03x05 - Chasing the Dragon: Pain Pill Nation

[bunniefuu]

♪ ♪

TRAFFICKER: These just arrived

, pills

M pills

TRAFFICKER : Ms are in demand right now in the United States

M was originally

oxycodone

We tried getting the Ms from pharmacies

but it was difficult

The cartel thought, let's make them ourselves

Let's add fentanyl

It hits you hard and it's more effective

So now we're doing it with fentanyl

TRAFFICKER: Let's get to work

This secret compartment is perfect for M pills

Here the pills cost cents for each pill

In the U.S. they're paying $ a pill

So they'll pay $,

It is a perfect business

But it's a very strong drug

It is a drug that kills

This drug is going to Los Angeles, California

TRAFFICKER : The United States

They got their own people hooked on this

Their medical system created the oxycodone boom

They started this

MAN (over TV): Shake this square world and

blast off for Kicksville.

NIXON: America's public enemy number one is drug abuse.

MAN: Heroin destroys everything.

MAN: Prescribing pain pills created huge numbers of addicts.

CROWD: People die, Sacklers lie.

MAN: Opium is cash.

It's like you're growing bills on the bush.

MAN: Crime and drug abuse go hand in hand.

It's like peanut butter and jelly.

HARRIS: There's now an understanding that the

w*r on drugs was an abject failure.

MAN: You have to stop and ask yourself, how did we get here?

TINA: Jonathan was really a fun kid, loving, generous.

He had a lot of friends.

He was very sociable.

My name is Tina Reed and my son was an oxycodone addict.

We have such good memories of Jonathan, until one morning

I go in his room and he's sitting at the edge of the bed

and he had his hands on the dresser covering something and

he had a bill rolled up behind his ear.

"What is that, are you snorting cocaine?

What are you doing?"

And then I moved his hands and what was there was blue powder

and he said, "it's my pain pills, mom"

and then he brushed me off, like no big deal.

He was so clueless that he was going to die.

He was clueless.

It was sad, very, very sad.

I saw the pill, I looked at the bottle and the

first thing it says is South Florida Pain Clinic

on Oakland Park Boulevard.

The owners, Chris George and his brother, they're the ones

who really took advantage of so many people,

really, they took so, so many lives away and

just created an epidemic of pain.

CHRIS: I think having a twin brother made me a competitive person.

Jeff really helped, you know, push myself to be the best

I could be.

My name is Chris George and I was the owner of

South Florida Pain and American Pain,

the largest pain clinic in the world.

Growing up in South Florida,

we were a little bit crazy growing up.

We had a lot of parties, we worked out.

We were probably known as, you know, some of the

worst people in the area just 'cause we would do stupid things

and cause problems.

It wasn't too serious of stuff but, you know, we stood out a lot.

I was always trying to make money growing up and

wanted to start a business.

Since our senior year in high school,

me and my brother were taking steroids.

I wanted to find out a way to do it legally and that's why

I started getting them prescribed by a doctor.

He was a young doctor, he was pretty laid back and it seemed

like he would do anything and he was the one that came up

with the idea to do the pain clinic.

It didn't seem like there was anything wrong with it.

I didn't know what oxycodone even was.

He was gonna see the patients and prescribe pain medication

to people that are in pain.

I was just gonna run the business.

But we ran the numbers and it was like, yeah,

it didn't seem that great.

But in business, you gotta take risks and we did.

It was a regular doctor's office.

I just prescribed medication to help people that were in pain.

No physical therapy, no injections or anything else.

But I didn't know anything about running a medical office.

Derik Nolan was one of my best friends.

I gave him a call, I said "hey you wanna work here?"

DERIK: You know, I'd done construction my whole life.

I honestly didn't even know what a pain clinic was.

Obviously, we wanted to make this thing legit

as we possibly can.

We called the DEA, we called the health department,

we called everybody.

There was nothing on the books on what to do

to open up a pain clinic.

All you had to have was a DEA's license.

So, we would order the drugs under the doctor's license and

they would go in the safe, which seems kind of crazy

but it's America.

I didn't really know anything about the pain pills.

On my first day or two there, it was all coming into

perspective for me and I was like I wonder what exactly

we've stumbled into here?

CHRIS: We only took cash, but otherwise you could be just

over and no documentation and you can get medication and

you're pretty much getting pills every time of the

oxycodone milligram pill.

ANDREW: When we talk about oxycodone, we are essentially

talking about a heroin pill.

Oxycodone had been on the market in the US for decades,

for patients at the end of life with cancer pain.

In , the pharmaceutical company Purdue Pharma wanted

to turn this old generic drug into a blockbuster.

So, Purdue launches a brilliant, multifaceted

marketing campaign disguised as education.

WOMAN (over TV): The undertreatment of pain is a major public health problem.

ANDREW: They repackaged oxycodone for common

long term chronic pain, like back pain.

Oxycontin is the cure.

ALAN: We now find that these medicines are much safer,

much more powerful, much more versatile than we used to think

and we feel that they should be used much more liberally

for people with all sorts of chronic pain.

SAM: Purdue marketed oxycontin with the claim that it's

virtually non addictive when used to treat pain.

MAN: Less than % of patients taking opioids actually become addicted.

SAM: This claim became gospel,

and that proved completely untrue.

CHRIS: Little did I know, there were a lot more people

in pain than I thought there was.

At least they said they were.

(door dings)

(cash register noise)

It grew at an exponential rate, way faster than anyone

knew it was gonna grow.

DERIK: I mean, it seemed like overnight it went from

ten to patients a day,

to to to

CHRIS: And within six months we were bringing in at least

$, or $, every day.

When we got to work, there was a line around the building of

people waiting and we were working until : at night.

So, I needed more doctors.

(phone dialing)

(dial-up connecting)

When you look online, there's all these headhunter services

that you can find doctors from

but they charge a ton of money for it.

So, we just said, you know what, let's just try hiring

a doctor from Craigslist.

DERIK: Craigslist, where you buy a new couch

or an escort if you like.

CHRIS: We just mentioned that the hours are Monday to Friday

: to : and the pay ranges from, you know,

a couple of thousand a week to , or , a week.

We got great results from it.

DERIK: Emergency room doctors.

We had an eye doctor, family medicine,

multiple plastic surgeons.

As long as you had a DEA license to write a script,

you could work.

CHRIS: Within the first six months we had three to four

doctors working at that office.

TINA: I always trusted doctors.

You go to your doctor for help.

You trust their decision.

These are highly educated medical professionals,

but my son was not in pain.

Dr Enock Joseph was the doctor whose name was on

the prescription bottle from South Florida Pain Clinic

and when I looked up Dr Enock Joseph,

he was a gynecologist.

A gynecologist prescribing pain pills to my son.

I don't think so.

JONATHAN: The feeling is really complete euphoria.

Your whole body tingling.

It being a synthetic heroin,

I would feel sick if I didn't have the pill.

I would not eat, not sleep and it would just go on and on.

The only release I could get would be my next pill.

My name's JD.

I was an opioid addict for many years and also a customer

of Chris George's pain clinic.

(phone ringing)

Around , I was working in a telemarketing office.

People were kind of just taking drugs because it's

a very repetitive miserable thing.

Most of the people in there were doing cocaine,

doing crack and pills.

People would fight in the middle of the office.

It was, I mean if you've seen Wolf of Wall Street,

it's a lot like that, with a little bit less money.

So, it was just there and I was like hey,

let me try one of those.

That was my first real entry into opioids.

The friends that you have, they give tips.

Tell your doctor that your knee hurts a whole lot and the

good thing about pain, no one in the world can say,

yes you're in pain or no you're not in pain.

So, I had that doctor I kept going to, but being

a good doctor I get the medication in small quantities.

That was barely enough to get me through.

So, I had to find more ways to get pills and that's what

led us to the pain clinics.

(snorting)

(car starts)

The first time I went to the South Florida Pain Clinic,

I can remember pulling up in my Honda Civic and

seeing a line of people outside half comatose, nodding out.

Wow, where, where am I at?

This has got to be ill*gal.

So, I'm nervous.

I walk in there and it's business as usual.

The lady at the desk was taking the money.

Then you had to fill out a form.

You see the doctor.

"So, what's going on?"

"Oh, I have a pain in my knee."

I think he grabbed my knee while I moved my leg.

"Oh, that hurts horribly."

You know, a complete lie

and you walk out with your prescription

for Oxycodone

and then I was told, as I'm walking out the door,

"if you want, I can fill them right here."

"All right."

So, I guess this is a one stop shop.

I go to my car, crush up two pills

and snort in the parking lot.

It was extremely obvious that they were trying to sell

as many pills as possible to as many people as possible.

MAN (over TV): Oxycontin has quickly become one of the best-selling

brand name drugs in the world.

WOMAN (over TV): Oxycodone is the primary ingredient in Oxycontin.

Prescriptions for the synthetic morphine has risen

from around , to nearly six million.

MAN: It's unusual to see a controlled substance be

so aggressively marketed.

WOMAN: Many wonder if this media blitz and

liberal dispensing of Oxycontin are contributing

to the epidemic of abuse that's spreading across the country.

SAM: When patients begin to display symptoms of addiction,

a fellow at Purdue Pharma coins the term pseudo addiction.

ALAN: Pseudo addiction is a fairly new term,

when a patient is looking like a drug addict because

they're pursuing pain relief.

So, pseudo addiction is relief seeking behavior

mistaken as drug addiction.

ANDREW: The problem wasn't the patient was getting addicted.

The problem is you doctor, you're not giving them

a high enough dose.

SAM: Which sounds to me a little bit like what

a drug dealer might say.

It's a magnificent, highly profitable business model,

practiced on the street and then practiced at Purdue Pharma.

TINA: Opioid addiction, it really tears families apart.

Jonathan became a different person when he was high.

You couldn't understand him.

He couldn't walk.

It's not your loved one.

They're in there somewhere, but it's like gone.

It's something changes, even in their eyes.

I knew I had to do something about it.

WOMAN: Always on the case and usually on someone's tail.

CARMEL: I'm Carmel Cafiero from Channel .

Can you tell me who is in charge here?

TINA: Carmel Cafiero was one of the best.

CARMEL: Look, these people say, don't put that in my face, mister.

TINA: I think I might even still have the letter I wrote her.

CARMEL: I'll never forget Tina.

She is one of the bravest moms I've ever met.

I'm Carmel Cafiero.

I was an investigative reporter for close to years.

When the tip came in, we went by the pain clinic

in an undercover van.

People were getting pills and going out into the

parking lots and snorting the pills and sh**ting up.

Nobody was really aware of what was going on.

Chris George was running a place where he prescribed

to everybody who showed up.

So I decided to confront him.

DERIK: We're opening up and she popped out of the bushes.

CARMEL: Morning, Mr. George?

Christopher George legally operates the busy Pain Clinic.

We have pictures of people snorting, sh**ting up in

this parking lot after coming out of your clinic.

I mean, what do you have to say about what's going on here?

CHRIS: I don't believe you're right.

CARMEL: That's all you have to say?

CHRIS: I just told her she was wrong and I walked away

because she doesn't know who that person was,

she doesn't know they're a patient of mine.

Most likely they were and, you know, she's just speculating,

and I don't really care.

CARMEL: Good morning.

We wanted to talk to the doctor working at this pain clinic.

According to state records, Dr Enock Joseph is certified

in obstetrics and gynecology.

DERIK: When the doctor's pulled up, we kinda looked at each other

and Chris was like, "go out there and get him."

CARMEL: Are you certified in pain management?

He would not answer questions about his pain clinic practice.

It really made me angry.

But what they were doing was legal because

doctors were writing prescriptions for the pills.

DERIK: Whatever, you wanna make me look like a fool,

you can do that but I'm not breaking any laws,

so I don't care.

CHRIS: Whether people like it or not, doesn't matter.

Their opinions don't make it ill*gal and them not liking

this business doesn't make it ill*gal.

I know some people did abuse the medication, some are gonna

be drug addicts, whether it's % or % or whatever it is,

there's always gonna be that percentage.

DERIK: Did I know there was drug addicts and junkies and

all that kind of stuff?

Absolutely.

I don't think anybody really took them orally,

as prescribed.

I wouldn't even go into the patient bathrooms.

They put the needle in and they pull it out and the blood spurts.

You got these blood spurts on the walls, on the toilets,

on the floor, they're all over the place.

To be honest, I came kinda numb to it.

CHRIS: The way the business was growing, we probably

maxed out at about patients a day.

DERIK: I mean I'm not a terrible person.

So, there was, I started to see the moral issue of what

was happening here.

We were like, we're basically legal drug dealers,

you know what I mean.

It was like the Wild West.

We could do whatever we wanted basically and then people were

coming in from Kentucky, Tennessee, all over the place,

and it really got out of hand.

SAM: Appalachia has historically been one of the

poorest regions in America.

Kentucky, West Virginia,

southern Ohio, eastern Tennessee.

The work is very hard.

It's industrial or its mining work.

There's a lot of pain, economic and physical pain

in that region goes back a lot of decades.

Purdue started targeting Appalachian states,

and so there's this sales force unleashed with this mandate to

go out and relentlessly, relentlessly visit doctors,

get in their face, to sell a narcotic, as if it's almost an

over-the-counter medicine and that idea then spread and

became part of medicine in the rest of America after that.

At the very moment when we are creating a large and growing

population of opioid addicted Americans, the truth began to

come out into the public.

JENNINGS: There is a prescription painkiller in the

news today for all the wrong reasons.

Oxycontin is a best seller as drugs go and

many patients swear by it.

But it turns out to be fiercely addictive.

LORRAINE: Treat it as if it was a loaded g*n.

WILLIAMS: A startling admission today.

Oxycontin, which was once marketed as something of a

wonder drug, one that could stop pain without getting

patients addicted.

It turns out that was a lie and a deliberate one.

WOMAN (over TV): Makers of the popular painkiller Oxycontin

pleaded guilty in federal court in Virginia.

Prosecutors say Purdue Pharma knew more than a decade ago

its drug was highly addictive.

MAN (over TV): Purdue Pharma must pay a $ million fine,

one of the biggest ever against a drug company.

SAM: $ million was a lot for a fine but, the truth is,

by then they were making billions selling Oxycontin.

MAN: The legal action doesn't block sale of Oxycontin.

The government says it's safe if used properly.

SAM: In Appalachia, some doctors cut back,

pain clinics and pill mills began to shut down.

A lot of people with now serious drug problems

began to look for other sources of these pills.

CHRIS: When we first opened,

patients were mostly local people.

As time went on though, over % of our patients

came from out of state.

WOMAN: We're talking hundreds of thousands of individuals

trafficking into the state of Florida specifically to obtain

pharmaceutical drugs.

WOMAN: Look at these license plates.

Almost every car in this lot is not from the state of Florida.

CHRIS: I don't really care why they were travelling so far,

as long as they do it.

There's no law against it.

DERIK: As the business grew, me and Chris were talking and

we were like, we need to move.

We quickly found another place up the street,

in an industrial park and South Florida Pain became

American Pain because American Pain would be

one of the first businesses listed in the Yellow Pages.

Chris bought billboards on the turnpike and I-.

CHRIS: That was some of the best money spent on advertising.

Anyone coming to Florida for a pain clinic would drive by it.

It grew our business more than any other thing.

We were seeing people a day.

We are bringing in $, every day.

So, to make things more efficient,

I say put the money in garbage cans.

I just wanna take the cash, throw it in a garbage can and

get the patient through.

It was all about making it a quick, you know,

assembly line process of getting his patients in here

to see the doctor.

Being an only cash only business, in a week there

could be millions of dollars at the office.

I mean, what we spent money on, I think everything

(laughs).

Derik and I, we'd go on gambling cruise.

DERIK: Vegas. CHRIS: Strip clubs.

DERIK: UFC fight in LA.

CHRIS: Super Bowls. DERIK: The Playboy Mansion.

CHRIS: I had a Mercedes, a Bentley, Lamborghini.

DERIK: Puerto Rico.

CHRIS: Four boats.

DERIK: Paradise Island in the Bahamas.

CHRIS: A few houses.

DERIK: Money was no object.

CHRIS: The way the business was growing,

pretty much anything I wanted I would buy.

DERIK: I look back on it now and I laugh, you know,

but that's just what we did, you know.

Long as we didn't screw up, it was gonna be smooth sailing.

(sobs).

(sighs).

JAIME: On April the st of , I walked into this room

at : in the morning and found my son laying in his bed.

(sobs).

His eyes half slit and he had a blue tint on top of his lips.

I knew that my son was gone.

(sobs).

This is where my son died.

He gave the best hugs in the world.

He's just a loving, beautiful kid and he didn't deserve this.

The pandemic hit and he couldn't go to school.

He couldn't socialize with his friends.

It was very, very difficult for him.

He decided to reach out to a drug dealer on Snapchat.

My son thought that he was taking Oxycodone,

but in reality, he took a counterfeit pill made of fentanyl.

He consumed half that pill and that pill k*lled him.

That is not an overdose.

That is a poisoning.

Big Pharma created the crisis.

In the s doctors were prescribing Oxycodone,

like it was candy and kids are still dying.

How is that possible?

How is that even possible?

MAN: Thousands and thousands of people come from all over

the eastern seaboard to south Florida.

You'll get people come in vans, eight or ten at a time.

CHRIS: After the first year of being open, you know,

tons of people copied the same business model we had.

All of them were trying to, you know, be like us.

TINA: We all had children hooked on the Oxy,

so we would stand out front of the pill mill with our signs.

The police, they had their head in the sand

and meanwhile people were just losing their lives.

At that time, my son Jonathan was so out of control,

just spiraling really.

He was on probation already for driving while high.

I couldn't get him to do anything cooperatively,

so I decided we gotta lock him up.

He's got to be locked up.

He's gonna die.

I want my son to be locked up in jail

in a treatment program.

I drove to the police and I said

"I want to file a complaint against this drug dealer,

this doctor in this clinic."

"Well let me get the officer to speak with you"

and then he came out and he said, "We know, we're on it."

JENNIFER: I don't think any of us really had an appreciation

for the scope of the investigation and for

what the investigation would become.

I was the lead agent with the FBI's investigation against

Chris George and American Pain.

We were investigating the largest drug trafficking

organization in the United States at the time

that was operating under the guise of legality.

We had to put a stop to it, but we couldn't just go in and

shut it down while he was operating legally

within the state of Florida.

I had to find a different way of investigating this case.

The question is, what makes the business ill*gal?

MAN (over TV): The cops say it all began here with this one

pain clinic that has now relocated.

DERIK: We were the biggest, baddest there was, right.

There's nobody that's gonna be able to have the

amount of doctors, get the amount of pills.

We had everything, you know, I mean, we were the top dog

and they can't touch us.

Everything is legit.

JENNIFER: There had to be a way to stop it.

We needed a multi-agency approach in order to

combat this problem.

We brought the DEA and the IRS on board.

We started listening to a title three wire intercept

on Chris George's phone.

I also deputized local law enforcement officers.

They worked surveillance, they worked as undercover employees

that went into the clinic.

What went on just in the waiting room at American Pain

was complete madness.

The patients, they're high, they're strung out,

they can barely stand up straight, let alone walk

and then we learned that Chris George

was opening up a new clinic.

It was a former bank.

CHRIS: It was time to get a bigger place.

We found the huge , square foot old bank building.

DERIK: We built the place out, moved all the stuff over the

weekend and we're open for business the next day.

CHRIS: It was huge. No windows.

It was like a fortress.

It had a two acre parking lot with hundreds of parking spots.

It basically had everything we needed.

At our peak, we would see about patients a day

in American Pain and that would generate about

$, in cash every day.

DERIK: We were just pushing, pushing.

DIRECTOR: Why?

DERIK: I don't know. Money, power.

It's addicting.

You just want more and more and more.

JENNIFER: I went up there to get a look at the place.

It was enormous.

It was really on that day that I remember saying,

"We have to put an end to this."

But I knew I couldn't do it alone.

Special Agent Kurt McKenzie, he dove in with both feet and

he owned this case along with me.

KURT: My reputation was that if you told me something was

impossible, I'd say okay and leave and figure it out.

Their prescribing numbers were off the charts.

Five doctors from American Pain prescribed more Oxycodone

than every single doctor in the entire state of California.

We interviewed real pain management specialists and

they explained to us, "Oh, you don't just hand out narcotics.

First of all you have to determine what's causing the pain."

We realized we needed to focus on the doctors.

Shutting them down, would shut this operation down.

We had sent in undercover law enforcement officers

with cameras and body mics.

JENNIFER: We wanted to establish a pattern of

prescribing practices amongst the American Pain doctors.

KURT: I would take notes about when the person walked into

the examination room and when they walked out.

I spent over a week looking at examinations.

It should have taken an hour to an hour and a half

to conduct these tests.

But the doctors in American Pain somehow managed to get

them done in three minutes and seconds.

Three minutes and seconds

to get between and narcotics

and walk out the door.

This is a drug distribution operation.

There's no medicine going on here.

JENNIFER: On March rd, , I wanted Chris George to feel

the weight of the federal government come down on him.

KURT: My job was to lead the team that ex*cuted the

search warrant at Chris George's house.

CHRIS: Babe, they have a search warrant for the house, they're inside the house.

DIANE: What?

KURT: We found two shotguns and a millimeter p*stol

that were stolen.

CHRIS: They're gonna put me in jail for a long time babe

A long ******* time!

JENNIFER: Chris George was on the phone with his girlfriend,

Diana Pavnick.

CHRIS: Babe, I'm ******!

I'm ****** baby!

JENNIFER: This was the first time we ever heard him show emotion.

He was scared.

He was running scared.

JENNIFER: We took his boats, his luxury vehicles.

We seized his bank accounts

and served a multitude of seizure warrants,

which yielded just shy of $ million.

But, more importantly, we seized about , patient files.

KURT: We started taking a hard look at the deaths.

We had an intelligence analyst pull names randomly

from the patient files.

We found out that of those people were deceased.

So, if you extrapolate that out to the , individuals

we knew that visited this clinic,

we could have as many as , deceased.

(laughs)

CHRIS: You make me sound like a mass m*rder*r.

They did tell me that I k*lled more people than /,

and I'm like, that's just crazy.

(laughs).

KURT: Chris George is a psychopath.

He had no feeling whatsoever and he did not care that he

was responsible for causing these people's deaths.

JENNIFER: Chris George believed if anyone ever took

any blame for the ill*gal activity within the clinic,

that it was going to be the physicians and not him.

KURT: The average doctor in their organization made

over $ million dollars a year.

They were drug dealers, in white lab coats.

That's all they were.

After they'd been arrested, most of the doctors ended up

agreeing to cooperate.

CHRIS: The doctors started pleading out, saying that

I told them to prescribe large amounts of drugs and

don't care about the patients

and that's how they built their case.

JENNIFER: The doctors provided us with the

final piece of evidence that we needed and admitted to

the fact that they sold their medical licenses

to be drug dealers for Chris George.

KURT: We told him the evidence that we had against him was

enough to put him in federal prison for

the rest of his natural life.

So, that was used sort of as a tool to get him to plead guilty.

CHRIS: It was, you know, the hardest decision I made

in my life.

I plead out to one count of racketeering conspiracy,

and was sentenced to just over years in prison.

I was pretty angry that they could do all this to me.

I pretty much lost everything.

DERIK: You know, pretty much everybody had rolled over on me,

so their case was just building and building and building.

I plead guilty to federal racketeering charges and

I was sentenced to years in federal prison.

It really hit home when that judge said years.

JENNIFER: We shut down the largest prescription drug trafficking organization

in the United States at the time.

It is one of the most proud things I have

ever accomplished in my career.

KURT: In the year following us shutting down the

American Pain organization,

the death rate from oxycodone overdose

in the state of Florida dropped %.

JONATHAN: They profited hand over fist and they destroyed

a lot of lives, a lot of lives,

and when I look back at it,

I was gonna die too, %.

I would definitely say my mom saved my life

and my mother is Tina Reed.

TINA: Sometimes I wonder if he realizes that

I had him arrested.

It's just so wonderful to see how far he's come.

We are so lucky and so grateful.

He coulda just been another one of those numbers.

DIRECTOR: What's next for Chris George?

What does the future hold?

CHRIS: So, I just got out recently and I'm looking at

other things, other businesses and, you know, see what looks

the best and I wouldn't do pain management again.

But, you know, something in the medical field I'm open to.

(laughs).