Q&A with State Attorney, 7th Judicial Circuit, R.J. Larizza

Q: This month, can you give us some information about the opioid epidemic?
A: This is an issue that has touched every corner of our state. It started to surface with the so-called “pill mills;” Florida had the dubious distinction of being among the top states where people would get pills for pain management. Pharmaceuticals were making a lot of money and we had an epidemic. Then fentanyl came into play and people started dying from this. Law enforcement and first responders had to use Narcan to bring people back from the brink of death, but some of this had adverse effects when it got into the skin of those administering it.

Q: What is your office doing to try to tackle this epidemic?
A: Under former State Attorney General Pam Bondi, the PDMP (Prescription Data Monitoring Program) was created. All prescriptions in Florida had to be entered into this system, which gave law enforcement the ability to look at one database to see where abuse might be taking place — either a doctor writing too many prescriptions or an individual who was going to multiple doctors to get pills. This has been very helpful.

Also, prosecutors started using a first degree murder charge against providers of pills. We utilize this in the 7th Circuit. If we can prove that the person who sold or provided the specific drug that caused the death of the person who took it, we can charge the provider with first degree murder. This can be very difficult to prove, but it can be done. This is a way of trying to attack the problem from the distribution side. One thing that is important in proving this charge is that a lot of these drugs are synthetics and in order to prosecute, the drug must be listed as a controlled substance. The legislature has added many drugs to the list for us.

Q: What is the emphasis of your office going forward?
A: Now, the big push is to educate people who might become users as to the dangers of these drugs. Many people don’t intend to become addicts, they just become hooked on these drugs as a result of pain management. For those who are already addicted, we try to find non-incarcerative ways to help them get treatment. There are diversion programs, the Drug Court process where the person reports in weekly with the judge, prosecutors and treatment personnel to discuss progress, and drug offender probation. In St. Johns County, the SIGHT Program requires 90 days in jail to clean up (with treatment and education) and then follow up for 180 days to include monitoring. There often needs to be some leverage to get people into these programs and this is where the State Attorney’s Office comes in — to show that other options are worse and so it might be a good idea to take part in a treatment program.

Finally, we have to look at the pharmaceutical companies. This part of the puzzle is not as easy to solve. Some states have sued pharmaceutical companies. It is essential to get them to be transparent about what these drugs do and potentially find alternatives for those with chronic pain. How we mitigate and ultimately eradicate the opioid crisis depends on addressing all these areas.