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Nearly two years ago, a post here discussed the growing problem of unregulated pain-management clinics, so-called “pill mills,” and how South Florida – Broward County in particular – was ground zero.

According to the Centers for Disease Control, overdose deaths from painkillers are rivaling the No. 1 killer, traffic accidents. It attributes much of the increase to the overuse of prescription opiates such as OxyContin and Vicodin. In Florida, deaths from prescription-drug use rose from 2,780 in 2006 to 3,750 in 2008 – more than cocaine, according to the Florida Medical Examiners Commission.

You don’t even have to be a doctor to run a pain-management clinic. “You need a background check to get a liquor license — you can’t be a convicted felon and open up a bar — but you can be a convicted felon and open up a pain clinic,” says Broward Sheriff Al Lamberti.

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The signs: Increased business at rehab centers. Those Ski-related personal ads. A big spike in death rates. The trend began to reveal itself about five years ago — in centrifuges and under microscopes — at the University of Florida’s Forensic Toxicology Laboratory. Each year, the lab assists seven Florida medical examiners’ offices with about 3,000 cases, helping to identify toxic substances in bodies as medical examiners perform autopsies. Dr. Bruce Goldberger, the UF toxicologist who runs the lab, says he began to notice a “significant increase” in the number of cases in which cocaine either caused the death or was present in the blood stream. When he and his colleagues looked at data collected by the Florida Department of Law Enforcement from all 24 of the state’s medical examiners, they found that cocaine-related deaths had been rising all over Florida — from 1,034 in 2000 to 2,052 in 2006. The raw numbers also translated into a statistical spike in the cocaine-related death rate, from 6.4 deaths per 100,000 people in 2001 to 11.2 in 2005.

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