Counties with 20 to 50 pain clinics in Tennessee include Bradley’s neighboring county, Hamilton, as well as Shelby, Davidson, Rutherford and Knox. There are a total of 284 pain clinics in Tennessee as of January 2013, according to the Tennessee Department of Health’s map.
Jim Derry, information systems manager, said the prescription drug market is worth about $300 billion every year in America.
“Doctors no longer have to use pain while diagnosing patients [due to advances in technology]. Now they can treat pain. This has led to a lot of pain clinics popping up,” Derry said. “Just because there is a pain clinic does not mean it is an evil organization. There are several in this town, and by all accounts, they are fine places.”
Unlike some of the legitimate pain clinics, there are also places known as “pill mills.” According to Derry, pill mills exist to prescribe drugs to addicts. Prescription drugs are sold in the clinics for cash only.
Many pill mills once existed in Florida before state regulations cracked down on the epidemic. Pill mills began moving north up Interstate 75. There are now over 100 of them in Georgia alone.
According to Derry, it is difficult for law enforcement to determine when a pain center is legitimate.
He said prescription drug trafficking attracts illegal drug business, as well. He said the illegal drug trade is even larger than pharmaceutical drugs at a trillion dollars worldwide annually.
“It is huge. Mexican drug traffickers will come to a place like Tennessee where there is a huge prescription drug problem and they will target that area for heroin,” Derry said. “An opiate is just a well-made version of heroin.”
Derry described a grim cycle for those already addicted to prescription drugs.
“What happens is someone gets addicted to a prescription drug and they will gradually lose their home, their family and their job, but they will still have their addiction. At that point, they will turn to heroin,” Derry said.
A heavy hitter pill connecting substance abuse and illegal drugs is pseudoephedrine. The drug is currently sold over the counter in Tennessee. Limitations are set on how much a person can buy at one time and within one month. It is the one ingredient needed to make methamphetamine in Tennessee.
Derry said some people would like to see the pill become a prescription drug.
“In the two states where it has been made a prescription, which are Mississippi and Oregon, they have seen a tremendous drop in meth lab seizures. And it has stayed down,” Derry said. “Oregon did it back in 2006 and their labs dropped 60 to 70 percent and they stayed down. Mississippi did it back in 2010, and labs have dropped 70 percent or so.”
Del Thomasson, authorized central storage container coordinator, agreed it is difficult to track, identify and incriminate pill mills for prescription drug abuse.
“There are exits in Georgia on Interstate 75 where you can go off on either side and find a half dozen or a dozen pain clinics. There would be cars from everywhere: Ohio, Tennessee, Kentucky. That problems has moved north to here in Tennessee,” Thomasson said.
Investigations are difficult for multiple reasons, according to Thomasson.
“It takes a lot of milligrams of a drug in order to get a good prosecution,” Thomasson said. “You have to buy a lot of pills.”
He said pain clinics are able to continue operations while law enforcement officers try to collect the evidence they need. He also said there is no set profile for these “drug dealers.”
“Everybody thinks about a drug dealer as some guy with tattoos, long hair and a beard. That is not so. My biggest drug dealer in the last investigation was a 64-year-old white woman sitting in her house,” Thomasson said. “She began to deal pills at 5:30 or six in the morning and it went on until midnight.” She added there was a steady clientele for the illegal activity.
Continued Thomasson, “The best you can do is make your buys, make your cases and make your arrests.”
He said Tennessee is trying to shut down the pseudoephedrine problem, but faces issues due to North Carolina and Georgia’s laws. Neither state has placed limits on pseudoephedrine. All Tennessee pill makers have to do is cross the state line and buy the pills from various pharmacies.
Joyce Vanderpool, Kiwanis member, reminded Kiwanis members to do their part by keeping a close eye on their pharmaceutical drugs.