AMERICAN PAIN (32 page)

Turner couldn’t imagine the guy was able to speak, but she asked him if he was OK.

He mumbled through the bandages: Yes, ma’am.

So Turner went ahead with the interview, and the defendant willingly told her about his travels to Florida. Near the end of the interview, Turner was shocked when the man said he’d be heading back to Florida as soon as he got out of jail.

Turner said: Hold on. You’re in jail, you just had this major accident, and you almost lost your life. Why on Earth would you go back to Florida to get pills?

The man explained, patiently: Well, ma’am, I’m addicted to them.

Turner wanted to understand. She had no addicts in her family, and she’d never met anyone like this. She could tell that he wanted her to understand too.

She said: OK, but why Florida? Why not just go somewhere closer?

The man turned to face her more directly.

He said: Because it’s so easy to get pills there. Florida is the candy store.

When she left the jail, Turner was shaking. She thought: How are we ever going to stop this? It’s so much more powerful than we are.

Whitney Summitt was seventeen the first time she made the run to American Pain. Her mother was an addict, her father in prison, and Whitney herself had started using drugs when she was fourteen. Her aunt, Pat Sand-lin, had raised her, so when Aunt Pat told her to drive some folks from Louisville to Florida and back, Whitney did it. The doctors at American Pain wouldn’t write for a minor, so during Whitney’s first runs, she just drove and collected the pills afterward. Whitney had dropped out of school after the ninth grade, a young doughy girl with a moon face, but she was bold and businesslike. She made the seventeen-hour drive with as few stops as possible, and she told the three adults in the car exactly what their cut would be: their choice between fifty oxy 30s or $500. Most took the drugs.

Over the next few months, Whitney made the long drive about once a week with carloads of uncles, aunts, cousins, friends, even her father. She got to know the American Pain staff, knew she could slip the clerk at the window $50 and ask him to rush a patient, knew Dr. Graham and Dr. Cadet were considered to be the biggest writers. She showed her passengers how to tilt their hips in the MRI machine so their spines would look out of whack. If she didn’t have a passenger who had clean urine that everyone could share, she brought a bottle of clean urine (clean-ish, actually—there was supposed to be some oxycodone in there, since you were supposedly a pain patient). It wasn’t hard to get urine. Folks back home had taken to selling Mason jars of it at flea markets.

Whitney knew the fees by heart: $200 for a first-time visit, $250 for an MRI, $50 to bump a patient to the head of the line. Plus maybe $500 to fill the scrips. So sponsoring one runner’s trip might set Aunt Pat back a thousand bucks, plus fifty of the oxy 30s, plus gas. The remaining 190 oxy 30s might net her $20 each back home, which was $3,800. And that didn’t even include the ninety oxy 15s and ninety Xanaxes that the docs at American Pain usually tossed in.

A couple months after she turned eighteen, Whitney told Aunt Pat she reckoned she was old enough to do more than just drive. Aunt Pat agreed: It was time. In March 2009, Whitney took a full carload of people to American Pain and got her own paperwork. She paid the clerk $50 to sign off on her drug screen, since she knew she definitely had marijuana in her system, and possibly coke, in addition to oxycodone, which she was hooked on by now. She filled out the paperwork as quickly as possible. She knew it didn’t really matter. One question asked where her pain was. She wrote: “Low back.” On a scale of one to ten, how would she rate her pain? This was a no-brainer: Whitney circled ten. She circled a bunch of words that sounded painful. She said she’d taken prescription Lortabs for her back problems, which was true except that the pills hadn’t been her prescription, and she hadn’t been in pain.

Finally she was escorted to the office of a young male doctor she didn’t recognize. He took one look at her, said: Exactly how old are you?

Whitney said: Eighteen.

The young doctor wasn’t happy.

He said: I’m not comfortable writing you a prescription.

But he didn’t outright say he wouldn’t. So Whitney sat down next to the doctor’s desk, and the doctor started checking items off on his paperwork, still looking unhappy. And maybe ten minutes later, she walked out with the scrip in her hand and went to wait for her passengers in the waiting room. When they came out, they went straight to the American Pain pharmacy to get them filled. Whitney waited until she got home to go to the pharmacy; the retail drugs were cheaper in Kentucky.

Whitney kept returning, but eventually a doctor at American Pain refused to write for her because she was under twenty-one. An employee sent her to Executive Pain, and she continued to get her pills. In between her own once-a-month appointments, she continued running other folks down every week or so.

By the time she turned nineteen, Whitney was no longer chubby. She’d lost weight and had stopped paying attention to her hair and clothing. Needle marks scarred her hands, the only place on her body she could still find a vessel. She was dissolving and injecting ten to twenty pills a day. The highs weren’t really highs anymore, just a break from the bone-deep pain of withdrawal.

By this time, Florida’s new pill-based economy was in full swing. Billboards plugged pain management. Dive motels catered to “oxy-tourists.” Drugstores and MRI facilities flourished. And the pain clinics’ parking lots were clogged with out-of-state vehicles.

Clinics opened and closed and changed locations and owners, and no one kept track of them, so it was hard to pin down an exact number, but officers in the Broward Sheriff’s Office Pharmaceutical Drug Diversion Unit said the county had been home to four pain clinics in 2007.

Now, two years later, the unit tallied 115 pain clinics.

Odd connections had begun to emerge between flat, scorching, teeming South Florida and the green hills and slow brown rivers of the Appalachian Mountains. Broward County drug court judges saw defendants from places like Harlan County or Hazard at nearly every arraignment. Pain clinic staffers kept an eye on weather patterns in Kentucky and West Virginia; if a winter storm hit the mountains, business in Florida would be slow. Lots of Kentuckians and Tennesseeans began dying in South Florida motels that catered to the oxy-tourists. Likewise, coroners and ER doctors and airport security in Kentucky began recognizing the names of certain South Florida physicians after seeing them repeatedly on amber pill bottles they’d confiscated.

Sandwiched between Miami-Dade and Palm Beach Counties, Bro-ward County was the epicenter of the new painkiller trade. The newspapers were catching on to the story. Board of Medicine members had been calling reporters at the major South Florida papers for some time, trying to get them to write about the proliferation of pain clinics, to little avail. The phrase “prescription drug abuse” sounded lackluster, especially to reporters who were used to covering huge, international, illegal cocaine busts. But suddenly the pill mills were everywhere, and business owners and residents in oxy hotspots seethed and politicians mulled legislation. A Broward County grand jury was appointed to study pill mills.

And reporters at the
Palm Beach Post
and the
Sun-Sentinel
began to pay attention. The
Sun-Sentinel
ran a story in April 2009 that said every single one of the fifty largest-selling oxycodone clinics in the United States was located in Florida. Thirty-three of them were in Broward County. A single small municipality, Oakland Park, was home to eighteen clinics within a two-mile radius.

Many people were upset about the pill mills, but parents of pill seekers had the deepest reservoir of rage—people like Karen Perry, a Palm Beach County woman who founded the Narcotics Overdose Prevention & Education (NOPE) Task Force after her son died in 2003. NOPE ran support groups and conducted educational presentations in schools. Pete Jackson, a biologist in Illinois, whose eighteen-year-old daughter died after taking a single oxycodone pill in 2006, founded Advocates for the Reform of Prescription Opioids, dedicated to ensuring that regulations surrounding prescription narcotics made scientific sense.

Tina Reed, a diminutive woman who worked at a sporting goods store in Broward County, had little money or scientific knowledge. But she possessed a deep and abiding anger, fueled by fear, not grief. She was lucky. Her son was still alive.

The fear and anger had taken over her life one November morning in 2007, when she walked into her son’s room and saw him hiding something on his desk, a bill rolled up behind one ear. Her son was twenty-three years old and a marine mechanic. He’d already been arrested two months earlier for possession of oxycodone, which had led to his move back home.

Tina said: Are you snorting coke?

Her son moved his hands away, revealing a tiny pile of blue powder. It was his pain pills, he said. He’d crushed them to make them work faster.

The next five months, Tina watched her son spiral. She confronted his doctor, who refused to stop writing him prescriptions. Her son was caught snorting oxycodone again, and the family staged an intervention. He agreed to go to detox, but didn’t follow through. High at work, he accidentally cut off part of two fingers, which made it even easier for him to get oxycodone. Tina researched oxycodone and wrote letters about his doctor to the state board of medicine. Her son went to a detox program, then relapsed a few weeks into it. He disappeared for stretches. He nodded off in front of her. He was arrested for shoplifting cigarettes.

Tina began writing down everything that happened, as well as her frantic thoughts: “Heroin addicts, crack addicts, cocaine addicts,
oxy
addicts? What? What? Why? What is this drug/poison/curse?”

In April 2008, terrified that her son was going to overdose, she went to his probation officer and begged him to have her son arrested. The probation officer met with her son, who failed his drug test. Her son was arrested and put in a rehab program, and Tina felt some small relief. He was safe for the moment.

When she got her son’s car back, Tina found pill bottles in his name from a different doctor—a Dr. Enock Joseph from South Florida Pain on Oakland Park Boulevard. Tina filed complaints with the local police and with the Florida Department of Health, but she didn’t expect much would come of it.

In July 2008, a week before Tina’s son was to get out of rehab, the
Sun-Sentinel
ran a big story and photo about the South Florida Pain Clinic. The article filled Tina with energy and hope. She wasn’t alone. Others were upset too. She began calling people named in the article, and, over the next year and a half, Tina Reed became a leading voice against the pill mills. She testified in front of the Broward grand jury investigating pill mills. She called in to Larry Golbom’s radio show in Tampa, and Carmel Cafiero featured her on Channel 7. She talked to the White House’s drug czar when he came to Broward to learn about the oxycodone trade.

Tina pushed state lawmakers to create a drug database that would prevent patients from doctor shopping. Thirty-two states had databases that tracked prescriptions for controlled substances, and six more states were launching databases soon. Some Florida lawmakers had been trying to create a prescription database since 2002, but pain-management advocates and doctor’s groups had repeatedly blocked the legislation, raising concerns about privacy and funding. By 2009, Florida was the largest of the dwindling number of states that lacked a database, which meant that addicts and dealers could seek drugs from multiple doctors with relative ease. No one knew where the pills were going once they got to the pharmacist or doctor’s office.