Ohio’s pain management clinics come under tough new regulations Sunday. Many of the clinics are blamed for prescription drug abuse in a state where the leading cause of accidental death is unintentional drug overdose. In the south of the state, Scioto County is leading the fight against the so-called “pill mills.”

Anybody you talk to around the city of Portsmouth can tell you about a family member, a teammate or a colleague who’s been in trouble with painkillers.

“I have an employee that will go through detox next week,” motel manager Sharon Smith says. “She needs to get completely off of it again, or she’ll … go back to prison.”

Parked outside a local pain clinic, nurse Lisa Roberts of the Portsmouth City Health Department has a front-row seat to the problem. “We sometimes see plates here from Florida, Texas, Pennsylvania — we’ve seen Maine people come from all over to get pills here.”

She points out a couple going into the clinic. “There’s some chronic pain patients now,” she says. “So they go in, and they immediately pay $200 cash — that covers the office visit, and then they leave with a prescription.”

A prescription written by a pain clinic doctor usually won’t be filled in Scioto County, where local drug stores recognize “pill mill” scripts by the quantity of pills and potentially deadly combinations. Now people drive off in search of a willing pharmacist.

“They’ll call from three states away and say, ‘Who is this doctor, and what in the heck is he doing writing this kind of stuff,’” Roberts says.

A Growing List Of Victims

If you count up every pain pill that was legally prescribed within Scioto County last year, you get 9.7 million tablets and capsules. That’s more than a 120 for every person and child in the county. The county had 22 overdose deaths last year.

“The victims are frequently found bent over in a sitting position but bent completely over, like completely folded in two, because their muscles have just been relaxed and they stop breathing,” Roberts says.

In the display window of an empty downtown store, there’s a memorial to victims of prescription drug overdoses with photos donated by their families. Roberts picks out one picture.

“This is Ryan Dickerson,” she says. “He was probably 19 or so, real young. He had been given some Oxycontin from a knee surgery that he had, and he was trying to hold onto his job. He didn’t want to miss any days, and he ended up becoming addicted. And he overdosed and he died.”

Portsmouth police blame the clinics for a rise in crime, too – like the body of a young man discovered in a manhole a couple of weeks ago.

Finally, A Victory

Portsmouth has been trying to get rid of its numerous pain clinics for more than a decade. Organizing through Facebook, Roberts formed the Prescription Drug Action Team, which campaigned for the stronger regulations passed earlier this year.

Barbara Howard worked with Roberts on the team. Her daughter Leslie died of an overdose in 2009. She says Leslie got help buying her drugs from a “sponsor,” who profited off the transactions with the clinics.

“The lady took my daughter to a pain clinic,” Howard says. “No one here in the area would fill the prescription. She was taken to Columbus, Ohio, to get the prescription filled, and she died that night.”

Howard says the new state law is justice for her daughter. Ohio lawmakers passed it with no opposition, and Gov. John Kasich signed it into law immediately; he’d been to Scioto County.

Starting Sunday, only a doctor can own and operate a pain management clinic. Also, according to the new rules, convicted felons may not work at the clinics. Anticipating the changes, all the clinics have shut down.

Copyright 2011 National Public Radio. To see more, visit http://www.npr.org/.