South Florida Pill MILL doc goes to trial

According to records filed in federal court in Fort Lauderdale on Thursday, Piazza worked at Margate Pain Management from Oct. 20, 2009, until Aug. 2, 2010, charging patients between $250 and $350 on their first visits and between $150 and $250 for return visits. The payments, according to the charges, had to be made in cash – the clinic did not accept checks or insurance.

Prosecutors say Piazza personally earned $253,800 in the nine and a half months he worked at the clinic. In that same period, he allegedly prescribed 152,774 pills.

The charges describe Piazza as a co-owner of the operation, though the business was still running and changed its name to Total Medical Express some time after he stopped working there. Total Medical Express was raided and shut down in June 2011, resulting in six arrests, including two doctors.

In addition to the possible prison time, Piazza would be subject to three years of probation, a $250,000 fine and forfeiture of all the money he made if he’s convicted.

Todd Weicholz, the Boca Raton attorney representing Piazza, said he would not comment on the allegations because he has not had enough time to review the charges, which were filed Thursday.

Piazza is due in federal court in Fort Lauderdale on Wednesday.

Federal crackdowns on pill mill operations in South Florida have met with significant results, with some setbacks. Earlier this month, Deerfield Beach doctor Charles Neuringer, 73, was sentenced to 21 months in prison for authorizing thousands of unneeded prescriptions out of Coast to Coast Healthcare Management Clinic.

Guilty pleas were entered by 28 of 30 defendants charged in connection with South Florida pill mills owned by Christopher George: American Pain in Fort Lauderdale and Executive Pain in Lake Worth.

Two of the doctors took their case to trial. Cynthia Cadet and Joseph Castronuovo were acquitted by a federal jury in West Palm Beach of charges accusing them of overprescribing oxycodone and other drugs, but convicted of conspiracy to commit money laundering.

Vermont is the state with the highest drug use problem

Vermont has the highest rate of illicit drug use in the country with 15% of people saying they’ve used within the past month (compared to 4.2% in Utah, where drug use is the lowest), according to 2010-2011 surveys from the Substance Abuse and Mental Health Services Administration. The state ranked high for almost every type of drug, from marijuana to cocaine.

Experts attribute the problem to a combination of factors, including weather, politics, and proximity to big cities. “You have everything from the colder climate, which tends to be a reason some people give, to more liberal attitudes, to higher income levels, to people having more access, but I don’t think anyone knows for sure,” Barbara Cimaglio, the Vermont Department of Health’s deputy commissioner for alcohol and drug abuse programs, told Business Insider.

Cimaglio pointed out that marijuana accounts for a large portion of the state’s drug use. Vermont ranked highest in the U.S. for marijuana use, with about 13% of people saying they’ve used it in the past month. “I think what drives this up tends to be the higher use of marijuana, and if you look at the states [with high illicit drug use], they tend to be the states that have decriminalized or have more favorable attitudes toward use of marijuana,” she said.

Trafficking from out-of-state drug dealers has also worsened Vermont’s drug problem, likely because the state has highways that feed into big cities. “I think Vermont is really in sort of a perfect storm because we’re on that highway between Montreal, Boston, New York, and also going to Philadelphia,” Cimaglio said. “You have to go through Vermont to get to some of the bigger cities like Boston, so it seems like some people are just trafficking along the way and Vermont is one of the stops.”

Within the last year or so, she said, she’s heard more stories of burglaries related to drug trafficking and more stories about people being arrested in Vermont who aren’t from the state. Seven Days, an independent newspaper in Vermont, reported earlier this year that large amounts of heroin have been coming into the state from big-city dealers who can sell the drug at a higher price in Vermont. The drug is coming from New York City, Boston, Philadelphia, Chicago, and Detroit.

A bag of heroin that would cost $5 in a big city can sell for as much as $30 in Rutland, Vt., the city’s police chief James Baker told the newspaper. Vermont is seeing an uptick in heroin use, Cimaglio confirmed. Prescription drug use has also risen dramatically in Vermont, as it has around the country, the Burlington Free Press reported in 2011.

Vermont officials have taken notice of the drug use trends and are trying to curb the problem. “We’ve enhanced our treatment services greatly, and also law enforcement,” Cimaglio said. “We’re addressing it on all fronts.”