More States Should Regulate Pain Management Clinics to Promote Public Health

Since 2000, annual US deaths from poisonings associated with prescription opioid pain relievers (OPRs) have steadily increased, with nearly 19 000 in 2014.1 Addiction to OPRs may also lead to illicit drug use for some persons, resulting in an even greater public health burden.2 As a result, states have implemented a variety ofpolicies intended to minimize harms associated with OPR misuse and diversion. Heroin deaths increased slightly in Florida in 20 12, but the decline in OPR deaths was approximately 10-fold greater than this increase.5 Other work observed that the largest decreases in OPR prescribing and use were among prescribers and patients with the highest baseline levels, respectively.6 In addition, Kennedy-Hendricks et al. found that enforcement activity accompanying Florida's pill mill law, including regional strike forces, was critical to reductions in deaths.7 FUTURE OPPORTUNITIES Prescription drug monitoring programs have received significantly more attention than pill mill laws from researchers and the media, yet pill mill laws- opposed by some interest groups and simply not introduced in many states-fill an important gap with their unique targeting of high-risk prescribing environments while minimizing impact on legitimate users.