Clients could pay extra to have their prescriptions increased, and the "Portsmouth cocktail" was often dispensed to convicted drug dealers and addicts, according to the documents.
Clinic employee Tammy Newman would take a "pill tax" from patients, usually two to five tablets, during the pill counts, the indictment against Adkins said.
Many patients traveled long distances, sometimes from other states, bypassing other clinics and pharmacies, documents said. Many patients appeared stoned while at the clinic, and unsigned prescriptions or prescriptions with stamped signatures were found, in violation of Ohio law.
Georgescu frequently wrote prescriptions that lasted longer and with higher and stronger dosages than other doctors, according to the search warrant request. During one nine-month stretch more than 14,000 prescriptions were written.
"A review of patient records found massive failure to comply with health care standards and Ohio law," according to Adkins' indictment.
The pill mills in Scioto County — there were once more than a dozen — created regional collateral damage, feeding addiction and crime in surrounding counties and states that lacked the clinics but not the people they served, said Aaron Haslam, the painkiller drug czar for Ohio Attorney General Mike DeWine.
Wiping them out in a single county was significant, but the painkiller addiction crisis is still responsible for huge problems that will take years to resolve.
The number of children born addicted to drugs, an increase linked to painkiller abuse, is skyrocketing in Ohio and elsewhere. Last year, nearly 1,200 Ohio newborns were diagnosed with drug withdrawal syndrome, up from just 310 in 2005.
Florida, also struggling with rampant prescription painkiller abuse, saw 1,374 babies with the syndrome discharged from hospitals last year, a nearly 300 percent increase from 2006. Kentucky, Maine and Pennsylvania have also documented the increase, among other states.
Drug overdose deaths have surpassed traffic accidents as the top cause of accidental death in Ohio, Colorado, Massachusetts, New York, Oregon and 11 other states. Substance abuse counseling centers are getting more and more referrals.
More than 1,300 people died from accidental drug overdoses in 2009 in Ohio, according to the most recent data from the Ohio Department of Health. The number of fatal overdoses has more than quadrupled from 1999, when the state recorded 327 accidental deaths, according to the department.
"A drug addict is sick; there's something that is not right, and they need help," said Angela Hamilton, 40, whose sister died in 2009 the day after getting a prescription from Georgescu, according to U.S. Drug Enforcement Administration records.
"They don't need people to be greedy and look at them as a dollar sign," said Hamilton, of Greenup County, Ky., across the Ohio River from Scioto County.
Ohio Gov. John Kasich signed a bill in May cracking down on pill mills, blamed by health officials for contributing to hundreds of overdose deaths in the state each year.
Around the country, heroin use is on the rise as addicts switch to the cheaper drug after starting with painkillers, which can be expensive, according to the DEA and doctors and counselors who treat addictions.
Haslam likened the fight against pill mills to squeezing a balloon.
"They're going to find ways to make money," he said. "If it's not in Scioto County, they're going to go to another county in Ohio or they're going to go to Kentucky, to Indiana, to Pennsylvania, to Florida, to whatever state will allow them to do this until they're policed and forced out."
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