Health department officials in Miami have a bitter pill to swallow after uncovering more than 40 licensed physicians who legally operate clinics that treat patients with chronic pain using narcotic-based prescriptions, while marketing non-narcotics for those struggling with others for pain killer addictions.

Narcotics officers in a number of states from Kentucky to Texas and throughout the Northeastern United States blame Florida for their own states’ influx of prescription drug abusers and fatal drug overdoses since federal regulation of such clinics in Florida is non-existent, thanks to a provision in state law that makes it impossible to prosecute physicians who prescribe such narcotics without a court order.

The issue that health officials face isn’t the pain clinics themselves, but the turn-style marketing tactics some use when they knowingly treat patients who suffer from legitimate chronic pain conditions with excessive amounts of narcotics and attempt to wean them off the drugs with non-narcotic replacements after they become addicts.

Dr. Bernd Wollschlaeger, an addiction specialist and past president of the Dade County Medical Association tells the Miami Herald that “offering such services is like a slap in the face.”  He says some pain clinics are seeking not to help addicts but to profit from selling drugs used to curb dependency — in addition to selling large amounts of painkillers to patients who don’t necessarily need them.

Wollschlaeger calls pain clinics “pill mills,” because of their well-known reputation among drug traffickers in other states who regularly travel to South Florida with the sole intent of shopping these clinics for easy access to narcotics. The recipients then sell the drugs on streets in their home states. The Herald reports that neighboring Broward county / Ft. Lauderdale is home to two-thirds of all physicians identified by the DEA as prescribing the most Oxycodone anywhere in the United States.

The irony is that Federal officials essentially built the market for such clinics in 2002 by allowing physicians who operate pain management clinics to prescribe a drug called Suboxone, a medication commonly used to treat heroine and narcotic addiction. Its better-known alternative, Methadone, is strictly dispensed through licensed and regulated hospital-based clinical settings.

Suboxone was introduced by the Feds at a time when prescription drug abuse was increasing to almost epidemic proportions in the United Stated. The idea was to encourage more addicts to seek treatment for abuse without having to visit hospitals or traditional medical clinics for care.

The problem in Florida is lax regulation and training requirements, according to pain management experts. Unlike in other states, Florida does not require a physician to be board certified in pain management to dispense Suboxone. All it takes to open up shop is an 8-hour training session before any physician with a clean medical license and the desire can start a clinic. On the Federal level, the requirements are the same in any state, but most states have more rigorous standards for Suboxone prescribers.

“If the physician has a license to practice medicine, we don’t have the right to prevent them from prescribing Suboxone,” said Nick Reuter, a senior policy analyst with the Substance Abuse and Mental Health Services Administration, a branch of the U.S. Department of Health and Human Services that oversees the Suboxone certification program.

The presumptive leader in the 2010 race for governor of the Sunshine State has launched a controversial public campaign to persuade Attorneys Generals in other states to join him in “launching a full review of the constitutionality of the individual mandate and potential legal options for States to pursue on behalf of their citizens should this mandate become law,” Florida Attorney General Bill McCollum writes in a letter to his AG peers.

The Senate recently approved a draft of the healthcare reform bill that provides for a mandatory tax of $700 to $4,000 against individuals who do not obtain health insurance coverage, either individually or through their employers, before 2013. The provision was added when lobbyists for the nation’s top health insurance companies successfully negotiated it in exchange for dropping an additional proposal that bans insurance companies from declining to provide coverage for people with pre-existing health conditions.

McCollum maintains that the tax would violate the provision of individual freedoms contained in both the United States Constitution and that of the State of Florida.

“I have grave concerns about the constitutionality of this mandate,” said McCullom. “Such a ‘living tax’ is worrisome because it would be levied on a person who does nothing, a person who simply wishes not to be forced to buy health insurance coverage…The mandate is especially troubling to Floridians who are guaranteed through the Florida Constitution to have ‘the right to be let alone and free from governmental intrusion into [their] private life.’”

In another public statement to the media, McCullom explained his stance against the proposed tax and threatens legal action if it becomes law.

“I am committed to pursuing any legal action necessary to defend (the rights)…of the more than 18 million individuals who call Florida home,” writes McCollum.

Earlier this year, McCollum announced his intent to seek the Republican nomination for Governor of Florida in 2010. He intends to replace Governor Charlie Crist, a fellow Florida Republican, after serving one term as Attorney General. McCollum is considered the frontrunner in the race for the nomination because Crist also served as AG for Florida before he took over the state’s highest office.

Democratic Senator Dan Gelber of Miami, who is running to replace McCullom as Attorney General, quickly criticized McCullom in a statement shortly after McCllom announced his intent to review the constitutionality of the healthcare tax.

“General McCollum’s decision to use his office to investigate ways to block health insurance reform is exactly why we need new leadership in the Attorney General’s office,” said Gelber. “There are four million Floridians without health care including 800,000 children. Only one state has a higher percentage of uninsured. I wish McCollum was as concerned about solving Florida’s health care crisis as he was about stopping the solving of the health care crisis.”

Smoking addictions could soon become a thing of the past. An anti- nicotine vaccine is about to go before the FDA.

Nabi BioPharmaceuticals was awarded a $10 million grant to take its anti-nicotine vaccine, NicVAX, to Phase III clinical trials. The testing began last week.

NicVAX is designed to stimulate the immune system to generate antibodies that latch on to nicotine in a smoker’s body and actually prevent nicotine from ever entering the brain. As a result, the brain does not produce the positive-sensation stimulants as a response to nicotine.

Smoking-related diseases cause an estimated 440,000 American deaths each year. Smoking costs the United States over $150 billion annually in health care costs.

Lenneice A. Drew is an experienced journalist currently focused on healthcare reform. She is working to help others achieve better lives by finding affordable health insurance alternatives and reporting stories related to the healthcare industry. She lives in Miami, Florida.