PRESCIPTIVE IDENTITY THEFT, PILL MILL VERSION 2.0
There is a plague of prescription medication diversion in the Houston area that has developed a new strain of “Pill Mill Version 2.0” involving homemade prescription pads, fictitious clinic names and disposable cell phone numbers all claiming numerous physicians as victims. What is worse is there is no rapid remedy in sight. The following is my story. May it provide some insights if your prescriptive identity is stolen and pose potential solutions for our profession.
I became aware of the plot in March of this year when a pharmacist contacted my office about a suspicious prescription that had been presented. Upon further investigation, it was clearly a fraudulently manufactured prescription, though quite authentic looking on the surface. It used my medical and prescribing credentials, but the clinic’s name, address, and phone number as well as the signature were fabricated.
I realized that my DEA/DPS and medical license numbers (my Prescriptive Identity) had been stolen. Apparently, the thieves were highly organized and able to write fraudulent prescriptions across Southeast Texas and into the Houston Metroplex. The current estimate is that a few hundred individuals have cashed in on my information alone, and the number of prescriptions filled on my profile increases weekly. I have been able to identify over 70 other physicians in Houston affected by this same scheme, involving numerous specialty boundaries. As of mid-June 2014, approximately 45% of the prescriptions for controlled substances on my PATx profile are fraudulent.
Traditionally, “Pill Mills” were highly organized drug diversion schemes disguised as medical practices, incorporating the employment of unethical physicians, advanced practice nurses and physician assistants to run “sham” medical practices. These clinics invariably saw high volumes of cash paying “patients” who presented pain, insomnia, muscle spasms and anxiety. Only a perfunctory history and physical examination ensued and the “patient” was invariably prescribed large numbers of the “Houston Cocktail” – hydrocodone, carisoprodol (Soma), and alprazolam (Xanax). A “patient” was out the door within only a few minutes and directed to go to certain pharmacies that were often involved in the scheme.
The clinics were typically located in low-income areas, heavily staffed by security and saw “patients” on a monthly basis, often at several clinic locations. “Pill Mill Tourists“ likely traveled from far away areas, tended to be young, and were often influenced by either ulterior motives or psychological issues with regard to their complaints of pain. Little to no other conservative or diagnostic care was ordered or provided such as diagnostic imaging, physical therapy, weight management, psychological testing or electrodiagnostic testing. Practitioners who worked in “Pill Mills” were tied to non-therapeutic prescribing of controlled substances and posed an imminent threat to the public safety because of the risk of accidental lethal overdose, chemical impairment and diversion. 
