Category: Opioid Crisis

American Pain: How a Young Felon and His Ring of Doctors Unleashed America’s Deadliest Drug Epidemic – John Temple

On By Genyc79In American History, Opioid CrisisLeave a comment

It is no secret that America has been embroiled in an epidemic regarding opioid addiction. But in 2024, the country saw a decrease in overdose deaths which provides hope that the crisis will be further contained. Despite the positive trend, the battle continues against the synthetic opioid fentanyl which has become the drug of choice due to its strong addiction inducing properties. In 1874, C. R. Wright, a physician at St. Mary’s Hospital in London, first synthesized heroin. However, he could not have known what would exist in 2025. In the state of Florida, “pill mills” popped up across the state as addicts obtained their fix of the euphoria producing narcotics. These small circular pills inside of a prescription bottle were initially misunderstood but caught the attention of Derik Nolan and twin brothers Chris and Jeff George who created the blueprint for the mills through their business venture American Pain. This is an investigative report into its rise and fall by author John Temple.

Although the George brothers and Nolan did not create the opioid crisis, what they did with American Pain was instrumental in the exponential growth of pill mills. But what is shocking is that none of them had any medical training and were not licensed physicians. In fact, they knew nothing about running a medical clinic or the drugs that customers would kill to obtain. However, they did have a passion for making money and that thirst would drive them to create an empire that was nothing short of horrifying. Temple introduces us to the main players, and their back stories come with dark aspects. Nolan survives family trauma which left me speechless. Upon meeting the George brothers, his fortunes change and he becomes centrally involved in Chris’s new venture into the pain management arena. And when their brainchild named American Pain opens for business, everything changes in ways no one could have predicted. Temple takes us on a wild ride complete with addiction, money, sex, and the attention of both the Federal Bureau of Investigation (“FBI”) and Drug Enforcement Agency (“DEA”).

The clinic was set up but the guys realized they needed doctors and began recruiting physicians who had no qualms about prescribing pain medication. And the way in which they find the doctors left me shaking my head. It is as no frills as one would expect. But once the doctors arrive and the parking lot begins to fill up, the book takes a much darker turn. Between the excessive amounts of pills, the behavior of addicts in and outside of the clinic, and the effect on residents of other states, American Pain transformed into a menace to society. However, readers will be shocked to learn how the law initially viewed their operation. And that stance extended to other states as well. Frankly, as Temple shows, America was slow to react to a crisis brewing right under its nose.

The success the boys enjoyed provided extensive wealth, notoriety, and a steady stream of addicts in need of their fix. But soon people begin to take notice and ask questions. The media and law enforcement soon surmise that all is not right with this clinic and its line of daily visitors. And when the FBI enters the picture, we see the writing on the wall. But their downfall happens in slow motion in a step-by-step process which reveals the arrogance and recklessness which should have been raising alarm bells for anyone connected to American Pain. And when other clinics begin to pop up copying their platform, their response and the events that follow should have also served as a warning that they were approaching the edge of a cliff. Unbeknownst to them, the FBI and DEA had already set into motion the operation that would pull everything apart at the seams. And when the fallout occurs, everyone wants off the sinking ship. However, once section that gave me chills is the role of Dr. Cynthia Cadet and the dark effects of the prescriptions she wrote. What Temple shows is chilling and after finishing the book I continued to think about it.

Once the clinic falls apart and the American Pain team is face to face with the reality that they are not going home, the wheels of justice spin in overdrive as defendants turn state’s evidence and admit their role in the spread of addiction and death. They also face the families of the people whose lives were lost to the black hole of addiction. The tragedy of Stacy Mason as told by the author is only one example of the heartbreak families endured as the crisis hit home. His mother Alice helps clench the outcome towards the end of the story as the government proves its case. Tina Reed emerges as a voice of reason through her crusade to create a statewide database to monitor drug usage and distribution should not be overlooked. These women from small towns in America are a fraction of the list of mothers whose children succumbed to opioid dependence.

American Pain is eventually shut down but the crisis is far from over. Derik Nolan is the most talkative of them all and is frank in the book about his actions. But that in no way excuses what he did. He, the George brothers, and staff at the clinic operated a business which thrived on fraud. Today, doctors are under tighter controls when prescribing opioids and lessons of the past have been learned. But the fight is not over and the temptation to earn significant revenue by exploiting the desperation of others never disappears. This book by John Temple is eye-opening, shocking, and upsetting, but it is also a case study of what happens when regulation is non-existent and greed is left unchecked.

“Of course we did it. The f–ed-up thing is that we were allowed to do it. That they let us do it. Why were two guys like me and Chris allowed to set up a business like this? When we said we wanted to set up a pain clinic, they shoulda been like, ‘Umm . . . No.’ Or, ‘Let’s see your criminal record.’ When we said we wanted to order $100,000 worth of pain medication, they shoulda said no.”

ASIN ‏ : ‎ B01448QLIS
Publisher ‏ : ‎ Lyons Press, ‎ September 29, 2015

Smacked: A Story of White Collar Ambition, Addiction and Tragedy – Eilene Zimmerman

On By Genyc79In Opioid Crisis2 Comments

SmackedDrug addiction has steadily become one of the greatest plagues to affict mankind.  Nearly all of us know someone who has struggled with addiction or lost their life to it.  Recently, I read Sam Quinones’ spellbinding account of the rise in opioid in the United States Dreamland: The True Tale of America’s Opioid Epidemic , in which Quinones explains how and why opioids have become so ingrained and deadly in American culture. My boss had recently ordered this book about drug addiction to understand the matter which had come up in one of our cases.  He mentioned that he did not have the time to read it at the moment but let us know that the book was for the taking to anyone who had interest in it. I decided to take it along with a few other books also on the opioid epidemic.  Similar to Dan Peres As Needed for Pain: A Memoir of Addiction , the story at hand involves the drug addiciton of a successful individual whom many would not suspect of being an addict.  Eilene Zimmerman tells the story of her late husband Peter, whose battle with addiction claimed his life and led her on a mission to understand how drugs have infiltrated the lives of even the most successful.

As the book opens, Eilene arrives at Peter’s house after learning he had a bizarrer outburst at his son Evan and daughter Anna.  No one has heard from him and she decides to check on him and confront him over his behavior.  Upon arrival at his house, she notices several odd things before finding him face up and deceased.  A called is placed to 911 and she desperately tries reviving him but it is soon clear that Peter is gone.  At this point in the book, we are not sure why he has died but only that something terrible has happended and many questions now exist that are answered as the book progresses.

The story of his life and their time together is equally as important as his death and Eilene takes us all the way back to the time when she was twenty-three and in search of a job after recently being laid off.  She meets Peter after he interviews her at a job placement center. Over the next two years they became friends and eventually found themselves in a committed relationship.  Zimmerman’s memories provide examples of how true love flourishes under the most unexpected of cirumstances.  Marriage, children and an eventual move to San Diego, California follow where they settle in with their children Evan and Anna.  Peter is a successful partner in a law firm whileEilene exercises her talents in journalism.  However, their marriage soon desolves and not long after, Peter starts to exhibit some very strange behavior. 

Peter, who was once a doting father and husband, begins to unravel, missing appointments or in some cases not showing for events. Although the couple divorced, they remained close because of their children.  Eilene notices some very disturbing aspects of his appearance which Peter quickly explains as Hasimoto’s disease.  Wanting to believe him at face value, she accepts his expanation until discovering one day that some parts of the story do not add up.  But Peter has an answer for everything, a commonly known trademark of drug users.  As she relays the memories of his behavior, readers will be tempted to think “why didn’t she see that he was using drugs?”.  One answer is that prior to Peter, she had no direct exposure to it.  Her story is similar to thousands of grieving relatives who have never seen up close, the effects of drugs that are mentioned on television and the internet.  Peter’s children are equally disturbed and distressed by their dad’s behavior but no one can come up with a logical answer for his erratic actions.

The author looks back with hindsight and provides insightful comments as she tells the story.  It is clear that she is now well immersed in the underpinnings of drug addiction in America and also part of the growing number of those who have lost someone close to narcotics.  She is candidly honest about her failure to see what was slowly becoming obvious and why she held on to her belief that he needed to see another doctor about the Hashimoto diagnosis.   But through her words, readers will be able to piece together a picture of a man who is in the grip of a serious addiction that is literally changing him mentally, physically and emotionally. The meltdown kicks into high gear and for Zimmerman and her children, events soon take a dark turn.

After learning about their lives and the road leading up to Peter’s death, Zimmerman has a lot more to discuss in the book and devotes a signficant portion to the use of drugs in corporate America, in particular among lawyers.  This section hit home because I work in the legal field and bear witness to the amount of pressure and stress that attorneys carry daily.   Some handle it better than others and yes, from my own knowledge as well, some turn to drugs to ease the stress.  But wht I learned here was more than I had bargained for. And to make matters even more surprising, what Zimmerman relays is just a small sample of what is possibly very large scale.  Further, what she relays is that drug use is more prevalent among professionals than most of us think.  It also reinforces the notion that not all drug users look like they use.

Towards the end of the book, she also devotes a section to Generation Z and the modern day professional.  The invention of social media and concept of being “plugged in” all day long has not only increased workloads but stress.  The use of drugs culd very well increase among the younger generation who are coming of age in an era where social and workplace pressures are higher than ever.  In Japan,  it is well documented that some people have succumbed from working themselves to death.  While the United States does not appear to be as extreme in the idea of overwork, there are many professionals who do work eighty or more hours each week.  For some of them, the keep going, they will turn to illegal drugs that give them the assist they need to keep going. But how do we then give them the help they need before it is too late?

I found myself glued to the pages of this book.  Once the story begins, it continues to pick up speed as Peter begins his descent from which he will never return.  Zimmerman’s honesty about her own actions and beliefs will provide solace to other wives and mothers who have been in the same situation.  And in spite of all that happens in the book, she never stops loving him even after he is gone, showing the long lasting effects of losing someone to drugs.  This is a great read from a very strong person who tells you her story so that your family does not live through what she did.  Highly recommended.

ISBN-10: 0525511008
ISBN-13: 978-0525511007

Dreamland: The True Tale of America’s Opioid Epidemic – Sam Quinones

On By Genyc79In Opioid Crisis5 Comments

DreamlandIn August, 2019, a close friend lost her brother, who became yet another statistic in the ongoing crisis regarding opioid and other drug use in America.  I had met him previously and his death seemed surreal at the time. In fact, it still does.   His parents had never experienced anything like it and did what they could to get him the help that he needed.   For them and thousands of other parents who have lost a child to drugs, they often wonder how did this happen?  And what could we have done to stop it?  There are many answers to both questions but in this eye-opening book, Sam Quinones tackles the first question and tells the story of the development of the opioid epidemic in America.

Purdue Pharma, the company that reaped billions of dollars in the manufacture and sale of OxyContin, filed for bankruptcy in September, 2019, as it settled scores of claims former opioid addicts and family members of those who perished while addicted to the drug.  As part of its bankruptcy filing, it will pay out billions of dollars to those who fell victim to the company’s false adveritsing.   However, it is not the first time Purdue Pharma paid out money in litigation. Quinones revisits the year 2007, in which former U.S. Attorney for the Western District of Virginia John Brownlee launched an investigation into the company’s advertising practices. Purdue later entered into a plea deal with the government in which it agreed to pay a $634.5 million dollar fine. Several of its top executives later served time in prison.

When we think of the opioid epidemic, many ideas come to mind of the drugs that people take the alleviate pain and in other cases, feed an addiction that has become a raging monster.   Some users rely on prescription drugs while others have turned to street drugs, the most popular of which is heroin.   I personally knew someone who succumbed to heroin and each time I think of how short his life was, I shake my head in disbelief.   But I also realize that he was not himself and was caught in the grip of a drug that changes the way the mind and body functions.  We know these drugs exist, but the question is why?

Quinones presents a premise for the book which answers why we have opioids to begin with. Doctors have long sought a way to relieve pain for patients without casuing  addiction.  In short, they were searching for what Quinones calls the “holy grail”, a nonaddictive pain killer.   But to understand the current crisis, we first must learn how opioids were developed and the author provides a back story to their development.  The origins of heroin, methadone, diacetylmorphine and morhpine are discussed.  As I read the book, I thought to myself that the doctors who discovered these drugs most likely had no idea what they would become in years after their deaths.  If they had, perhaps one of more of them would have tried to halt its production.  We shall never know.

The story at hand is really two separate account of opioids, both legal and illegal.  Quinones weaves both into one story but alternates between the two as the book progresses. One part of the story begins with prescription pain killers in the medical field, whose development was quite low until phyiscians Dr. Russell Portenoy and Dr. Kathleen Foley published a paper in 1981 which did not find a direct link to opioid use and later addiction.  The pharmaceutical industry took notice and the town of Portsmouth, Ohio began to feel the effects from a wave of drugs that later changed an entire country.  Portsmouth had once been a thriving city in small town America and Quinones provides a well-written and informative section devoted to its rise and decline, with particular focus on its once mega-sized pool called dreamland.  The small town’s story forms part of the rust-belt narrative featured prominently throughout the rest of the book.

The other part of the story begins in Mexico where we visit the town of Xalisco in the State of Nayarit.   Some readers may be unfamiliar with the town and I personally did not know of its importance to the drug epidemic.  Quinones explains life in this small town, based largely in part of his time living in Mexico.  As the story of the Xalisco becomes more important,  I began to ask myself the same questions as law enforcement personnel: how did this small Mexican town flood the United States with heroin?  The story is actually quite simple and Quinones re-assembles the pieces of the puzzle so readers can see how the infiltration in America’s suburbs began, targeting a generation of young white suburban kids. It is a part of the war on drugs that many still do not fully understand but this book certainly removes all doubt.  The ghost of trafficker David Tejada and others continues to haunt the lives of kids addicted to black tar heroin which has caused the deaths of thousands of young men and women.

The pharmaceutical industry has become a behemoth in the manufacture and distribution of pain killers.  Purdue Pharma, which has been embroiled in controversy, traces its origins back to the legacy of Arthur Sackler (1913-1987), whose family was also named as a defendant in the lawsuit that resulted in its recent bankruptcy filing.  It is imperative to understand Sackler’s influence and Quinones delivers the goods.  In addition to Sackler, there are many others who played a crucial role in the development of prescription pain killers with varying degrees of influence including Dr. Hershel Jick and his then assistant Jane Porter Boston Collaborative Drug Surveillance Program,  Dr. Nathaniel Katz and quack phsyician Dr. David Procter, who could be described as the father of the pill mill.

On the other side of the battle there were many who realized early that something was brewing and that America was in trouble.  Law enforcment officers began to notice a new trend in drug use across small town America but sadly, many of these departments had never been exposed to narcotics of that caliber. And it is an issue which the author explains quite well.  Heroin and other dangerous drugs were never thought of something suburban kids did, it was only what the “city people” did.  However, its introduction into the American heartland changed all perceptions and people soon realized that the drug spares no one. It does not care about wealth, gender, ethnicity or anything else. Its sole purpose is to addict the user.  Drs. Jennifer Sable, Ed Socie and Gary Franklin had begun to sound the alarm bells with the help of pharmacologist Jaymie Mai but many years would pass before those in power too notice.  And years before Purdue came crumbling down, another lawyer named Joe Hale had attempted to bring the company to justice.  The stories of these men and women whose efforts did not go in vain are covered here and Quinones has done a great service to them in showing readers that there were those fighting the battle many years ago.

To say that this book is incredible would be an understatement. It is at times surreal and at others, infuriating.  Greed and negligence combined to spread a wave of deadly addiction across an entire country.  And the failed war on drugs was equally responsible.  Quinones has presented an irrefutable account of the opioid epidemic and its stranglehold on the nation.  For the families of victims such as Matt Schoonover, the pain never ends.  And I think of Francisco Baez, whom I knew very well until his death at the young age of twenty-four.  Their stories are just a sample of the thousands of opoid related deaths every year in America.  And parts of the country which never knew hard drugs are being forced to reckon with a new demon that destroys everything in its path.  This story is an American tragedy but it allows us to see how and why America turned into dreamland.  Excellent read.

ISBN-10: 1620402505
ISBN-13: 978-1620402504