AMERICAN PAIN (5 page)

Derik never really explained to anybody what he thought about his father. He knew that a beast had lived inside Robert Nolan. But most of the rest of the time, he hadn’t been a bad father. Derik had a temper, could kind of understand how someone could do what his father had done, snap under the pressure of family and work, especially if you saw your wife with another man. He didn’t hate his dad. What good would that do? Instead, Derik directed his hate toward the cops and prosecutors who tried to put his father away.

Derik grew up, but he didn’t plan for the future. He was easily influenced by friends. He liked swords and slingshots and fistfights and blowing things up. People sometimes told Derik he was basically a 6'1" child, even at thirty years old. Derik didn’t mind because he knew it was true, and because he felt like acting like a kid was something everybody should try—it was fun. Still, he was smart enough, and he worked hard. He made good money as a plumber and used it to start building houses. He believed he’d found his one gift: running a business day-to-day. And then Chris George came along, and gave him a shot at the pain management racket.

When his cell phone lit up with Chris George’s phone number, Derik was crossing the Royal Park Bridge on his way home from a window job on Palm Beach. It was March 2008, a couple weeks after Derik had completed the renovation of Chris’s pain clinic. Even as recession loomed, the Florida dream was everywhere around him, a cluster of sparkling white boats bobbing on the intracoastal marina to his left, coral-and-white office towers and condos of downtown West Palm standing tall straight ahead.

Derik answered the call.

Chris needed a favor. South Florida Pain had opened the previous week and was already pulling in decent traffic, fifteen to twenty patients a day. But Chris’s father needed him to go to the west coast for the day on Majestic Homes business. So Chris asked if Derik could keep an eye on the pain clinic while Chris was gone, make sure Dianna was safe. Because, Chris said, everyone in the place was a fucking junkie.

Chris didn’t want to leave Dianna alone with those people, all the cash and pills lying around. He said Dianna would be happy to drive Derik to the clinic, since he still had no license. Two hundred bucks for the day. Easy money.

Derik pondered Chris’s offer. He’d thought he was done with South Florida Pain when he’d finished the renovation. Derik was on probation, couldn’t afford to get in trouble. And this sounded sketchy. He wasn’t even supposed to leave Palm Beach County, and South Florida Pain was in Broward. Besides, Derik was a construction superintendent, not a security guard.

But no one had ever accused Derik of being prudent, a good decision maker. He had a hard time saying no to friends, especially Chris. When they were renovating the clinic building, Chris had explained to him how the place would work, and Derik was curious to see it in action.

So Derik told Chris he’d do it, even though he knew it was probably a bad idea.

In fact, what Derik said was this: Man, you’re gonna get me locked up again.

So Derik hung out at the clinic the next day, twiddling his thumbs, helping out when he could. There wasn’t much need for muscle. The patients got what they came for and went away happy. The place felt illegitimate to Derik. The exam rooms had examination tables and blood pressure cuffs and anatomical posters depicting the human spine, just enough medical stuff to be identifiable as a doctor’s office—but somehow it didn’t feel
real
. Derik doubted the patients ever actually lay down on the exam tables.

It was a simple operation. Dianna greeted patients through the customer window, explaining that seeing the doctor required cash or credit card up front. No health insurance. Dr. Overstreet, the clinic’s sole physician, had explained that insurance companies would cause problems for pain clinics if they felt they were paying for unnecessary prescriptions. Taking insured patients wasn’t worth the scrutiny. Dianna took the $200 they charged for new patient visits, and the patient filled out the paperwork Chris and Derik had lifted from the other clinic. When it was the patient’s turn to see Overstreet, Dianna hit a switch that unbolted the magnetic lock on the door between the waiting room and the exam rooms. The patient went back to the exam room, came out five or ten minutes later with a prescription in hand, usually 240 oxycodone 30 milligrams, 60 to 120 oxycodone 15 milligrams, and 60 alprazolam. Chris hadn’t known how to order prescription pads, so he had called a print shop in West Palm Beach and given them Overstreet’s name, address, phone, and license number, and they’d printed them up, using some kind of special prescription paper.

So the patient would give the scrip to Dianna, and she would go back to the “dispensary,” a big name for the nine-by-three-and-a-half-foot closet where they kept the drugs in a gun safe they’d picked up at Costco and bolted to the floor. A laptop connected to a label printer sat on a card table. They’d copied the label format from a legit pill bottle to make sure they had all the right information on there. She’d punch in the patient’s information, print a label, fix it to a pill bottle, pull the drugs from the safe, and fill the bottle. Back at the front desk, she’d take the money for the meds, usually between $400 and $700, hand over the bottle, staple the receipt to the patient’s paperwork, and file it. Done.

Chris had Googled a few policies; the rest he either made up as he went along or he asked Overstreet. The doctor didn’t seem worried that anybody would be checking up on them.

On the first day of business, Dr. Overstreet had brought a bunch of small bags filled with pills from his house—oxycodone, Xanax, and Valium. He’d ordered the pills when he was still working at the One Stop Medical clinic and took them when he left. The bags weren’t labeled, and Overstreet didn’t even seem entirely sure exactly what was inside them. Five patients showed up on Day One, and Dianna counted their pills out of the bags and put them in pill bottles.

Everyone got pills, or, if the dispensary was bare, they got a prescription. Overstreet never turned anyone away empty-handed. His only restriction seemed to be that he wouldn’t prescribe more than 240 oxyco-done 30-milligram pills per patient every twenty-eight days. More than 240 pills, he told Chris, and you’re likely to attract police or DEA attention. Better to stay under the radar. He didn’t say how he knew this.

Derik figured it couldn’t be kosher for Dianna—whose previous work experience consisted primarily of dancing at Emerald City Gentleman’s Club—to be operating the drug dispensary. He asked Chris about it. Didn’t you have to be a pharmacist to hand out pills? Especially
these
pills? Chris said he’d asked Overstreet the same thing, and the doctor said it was OK because Dianna was under his supervision. Chris had looked up the rules, and as far as he could tell Overstreet was right. Lucky for them, Florida law allowed doctors not only to write prescriptions but also to actually
sell
the controlled substances themselves. No pharmacist needed.

In fact, a major key to the pain clinic business, Overstreet had told Chris, was dispensing the drugs in-house. That way, patients didn’t have to find a pharmacy to fill their prescriptions, which wasn’t always easy. Legitimate pharmacies sometimes blacklisted a pain clinic, refused to fill its scrips. They didn’t like to see too many suspicious-looking patients with large narcotics prescriptions from the same place. They’d grill the patient, call the clinic. Patients hated this. If South Florida Pain Clinic wrote
and
filled the prescriptions, patients would flock there. And the clinic would get paid twice—once for the doctor’s visit and once for the pills.

Overstreet’s stash of pills had lasted less than a week, but by then Chris had bought more. The doctor had told Chris which drug wholesalers he’d used in the past and how to fill out the order forms, called 222 forms, that let the DEA track the flow of controlled substances. The order forms listed the supplier, the purchaser, the drugs and amounts. Before the clinic opened, Chris had called Overstreet’s wholesalers and asked them about the ordering process. He was used to dealing with vendors from his days at Majestic Homes, and he was good at working the phone, asking the right questions. He sent in the forms, along with Overstreet’s state medical license and DEA registration number, which allowed the doctor to prescribe controlled substances, and the drugs were shipped. The wholesalers didn’t ask many questions about the office or Chris, though some said they would be sending someone to inspect the clinic. Basically, the wholesalers verified that Overstreet had an active DEA registration, and if the credit card number went through, they sent the drugs. It was unbelievably easy, like ordering a shipment of drywall.

And that was the part that blew Derik’s mind the most: how this quack Overstreet could order narcotics and no one blinked an eye. He’d assumed there was someone paying attention to this stuff, that you couldn’t just team up with a doctor to buy and sell pills to drug addicts. It was way too easy. But that’s what they were doing, and Derik was starting to wonder if Chris was on to something.

The clinic was pulling in a few more patients every day, Chris told Derik. Five on Day One. Then seven. Twelve. Eighteen. Twenty. Word was spreading. Even better, every patient booked a follow-up appointment twenty-eight days later. After a couple of days, Chris had begun to wonder if his early volume projections were a little low. Less than two full weeks in, he knew the pain clinic was a go.

Chris wanted to make the whole process as easy as possible for the patients. The word about convenience would definitely get around. That was good business. Patients were used to doctors giving them a hard time. At South Florida Pain, they would be treated differently. Customer service was key. Overstreet said they didn’t need any sort of diagnostic test—no CAT scan or MRI—on the first visit, though he thought they should start requiring them on the second visit a month later.

Chris had come to the conclusion that almost every single patient was a drug seeker. Overstreet had never really spelled this out, and it wasn’t always obvious, because the patients would lie their asses off to get a fix, saying they were in agony from an old construction injury or whatever. And sometimes Chris wondered if maybe some of them
were
in pain. It was hard to tell who was injured and who was in withdrawal—both conditions gave people a panicky look. Chris didn’t know what Overstreet was doing in the examination room, but the appointments took just a few minutes and nobody was asking for the other meds they offered—HGH or testosterone or weight-loss pills. These people didn’t care about looking good. All they wanted was oxycodone. For all Chris knew, some of the patients might be in real pain and maybe need the drugs. But it hadn’t taken him long to realize that pain sufferers weren’t the target demographic. The clinic’s bread-and-butter was people who took the pills to get high.

The following week, Chris asked Derik to spend another day guarding the clinic, a Friday. Derik agreed, though he already couldn’t stand Overstreet. The doctor seemed arrogant, cocky, thought he was some kind of gangster. Derik saw Overstreet popping Vicodin, which he kept in the gun safe along with some Viagra and the rest of the clinic’s drugs, and meeting with shady-looking people next to his Land Rover after closing time.