ATLANTA - As Southern states cracked down on so-called pill mills, Georgia's lax regulation made it a magnet for clinics known for prescribing powerful painkillers to drug dealers and addicts for an illicit high.
The dozens of pain clinics across Georgia that authorities believe are illegally prescribing or dispensing the drugs often have parking lots full of out-of-state license plates, evidence that people are coming from hundreds of miles to seize on an unregulated industry, authorities say. The rapid spread of the clinics led state senators to pass legislation Thursday to try to get rid of illegitimate businesses.
"We're one of the few states in the Southeast that hasn't touched it, so we're the place that all these out-of-towners come," said Attorney General Sam Olens. "It's a huge problem that's killing our kids, and we need to be going after the bad actors and protecting the professionals."
The bill would license and regulate pain management clinics, and require the owner to be a doctor. The law would stop short of requiring doctors or pharmacists to use a state registry to track how much of a painkiller a person is receiving, which some neighboring states have done.
The bill, which already passed the House, now goes to Republican Gov. Nathan Deal.
A spokesman declined to say whether the governor would sign it.
Because some pain clinics are legitimate, prosecuting those that aren't can be difficult, said Barbara Heath, the head of the Drug Enforcement Administration's diversion program in Georgia, Tennessee, North Carolina and South Carolina. If the prescriber is a doctor -- and not someone forging prescriptions -- prosecutors must prove the pills aren't for a medical need.
Red flags include clinics with a large percentage of out-of-state patients, patients receiving the same large amount of the same drug and clinics with a bouncer at the door.
Kentucky, Ohio, Tennessee, West Virginia, Texas, Louisiana, Florida and Mississippi all recently have passed laws targeting such pain clinics, according to the National Conference of State Legislatures.
The DEA is prosecuting pain clinic operators who used to do business in Florida and picked up and moved to Georgia immediately after Florida passed tougher restrictions in 2011. But it's hard to tell exactly how many pill mills exist in Georgia.
According to estimates from the Georgia Drugs and Narcotics Agency, there were fewer than 10 pill mills in the state in 2010, while the number has exploded since then, fluctuating between 90 and 140 over the last year.
The most common pills dealers and addicts want are oxycodone and hydrocodone, which are highly addictive. Some shop around the state, gathering prescriptions from numerous clinics before returning home to sell the drugs.
Georgia passed legislation in 2011 to create a program to track prescription drugs dispensed here, but it isn't expected to start operating until May, in part because of a delay in funding.
"If someone were to ask me what would be the best first step to really trying to curtail this problem, I would say get the [program] up and going because that's the information tool that's going to tell you who's prescribing what and who's receiving what pills," said Sherry Green, CEO of the National Alliance for Model State Drug Laws.
DeKalb County District Attorney Robert James, who has made prosecuting rogue pain clinics a priority, said the easy access in Georgia also leads more people in this state to become addicted.
He said a person with a knee injury can get a legitimate prescription for painkillers, and once it's gone, they can just go to a pain clinic to get more.
A pain clinic is defined in the bill as a medical enterprise where at least half of the patient population is being treated for chronic pain. Affected businesses would have to get a state license beginning in July. Licenses would have to be renewed every two years.
The proposal would also would require new pain clinics to be owned by physicians licensed in Georgia. Existing clinics where non-physicians have ownership with doctors would be allowed to remain open.
Green, of the National Alliance for Model State Drug Laws, said requiring owners to be doctors is an important step because their livelihood is at stake.
"So the thought is you've got to have somebody with that level of accountability with a pain clinic because you're giving out substances that are the most potentially addictive substances we have," she said.