AMERICAN PAIN (43 page)

The hearing’s primary witness was Dr. L. Douglas Kennedy, an expert in pain medicine from the University of Miami. He’d reviewed seventy-eight patient files selected at random, plus the files of Stacy Mason and “Luis Lopez,” the undercover pseudonym of Detective Sergio Lopez. Good pain doctors, Kennedy said, conducted thorough medical histories and physical exams, sought past medical records, modified and reviewed initial diagnoses. But the American Pain charts he reviewed, while stuffed with documents, showed no signs that these activities were occurring. The doctors did take cursory histories, but the operation was a prescription assembly line. His report recommended the DEA bar all five doctors from prescribing controlled substances.

“Drug diversion most likely caused a ‘mushroom’ effect of increased drug abuse, drug addiction, drug overdoses, serious bodily injury and death in those communities spread over several different states,” he wrote. “(The doctors’) continued ability to prescribe controlled substances will only perpetuate the suffering and be a threat to the public.”

The DEA also went after wholesalers, shutting down two distributors that had supplied American Pain with oxycodone: Sunrise Wholesale from Florida and Harvard Drug Group from Michigan. Sunrise surrendered its DEA license. Harvard, one of the ten largest wholesalers of generic drugs in the country, didn’t give up so easily and began to work with the DEA to revise its oversight methods.
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Spooked, many other drug wholesalers immediately stopped selling to Florida pain clinics. By July 2010, the amount of oxycodone doses purchased by Florida doctors had fallen from more than eight million per month to around one million.

Out of prospects and almost out of money, Derik packed up the big house in Black Diamond Estates in July 2010 and drove back home to upstate New York. His girlfriend and her daughter moved back in with her parents. Derik and his cousin were going to run a sub shop in Lake George, but that plan went bust, and Derik moved back to the farm where he’d grown up with his aunt and uncle. He put a new roof on the barn, mended some fences, shoveled horse manure, and tried to get his head right, forget what was going on in Florida.

One day, Derik took his aunt to a doctor’s appointment and had a revelation: Her doctor’s office was a pill mill. It was basically American Pain, just a fraction of the size and without the out-of-state patients. The cars in the parking lot all had New York plates, but they were from counties all over the state. The amount of oxycodone his aunt was taking explained a few things, Derik believed, such as why she’d disconnected from his life over time, and his sister’s too, stopped answering the phone or sending birthday cards. She’d been on the meds for years, and Derik had never paid much attention, figured it was OK because a doctor had prescribed it. Like most people, he never questioned it, not until he’d been running American Pain for two years and knew the signs. It made him wonder. How many of these places were out there, doing the same thing as American Pain, just not as aggressively? It would be so easy to fly under the radar, make a lot of money without going all-out like he and Chris had.

A few weeks after Derik moved up to New York, Mike Burt called his cell phone early in the morning. Derik told the DEA agent to speak to his lawyer. Paul Schwartz, the lead prosecutor, called Derik’s lawyer, and the news wasn’t good. Schwartz said Derik was going to prison for life, that he was a dangerous individual and they had him cold on kidnapping, extortion, and running a drug ring in Loxahatchee. Derik’s lawyer said he was, basically, fucked. He said Derik needed to meet with the feds, if only to find out what cards they were holding. Derik returned to Florida.

The feds were pressuring Chris the same way. Derik and Chris agreed to meet with the prosecutors individually. Chris went first. The feds told Chris they had three months of wiretaps of his phone, which was actually kind of a relief, since Chris and Derik had been worried that everybody’s phones had been tapped for the past year. Chris refused to give them anything, and they kicked him out.

Derik met with the feds a week later. Before the meeting, he went over to Chris’s house. Derik was freaking out, and Dianna gave him a handful of Valium, which he downed.

The meeting was in an eighth-floor conference room in the US Attorney’s Office in downtown Fort Lauderdale, palm trees and sunny boulevards visible far below, through the plate-glass windows. A dozen lawyers and agents crowded around a long table. Derik recognized Mike Burt and the tall blonde FBI agent, Jennifer Turner. He’d seen them before—the day he and Chris had been on the roof of American Pain, looking down at an unmarked car across the street. He and Chris had laughed, wondering why the cops were bothering to surveil. That seemed like a long time ago.

Now, Derik was prepared for an interrogation or a negotiation or some kind of offer. But the agents and lawyers didn’t ask questions at first. They seemed hostile, like they
hoped
he didn’t plead guilty, like they
wanted
him to go to trial, so they could send him away for good.

Schwartz had a close-trimmed beard and an intense stare. He said he was going to quote some lines from the wiretap recordings, some things Derik had said to Chris George. One quote was from one of Derik’s lengthy rants about Ethan Baumhoff: “You hate cops. I hate cops. If he was still a cop, he would throw the handcuffs on us.” Awkward to hear those words in a roomful of cops.

Then, one of the cops asked: Do you hate cops, Derik?

It didn’t seem like a question from someone who wanted to make a deal. Derik shrugged, said something about how, yeah, man, he hated cops.

Schwartz read something else Derik had apparently said to Chris, referring to the large crew of Loxahatchee construction workers who’d become American Pain patients: “Loxahatchee is a gold mine.”

Schwartz said: Did someone discover gold in Loxahatchee, Derik?

The Valium was starting to penetrate Derik’s brain. The whole scene seemed unreal. He didn’t know what to say.

A deputy sheriff from Palm Beach, playing the good cop, said: OK, Derik, you need to tell the truth here. This is your one shot.

Then he started to ask real questions. He wanted Derik to confess to selling pills on the street. They’d heard that Derik had sold a large stash of pills. Derik said he hadn’t sold any pills directly, and the cop lost his temper. Derik got up to leave, and Schwartz barked: Sit down! Derik sat down.

They asked about a different pill-selling situation, and Derik said they had the story wrong. Derik said he knew what they were talking about, but someone else had done it. They said he was lying.

The meeting was going in the wrong direction. Derik’s lawyer asked for a moment, and they left the room, went down to a parking garage. Derik nervously lit a cigarette and asked the lawyer why he hadn’t warned him the feds were going to be so aggressive. The attorney said he hadn’t expected it either.

They went back inside, and Schwartz asked the same question in a broader way: Had Derik ever illegally diverted pills from American Pain?

Derik said no.

Schwartz was finished with him. He gave Derik twenty-four hours to get back to him or, he said, they were going to put him away for life. Derik got out of there, feeling wobbly.

Chris was getting the same pressure. Schwartz called Chris’s new attorney, a well-known Mob lawyer, and asked if Chris was ready to cooperate. The lawyer said no.

Schwartz said: Well, I’m going to put his ass in jail and see if that will change his mind.

Over the next few weeks, Derik and Chris kept hearing rumors that one person or another had flipped, including Jeff. They went to a tattoo parlor together and got matching leg tattoos: a rat hanging from a noose. Someone took a picture of Chris’s rat and sent it to some people.

The feds found out about the rat-tattoo photo, which they believed to be witness tampering, and in mid-October, Schwartz followed through on his threat. The police showed up at Chris’s house and arrested him. Apparently, they weren’t ready to charge him with anything related to American Pain. They did, however, have him cold on weapons charges, based on the guns they’d found in his home on the day of the raids: the two shotguns Chris had asked Dianna to take the fall for, as well as a pistol found in an upstairs bedroom. As a felon, he wasn’t supposed to have guns.

But the raids had taken place seven months ago. Chris knew the feds were arresting him now only to pressure him to cooperate. He seemed unsurprised by the arrest, but he did complain about the cops hauling him to jail in handcuffs instead of just letting him surrender.

Chris said: Why didn’t you just call me? I would have come in.

On the west coast of Florida, Larry Golbom told his radio audience about the downfall of the George clinics. The pharmacist was still doing his talk show about prescription narcotics, but he no longer felt like a voice in the wilderness. American Pain and its counterparts had the whole state abuzz with talk about prescription narcotics. The pill mills weren’t the root of the problem, Golbom believed, but simply an inevitable side effect of the unleashing of legal opium. Nevertheless, the pill mills were bringing attention to the larger problem, and that was a good thing.

Three years into the show, Golbom had found himself relaxing behind the microphone. He grew looser. Funnier. He stopped channeling the style of other talk radio hosts, stopped shouting. His stomach no longer hurt before shows. He stopped writing out scripts to read aloud. Instead, he went into the studio with a loose outline and a guest lined up. He knew what he believed about the opioid epidemic, and he knew what he wanted to say. Behind the mic, the words just came.

And there was plenty to talk about. The fact that drug deaths had overtaken traffic fatalities as the leading cause of death in the United States, a trend driven by prescription narcotics overdoses. The new Florida law, signed in June 2010, that barred drug felons from operating pain clinics, required pain clinic doctors to undergo special training and allowed them to dispense only three days’ worth of medication to patients who paid by cash, check, or credit card, instead of insurance.

Despite the furor, few people paid attention in 2010 when another DEA-approved hike in the oxycodone manufacturing quota took effect, boosting the output from 94,000 kilograms to 105,500 kilograms. This was more than twice the total manufactured in 2005, and almost thirty times the amount manufactured seventeen years earlier. The numbers boggled Golbom’s mind. It wasn’t as if oxycodone was a new drug. It had been developed almost a century earlier. The basic drug hadn’t changed at all, simply the mind-set around how it was prescribed.

Despite the new pressures, many pain clinics simply evolved and continued to operate. The laws limited the amounts physicians could dispense, but many pill mill doctors continued to write large prescriptions to be filled elsewhere. When the laws required pain clinics to register with the state health department, 1,031 applications poured into the department. The department could find no reason to deny most of the applications; 904 pain clinic licenses were approved, including one for the Oakland Plaza Medical Center, registered to Dr. Rachael Gittens, formerly of South Florida Pain.
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