At first glance, pharmacies seem like unlikely customers for bullet-resistant glass: These are largely not cash businesses–there’s no safe full of money or wealthy patrons with pockets full of cash–and are generally located near population centers (which complicates a smooth escape). Nonetheless, pharmacy hold-ups nationwide have increased 80 percent over the last five years, largely driven by the abuse of narcotic pain killers, which has spiked 400 percent since 2000.
GROUND ZERO: FLORIDA
While bullet-resistant glass is a new and disorientating concern for pharmacists in Seattle, WA or Long Island, NY, it’s become the norm in sunny Florida, where a unique confluence of circumstances has fueled the nationwide abuse of prescription pain medicine.
In most of the United States a “pain clinic” is a small alternative medicine office where a chiropractor, acupuncturist, massage therapist, anesthesiologist, or other caregiver seeks to ease chronic pain. Such pain clinics occasionally employ licensed pharmacists to dispense powerful prescription pain killers like Percocet, OxyContin, and the like. In some areas, these “pain clinics” have drifted away from being multi-modality offices for managing pain, and become little more than “pill mills” handing out narcotics with little attention to why–or if–a patient needs them.
While pill dispensing “pain clinics” may have begun as legitimate endeavors, a combination of poor oversight and lax regulation quickly led to thinly veiled drug cartels dominating Florida’s strip-mall pain clinic industry (e.g., until 2011 even convicted felons could open “pill mill” pain clinics in Florida). By 2010 Florida doctors were dispensing more narcotic-based pain killers than the entire rest of the United States; for example, in 2010, 89 percent of all of the doctor-prescribed oxycodone in the US passed through a Florida office.
Oxycodone is dispensed by a pill mill at the standard pharmacy rate of a few dollars per dose. On the street these pills sell for 50-cents to a dollar per milligram (with the 15mg, 30mg, and 80mg pills being the most common)–that’s a markup of 200 to 500 percent. The absence of any sort of organized oversight in Florida–including the very common computer-based prescription drug-monitoring system that is now coordinated among many states–attracted pill-seekers from across the southeast, who then distributed pills at a profit as far north as the Great Lakes region and New England.
PILL MILL CRACKDOWN SHIFTS RISK
Cash operations dispensing valuable street drugs have little motivation to contact law enforcement; Florida pill mills were obvious targets for armed robbery, and routinely sought out bullet-resistant glass installation as a regular part of “doing business.” Legitimate pharmacies, on the other hand, did not.
Around 2006–as the nationwide surge in prescription drug abuse was becoming apparent, with prescription drugs closing in on marijuana as the drug of choice among teens–Florida law enforcement finally began investigating pill mills, and occasionally shutting down the most egregious operations. In late 2011 Florida finally cracked down completely, freezing new licenses and mandating coordinated monitoring of prescriptions. Unfortunately, the damage was done: Florida had become firmly seated as the source for prescription pain medication, with a regular stream of “pill tourists” coming into the state.
When pill mills started closing in 2006 pain-pill addicts–both local and out-of-state–began to shop, and then attack Florida pharmacies; since 2007 there have been more pharmacy robberies in Florida than in any other state. As these pharmacies embraced bullet-resistant glass and other security measures, it ceased to be worthwhile to head to Florida for pain meds. Nationwide street-level drug distribution networks crumbled, and narcotic pain-killer–once plentiful and affordable–became scarce and pricey. Today small pharmacies across the United States are finding themselves in need of bulletproof glass and a whole new kind of on-the-job vigilance.