Texas `Pill Mills` Skirt Law by Playing Name Game

Dec. 29--Pain management clinics targeted for prescribing drugs illegally are finding a simple way to skirt a new law that requires them to register their businesses: They're just not calling themselves pain management clinics.

Despite new laws designed to stop them, these clinics are finding ways to disguise themselves and falsify reports to continue the flow of addictive prescription drugs that have led to hundreds of overdose deaths in the Houston area in recent years.

The rogue "pill mill" clinics are trying to circumvent a state law that went into effect last year that requires pain management clinics to register and be inspected by the Texas Medical Board if half of their patients receive controlled substances. These clinics are now trying to fly under the radar by branding themselves with new misleading names.

"They call themselves 'wellness' or 'rehabilitation' clinics," U.S. Drug Enforcement Administration spokeswoman Sharnett Latimore said, even though most patients come to these clinics to get prescriptions for addictive drugs.

A single thermometer

For instance, Dr. John Stafford did not register his facility in Santa Fe as a pain clinic, instead calling it a "family practice" operation, authorities said.

But investigators said his office had no stethoscopes or blood pressure cuffs and only a single thermometer. His records indicated he dispensed hundreds of thousands of highly addictive pills to known drug abusers, the Texas Medical Board said before suspending the doctor's medical license in March.

Similarly, Dr. Julia Ward failed to register her facility that was called "an urgent care clinic" on W. Little York in Houston. But the Texas Medical Board found she was operating a pill mill that dispensed thousands of addictive drugs before the board temporarily suspended her license in January.

"While we're asleep they're always coming up with ways to get around us," Latimore said.

188 deaths this year

The Houston Chronicle recently reported that hydrocodone prescriptions are continuing to soar despite new state regulations targeting pill mills. At least 188 people have died from prescription overdoses in Harris County this year.

A Texas Department of Public Safety database tracks prescriptions for addictive drugs, but pill mill operations are falsifying reports to that database.

In August, the state pharmacy board reported pharmacist Bright Wokocha was deliberately under- reporting the amount of controlled substances he dispensed from two pharmacies he directed, Richmond Professional Pharmacy in Richmond and Adbright Pharmacy in Rosenberg.

The discovery was made after an undercover officer paid Wokocha $4,200 to purchase 2,400 tablets of the narcotic hydrocodone and 1,200 tablets of the anti- anxiety drug alprazolam without a prescription.

Subsequently, an audit of his records revealed the two pharmacies could not account for more than 13,000 hydrocodone tablets and 10,000 alprazolam tablets that had been dispensed.

Also, the state alleges that within a four-month span, Wokocha had filled another 7,000 prescriptions for controlled substances written by various pain clinic physicians that he "should have known were invalid."

"Pharmacies are often in bed with rogue pain clinics who need their prescriptions filled," Latimore said.

Records don't match up

Dr. Ward, whose license was suspended for improperly writing prescriptions for addictive drugs from Tejas Urgent Care Clinic, was sending patients to H&W pharmacy, which was falsifying reports on the amount of drugs dispensed, authorities said.

The pharmacy, located next to the clinic on W. Little York, reported it had filled 95 prescriptions for controlled substances within a year ending in October 2010. However, a download of the pharmacy's computer showed 13,469 such prescriptions had actually been filled.

Undercover officers staking out the pharmacy and clinic reported seeing suspicious activity resembling drug crews that drove vehicles with out-of-state license plates obtaining and filling prescriptions.

The Texas State Board of Pharmacy suspended last year the licenses of the pharmacy and the pharmacist, Victor Egbulefu, just as the medical board suspended the licenses of the doctor and clinic.

Licenses lost

Thirteen other pain clinics that complied with the new law by registering with the medical board have since been disciplined for operating improperly in the past year. They either surrendered their license or had it suspended and all were located within Harris County, records show.

The last discipline case involved internist Dr. Donnie Evans, who surrendered his licenses to operate Holland Medical Group and CPR Medical Group on Aug. 26. The state reviewed 15 patients' case files and concluded that he was doing "non-therapeutic prescribing."

Nonetheless, the Houston area has no shortage of pain clinics as 36 percent of the state's 345 clinics are located in this region.

"It's hard to stop rogue clinics that can earn $1 million to $2 million a year," said Dr. C.M. Schade, the Texas Pain Society director, who is working to strengthen pain clinic regulations. "But I hope the tide will soon be turning as we keep refining and closing the loopholes."

cindy.horswell@chron.com

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