Pill Mill Operation

The operation of a pill mill, an illegal facility that resembles an ordinary pain clinic but routinely prescribes narcotic painkillers without an adequate medical history, physical examination, diagnosis or documentation, with the doctors involved prescribing opioids for non-existent or exaggerated pain and profit rather than patient care as the primary motive; typical characteristics include cash-only payment, minimal or fabricated examinations, and a pop-up style of operation designed to mimic a legitimate clinic while evading prosecution. The model is credited to David Herbert Procter, described as originating it in Kentucky in 1979, with the business expanding sharply after the introduction of OxyContin. Pill mills became a significant driver of the American opioid crisis and drew a substantial law enforcement response: by 2016, Florida alone had convicted three hundred seventy eight physicians on pill mill related charges, with ninety five more under indictment, and states responded by building prescription drug monitoring programs, which forty one states had adopted by 2012 and all states except Missouri had adopted by 2019.