Apr 7 2012
09:16 am

Yesterday, I received a slick-looking, double sided marketing flyer, delivered straight to our home mailbox, advertising the "comprehensive pain management" services of a practice called "Tennessee Preferred Medical."

I'm thinking that whichever mailing list provider sold my name and address to "Tennessee Preferred Medical" won't be getting their business again, because really, it's just not a good idea to send marketing flyers for what sure looks to be a pill mill (albeit one that takes insurance) to the mother of a teenager who died as a result of pain pill peddling in our community.

This is my just-published open letter to Tennessee Preferred Medical. I will also be contacting the TBI, DEA, Tenncare hotline and state medical board with the questions and concerns that I uncovered after receiving that flyer in the mail. I hope that some other Knoxviews readers will do the same.

R. Neal's picture

See also this KNS op-ed:

See also this KNS op-ed: Doctors must rein in prescription drug abuse for children's sake

There's no doubt in my mind that "pain clinics" contribute to the prescription med addiction epidemic. There was no such thing as a "pain clinic" 20 or 30 years ago that I can recall.

What changed? Why can't people go their regular doctor (or a legit clinic) and get a prescription from a legit physician and buy their medications at a drug store like everybody else for every other ailment?

kag's picture

Randy,Here's how I see the


Here's how I see the situation. Until 20 years ago or less, when pharma companies began aggressively marketing new formulations of opiate painkillers (like oxycontin) directly to physicians, these kinds of pills and IV pain meds (patches didnt exist yet) just weren't routinely prescribed to most people. You got morphine if you were actually IN the hospital, or in hospice. You might get a week's supply of the less powerful opiate pills like Percocet after back surgery or with a badly broken leg, but nobody was routinely prescribing "heroin in a pill" to people with headaches an nagging back pain.

Then Purdue Pharma began very, very aggressively marketing OxyContin to doctors with the explicit message that this new opiate pill COULD NOT lead to addiction. Profits went berserk as doctors believed Purdue. Non-profit "advocacy groups" funded by Purdue and other companies began a major PR push to convince doctors and the public that pain in the U.S. was being woefully under treated, leading to all kinds of problems. That sounded bad, so doctors prescribed more opiate pills of various types, and patients began demanding them.

But over time, it became clear that these new opiate pain meds were actually INCREDIBLY and uniquely addictive, plus they started killing more and more people via overdose. Purdue lost a major class action suit alleging they had purposely misled doctors in their marketing campaigns in claiming Oxy could not be abused. Ethical doctors began slowly pulling back from handing these opiate pills out as they had been, as research mounted that for almost all patients (there are exceptions of course) the now well documented , exceptional risk of addiction and overdose presented by this class of meds clearly outweighed their potential therapeutic benefits. Then it was determined that the pain pills that also had acetominephen included were killing even more people, because when they wet used up feed an opiate addiction, the acetaminophen would destroy organs. So more caution was raised among "regular" doctors.

In the last 36 months, most good doctors have now gotten the message and have become **extremely* * cautious about prescribing any pills in the opiate and benzodiazepine class. But by that point, the genie was out of the bottle. We now have a nation of people who both expect the inarguably fast and effective pain and anxiety relief that these pills provide, and expect to get them for even a bad muscle strain, us we have millions of people from all walks of life quietly or not so quietly addicted to these opiates and benzos - physically this addiction is as bad as heroin, or worse. And now that they really can't get their pills too easily from "good" doctors, they have three choices: go to one of the very, very carefully run and regulated, legitimate pain specialist MD practices (addicts hate these because they are very judicious in prescribing narcotics, and monitor patients very closely for developing or escalating addiction), go to a "pain clinic" like the one I wrote about, or buy on the street.

And where do the street dealers get their pills for resale? Well, the pills can't be easily grown in Ecuador and flown into Florida, and they can't be manufacturered in a dorm room or house trailer, not can they be grown in a backyard patch in Cocke County. They must come from big pharma, thru some doctor with prescribing privileges, and onto the streets

Some pain clinics and doctors are purposefully, actively participating in selling pills, making huge amounts of money doing it. They hold the key for the whole pipeline in their Rx pads. But I believe there is a much larger group of clinics and doctors who would swear to you up one side and down the other that they would NEVER knowingly facilitate opiate and benzo pill diversion, but are well aware that the way they are running their hugely profitable "pain management practices" is designed to feed the pipeline while claiming they don't know what's going on with all the prescriptions they hand out to "patients " for cash.

I had a DEA agent tell me last year that in the entire history of human addiction - which is, of course - as old as humanity - there has never been a situation like the one we have now in which the substance pretty much universally acknowledged to be the most powerfully addictive to the greatest number of people - the poppy seed (opium) - has been legally monetized and turned into a huge, huge, unprecedented revenue stream for big, profit driven corporations. That's a perfect storm of unholy destruction and death, and the almost unbelievable (and still exploding) numbers around addiction and overdose deaths from these Rx medications bear that out.

Midori Barstow's picture

'...all the pain is in

'...all the pain is in Appalachia, while all the profit is in Florida.'

While death and use is on the rise nationwide, Appalachia has been so hard hit by OxyContin that it has given the pill a new name: Hillbilly Heroin. According to the 2010 National Drug Intelligence Center (NDIC) National Drug Threat Survey (NDTS), 25 of the 43 law enforcement respondents in the Appalachia High Intensity Drug Trafficking Areas identify controlled prescription drugs, of which oxycodone is most popular, as the greatest threat to their regions.

“Readily available and abused at high levels,” controlled prescription drugs also result in a wealth of crime, from hustling to burglaries. Law enforcement officers estimate that 90 percent of all property crimes committed in several West Virginia counties stem from OxyContin abuse alone.

Appalachian Oxy use exposes not only the street level crime associated with OxyContin, it also reveals a bigger trend in OxyContin trafficking – pill mills. In Current TV’s documentary series "Vanguard," reporters exposed “The OxyContin Express,” a flight from West Virginia to Florida, where pain management clinics, commonly referred to as “pill mills,” handed out hundreds of pills per patient, many of whom took their pills back home to sell. Prisons were stocked full of people locked away for selling drugs to support their own habits. As the show noted, all the pain is in Appalachia, while all the profit is in Florida.


AlterNet / By Kristen Gwynne

Drug Company Profiteering, Pill Mills and Thousands of Addicts: How Oxycontin Has Spread Through America

bizgrrl's picture

The DEA has been working hard

The DEA has been working hard busting drug stores for ordering and selling narcotics far in "excess of legitimate needs". Two Sanford, FL, CVS stores in February and one distributor, Cardinal Health in Lakeland, FL. Six Walgreens stores in south and central Florida and one distribution center in Jupiter, FL, in April.

fischbobber's picture

The situation

is worse than you think it is. Follow the money. It goes to Florida and Texas.

Midori Barstow's picture

Hospital seeing more babies

Hospital seeing more babies born exposed to prescription drugs


S Carpenter's picture


WBIR did well on this piece.

Because nothing says consequences like ICU babies.

Somebody's picture

While I appreciate the

While I appreciate the cathartic effect of the dripping sarcasm in the open letter, I do hope that the questions and concerns addressed to the TBI, DEA, Tenncare hotline and state medical board are dry and straightforward. If this clinic is what you say it is, I don't want - even for a second - those agencies to take your inquiries less than completely seriously.

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