Screen Shot 2016-01-09 at 3.57.22 PM(originally on AfterPartyMagazine)

In a recent HuffPo essay, John Temple, the author of American Pain—a gripping, sordid history of a Florida Medical clinic that sparked the deadliest drug epidemic in history–explained what compelled him to write the book. First, a bit about the history: the clinic, simply called The American Pain Clinic, prescribed over 20 million doses of oxycodone before being shut down in 2010. Temple’s book addresses how this pill mill run by brothers with criminal backgrounds could tip an entire nation into the opiate crisis we’re seeing today. It is a hell of a story plus an important read, so don’t wait for the inevitable movie.

Temple—who entered recovery in 1995 and now teaches Journalism at the University of West Virginia—wrote in the story that a “sea change had occurred without me even noticing.” He was dealing with students whose opiate addictions were ruining their lives, and “everyone I knew seemed to know somebody who had a problem with them. Opioids had been normalized. And I wasn’t sure when or how it had happened.”

American Pain is what happened.

Down the Oxy Rabbit Hole

The book focuses on the true tale of twin brothers—one a felon with jail time and a drug offense already behind him, the other on probation for battery and resisting arrest—who met a corrupt doctor and got the 411 on a stellar moneymaking scheme. Doc showed the bros how to create a seemingly legit clinic for prescribing oxy, thereby giving Florida’s lax drug laws the run-around.

Soon Chris and Jeff George were raking it in while former strippers operated the pharmacy, working their pasties off to set up dole out prescriptions as fast as the brothers’ hired stable of disreputable docs could write them. These doctors soon felt so unsafe in the clinic that they began carrying guns beneath their white jackets. Meanwhile, patients often went into violent withdrawals in the waiting rooms, while other addicts simply waited outside to trade sex for pills. Over the next two years, the American Pain Clinic made over 40 million bucks, and 80% of the prescribed opiates were headed north up highway 75, soon called “Oxy Alley.” Inevitably, the brothers fought, then started running dueling clinics. Their mother got into the business and kept her boys’ spare $4.5 million in cash in her attic on Primrose Lane. But the family’s empire collapsed when the Feds raided in March of 2010. Prosecutors traced 56 deaths directly to the George clinics, although the real number is probably far higher.

Basically, American Pain is the sordid capitalistic heart of the nation’s drug culture. It’s this decade’s Studio 54, but far more lethal and with a less exuberant sound track.

The Fallout

Although the clinic is now shut down (along with many of its copycat versions), its effects are everywhere. According to Temple, in 2014 US drug manufacturers sold nearly 150,000 kilos of Oxycodone. Of course, there’s been a lot of media coverage of the fallout of the clinics’ closings, including the rise of Mexican Oxyand how addicts’ conversion to heroin has seen overdoses on the drug double.

Since oxycodone comes from the same plant as heroin and they produce a parallel high, addicts switch to the cheaper illegal drug, one that’s not nearly so controlled, when their scrips are no longer available. But whether you’re getting your opiates via a legit-looking pill in an amber bottle or off the streets, the addiction is equally merciless.

Readers’ comments on the HuffPo piece reflect the controversy around Temple’s opinion that doctors should simply stop writing oxy prescriptions for chronic pain. To many, this seemed an obvious and overdue solution. But there were others who were enraged; they say they’re living with terrible chronic pain and are already having problems getting legit prescriptions filled. They feel stigmatized for needing pain relief, and exhausted by the hoops they have to jump through.

Maybe this complicated issue deserves a more nuanced response than the feast-or-famine pendulum from which we’re swinging. Temple mentions that as well: Any doctor that does write these prescriptions should have received solid and recent training in pain medication and—equally important—in addiction treatment.

The Pain Goes On

I’m assuming the upcoming movie will star Bradley Cooper and Jennifer Lawrence as the George Brothers. Maybe Jlaw will finally receive equal pay if she plays a man, plus she could act the hell out of any role where she gets to operate a mobile MRI business behind a strip club.

But behind headlines and cool-ass casting ideas, American Pain is more than what’s on the label. It’s the result of a formerly optimistic and still puritanical nation that doesn’t tolerate discomfort and can’t manage chronic suffering. It’s how we manage pain, addiction, and the gray, deadly confluence of the two.

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