent buyers in the nation of the highly abused painkiller oxycodone.
In 2010, Florida drug czar Bruce Grant called the prescription-drug epidemic the single greatest challenge to the state's public health and safety.
Today, the picture is vastly different.
The number of Floridians killed by prescription drugs is on the decline for the first time in several years; the U.S. Drug Enforcement Administration's list of physicians who buy the most oxycodone doesn't boast a single doctor from Florida; and doctors accused of improperly doling out pills are in prison, serving probation or facing criminal charges.
So what happened?
A combination of swift law-enforcement and legislative action have made Florida an inhospitable place for doctors running so-called "pill mills" and the dealers and addicts who relied for years on easy access to drugs for cash.
Today, most physicians are banned from selling oxycodone out of their offices, many local governments have blocked new pain clinics from opening in their communities, and a database tracks controlled substances prescribed in Florida.
Since it was launched in September 2011, more than 56 million records have been loaded into Florida's Prescription Drug Monitoring Program, touted as one of the best tools for law enforcement to catch doctor-shoppers and physicians who overprescribe.
By late 2012, the PDMP had been queried by law enforcement more than 20,000 times.
Metropolitan Bureau of Investigation agents used the PDMP to help build a case against Orlando physician John Spencer Archinihu, who was arrested last month on charges of illegally operating a pain clinic.
While local and state law-enforcement officers investigated suspectedrogue physicians and pharmacists — more than a dozen have been arrested in Central Florida since 2010 — federal authorities began taking unprecedented action against national pharmacy and pharmaceutical companies.
The U.S. Drug Enforcement Administration in February 2012 banned two CVS stores in Sanford from selling controlled substances. At the same time, the agency blocked a national wholesale drug distributor from shipping certain drugs out of its Lakeland facility.
And most recently, UPS recently agreed to a $40 million settlement to avoid federal prosecution in an online-pharmacy investigation.
All of these factors have reduced the supply of prescription drugs on Central Florida streets, local narcotics agents say.
"Law enforcement in Central Florida has committed a lot of resources to the problem," said MBI Director Larry Zwieg. "I think we're starting to see the benefits."
But as task forces and law-enforcement agencies work their way up the prescription-drug supply chain and lawmakers take aim at the medical community, their actions have brought unintended consequences.
Some legitimate chronic-pain patients complain it is difficult, if not impossible, to find the drugs they need in Florida. Experts say some pharmacists, not wanting to be the next target of a DEA investigation, are more cautious about whose prescriptions they fill.
Some law-enforcement officers speculate that addicts may now turn to heroin as the prescription-drug supply on the street dwindles.
And recently in Central Florida, patients of physicians who are under investigation have raised privacy concerns with the courts as their medical records are being pored over by local and federal law-enforcement agencies.
"There are often times politics enters into the law. We seem to routinely have a crime du jour, or a crime of the year," said Orlando defense attorney Mark NeJame, whose firm has represented several of the physicians arrested in suspected pill-mill cases.
This year, he said, it's prescription drugs.
Despite the headway made so far, prescription drugs still pose a serious problem in Florida. In the first half of 2012 alone — the most recent data available — 1,054 people died with at least one prescription drug in their system that contributed to their death.
Doctors remain under investigation in Central Florida, as do the addicts who steal prescription pads, write fraudulent scrips and doctor-shop.
MBI agents have arrested several Orlando-area pharmacists in recent months on charges they knowingly filled fraudulent prescriptions.
"We've still got a hell of a prescription-drug problem," Grant said. "No mistake about that."
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