License to pill
How one ex-con, gun-toting doctors and a slew of strippers built a drug empire e
American Pain How a Young Felon and His Ring of Doctors Unleashed America’s Deadliest Drug Epidemic
Late in 2007, Chris George, a 27yearold former convict with no medical training, opened his first pain pill clinic in South Florida. With no laws to stop him, George and his twin brother, Jeff, were about to become kingpins, running pills up and down I75 — quickly dubbed “Oxy Alley.”
In his new book “American Pain” (Lyons Press), author John Temple chronicles the rise and fall of the George brothers and how hard it was for law enforcement to shut them down.
At their height, George’s six South Florida pain clinics, the largest of which he called American Pain,in, saw thousands of patients a day.
It all began innocently enough.ugh. In the early 1990s, a relatively small pharmaceutical company calleded PurPurdue Pharma had developed anan extendedrelease morphine drugdrug called OxyContin. Since thehe pill broke down slowly in the digestive gestive system, the company was allowedwed toto put higher doses of the active ingredient, oxycodone into each pill — up to 160 milligrams.
Essentially synthetic heroin in pill form, oxycodone alters the perception of pain while decreasing anxiety and elevating mood.
Drug users quickly figured out how to get around the timerelease: crushing the pills, then shooting or snorting them up, delivered an immediate, powerful rush, as addictive as any hard street drug.
Purdue Pharma launched a counteroffensive, hiring “experts” to talk to the media about the undertreatment of pain.
They poured millions of dollars into internal research that conveniently found OxyContin addictive in fewer than 1% off patipatients.
The drug was a gamechanger. Before OxyContin, pain drugs of this caliber were limited to treatments for bone cancers and endoflife pain management. But Purdue — along with other Big Pharma companies developing similar oxycodonebased products — began pushing the drug for treatment of vague chronic conditions like back pain.
For the George twins, Florida was the best place to open pain clinics. The state had no centralized prescription database. Anyone could open a painpill clinic — no license or authorization required — and doctors were legally permitted to sell drugs directly to patients.
So, Chris George hired one doctor and another and another, until he had a raft of them. He paid them per patient, incentivizing large and frequent prescriptions.
By now, doctors in Florida were ordering nine times more oxycodonebased pills than doctors in the other 49 states combined — 41.2 million doses to 4.8 million collectively.
American Pain alone prescribed almost 20 million pills over two years.
The clinic’s top performer was a young doctor named Cynthia Cadet. During her 16month tenure, Cadet became the No. 1 writer of scrips for oxycodone pills in the country — some days seeing more than 70 patients.
“Everyone loved that fact that she generally wrote big scrips,” Temple writes. “Even on the first visit.”
But the FBI and the DEA soon targeted American Pain, which did not operate discreetly.
George’s clinics were staffed with strippers; heavily tattooed bouncers patrolled the parking lots in golf carts. Doctors carried guns. Clients were peeing on the sidewalk, shooting up in the parking lot, dealing drugs in plain view.
On Wednesday, March 3, 2010, the FBI raided George’s home, along with American Pain and six other clinics.
That year, Cadet stood trial for distributing narcotics for nonmedical reasons and a resultant seven deaths. In fact, Dr. Cadet alone had served 51 patients whose deaths could be linked to prescription pills.
Cadet was found not guilty. Her defense: How could she possibly know if patients were lying about their pain levels?
Facing a possible life sentence, George eventually agreed to cooperate with prosecutors and was given a reduced 17 ¹ /₂ year sentence.
In the wake of the trial and the media coverage it generated, Florida changed many of its laws and established a prescriptionpill database to minimize doctorshopping.
“So the pill mills left Florida, to great fanfare,” Temple writes. “But, unabated and under the radar, the country’s appetite for pills has only continued to grow.” Last year, the number of kilograms of Oxy produced in America jumped from 131,500 to 149,375 — three times greater than in 2004.
And the very agency involved with the takedown of George’s pill mills is partly to blame.
As Temple writes, “the manufacturing companies keep asking the DEA for permission to make more pills, and the DEA keeps granting it.”