See: http://www.miamiherald.com/projects/2014/innocents-lost/stories/pill-mills/
In the nondescript shopping plazas dotting Florida, the unchecked prescription drug marketplace was
thriving. Called pill mills, the storefront cash-fueled businesses operated with the rush and thrill of candy
stores, with long lines of pill-popping addicts chasing their next high. Parents with unshakeable habits
were dying. Drug deaths in Florida
The number of prescription drug deaths in Florida began a steady climb early in the previous decade,
fueled mostly by a surge in deaths from oxycodone and similar painkillers.
So were babies. Hardly anyone noticed. “We saw the explosion,” said Bob Dillinger, for 17 years the
elected public defender of Pinellas County. “Nobody was making a connection to the deaths of children.
We were all focusing on the deaths of adults. ”Among those failing to make the connection was the
Department of Children & Families. “I never was fully aware of the depth of it,” George Shelton, DCF’s
secretary at the time, said recently. A prolific prescription drug trade, a state government caught flatfooted and a troubled child protection system set the stage for what was to come. Collectively, it was an
incubator for child deaths. Since 2008, 123 children have died after DCF had been told that one or both
parents were abusing prescription drugs, a Miami Herald investigation found. More than 85 percent of
the children were 2 or younger.
Jacob Langston / Orlando Sentinel
Law enforcement officers outside a pill mill near downtown Orlando on June 3, 2011.Oxycodone, Xanax,
methadone and other prescription meds were found in the stomachs of deceased infants and toddlers
or in the urine of their parents. Parents accidentally smothered their babies in bed while under the
influence. They left pills where their kids could get to them, swallow them and overdose. Some children
drowned while their parents slept off their highs. They were as young as Jaiden Washpun, whose
mother was arrested for doctor-shopping — dashing from doctor to doctor in search of multiple
prescriptions — the day before he was born. He suffocated in bed 104 days later. His mother pleaded no
contest to the doctor-shopping charge. Pill Mills closing
The drop in prescription drug deaths correlates with a drop in the number of pill mills operating in
Florida. The state began tracking pill mills and its progress in stemming the epidemic after 2010.
They were as old as Seth Mixon, who became a user just like his mother, DCF reports say. He overdosed
at 13. His 9-year-old sister said she saw Seth grab seven to nine of his mother’s Xanax pills the day he
died. The prescription drug epidemic took hold of Florida in ways big and small. Pain doctors asked few
questions as they dispensed thousands of prescriptions for narcotics each day to drug tourists from as
far away as Canada, as well as to locals, often under the guise of treating suspect injuries. As the drug
trade prospered, Florida became known as the pill mill capital of the United States. Police in other states
called highways to Florida the “Oxycontin Express.” A prosecutor based in Fort Lauderdale issued a dire
warning to health regulators: Without swift action, the epidemic would destroy families. Assistant
statewide prosecutor Oscar Gelpi called Florida’s burgeoning prescription drug trade a “public safety
issue,” and characterized the state’s halfhearted reaction to it as “dangerous” and “irresponsible. ”That
was in December 2004. Seven years later, Florida finally began to systematically shut the pill mills, but
only after the state was humiliated by officials in other states — most memorably Kentucky’s lieutenant
governor, who publicly begged Florida to do something to choke off the supply of drugs coursing into his
state.
O.D. on methadone
Before Kristin Love Adams died, her mother had been busted more than a dozen times, including an
arrest on felony charges of doctor-shopping. During Kristin’s infancy, DCF received at least three reports
on the Nassau County family, including allegations in March 2007 that Kristin’s mom, Brandy Love
Edwards, would become sleepy and “veer off the road” while Kristin was unrestrained in the car.
Edwards denied the allegations. Two months later, DCF was told Edwards nodded out in a methadone
haze while caring for Kristin.
“There are burn holes in the sheets, and no food in the home,” a May 2007 report said. Edwards, the file
said, had been arrested while trying to obtain prescription drugs from two different doctors on the same
day. But after Kristin’s mother appeared to be “coherent,” DCF did not move to shelter the child.
Instead, the parents agreed to voluntary supervision, though it is unclear from the record whether that
ever happened. Kristin died of a lethal dose of methadone in the bed she shared with her parents on
Jan. 25, 2008. Edwards was convicted of child neglect. Meanwhile, Gelpi’s push for the state to crack
down on the pill mill industry was encountering pushback. The Agency for Health Care Administration,
which regulates the healthcare industry, said these clinics were operating essentially as cash businesses
and not accepting reimbursement from insurance companies. Therefore, AHCA said, the agency had no
jurisdiction; they were not subject to licensing or monitoring as long as patients paid with cash. Gelpi
disagreed — strongly. “AHCA has created a loophole by interpreting the statute to mean that only clinics
that tender charges to third parties [Medicare, Medicaid or private insurers] are required to be
licensed,” Gelpi wrote in an email to his boss at the Florida attorney general’s office. AHCA’s thendeputy secretary, Elizabeth Dudek, wrote in a letter to Gelpi that AHCA could not even “enter and
review records” at the clinics. Remaining unlicensed, Dudek wrote, was “in the clinics’ sole discretion.”
Public Insight Network
Is there a need for stronger child welfare legislation? In a 2006 email, Jim Schneider, another prosecutor
at the attorney general’s office, suggested that AHCA’s reluctance to license the clinics might stem from
a desire to avoid the cost of taking on a new regulatory burden. Gelpi kept trying. In 2007, he wrote that
the clinics — with the “loophole” still open — were “operating without any sort of supervision or
oversight by the state.” In various emails and memos, he wrote that AHCA was misinterpreting state
law.Dudek, now secretary of AHCA, told the Herald on Thursday that she stands by her opinion that the
agency had no authority to act.In 2009, the Florida Legislature approved a prescription drug monitoring
database that launched in 2011. It was intended as a tool to stem doctor shopping and weed out rogue
physicians. Florida was the largest state without such a database. Gov. Rick Scott, elected in 2010,
wanted to repeal the measure, saying it was a violation of patient privacy. After Scott shut down the
office charged with raising money to run the database, the funds were raised through a private
foundation. Among those who supported the database was Florida’s newly elected attorney general,
Pam Bondi.“We had become one of the top oxycodone dispensers in the country. We had this horrible,
horrible problem,” Bondi said. “Children were dying because their parents were addicts.”The new
database, stronger anti-pill mill laws, a statewide strike force and a $3 million budget finally slowed the
flow of narcotics, with more than 3,700 arrests and the closing of hundreds of pain clinics.Related story
Death by irresponsible parenting, bureaucratic inaction
One year later, Ashton-Lynette Arnold's grandma laments the many missed opportunities to save her
from her mother's demons.
“The pill mills created an environmental crisis. You had addicts in the home, and it had taken over their
whole lives,” said Jim Hall, an epidemiologist and co-director of Nova Southeastern University’s Center
for Applied Research on Substance Abuse and Health Disparities. “Everything is focused on obtaining the
next fix, not their family life. ”Child protection administrators were more concerned with keeping
families together than taking a hard look at why children were succumbing to their parents’ addictions,
said Dillinger, the public defender. “They never talked about children dying,” said Dillinger, a member of
Pinellas County’s Juvenile Welfare Board. “It just never came up. ”There was another problem, a prickly
one: Many of the parents who were reported to the state’s abuse hotline had prescriptions, however
dubious, for the drugs that could kill their children. “When a parent is prescribed a legal drug for any
purpose, it is very difficult for a government agency to restrict that parent’s contact with their child, and
the burden is on the family to provide the necessary protection and supervision if they perceive a
problem,” DCF wrote in September 2009 after the death of an 8-day-old baby whose methadoneaddicted mother passed out on top of him. Threefold increase In 2012, 1,630 babies were born in
Florida with Neonatal Abstinence Syndrome, a condition in which the infants must be medically
withdrawn from their mothers’ drugs. That number had increased more than threefold since 2007, state
records show. Newborns addicted to oxycodone and other drugs suffered terribly from withdrawal
symptoms, including tremors, abdominal pain, incessant crying and rapid breathing. Drug-exposed
newborns
The number of children exposed to drugs in the womb also spiked as the pill mills flourished — and was
still climbing in 2012. In addition to Rx medications, this number includes cocaine, heroin, marijuana and
other drugs not dispensed by pill mills.
Jaiden David Washpun was one of the children who came out of the womb with drugs in his system.
Born on June 26, 2009, at about 26 weeks and weighing two pounds and four ounces, Jaiden carried his
mother’s opiates, benzodiazepines and marijuana. Carrie Leah West had been arrested for doctorshopping the day before he was born, and had lost custody of two other children due to her intractable
addiction. DCF was told West had no interest in her baby: She declined to see him when he was born,
and asked for a cigarette instead, one report alleged. An investigator was told West had tried to give the
baby away to another couple “as a wedding present.” That could not be confirmed.
DCF lawyers decided that as long as West was in drug treatment, they had no cause to remove Jaiden.
He died before he reached 4 months, found unresponsive on a bed in a Panama City motel room where,
DCF noted. West and her ex-boyfriend had set up shop as drug dealers. “The mother was seen scooping
up pills off the nightstand” into a backpack when officers arrived to investigate Jaiden’s death, the DCF
file noted. The infant had been smothered in a co-sleeping incident. His mother had not brought with
her a medically required apnea monitor. West tested positive for opiates, marijuana and
benzodiazepine, but could not provide prescriptions for them. She served time.“It is extremely difficult
to understand why an infant would be considered safe in the care of the mother, with only voluntary
services, while older siblings remained in out-of-home care,” a review of Jaiden’s death concluded.
Matthew Condatore’s mother wasn’t picky about the substances she abused, though they largely came
in the shape of a pill, DCF files said. There were two DCF investigations in December 2012 and February
2013. In March, Amanda Condatore acknowledged using alcohol, methamphetamine, marijuana,
synthetic marijuana, Lortab, Soma, Vicodin, Percoet, Darvocet, Xanax, “Roxies” and benzodiazepine.
Substance abuse and child deaths
Over the past six years, some form of substance abuse was involved in 68 percent of the abuse/neglect
deaths that the Herald investigated. More than one-third of those involved prescription pills. The rest
involved other drugs plus alcohol.
Miami Herald reporting Matthew’s parents already had long histories with DCF in Lake County when the
agency was told just after Christmas 2012 that his mother disappeared “days at a time” while she went
to her drug dealer to buy and smoke methamphetamine. She had been arrested for DUI three months
earlier. With that investigation still open, DCF received a report on Feb. 5, 2013, alleging Matthew’s
mother continued to abuse narcotics and alcohol, and was beating one of her children. She told another
child, the report said, she was “going to burn him alive. ”During the 2012 investigation, Amanda
Condatore denied prescription drug abuse, admitting only to drinking alcohol. Matthew died two weeks
shy of his first birthday. He was found by his 8-year-old sister, face-down in an overflowing bathtub.
According to the death review, his mother was unconscious by the tub. She said she had blacked out. At
the time of Matthew’s death, his 28-year-old mother tested positive for amphetamines,
methamphetamine, opiates and benzodiazepine — some with prescriptions. She later told investigators
she had taken one of her husband’s pain pills, and had smoked methamphetamine. A family affairSome
of the pain pill epidemic’s child victims lived long enough to become addicts themselves, including Seth
Mixon, son of Michelle Windham. Seth, who first came to DCF’s attention in Hillsborough County when
he was 2 — and had more DCF reports than birthdays — overdosed in his bed on Feb. 12, 2010, at age
13.
A DCF death review says the teen took his mother’s Xanax bars — long, skinny pills from which pieces
can be broken off and are intended to treat anxiety — as well as methadone. Windham had been
getting her drugs, a DCF report said, from Dr. John Mubang, who was arrested two years earlier for
trafficking at two Hillsborough County clinics. Mubang wore an ankle monitor to work each day as he
dispensed pills. Seth’s history with child protection investigators began on April 13, 1998, when he was
found wandering around his parents’ trailer park barefoot, wearing only a T-shirt, while his mother was
home asleep. Among the 15 other hotline calls about Seth: • September 1998: Seth was again
wandering the neighborhood unsupervised — “digging in the trash looking for food” — while his mother
was allegedly “using crank and marijuana.” Windham refused services. • January 1999: Seth was found
outside unsupervised, and Windham was allegedly using and dealing crack. She fled as the investigation
got underway.• February and March 2001: Seth, then 5, was “observed outside for hours by himself,”
and playing behind dumpsters. He was also his 6-month-old sibling’s baby-sitter. DCF offered Windham
free daycare and other services, and warned that the agency would yank her children if she continued to
abuse drugs and neglect them.• February 2004: Windham and her boyfriend were allegedly using and
selling drugs out of their home, and her children were “not being properly supervised.” DCF
investigators were told by DCF lawyers that they did not have legal cause to pursue court action.
Instead, she agreed to accept more voluntary services.• November 2005: While Seth and his sister were
living with their maternal grandmother, Windham was arrested and later convicted on robbery charges
after she held up a drugstore. • January 2007: Seth was now living with his paternal grandparents after
his maternal grandmother died of an overdose. Windham was in jail, and Seth’s father was homeless
and selling pain pills. Reader comments
What do you think of the state of child welfare in Florida?
Leave a comment• September 2009: Seth, now 13, was suspended for bringing Xanax to school.
Windham tested positive for several drugs, but an investigator was stymied by the refusal of her clinic
doctor, Mubang, to return phone calls. Six months after Seth’s fatal overdose, a lengthy DCF analysis of
the case acknowledged “missed opportunities” to intervene on his behalf. It concluded that those
missteps “had no direct impact” on his death.
After Florida cut protections for children from troubled homes, more children died, often in cruel and
preventable ways. To understand the magnitude of the problem — and possible solutions — the Herald
studied every death over a six-year period involving families with child welfare histories. This series is
the result of a year's worth of reporting by the Herald's Investigation Team, and multiple lawsuits to
obtain state death records.
More project Stories Database Videos Comment Series overview
Preserving families but losing children The role of drugs
The littlest victims of Florida's drug binge The role of lawyers
Investigators stymied by their own lawyers Case study
When everyone can see abuse — except those trained to prevent it
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