Prescription Drugs in the Media

Not sure how many of our readers are fans of the A&E show “The Glades,” but on Sunday, in a ripped-from-the-headlines move the Florida-based cop drama highlighted the Pill Mill problem that has been causing so many headaches throughout the Southeast. Read More

Your Complete Guide To Pill Mills: What Are They, And How Might You Be Affected

This week, the White House unveiled a new national plan to deal with prescription drug abuse, a subject we have devoted considerable time to on our blog. If you haven’t checked out the 2009 CurrentTV short documentary “The OxyContin Express,” it is well worth your time (45 minutes) and really gives the lay of the land in terms of the problem, especially when it comes to pill mills.

What’s a pill mill?

A particular focus of House talks in DC have been pill mills, clinics that dispense a great deal of medication without extensive scrutiny of the patient. How can you tell a pill mill is a pill mill? Well, according to CBS News and the Miami Herald (also worth reading is this Herald piece by Fred Grimm), signs include:

  • No physical exam
  • No medical records required
  • Medical equipment may be limited to non-existent
  • Pain is treated by pills alone; no alternative treatments available
  • Pharmacy is on-site
  • You can select your own medicines
  • Large volumes of medications are dispensed
  • Medications are dispensed that, when taken together, can cause serious problems or overdose
  • Giant crowds
  • Many patients are from out-of-state or have otherwise traveled great distances
  • Cash only

Or you can tell a pill mill is a pill mill if, as Florida’s new drug czar Dave Aronberg described, “the medical clinic is located between a tattoo parlor and a pawn shop.”

The cons of pill mills

Obviously, there are many disadvantages inherent in the way pill mills conduct business. Law enforcement frequently points to pill mills as a major factor in the prescription drug street trade; you can purchase pills at a $1 price and then sell them on the street for $4 to $10 a pill, or more. At a pill mill you can get enough medication that even if it is needed, you can still turn a profit by selling some of it off. And then there are people who can go into a pain clinic on behalf of someone else and purchase pills for them, for sale or otherwise. As documented by ABC News, the practice is known as “smurfing.” Homeless people are sometimes asked to retrieve the pills from pain clinics in return for cash. A man known as “Bill” interviewed by ABC News claims “he has gone on these types of prescription drug runs upwards of 75 times” and receives about $20 per filled prescription. It is difficult to imagine that “Bill’s” prescription was even remotely legitimate.

In another bizarre turn, until recently almost anyone could operate a pain clinic. Fred Grimm at the Miami Herald in a March 5th article describes the cases of a few ex-cons who have made huge sums by operating pain clinics. In fact, a man convicted of drug trafficking, who could not run a liquor store in Florida, was able to run a series of seven pain pill franchises before being busted on February 23rd of this year. Florida law requires that you must be a licensed doctor to own a pain clinic; that law was in effect when the bust of the former drug trafficker (among other ex-cons) on February 23rd took place. Problems clearly remain.

Another aspect of the pill mill problem is the lack of medical oversight and the damage that can do to patients. Dispensing massive amounts of oxycodone is hardly a good idea, especially when opioid overdose is now the no. 2 cause of accidental death in the United States (see Dr. Jaffe at Psychology Today for more info). But dispensing massive quantities of oxycodone AND Xanax at the same time is an even more terrible idea. Still, it happens. One particular combination has caught on, earning itself the nickname of “the Houston Cocktail.” Combine hydrocodone (the active ingredient in Lorcet, Lortab, Vicodin, Norco, Zydone, and others) with the muscle relaxer soma and Valium or Xanax and obtain a “heroin-like” high.  (See Houston-based Bacoda Blogs for more detail).  You can easily fill prescriptions for at least two of these three drugs from the same pill mill at the same time. According to a doctor interviewed by Dallas News, there is “no legitimate medical reason for a doctor to prescribe all three together.”  And yet a pain clinic director in Houston prescribed this combination 3,800 times between 2006-2007.  On Jan 18th of 2011, this man, Dr. Maurice Conte, was forced to pay millions of damages to the family of a man who died from taking this combination of drugs.

The pros of pill mills

Yes, there are in fact “pros” to pill mills.  Although tons of dealers and scammers rely upon pill mills to conduct their trade, legitimate patients in actual pain need pill mills too.  Crackdowns on the pill trade have made it harder for people to obtain the pain pills they need, and made the price per pill balloon from $1 to $6.  Maintaining supplies has also been difficult for some pharmacies.  One Florida woman with debilitating back pain and a legitimate prescription had to phone 26 area pharmacies before she could finally fill her prescription (St. Petersburg Times).  Patrick Coyne MSN, APN, FAAN, testified at a House hearing last week on the behalf of the Oncology Nursing Society on the already burdensome difficulties many of his patients face in dealing with chronic pain.  You can read his 2 1/2 page testimony here (PDF).

The solution to pill mills

As of this writing, Florida does not appear to have solved its pill mill problem.  Florida is one of the few states that have held out from creating a prescription drug database that would track prescriptions and patients, and flag people whose use signals illegal trade or abuse.  Florida’s database was authorized two years ago, but has never received the funding it requires to actually be established.  Such drug databases are not unusual; at least 38 other states have them, according to Time Magazine.  These databases, known as Prescription Drug Monitoring Programs (or PDMPs), will be playing a greater role in national efforts to combat prescription drug abuse announced yesterday by the White House Office of National Drug Policy (PDF here), although no national database has been established as yet and national agencies do not have oversight over any state PDMP, according to the DEA.  The extent to which this helps a state like Florida, still fighting over how and whether or not to fund its own PDMP, is unclear.

Clearly, in combating prescription drug abuse, states and the nation at large must be mindful of the needs of those in chronic pain.  If some in chronic pain are finding it possible to address their needs only through pill mills, that should be addressed so as to increase their access to pills and ensure they remain affordable.  Lower-income patients, for example, may find it necessary to pay for pills with cash, and their needs should not be neglected.  However, pill mills as they stand, in Florida and in a few remaining states like Texas, are a national scandal, that waste valuable law enforcement resources and contribute to the destruction of thousands of American lives.

article by Robyn Schelenz

Getting The Drugs Out Of Your Medicine Cabinet Before Someone Else Gets To Them

The DEA (Drug Enforcement Administration) is ratcheting up their efforts against prescription drug abuse (see Yahoo News):

We have reported on various aspects of the prescription drug problem before (see our blog entry on fraudulent prescriptions for example).  The DEA’s call for the voluntary removal of prescription medications that are no longer needed from folks’ homes is not new, exactly – on a smaller scale, police departments have done this around the country.  Last weekend marked a monumental effort that indicated the seriousness of the problem – approximately 4,000 medication drop-off sites were set up across the country.

What kind of drugs might you have in your medicine cabinet that have become popular drugs of abuse?

Vicodin – You might receive Vicodin for a broken leg, or after a dental appointment, and not see a need for taking it after the pain is gone.  In fact, you may stop taking it because you know it’s addictive.  Leaving it around the house only presents the curious with an opportunity to try it recreationally.

Percocet – This is another popular prescription pain reliever that is popped recreationally for feelings of heightened well-being.  Withdrawal from this and other drugs on the list can be difficult though, especially when used recreationally/unnecessarily.  The use of this drug can be tested for with a percocet drug test, which we call on our site the “oxycodone drug test” (since it works for both, and other drugs too).

OxyContin – “Hillbilly heroin” or “oxy” it is one of the primary reasons the DEA organized the medication drop-off.  As explained in the video above, it is practically “synthetic heroin.”

Codeine – This can be found in cough medicines and is an important ingredient in “purple drank,” a popular underground narcotic/antihistamine beverage.  Like the others on this list, it can also be taken on its own for its narcotic effects.

Xanax/Valium – These benzodiazepines are often mixed with alcohol, which makes them much, much more dangerous and the user much more prone to overdose.

This may not seem like something everybody needs to worry about.  But if you are a parent, discarding pain medication when you no longer need it is probably a smart idea.  Far too many kids are not just searching through their parents’ liquor cabinets these days – they’re searching through the medicine cabinet too, or doing both.

New Reports on Lindsay Lohan Draw An Accurate Picture of Adderall’s Dangers

Although the wealth of reporting on Lindsay Lohan’s continuing struggle with addiction never seems entirely (or even half) true, it has brought to light a lot of interesting information on drugs and drug use.  Take Adderall for example.

Adderall has seeped into public consciousness over the past 25 years.  As a drug to deal with ADHD, it has been very popular and is frequently prescribed.  There are two types – IR and XR (instant release and extended release, respectively).

Its misuse is also well known.  It is a popular study aid at many colleges to help students stay up and finish studying or writing a paper.  Some athletic organizations have banned its use.  This is a category of misuse one might call “performance enhancement.”

Lindsay Lohan’s example, however, shows the real danger of the drug, which is after all just amphetamine, or speed.  A doctor specializing in addiction suggests “people who take Adderall when they don’t need it can experience similar effects as people who use cocaine or methamphetamine.” (source: TMZ via Jezebel) The story is that perhaps Lindsay Lohan was misdiagnosed with ADHD, and Adderall has not been having its intended effect for that reason.

Adderall can work wonders for someone with ADHD, but for those without, it can create cocaine-like highs and cravings. Dr. Marc Kern says (at the Jezebel link) “Adderall can be a godsend for some with ADHD, it can also in some cases cause mania, hallucinations, paranoia, and “believing things that are not true.” If you scan the comments to the article, you will find plenty of anecdotes about Adderall’s misuse, and plenty of comparisons to cocaine.

With prescription drugs, we may feel a false sense of security, but they are designed with specific medical issues in mind. I don’t take Advil when I don’t have a headache. It’s important to remember the power of prescription drugs to affect our behavior and our health – in both positive ways (for those with prescriptions) and negative ones (for those without).

(If you are concerned that someone you love has been abusing Adderall, please check out our Adderall Drug Test page, where you can purchase a safe and reliable home drug test).

Adderall and Drug Tests: What Drug Adderall Really Comes Up As In A Test

adderall drug testWhen stars fail drug tests, they attract a lot of attention and in most cases, their reputation seems to go down. The same is true of the average person too – nobody looks forward to failing a drug test.

Well, with the rise of prescription drug use and abuse, more and more people are facing a drug test failure.  Someone taking prescription Adderall can take a standard urine test and find out they’re positive!

When taking Adderall, you will come up positive for amphetamines in a test.  Informally known as speed, it was a popular drug especially in the 60s and 70s.  Testing for amphetamines in a urine drug screen is extremely common, and even considered standard.  

Adderall can be detected in your urine for about 2-4 days after use, perhaps longer depending on how much you take.  The Adderall Drug Test we carry has a standard cutoff level of 1,000 ng/mL, which is what is suggested by SAMHSA (the Substance Abuse and Mental Health Services Administration).  As early as 5-10 minutes after use, Adderall will show up positive on a saliva drug test – it stays in your saliva for up to 72 hours.

So a drug test for Adderall is not something that should surprise you as you apply to jobs and so forth.  Be aware of this and be sure you have your prescription handy.

Does Xanax Show Up On Drug Tests? The Answer…

xanax drug test
Does Xanax show up on drug tests?

The short answer is:  YES.

And here is why.

Xanax, also known as Alprazolam, is a benzodiazepine.  This is a major category of drugs that includes other “downers” such as Valium and Klonopin.  Benzodiazepines have been around since the 1950s, and they present some significant withdrawal risks.  So for practical reasons it is certainly no surprise that a Xanax Drug Test exists.

If you are on a benzodiazepine of any kind (Klonopin, Xanax, Valium, Ativan, etc.) the Xanax Drug Test will record a positive.  It can detect benzodiazepines in urine 3-7 days after use.

Aside from being picked up on a single strip urine drug test, Xanax and benzodiazepines in general can be tested for in multi drug urine tests.  Our 10 panel iCup test, as well as our 12 strip drug test, detect the presence of benzodiazepines in urine.  The 12 strip test is known as the “construction test” as a gesture to the extent of drug testing that is done on construction sites.

So again, the short answer is – yes, Xanax can be drug tested for.  Look for BZO, the abbreviation of benzodiazepine, or Xanax, or Valium when you are trying to purchase a Xanax Drug Test.  With prescription drug abuse on the rise in the United States, this type of drug test will no doubt become increasingly common.