CLINIC'S PAINKILLER PITCH GIVES SOME A HEADACHE

ST. PETERSBURG - A local clinic's marketing campaign, which offers
prescriptions for OxyContin and other often-abused drugs, is drawing
criticism from the medical community and state officials.

Although the pitch for painkillers appears legal, they say, the
Doctors Urgent Care Walk-in Clinic is crossing an ethical line by
using it to build its business. They fear the ads could encourage
abuse by patients with a physical dependency on the drugs and attract
fakers who want the drugs to sell on the street.

Brandon surgeon R. Vijay, a member of the Florida Board of Medicine,
said he almost choked on his dinner when he saw an ad with the
headline "Need Painkillers?" in a local shopper. It offered a $25
discount coupon for new patients.

"I could not believe my eyes," Vijay said. He sent the advertisement
to the state Department of Health, which licenses doctors, to see
whether there is anything in state regulations that covers this
particular approach.

Neurologist Maria-Carmen Wilson, medical director of the Headache and
Pain Management Program at Tampa General Hospital, also said she was
shocked by the clinic's aggressive marketing.

"I feel it shows a lack of responsibility and professional ethics to
advertise this way," she said.

But the public's response shows a huge demand for painkillers. At
times, the clinic at 4900 33rd Ave. N has more cars than will fit in
the lot. They fill the lawn and line the side street. A second
clinic, in Clearwater, is to open soon under the same logo.

Chiropractor Alex Petro, who owns the clinic and hires licensed
physicians to staff it, declined a request for an interview.

"We're very busy," he said.

That doesn't surprise Martha E. Brown, director of the Division of
Addiction Medicine at University of South Florida. She predicts the
ad will trigger a relapse among many who are trying to recover from a
dependency on narcotics.

"From an addiction standpoint," she said, the ad is "not a good idea."

The drugs listed in the ad - Vicodin, Percocet, OxyContin and Xanax -
are strictly regulated by the U.S. Drug Enforcement Administration
because they are considered to have a potential for abuse and
diversion to street sales.

Offering pain treatment through prescription of federally controlled
drugs is a risky business, those who have tried it say. DEA agents,
police and investigators for the state's Board of Medicine keep a
wary eye on such practices to be sure they're legitimate. Doctors
Strictly Regulated

Physicians who fail to follow prescribing guidelines can face fines
or criminal charges. Two weeks ago, a Clearwater family doctor was
fined for overprescribing some prescription pain medication to a
patient who turned out to be a pusher. A Pasco physician awaits
criminal trial on charges of prescription fraud following an arrest
in February.

Still, doctors' increasing reluctance to prescribe frequently abused
painkillers "leaves chronic pain patients in agony," said board-
certified anesthesiologist David VanDercar, who is also a licensed
psychologist.

He recently came out of semiretirement to open Tampa Pain Clinic
after having a hard time finding decent nonsurgical pain treatment
for his daughter's neck injury. Tampa Pain Clinic's Web site says the
goal is to control pain and side effects, increase patients' ability
to function and prevent abuse.

For selected patients, the Web site says, it is appropriate to
prescribe "Schedule III" drugs such as Tylenol with codeine, Lortab
and Vicodin, and the stronger "Schedule II" drugs morphine,
methadone, OxyContin and fentanyl. The term "schedules" refers to the
DEA's classification for drugs it controls. Schedule I drugs are illegal.

VanDercar says Tampa Pain Clinic's Web site has drawn patients from
as far as New York and California, chronic pain patients who cannot
obtain prescriptions where they live. Some patients are moved to
tears by finally getting relief, he said. Some Patients Avoid Surgery

One grateful patient is 51-year-old Billy Drummond of Land O' Lakes,
who has constant shooting pains down his leg since a worksite injury
in 1988 left him with two ruptured disks.

"Every time I went to a doctor he wanted to cut me open and stick
something inside me," Drummond said, adding that he didn't want
surgery. "All I want is for the pain to be controlled."

From VanDercar, Drummond gets prescriptions for methadone pills and
lollipops, which deliver a potent painkiller through the gums a
little at a time.

"I'm not groggy, I'm not falling down; I take enough medicine to
function," Drummond said. "Before, I couldn't do anything. I couldn't
get out of bed, couldn't move around, couldn't put my shoes on."

Drummond agrees with his doctor that he should take only enough
medication to send the pain into the background. If they tried to get
rid of it completely, he said, he would be too sedated.

He lives in fear of losing his doctor. At one point, Drummond says,
he had to call 50 medical offices before he found one that accepted
his workers compensation insurance and prescribed drugs strong enough
to control the pain. System Weeds Out Fakers

At Tampa Pain Clinic, VanDercar and daughter Ashley, 22, have devised
an elaborate system to filter out con artists and catch abusers.
VanDercar says he has turned away 48 such patients in seven months,
about 10 percent of his case load.

OxyContin and other opiates that block pain signals in the body are
worth about $6 a pill on the street, VanDercar said. They cause a
sense of euphoria if taken in excess or in a way that speeds the drug
to the bloodstream, such as by snorting or injecting. Such practices
can be dangerous, especially when other drugs are in the body.

Each day, according to Bill Janes, director of Florida's Office of
Drug Control, six Floridians die from abuse of prescription drugs -
more than from cocaine, heroin and 'crystal meth' combined. Thousands
of others become addicted, destroying themselves and their families, he said.

The cheats and crooks are making it hard for patients who have a real
need for narcotics to get them, VanDercar said. He wants the state
Legislature to pass SB 178, which would set up an electronic database
for federally controlled drugs that often are abused. The
prescription-validation bill has failed in the House twice before,
tripped up by concerns about privacy. Many Physicians Wary Of Painkillers

Some doctors avoid prescribing narcotics because they think drugs
that create physical dependency should be used only by cancer
patients and others in acute pain for a limited time. USF
psychiatrist Brown and Tampa General's Wilson say opiates are unwise
for chronic pain because patients develop tolerance and need
increasing doses for relief.

Tampa General Hospital's pain center prefers physical therapy,
nonaddicting prescription drugs, and other methods.

"We try to get people off pain medications," Wilson said.

The pain treatment regimen offered at Doctor's Urgent Care walk-in
clinic is unclear. A request to speak to the doctor on duty was
declined through the receptionist. According to the ad, the clinic's
physician is family practitioner Ty Anderson, an osteopath, which
under Florida law is equivalent to a medical doctor.

Petro, 41, worked at a clinic in Tampa before setting up a
chiropractic office in 1998 at the site now occupied by the walk-in
center. Originally called Acropolis Chiropractic and Sports Medicine
Clinic, court records show, the practice handled a lot of
auto-accident injuries. State health department records show that
Petro and Anderson have clean records.