FIGHT OVER A FIX FOR FLORIDA 'PILL MILLS'

Appalachian Region Seeks Tracking System to Stem Flow of Painkillers,
but Costs, Efficacy Questioned

MIAMI--Florida Gov. Rick Scott's call to cancel a state
drug-monitoring program has sparked an uproar in Appalachian states
that say they are deluged with illegally bought pills from South
Florida pain clinics.

Supporters of the program, which has yet to start operating, say it
would help combat Florida's "pill mills"--shady storefront operations
that provide a bounty of prescription drugs, such as oxycodone and
hydrodone, for addicts and traffickers. The tracking system would
include a centralized database to help identify buyers who are
accumulating large numbers of pills and the doctors who are
overprescribing them.

In his recently released budget proposal, however, Mr. Scott
recommended repealing the 2009 law directing the state to set up the system.

Mr. Scott has raised concerns about the database's effectiveness and
its possible intrusion on patient privacy. Pointing to a $3.6 billion
budget deficit for the coming fiscal year, he also worries that the
state would end up paying for a program that lawmakers designed to be
funded by federal grants and private donations. Most drug-monitoring
programs in other states rely on both federal and state funds.

"The governor does not support paying for a program with taxpayer
dollars that was originally intended to be funded privately," said
Brian Burgess, a spokesman for Mr. Scott.

The governor's opposition has provoked outrage in states on the
receiving end of Florida's pill pipeline. "It seems Gov. Scott wants
Florida to become the oxy-tourism capital of the world," said Lt.
Gov. Daniel Mongiardo of Kentucky. Lawmakers in Kentucky and West
Virginia have filed resolutions urging Mr. Scott to reconsider.

Mr. Scott questions whether unethical clinics will actually
self-report to the database, though such reporting is required under
the law. He also says pharmacies such as CVS and Walgreens already
keep records of patients' prescriptions. Critics say pharmacies don't
talk to one another, something a central database would resolve.

Pill mills have flourished in Florida, especially in Broward County,
in recent years. Weak standards governing who can set them up, a lack
of oversight by state agencies and the absence of a
prescription-monitoring program have contributed to the problem, said
Sherry Green, chief executive of the nonprofit National Alliance for
Model State Drug Laws.

According to the Florida attorney general's office, clinics are often
cash-only enterprises employing doctors who write prescriptions for
painkillers without examining patients.

They have proved to be a magnet for buyers in the Southeast.
According to Frank Rapier, director of the Appalachia High Intensity
Drug Trafficking Area, highway patrol officers in hot spots like
eastern Tennessee routinely stop vanloads of people returning from
Florida with fresh stockpiles of prescription drugs.

In West Virginia, state Sen. Evan Jenkins said flights on discount
airlines between Huntington, W. Va., and Fort Lauderdale, Fla., have
been dubbed the "Oxycontin Express."

States in the region have been cracking down. Kentucky created one of
the first prescription-monitoring programs in the country in 1999.
The system has helped stamp out the sort of storefront businesses
seen in Broward County, according to Keith Humphreys, a Stanford
University researcher who has studied the programs. In all, 34 states
have implemented them.

In Florida, the proliferation of pain clinics finally prompted the
legislature to act. But the only way to secure the necessary votes
for the program from fiscally conservative lawmakers was to bar it
from relying on state funding, said Bruce Grant, former director of
the Florida Office of Drug Control, which Mr. Scott disbanded last
month, partly for cost-cutting reasons.

Mr. Scott's opposition to the law has drawn criticism in Florida
itself, some from fellow Republicans. "It's really disappointing,"
said Greg Giordano, chief legislative assistant for GOP state Sen.
Mike Fasano, who sponsored the 2009 law. Mr. Giordano said a
nonprofit foundation created to fund the database had raised $1.2
million, which would cover start-up costs. "Repealing [the law]
doesn't save the state any money," he said.

Mr. Grant says, however, that beyond the funds needed to start the
program, it would require about $500,000 a year to run--money Gov.
Scott argues could end up coming from state coffers. Indeed, Mr.
Fasano, who intends to continue championing the system, has filed a
bill that would lift the prohibition against using state funds to finance it.

The governor faces stiff opposition in the legislature, which must
approve any repeal. Senate President Mike Haridopolos, a Republican,
also has said he is open to public financing. "If necessary, we will
have to put some state money toward it," he said. "People are dying."