Changes are on the way for how pain clinics can operate in Tennessee. Earlier this year the state legislature passed new regulations in an effort to crack down on so-called "pill mills" that prescribe massive amounts of painkillers.
Among the changes that take effect on January 1, 2012, is a requirement that all pain clinics obtain a certificate from the state board of health. Patients will no longer be able to pay cash at pain clinics, unless it is for an insurance copayment.
A medical doctor will also be required to be on-site for at least 33 percent of the clinic's total number of operating hours.
Knoxville Police Chief David Rausch said the new laws are a good first step, but they only address the regulatory side of pain clinics.
"If a clinic violates the regulations, they'll go before a medical board instead of a court," said Rausch. "There's no real enforcement from a police standpoint. There will still be pain clinics that break the rules and then the board can do things like issue fines or revoke a license."
Rausch said fines will be of little deterrent for pill mills.
"They'll pay a fine and continue. A fine is just the cost of doing business for these people," said Rausch. "If a certificate is revoked then a pain clinic can move and reopen with a different name."
Other areas Rausch wants the legislature to bolster are enforcement and education regarding abuse of prescription medicines.
"There are still people who believe these drugs are okay because they were legally prescribed to someone. If it's not prescribed for you, you shouldn't be taking it. If it's not prescribed legally to you, you shouldn't be taking it," said Rausch. "We have a huge responsibility right now to address this number one problem our nation is facing. It's the worst drug problem we've ever encountered."
In addition to dominating the time of law enforcement, powerful pain pills have also taken over the top spot on the U.S. pharmaceutical charts.
"Hydrocodone is the most prescribed drug that we have," said Dr. Glen Farr with the UT College of Pharmacy. "In fact, it is over 40 million more prescriptions in the United States per year than the second-leading prescribed drug which is for lowering cholesterol. That is incredible when you consider narcotics like Hydrocodone are meant to be taken over short periods of time."
Farr said powerful painkilling opiates are of great benefit to those who have chronic pain from terminal illnesses or those who have undergone surgery. However, almost all people tend to gauge their personal pain as severe and subsequently seek the strongest pain reliever.
Farr said the new regulations will not prevent drug abuse, but could be beneficial.
"The new law will help, particularly the elimination of cash payment. That is the favorite mode of transaction because it is not traceable," said Farr.
Farr said the pharmaceutical industry is also developing deterrents to drug abuse. For example, some narcotic painkillers are formulated to irritate sinuses to deter people from crushing and snorting pain pills. Other manufacturers are developing capsules that are more difficult to effectively crush and release an immediate large dose of what is intended to be an extended-release medication.