Authors: John Temple
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 Derik 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.
Derik didn’t know much about the guy, but he liked their chances. Over the last two years, Chris and Derik had pulled off this particular sleight of hand a hundred times, helping straight citizens profit from the painkiller trade. The key was to make sure nobody thought too deeply about what they were doing. And that was the power of oxycodone, a power they understood by now. Oxycodone came in amber pill bottles, not little plastic bags, and it took the form of manufactured tablets, not powder or jagged shards. Pills
looked
legitimate. Their precise, factory-shaped contours made it easy for people to believe they weren’t making money from opioid addiction, just as they made real patients believe they wouldn’t become junkies.
Or maybe it came down to an even simpler truth. No matter how many pillheads died in train crashes, no matter how many times cops or TV reporters set up cameras across the street from American Pain, no matter how many politicians complained about pill mills destroying Florida, one thing remained the same: Wave enough cash in an upstanding citizen’s face, and he suddenly stopped worrying about whether the money had come from an addict’s pocket.
When Jennifer Turner heard Chris George talking on the wiretap about moving, she drove to Lake Worth to take a look at the new building.
It was enormous, a three-story, gleaming-white colossus that stood by itself on Dixie Highway, isolated by a buffer of 153 parking spaces. Windowless and invincible-looking, a solid block-like structure, taller than anything else in the area.
Turner imagined a sea of addicts inside the massive facility, hundreds of them lined up at customer windows, receiving their bottles of narcotics, then streaming out into the Florida sunlight to wreak havoc.
The vision haunted her. She had to stop this. But how?
P
ART
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