What is a Pill Mill

By July 5, 2018Food for thought

The heroin epidemic is at an all-time high in our country, and a lot of the people who are addicted and dying can be traced back to the over-prescribing of pain medications that started in the late 2000’s. Once someone is hooked on strong narcotic pain relievers the chances of them switching to heroin increases. Pill mills are basically doctors who accept cash visits and prescribe pain medication for someone who doesn’t really need it. A pill mill could be a clinic, pharmacy or doctor. Recently, some state governments have taken action to get the pill mills closed down. Regardless, the laws still might not be strong enough. Find out more about pill mills, how they operate and how to tell if this is going on in your area.

What Exactly Are The Pill Mills?

A pill mill is a type of business that prescribes narcotic medications in larger numbers than would be prescribed in regular physician offices. State and local investigators came up with the name pill mills. Generally, they are talking about clinics, pharmacies and doctors. At the pill mills, prescription narcotics are given for non-medical or inappropriate reasons. This sends more drugs into the community which is one of the reasons for the prescription opiate abuse epidemic.

The doctors at the pill mills don’t offer education on the drugs or warnings for taking the drugs. They are often given cash which is one reason the pill mills make so much money. Most of these doctors, clinics and pharmacies think of an addiction as profitable. They mostly give out prescriptions for drugs like oxycodone. Some patients will travel a long way just because there aren’t any questions asked at the pill mills. Some even drive from another state just to get drugs from these doctors.

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What Drugs Are Most Commonly Sold By Pill Mills?

The prescription opioids can give the user a high that is like that of a heroin high. This is one of the reasons why the pain medication crackdown has led to a heroin epidemic. Since the high is very similar, when pill mills are shut down, the users feel they need some other type of substance and heroin often gives them the same type of high. Oxycodone, for example, is called hillbilly heroin, and that is why. The main reason for taking heroin or prescription opioids is to get relief from pain. That is one reason why the pill mills make the majority of money from the opioids. When tracking all types of prescription drugs, the opioids are abused the most. This mainly is due to the euphoria given to the user when taking the drugs. Prescription drugs even come in natural, semi-synthetic and synthetic forms. If you have abused prescription drugs and then turned to heroin, heroin rehab centers can help you today. Some of the other prescription opioids prescribed by pill mills are the following:

  • Hydrocodone (Zohydro ER, Hysingla ER)

  • Codeine (Generic)

  • Morphine (Ora-Morph SR, MS Contin, Kadian, Avinza or Astramorph)

  • Methadone (Methadose or Dolophine)

  • Hydromorphone (Exalgo, Dilaudid)

  • Fentanyl (Fentora, Duragesic or Actiq)

  • Hydrocodone and Acetaminophen (Vicodin, Norco, Lortab or Lorcet)

  • Meperidine (Demerol)

  • Oxycodone and Naloxone (Targiniq ER)

  • Oxycodone and Acetaminophen (Roxicet, Endocet or Percocet)

If you have can’t seem to stop taking these drugs, be sure to get addiction treatments immediately.


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What Should Be Known About Abuse of Prescription Opioids in the United States?

Over the past two decades, the number of people who have been abusing prescription opioids has increased greatly. There has also been an increase in the number of overdoses in the United States from prescription opioids as well. There are some reasons why this is happening. For one thing, practices related to prescribing have been different. There are also many more stronger drugs now than there were over 20 years ago. Additionally, there are more pill mills around now compared to a couple decades ago. Millions more prescriptions are being given out and most of those are in the United States. Some of the prescription opioid statistics from 2016 include the following:

  • 116 people lose their life every day from overdosing on opioids

  • 11.5 million people have abused opioids

  • 948,000 people use heroin

  • 17,087 people overdosed from prescription opioids commonly prescribed

These numbers are quite alarming and the results are devastating. Some studies show drug overdose is the leading cause for death in the United States. Around 10% of those who struggle with drug or alcohol addiction are addicted to prescription opioids. The numbers keep skyrocketing in many areas as well.

How Are the Pill Mills Operating?

The pill mills aren’t all the same. Some are described as independent pain management centers or something to that effect. Some open and then close down very quickly, as to avoid police and other law enforcement personnel. The house of the pill mills may be very random for that reason as well.

The doctors at these pill mills aren’t regular doctors. Many will have had complaints against them for different states they have been in. They may have had issues with their license for some reason or another. Generally, the doctors running the pill mills have partners who send funding to them. The partner may be a business owner who doesn’t have medical experience. The business owner just needs someone with a DEA valid license to work at the pill mill.

Some of the doctors at pill mills will have patients take in their older X-rays and health records and may do an exam of sorts. This is generally just to show they are running a “regular doctor’s office”. The records won’t be kept and if an exam is done, it is quick. The doctors want to get money and fast. Prescriptions will be written no questions asked. They don’t care about helping anyone. The office fee is usually between $200 and $400 and paid with cash. Then, the patients can leave with a lot of drugs.


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How Is This Related To The Drug Epidemic?

A clinic in Florida might have started the increase in the pill mills around the United States. In 2007, a man named Chris George had started his very first medical clinic. He was a convict and 27 years old. He didn’t have any experience in the medical field. In 2010, he and his brother had both been operating pill mills throughout Florida. The biggest of them named American Pain. The doctors at the pill mills had a payment for each patient. Due to this, they prescribed many drugs in very large amounts.

During that time, the pill mills could be run without being caught. Nothing was going to stop the George brothers, so they turned into kingpins quickly. Women who used to be strippers worked in pharmacies and the doctors would carry guns. The parking lots had bouncers who were filled with tattoos. They even directed the traffic. Bribes were made to get spots on waiting lists. Drugs had been trafficked on I-75. Soon, the highway had been given a nickname, Oxy Express.  

Later it was found out that:

  • The George brothers had been earning a maximum of $400,000 each day, cash, by 2010.

  • Around 20 million pills has been prescribed over 3 years.

  • Around 90% of those drugs had been found in different states.

By the end of their run, the George brothers had been arrested and their pill mills were shut down. Their arrests came in March of 2010 by the DEA and FBI. Their clinics were known to be the country’s deadliest pill mills. Throughout the case, it was found that 56 of their patients had died from overdose. That doesn’t included those who died from drugs which were trafficked through their pill mills.

Is Anything Being Done About The Pill Mills?

When American Pain was still opened it inspired the opening of more pill mills. Florida was taken over by pill mills. During 2010, just around South Florida, there had been 176 pill mills. People would travel across the state or even from others states to get drugs. Many of those people traveled from states that had more strict prescribing regulations. Officials and citizens did finally work on finding solutions. American Pain was closed and that turned a lot of things around. During 2011, over 400 pill mills in Florida were closed or shut down. There were certain reasons this could and did happen.

  • It was then illegal for a doctor to prescribe narcotic drugs in their own office.

  • Patients would need to get the drugs from pharmacies.

  • Those who had access to drugs would have to have a background check done first.

  • Severe penalties were created for anyone violating these new laws.

  • A monitoring system was made to track the sale of prescription drugs.

These laws had created an impact on the entire nation. Those with an addiction could no longer get their drugs from Florida pill mills. States near Florida, Georgia for instance, had bigger issues with the pill mills as well. Shortly after Florida enacted their laws, so did Georgia. Other states realized what they were doing and followed suit. Missouri finally created their drug monitoring system for prescription drugs in 2017. Now, every one of the United States has this type of system. During 2017, the DOJ (Department of Justice) began a program that broke the ground on reducing the amount of opioid drug-related fraud in the healthcare system. The measures are nowhere near perfect, but it is a start.


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Will These Measures and Programs Work Enough?

The measures which have been taken with the prescription drug monitoring system have been a great start. However, more still needs to be done. Taking pill mills out of the equation only stops the user’s supply. There is still a large demand for prescription drugs which hasn’t disappeared. For true changes to happen, states need to have better and more treatment options for addicts. However, most states haven’t gotten to this step yet. Many prescription drug abusers, especially who abused opioids, started using heroin. This increased the number of heroin addicts and heroin overdoses.

There are suboxone clinics which have helped to fight the addiction for many opioid addicts. Kentucky has a prescription drug abuse epidemic at this time. Some people in that state think this could lead to more pill mills being created. The purpose of suboxone is for treating those with an opiate addiction. Suboxone is an opioid of sorts and it can also be addictive. Since the laws aren’t always black and white, doctors can still prescribe Suboxone and some are overprescribing it. It may seem like a never-ending cycle when the addicts can always get drugs from somewhere else or turn to another type of drug.

The prescription drug monitoring systems are not concrete. Some of the states don’t have as great of a system as others. The systems in Missouri, for example, aren’t set up the greatest. The doctors can’t even see the database from the system. This means drug shoppers may slip right through the cracks and not be noticed by doctors. Unfortunately, this may mean the systems aren’t the best solution.


Johns Hopkins study shows the following:

  • Only 72% of the doctors know about the prescription drug monitoring systems.

  • Only 53% of the doctors use the prescription drug monitoring systems.

  • 58% of the doctors have reported the system takes to long for getting information.

  • 28% of the doctors have said the systems are difficult to use.

What About The Online Pill Mills?

It is great there are pill mills shutting down. However, addicts can still buy drugs online. There are numerous websites which are selling narcotics and people don’t even need prescriptions for the drugs. Some of the websites have a doctor who will complete written and oral exams. Sometimes people pay to get onto the site that is selling the drugs and don’t need a doctor’s exam. Most of these are located in different countries and can be tough to find out where they are at. It is very easy to pull up online pill mills through at Google search. 

Most of the websites take credit cards and will deliver via USPS. LegitScript is a company which monitors these online pill mills and pharmacies. The owner of this website says if an online pharmacy is selling 100 drugs – ⅓ are legit, ⅓ are close to legit and ⅓ are counterfeit. Since many of these pill mills online aren’t located in the United States, it is tough to get them shut down. They can also open back up through different website addresses as well.

What Are Some Signs There Is a Pill Mill In Your Area?

Pill mills have been around in almost every one of the United States. Many are found in the southern states. However, the other states are exempt, there are still pill mills opening up around the country. If you suspect there is a pill mill in your area, some signs to confirm this may include the following:

  • Cash is the only form of payment accepted

  • Physical exams aren’t given

  • Prescription pills are the only way the doctors treat pain

  • Crowds are formed around the building in lines

  • Many cars in and out of the building parking lot
  • Pharmacists complaining about the doctors

  • Other businesses complaining about the “office”

  • Patients aren’t in the building long for their appointments

  • Shady or unusual characters around the building

  • X-rays and medical records aren’t needed for appointments

  • Doctors send patients to a specific pharmacy

  • Patients can pick what medicine they want

  • Drugs are being used and sold right outside the building

  • Security guards are on the premises

If you recognize any of these signs, you can call the DEA and report the doctors or facility. Pill mills are a problem. If the citizens of the community report if they see signs of suspicious activity and more businesses keep an eye out for the above-mentioned signs as well, hopefully, these pill mills can be limited.