by John Temple
AMERICAN PAIN
ALSO BY JOHN TEMPLE
The Last Lawyer: The Fight to Save Death Row Inmates Deadhouse: Life in a Coroner’s Office
AMERICAN PAIN
How a Young Felon and His Ring of Doctors Unleashed America’s Deadliest Drug Epidemic
JOHN TEMPLE
Guilford, Connecticut
An imprint of Rowman & Littlefield
Distributed by NATIONAL BOOK NETWORK
Copyright © 2015 by John Temple
All rights reserved. No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without written permission from the publisher, except by a reviewer who may quote passages in a review.
British Library Cataloguing in Publication Information Available
Library of Congress Cataloging-in-Publication Data Available
ISBN 978-1-4930-0738-7 (hardcover)
ISBN 978-1-4930-1959-5 (e-book)
The paper used in this publication meets the minimum requirements of American National Standard for Information Sciences—Permanence of Paper for Printed Library Materials, ANSI/NISO Z39.48-1992.
In passages containing dialogue, quotation marks were used only when the author was reasonably sure that the speaker’s words were verbatim, such as exchanges taken from court testimony or captured on audio recordings. When a source recounted a conversation from memory, the author did not use quotation marks in that dialogue.
CONTENTS
Prologue: Broward County, Florida—November 19, 2009
PART I
Chapter One
Chapter Two
Chapter Three
PART II
Chapter Four
Chapter Five
Chapter Six
Chapter Seven
Chapter Eight
PART III
Chapter Nine
Chapter Ten
Chapter Eleven
Epilogue: Oakdale, Louisiana—May 31, 2014
Sources
Acknowledgments
About the Author
Prologue
Broward County, Florida November 19, 2009
Red caution lights flashed, warning bells chimed. A gold Toyota Camry with Tennessee plates approached the railroad crossing. It was 8:43 a.m., the end of rush hour in Fort Lauderdale.
The crossing gate was halfway down when the Camry lurched forward and slipped under the red-and-white-striped arm. Two hundred yards down the tracks, a train engine came into view, barreling toward the Camry at 60 mph, backed by a 325-ton chain of sky-blue Tri-Rail commuter cars. Plenty of time to get across, but drivers watching from other cars couldn’t believe the woman behind the wheel would risk it.
Then the Camry stopped. On the tracks.
For a few agonizing seconds, the car sat motionless as the caution lights alternated, and the warning bells sounded. The Camry driver put the car in reverse, but could back up only a few feet before running into the now-horizontal gate.
Just as the train engine hurtled into the crossing, the driver made an inexplicable decision, gunning the car forward. The engine’s rail guard slammed the Camry with an unearthly rending reverberation, and the gold sedan became a toy car flung by a child, flipping through the air sixty feet down the track, swiping a small service hut and coming to rest near a cluster of palmetto.
One of the drivers behind the Camry dialed 911 and ran over to help. He knelt by a middle-aged white woman who’d been thrown from the mangled car, which was resting on its roof nearby. A few yards away, the man’s fiancée attended to another bloody woman, younger, and she was praying. Other witnesses were screaming. Blood was everywhere, staining the man’s pants. The woman below him gasped for breath.
He said: Everything’s OK.
There was nothing he could do but simply be there as she tried to heave oxygen into her broken lungs.
He said: Ambulance is coming. Everything’s gonna be OK.
And soon the paramedics did come, and the cops, and the reporters, but they were too late. Both women died beside the train tracks. A man who was in the car was still alive, and they took him to North Bro-ward Medical Center. Crime scene investigators searched the crumpled, upside-down Camry and found an amber prescription bottle and a scattering of blue pills.
And that’s when everything made sense, as it would to any cop or paramedic or reporter working in South Florida in 2009. The Tennessee plates. The driver’s bad decisions. Her sluggish reactions.
Oxy.
Talking to his best friend and boss over the phone at a quarter after eight the next morning, Derik Nolan’s growling voice was as full of swagger and humor as usual, and it also contained an edge of wonderment, like, you believe this shit? Something Derik still felt every day working at American Pain. Wonderment at the things he witnessed, the jams that human beings, including himself, would get themselves into while they were trying to get the thing they wanted.
“They tried to fucking weave through a railroad crossing and got hit by a fucking train yesterday,” Derik said. “Two of them are dead. One of them is in critical condition.”
Derik was sitting in his office at American Pain, underneath the Spartan warrior swords he’d bought and mounted on the wall after seeing the movie 300. A few minutes earlier, a woman at one of the MRI services he used had called and told him to look at the Sun-Sentinel. Derik had immediately pulled the story up on his computer: two women from Tennessee killed in a train crash, another man badly injured. Derik’s contact was all upset because the police had called her after finding an MRI report from her company among the wreckage, along with a bunch of pills. She’d looked up the dead women; they’d been American Pain patients.
After that initial conversation, Derik had called Chris George about the story. Chris had just turned twenty-nine, three years younger than Derik, but he was the boss.
“Did it say they were pain clinic people?” Chris asked.
“No, the story doesn’t say anything about pills or American Pain. But it will tomorrow,” Derik predicted.
“Oh yeah?” Chris said.
“It’ll say tomorrow that there was roxies scattered throughout the car.”
It wasn’t good news, but, hey, add it to the list of administrative headaches that came with running the biggest oxycodone clinic in the country. Headaches like the upstart pain clinic that was getting ready to open in Jacksonville. Those crooks were trying to steal Derik’s patients, calling them up in Kentucky and saying they were a new branch of American Pain. Derik was going to have to drive up there and put the fear of God into them, show them who was top dog.
Or, speaking of problems, how about the story in the Palm Beach Post five days earlier about a different dead patient, a guy who’d overdosed after going to a pain clinic that belonged to Chris George’s twin brother, Jeff. And Jeff’s dumbass quote to the reporter comparing the dead guy to his car: “If I wreck my Lamborghini, am I going to hold the Lamborghini dealership responsible?” The quote was funny, and Derik thought it made sense, but it was needlessly inflammatory, perfectly in keeping with Jeff’s general attitude that everyone better get out of his way. Jeff, who was right now suing Chris, his own twin brother. Jeff thought Chris owed him a cut of American Pain because it had been Jeff’s idea to start a pain clinic. Whereas Chris thought that because Jeff had done almost none of the work actually building or running the place, he wasn’t entitled to half the profit.
Add to these problems the fact that every time Derik walked out of American Pain, the same Ford Excursion was parked across the street, with black windows and a little glass bubble thing that rose out of the roof. It was obvious the Boca Raton cops or the DEA or maybe that pesky reporter from Channel 7 had t
he pain clinic under surveillance, so obvious that Derik wondered why they didn’t just set up a tripod and camera on the sidewalk. Derik and Chris half-seriously discussed calling a tow truck or shooting out the vehicle’s windows with Derik’s trusty slingshot. Once, Derik walked across the street and tried to confront whoever was in the Excursion, but the vehicle hauled ass when he approached it, and they all had a good laugh.
Chris and Derik knew they were on the feds’ radar. Four of the doctors at American Pain were among the top nine physician purchasers of oxycodone in the United States, according to the DEA, which meant that together, they were a juggernaut. A buddy of Derik had been arrested a month earlier, and he’d told Derik the FBI had grilled him about American Pain, even pulling out an organization chart that included photos of Chris and Derik and everyone else, like in a mobster movie. Under Derik’s photo was the tag, “Enforcer.”
American Pain had made Derik rich, or it would have, if Derik had any ability to manage his money. But running American Pain consumed him. American Pain was drug addiction. Being inside the waiting room was like being inside the fevered skull of a junkie: conniving, scheming, desperate, desirous. It was loud in there, the babble of the zombie horde, and it stank. Ceiling fans stirred the air, but nothing could dispel the funk of 150 people who’d spent the night squeezed into the back seats of shitbox clunkers rolling south from Kentucky and West Virginia. They all wanted Derik’s attention, knew he could deny them their fix. Everyone had an angle, a hustle. Derik wasn’t sure how much longer he could do it. He was exhausted, depleted in every way, doing lots of pills and coke himself, just to keep going.
So, add the dead Tennessee women to the list of complications, a list that grew longer every day yet still never quite brought down American Pain. Because Derik and Chris had the law on their side. Or the lack of law.
“You gotta be an idiot to get hit by a train,” Chris said, and he and Derik laughed. Because that was reality at American Pain—tragic, sure, but also funny, if your eyes were open to the absurdity of it all. And you had to see the oxy business that way, or else how would you keep doing it?
At the Drug Enforcement Administration’s Miami Division office, in a large room devoted to the interception of Title III wiretaps, a federal agent was listening through headphones to the conversation between Chris George and Derik Nolan. The DEA had been running a wiretap on Chris George’s cell phone for fourteen days, under the supervision of an FBI special agent named Jennifer Turner.
Turner had first heard about rogue pain clinics a year earlier. Back then, she knew next to nothing about painkillers and addiction. Since then, she’d witnessed the destructive power of oxycodone, and it awed her.
To understand oxycodone, imagine everything that makes a man or woman feel good, all the preoccupations and pastimes we are programmed to enjoy. Sex, love, food. Money, power, health. Synthesize all of that pleasure-kindling potency, and multiply by ten. Then cram it all into a pebble-sized blue pill. That’s oxycodone—one of the most irresistible opioid narcotics ever cooked up in the six-thousand-year history of dope. Crush and snort a 30-milligram pill, known as an oxy 30, and feel the euphoria bloom in your limbs, the ecstatic warmth settle in the depths of your belly. It’s an interlude of bliss. It’s basically heroin, only synthetic and FDA-approved.
Not long ago, doctors feared the addictive power of narcotic painkillers so much that they prescribed them mostly to end-stage cancer patients or massively broken motorcyclists—patients who were going to heal or die. But since the mid-1990s, pharmaceutical giants have aggressively marketed painkillers to a wider group of patients with long-term or milder forms of pain. At the same time, the federal government has approved one massive increase after another in the quantities manufactured, even as its own officials declared prescription drug abuse a mounting epidemic. More and more of the pills were diverted to the black market and by the eve of 2010, more people were addicted to or abusing narcotic painkillers than any illegal drug except marijuana. Far more. The number of people who regularly used prescription drugs to get high in 2009 was more than four and a half times higher than the number of people who regularly used cocaine.
And like cocaine before it, the illicit painkiller trade was dominated by one state: Florida. But the similarities between cocaine and oxycodone ended there. Oxycodone wasn’t created in Colombian jungle laboratories or smuggled in suitcases or on thirty-foot “go-fast” speedboats. It was manufactured in pharmaceutical plants in St. Louis and promoted on highway billboards, and in page after page in the back of the New Times, a free weekly newspaper in South Florida. The bigger advertisements usually showed a woman holding her forehead and wincing, or a man’s torso arched in agony. The ads blared: “CHRONIC PAIN? STOP HURTING AND START LIVING!” Then, in smaller type: “Walk-Ins Welcome. Dispensing On-Site!” Some offered coupons or specials. One clinic’s ad said nothing about pain itself and simply displayed the goods: an amber prescription bottle, dozens of little blue pills tumbling out.
Florida pumped millions upon millions of doses of those narcotics—oxycodone, mostly—northward, not through a major criminal organization like the cartels of Mexico, but via thousands of individuals who streamed up and down Interstate 75 or flew from the Tri-State Airport in Huntington, West Virginia, to Miami International, on a flight nicknamed the Oxy Express. They went to the pain clinics complaining of back pain and received a massive supply of narcotics once only available to ease the agony of a Stage 4 cancer patient. A supply that could keep even the most hardcore junkie satisfied for a couple of weeks. A supply worth $6,000 to $8,000 in the coal patches and hollows of Kentucky.
Cops and reporters called these clinics “pill mills,” and American Pain was the king of them all. Its doctors distributed massive quantities of oxycodone to hundreds of customers a day. The clinic had already moved three times in less than two years; its current location was a ten-thousand-square-foot suite in a strip mall in Boca Raton, next to a family restaurant. Outside, it looked like a bustling doctor’s office, or the DMV. Inside, Derik Nolan’s crew of heavily inked muscle-heads and ex-strippers operated the office and pharmacy, counting out pills and stashing cash in garbage bags. Under their white lab coats, the doctors carried guns.
When Chris George had opened his first clinic in February 2008, there were only a handful of other pain clinics in Broward County. But he made millions, and soon it seemed every shady operator in South Florida had witnessed George’s success and wanted a piece. So by November 2009 there were 115 pain clinics in Broward alone. But American Pain had the drug wholesalers and the customer base. And American Pain was the first to advertise on billboards, to use rubber prescription stamps (so the doctors’ hands wouldn’t cramp from writing the same scrips over and over), to hire beautiful women to dispense the pills. Chris George and Derik Nolan developed record-keeping protocols and insisted that all patients have some sort of file, in case the DEA came calling.
Chris George was constantly expanding, trying to stay one step ahead of the evolving laws. He had two major pain clinics in South Florida, another new one starting up soon outside of Atlanta, pharmacies in Boca Raton and Orlando, all in the names of various straw owners: tens of thousands of patients, dozens of employees, eight full-time doctors, lawyers, private investigators.
American Pain—and the whole industry, really—had exploded in the year since Jennifer Turner began her investigation. There was no easy way to shut down the pill mills, or her task force would have done it months earlier. Traditional drug-enforcement strategies, such as searching patients’ cars or doing buy-and-busts, had proven relatively useless against pill mills. Even if they caught a patient selling pills, it rarely led to bigger fish. The pills originated from the same source—a doctor’s office—and it was next-to-impossible to prove that a doctor knew, beyond a reasonable doubt, that a patient was faking pain.
Turner was fighting a new crime with old laws, and she wasn’t sure who would prevail.
Chris and De
rik hadn’t expected any of this success or trouble when they’d started the ride almost two years earlier. Before opening the clinics, they’d run construction crews in North Port and didn’t know the first thing about painkillers. But they’d parlayed business skills and youthful aggression into a mega-clinic, and now oxycodone was the hottest game in Florida, in the country. They were riding a rampaging elephant; the only way to stop it was to kill it. And they didn’t want to kill American Pain. Not now, not when the clinic was inhaling $100,000 a day. A day.
Chris and Derik had a plan they believed would solve their problems. They were going to move the flagship. They’d moved the clinic three times before, but this time they weren’t just going to another office park or shopping plaza to get away from police pressure or angry neighbors. They needed a new start, one that reflected how far they’d come. The day after the train crash story in the Sun-Sentinel, Chris and Derik went to Lake Worth to check out a promising new location, a former bank building.
They loved it. Three floors and twenty thousand square feet, twice the size of their current space in Boca Raton and almost twenty times the size of the little bungalow they’d renovated on Oakland Park Boulevard two years earlier. A gigantic waiting room that could hold hundreds of pill-heads. Three vaults for the cash and oxy, actual bank vaults with those big round doors you walked through. A second floor for administrative offices with a catwalk for security to keep an eye on the waiting room below. And the open third floor where they could do whatever they wanted. It even had an elevator. The place would be a true headquarters, from which they would expand and seed the entire country with pain clinics. It would be a fortress.
All they had to do was talk the owner—an art-collecting millionaire CEO from Palm Beach—into letting them transform his building into a Walmart of oxycodone.