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American Pain: How a Young Felon and His Ring of Doctors Unleashed America’s Deadliest Drug Epidemic Hardcover – Illustrated, September 29, 2015
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* New York Post, “The Post’s Favorite Books of 2015”
* Suspense Magazine’s “Best True Crime Books of 2015”
* Foreword Reviews’ INDIEFAB Book of the Year in True Crime
* Publishers Weekly, Big Indie Book of Fall 2015
The king of the Florida pill mills was American Pain, a mega-clinic expressly created to serve addicts posing as patients. From a fortress-like former bank building, American Pain’s doctors distributed massive quantities of oxycodone to hundreds of customers a day, mostly traffickers and addicts who came by the vanload. Inked muscle-heads ran the clinic’s security. Former strippers operated the pharmacy, counting out pills and stashing cash in garbage bags. Under their lab coats, the doctors carried guns—and it was all legal… sort of.
American Pain was the brainchild of Chris George, a 27-year-old convicted drug felon. The son of a South Florida home builder, Chris George grew up in ultra-rich Wellington, where Bill Gates, Springsteen, and Madonna kept houses. Thick-necked from weightlifting, he and his twin brother hung out with mobsters, invested in strip clubs, brawled with cops, and grinned for their mug shots. After the housing market stalled, a local doctor clued in the brothers to the burgeoning underground market for lightly regulated prescription painkillers. In Florida, pain clinics could dispense the meds, and no one tracked the patients. Seizing the opportunity, Chris George teamed up with the doctor, and word got out. Just two years later Chris had raked in $40 million, and 90 percent of the pills his doctors prescribed flowed north to feed the rest of the country’s insatiable narcotics addiction. Meanwhile, hundreds more pain clinics in the mold of American Pain had popped up in the Sunshine State, creating a gigantic new drug industry.
American Pain chronicles the rise and fall of this game-changing pill mill, and how it helped tip the nation into its current opioid crisis, the deadliest drug epidemic in American history. The narrative swings back and forth between Florida and Kentucky, and is populated by a gaudy and diverse cast of characters. This includes the incongruous band of wealthy bad boys, thugs and esteemed physicians who built American Pain, as well as penniless Kentucky clans who transformed themselves into painkiller trafficking rings. It includes addicts whose lives were devastated by American Pain’s drugs, and the federal agents and grieving mothers who labored for years to bring the clinic’s crew to justice.
- Print length320 pages
- LanguageEnglish
- PublisherLyons Press
- Publication dateSeptember 29, 2015
- Dimensions6.41 x 1.05 x 9.26 inches
- ISBN-101493007386
- ISBN-13978-1493007387
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Editorial Reviews
Review
(Starred Review). . . . [An] exhilarating blow-by-blow account. . . . Journalism professor Temple dissects the . . . criminal operation and documents the rise and fall of American Pain with precision and authority in this highly readable true crime account. ― Publishers Weekly
“John Temple’s American Pain takes you on a hysterically funny, yet equally tragic, tour of Florida’s pill mill industry as the painkiller epidemic was reaching a fever pitch. He adeptly navigates the personal, political, and historical impacts of oxycodone, illustrating how the prescription opioid broke through all socioeconomic barriers to become the drug of choice for the super-rich and the super-poor. American Pain is a must-read for anyone trying to understand this government-sanctioned drug and the destructive power of Big Pharma.”
—Melisa Wallack, Oscar-nominated co-writer of Dallas Buyers Club
“American Pain made me angrier with every page. Why? Because John Temple has so adeptly reported this story of how a handful of criminals and shady doctors in Florida profited from the poverty and addiction of the Appalachian South. Right from the riveting opening chapter, American Pain is rife with tension, conflict, and good journalism. Temple sets up a collision course between the George twins and their buddy Derik against a lone FBI agent, who suddenly realizes she doesn’t exactly have the law on her side. Every chapter is worth it.”
—James Higdon, national bestselling author of The Cornbread Mafia: A Homegrown Syndicate’s Code of Silence and the Biggest Marijuana Bust in American History
Temple has written a. . . .macro look at how Mexican heroin has supplanted prescription painkillers as the opiate of choice. This title relates a hugely profitable Florida pain clinic that started in 2008 and collapsed in 2010 after a lengthy undercover federal investigation. It benefits greatly from the author’s interviews with the principals, Derik Nolan and Chris George, who had no medical background but saw a better opportunity than construction work or selling steroids. Using trial testimony, media reports, and interviews with many of the players, Temple reconstructed in a chronological fashion the day-to-day operations of the clinic. As a former news reporter, the author does an exquisite job of weaving a simple narrative of greed and addiction into a cautionary tale. . . .VERDICTHighly recommended for general and true crime audiences. ― Library Journal
“John Temple’s American Pain is as addicting a read as the little pills he writes about. Temple details the brazen operations of some of America’s largest pill mills and how they thrived in plain sight for years before the government took action. Forget back-alley deals, smuggled contraband and elusive kingpins, today’s war on drugs pits the government against much more formidable foes: pharmaceutical companies, doctors, and ambitious businessmen eager to facilitate prescriptions for patients’ pain, whether real or imagined.”
—Jason Ryan, author of Jackpot: High Times, High Seas, and the Sting That Launched the War on Drugs
" In his masterful nonfiction book American Pain, John Temple lays bare the perfect storm of lax regulation, aggressive marketing, greed, and addiction that created an opioid epidemic. .. .Temple’s writing is propulsive, and does justice to the many legal and ethical gray areas of the story. The fates of George, Nolan, their staff, and the doctors involved with American Pain are all satisfyingly recounted, along with the lasting impact of one of the overdose deaths directly attributable to them. An example of what can happen when individuals, companies, and politicians place their own interests before simple ethical considerations, American Pain is a cautionary tale of the finest sort." ― Foreword Reviews
Review
[Deadhouse gives] an insider’s view of one of the country’s most misunderstood professions. ― Charleston Gazette
Writing evenly and efficiently, [in Deadhouse] Temple will enlighten fans of the CSI television shows. Teens, especially fans of CSI and Mary Roach’s Stiff, will find the perspectives from two college-age interns particularly involving. ― Booklist
About the Author
Product details
- Publisher : Lyons Press; Illustrated edition (September 29, 2015)
- Language : English
- Hardcover : 320 pages
- ISBN-10 : 1493007386
- ISBN-13 : 978-1493007387
- Item Weight : 1.28 pounds
- Dimensions : 6.41 x 1.05 x 9.26 inches
- Best Sellers Rank: #2,385,815 in Books (See Top 100 in Books)
- #710 in White Collar Crime True Accounts
- #48,553 in U.S. State & Local History
- Customer Reviews:
About the author

From the rise and fall of the nation’s largest pill mill to a ranching family’s notorious armed standoffs with the federal government, the true stories chronicled in John Temple’s books illuminate significant issues in American life.
Temple’s book, American Pain: How a Young Felon and His Ring of Doctors Unleashed America’s Deadliest Drug Epidemic, was named a New York Post “Favorite Book of 2015” and was a 2016 Edgar Allan Poe Award nominee. American Pain chronicles how two young felons built the largest painkiller clinic in the United States and also explains the roots of the opioid epidemic. Temple is a frequent keynote speaker and commentator on the opioid epidemic.
Temple also wrote The Last Lawyer: The Fight to Save Death Row Inmates (2009) and Deadhouse: Life in a Coroner’s Office (2005). The Last Lawyer won the Scribes Book Award from the American Society of Legal Writers.
Temple is a tenured journalism professor at the Reed College of Media at West Virginia University. A veteran investigative journalist, he holds an MFA in Creative Nonfiction Writing from the University of Pittsburgh. Prior to academia, Temple worked as a newspaper reporter. He currently lives in Morgantown, West Virginia with his wife and two sons. Learn more at www.johntemplebooks.com.
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Customers find the book interesting, enlightening, and easy to follow. They describe the information as well-researched, insightful, and rich. Readers praise the writing quality as well-written, clear, and concise. They say it provides an amazing look into a world they never knew existed.
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Customers find the book interesting, enlightening, and easy to follow. They say it's one of the best non-fiction books they have ever read. Readers also mention the subject is fascinating and the true sense of discovery they feel as they read the book.
"This was a terrific book: part American tragedy, part Donald Westlake crime caper...." Read more
"...right amount of scholarly research and data, while still telling the alarmingly true story of the true beginning of the Florida pill mills...." Read more
"...But the story Temple tells is real, the details backed up by evidence collected by South Florida police, the FBI, and the DEA...." Read more
"As soon as I started the sample read I was hooked. Great read and easy to follow...." Read more
Customers find the book thoroughly researched, insightful, and a rich resource for those trying to understand the epidemic. They say it's well-written and grounded in facts and figures journalism. Readers also mention the book helps families of addicts understand they are not alone.
"...A good read, an important book." Read more
"...Just the right amount of scholarly research and data, while still telling the alarmingly true story of the true beginning of the Florida pill mills...." Read more
"The book is clear and concise. Very interesting. Well researched and backed by consistent and noted citing. Recommend to all." Read more
"...I enjoyed this book because it didn't glamorize pain clinics/ opioids .It made the story raw & real but I didn't like the way the author described..." Read more
Customers find the writing quality of the book extremely well-written, beautiful, and easy to read. They also say it's clear and concise. Readers mention the material is compelling and easy to follow.
"...As a tale of excess, American Pain is an easy read: fascinating, shocking, and cringingly entertaining...." Read more
"As soon as I started the sample read I was hooked. Great read and easy to follow...." Read more
"This book is written like a novel and not like usual nonfiction...." Read more
"The book is clear and concise. Very interesting. Well researched and backed by consistent and noted citing. Recommend to all." Read more
Customers find the book amazing, vivid, and visual. They say it provides a great view from the inside and creates very human portraits of the people involved.
"...This book provides such a great view from the “inside”...." Read more
"An amazing look into a world I never knew existed...." Read more
"...It did not disappoint. John creates very human portraits of the people involved in this story, but, as any good journalist does, he also shows where..." Read more
"...of detail brought to each character and event, makes this one of the most vivid and visual non-fiction accounts I have read in a long time...." Read more
Customers find the book fast-paced.
"...Anyone looking for a timely topic and a fast-paced, well written story won't be disappointed by John Temple's new book, American Pain." Read more
"This is a fast paced book about the rise and fall of the Florida pill mills, especially American Pain...." Read more
"American Pain is a fast and furious read, grounded in facts and figures journalism...." Read more
"...characters range from criminal to heroic, all caught up in this fast-paced, powerful story, written with vigor, poignancy, and humor...." Read more
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How Pill Mills Brought America the Oxycodone Epidemic
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Chris George, the wealthy son of a successful South Florida builder, was running a semi-successful shop selling anabolic steroids when he started seeing pain clinics pop up all over Broward County around 2008. If he made decent money selling steroids, he figured, why not take a shot at selling opioids?
Chris was in his late twenties, and with one felony conviction under his belt, he wasn’t sure he’d be allowed to open a medical practice. When he looked into Florida’s regulatory codes, he learned that all he needed to legally sell OxyContin and other narcotics was a business license and a doctor. He filled out a one-page business license application and put out an ad for doctors on Craigslist. In a few weeks, he opened the South Florida Pain Clinic in a strip mall on Oakland Park Boulevard near Fort Lauderdale.
Unlike the founders of competing pain clinics, Chris had a strong business background. He had managed many aspects of his father’s construction company, including marketing, logistics, supplies, and personnel management. He had a natural talent for bringing in new business, and for managing a growing enterprise. (If you’ve ever worked at a fast-growing startup, you’ll know how difficult it can be to manage growth, and to find a person who’s actually good at it.)
Chris advertised aggressively, running ads in local papers and putting billboards on the highways. The business grew beyond his wildest expectations. He had tapped into a market of desperate addicts far larger than he or anyone else knew existed. Patients came by the van load from Kentucky, West Virginia, Ohio, and other states. In the clinic’s crowded waiting room, they bribed their way to the front of the line, got their prescriptions, filled them right there at the front desk, then went out to the parking lot, crushed their pills and injected them. Some of them died on the car ride home.
The clinic moved twice as it outgrew its facilities. Along the way, it changed its name to American Pain, in an attempt to outrun the bad press that local media had attached to The South Florida Pain Clinic.
As the number of patients outgrew the waiting room at each location, junkies waiting for pills would loiter in the parking lot, angering neighbors and local businesses. Chris hired his friend Derik Nolan, another tattooed weightlifter with a penchant for steroids, to act as bouncer and get rid of the most problematic clients. Over time, Derik was pulling in five thousands dollars a week, all cash, in bribes from desperate patients who wanted to jump the line and get to the doctor ASAP.
Temple paints a portrait of the clinic that seems like something from the imagination of Carl Hiaasen. The doctors carried guns beneath their lab coats. Chris and Derik hired strippers to run the reception desk and collect payments. Chris paid for their breast implants. There was so much cash running through the clinic each day, the strippers collected it in garbage bags beneath the desk. Before Chris and his managers discovered the cash counting machines used by banks, the spent six hours a day just counting the bills they collected. One by one, the local banks stopped doing business with them, because they were uncomfortable seeing Chris and his managers walk in each day with a duffel bag full of cash.
If Hiaasen had written a novel about American Pain, his editor might have rejected it as over the top. But the story Temple tells is real, the details backed up by evidence collected by South Florida police, the FBI, and the DEA. The book relies heavily on interviews with Derik Nolan, the clinic’s enforcer, now serving a lengthy sentence in federal prison.
While the clinic’s tacky and outrageous excess comes off as a South Florida version of The Wolf of Wall Street, Temple dedicates several chapters to its victims. They are young or middle-aged, dead of overdoses or from collisions caused by driving under the influence of the pills.
The author also does a good job of tracing the enablers of the opioid crisis, from the clinic back up the chain to the truly powerful players. He looks at the prescription drug wholesalers who supplied American Pain, pumping millions of pills through a practice of five full-time doctors, and pretending there was nothing unusual about that. Temple notes that among all US states in 2010, Ohio had the second-highest number of OxyContin/oxycodone prescriptions–over a million pills in a single year. To illustrate the scale of Chris George’s enterprise, he notes that a single doctor at American Pain out-prescribed the entire state of Ohio.
Going further up the chain, Temple examines the pharmaceutical manufacturers who produce the pills. He describes Perdue Pharma’s long, coordinated campaign to convince America that chronic pain was a silent, under-treated disease to which OxyContin was the answer. Perdue spent an enormous amount of time and money persuading doctors to liberally prescribe their pills, producing misleading articles that showed opioids were not addictive.
At the top of the narcotic supply chain, Temple reports, is the DEA, which each year, in closed-door meetings, sets a limit on the total amount of opioids US pharmaceutical companies can legally produce. That number skyrocketed through the 1990s and early 2000s, as the pharmaceutical industry convinced the DEA of the soaring need for their product. Even now, as states have imposed tighter regulations and shut down mills like American Pain, the DEA continues to approve ever higher amounts of oxycodone production.
In 2014, as the number of opioid-related deaths in the US surpassed the number of deaths from motor vehicle accidents and the Centers for Disease Control declared opioid abuse a national epidemic, the DEA increased the production limit on legal opioids to almost 150,000 kilograms. That’s forty-two times the amount produced in 1993, when Perdue was preparing to launch its campaign to push OxyContin to the masses.
The DEA’s job, Temple reminds readers, is not only to stop the flow of illegal drugs, but to stop the diversion of legal controlled substances. The hundred and fifty thousand kilos that Big Pharma produces is still going somewhere, Temple notes. There simple aren’t enough patients in the terminal cancer and post-op wards to soak up that amount of narcotics.
If you don’t already know about the opioid crisis, this book will open your eyes. If you do know about it, this will sharpen your knowledge. As a tale of excess, American Pain is an easy read: fascinating, shocking, and cringingly entertaining. As a tale of individual and family devastation replicated on a vast scale throughout the country, it’s a tragedy. As a tale of greed, malpractice, and misgovernment, it’s an outrage.
Kudos to John Temple for putting this out there. Let’s hope this book pushes us toward a solution to a problem that we allowed to be manufactured.

