I was surprised to see an update on government busts related to “pill mills”. I suppose I thought this practice had been eliminated, in the wake of adverse publicity and threats from fierce-looking prosecutors.
Conservative pundits do like to blame the pill mill phenomenon on expansion of Medicaid, but as these cases illustrate, much of the pill-mill business is conducted on a cash basis. That makes it more difficult to track. The pills, sometimes in their original packaging, eventually find their way onto the black market for resale at inflated prices. Not just on the street, but to college students and the after-work bar crowd.
The official terminology is diversion. Defined as “unlawful channeling of regulated pharmaceuticals from legal sources to the illicit marketplace.” Like so much else in today’s society, it’s become genuinely big business.
In so many instances of diversion, we’re faced not with professional criminals or cartels, but with healthcare practitioners. Think physician practices and pharmacies and specialty clinics who were tempted by a lucrative sideline that may now be their main source of revenue. Corrupted by greed, but still professionals who swore an oath to ethical conduct and have managed to misplace it along the way.
This should be a warning to the rest of us.
People enter the healthcare professions for all sorts of reasons, money among them. Easy money, like that offered by drug diversion, makes people corruptible, in medicine as well as politics.
One thing I’ve noticed from accounts of pill mill busts: Later on, at trial, we often hear the accused claim to have been operating out of sympathy for the patient and a misdirected desire to be of help. They aren’t hucksters like Bernie Madoff, who when the police came, just shook his head and gave up. Pill mill docs almost never confess to ill intent.
But as one prosecutor put it, could any of you have written all those prescriptions for narcotics over all those years without once realizing something was very wrong? And of course, none of us could. “Well, neither could these guys,” he concluded.