AMERICAN PAIN

AMERICAN PAIN by John Temple

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Authors: John Temple
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about this because the doctors usually didn’t completely fill out scrips that were filled in-house. They weren’t trying to hide anything. It was just a time-saving measure. Why bother writing out the patient’s name and address if the scrip was never even going to leave the building? If the patient wanted to fill the prescription elsewhere, the doctors filled it out completely, and Derik or Dianna photocopied it and put the copy in the file.
    Derik thought the inspector looked pleased with himself as he put the copies in an envelope and sealed it. It was kind of funny. Chris and Derik were a couple of house builders who had only the slightest idea what they were doing in the pain clinic business, and they had found a way to crank tens of thousands of pills a day onto the street. And the state investigator was fine with that fact. Instead, he knocked them for not including the patients’ names or addresses on some prescriptions. And he didn’t like Moe being there.
    The inspector left with his envelope of photocopied prescriptions, and Derik and Chris did what they usually did when they were together: laughed it off. They made fun of the little guy, his street accent and bad grammar. That guy was going to bring them down? No way.

    Chris took the health department inspection more seriously than he let on to Derik. For one thing, he decided he would no longer rely on the doctors to know the rules and regulations around pain management. Other than her brief stint at One Stop Medical, Dr. Gittens was a family practitioner. Dr. Joseph was a gynecologist. They weren’t pain management specialists, and they probably weren’t even very good doctors, or else why would they be working here? Chris needed to figure things out on his own.
    After a local pharmacy began refusing to fill South Florida Pain prescriptions and said it was heeding the advice of the DEA, Chris called the DEA for clarification. He wanted to know, once and for all, what the rules were. He expected to get some kind of runaround, but he got lucky, connected with a woman who was some kind of higher-up in Florida. And then he introduced himself, and the DEA official knew who he was right away. Even knew his address.
    She said: Oh, yes, South Florida Pain Clinic. That’s 500 West Oakland Park Boulevard, right?
    The recognition freaked Chris out. A DEA official had his clinic’s address on the tip of her tongue. He asked her some questions, and she did what the state health investigator had done, told him to consult the DEA website. She couldn’t tell him anything more than what was there.

    Chris consulted the DEA website. It contained a policy, published in 2006, for dispensing pain meds. In the introduction, the policy quoted some statistics, including a national survey from 2004 that found that thirty-one million Americans had used painkillers to get high. But the eye-opening number was the 2.4 million people in the previous year who had tried painkillers non-medically for the first time. That number was higher than the number of new users of cocaine or even marijuana. Among illicit drug users, pharmaceuticals were the biggest growth market.
    Yet doctors hadn’t reached a consensus on painkillers. When the DEA had drafted the policy, many health professionals had provided input, and they split into two groups with different primary concerns: those who felt that pain was undertreated, and those who believed that painkillers were overprescribed. The document quoted one authority who said: “It takes only a few untrained or unscrupulous physicians to create large pockets of addicts.” But the document also said “undertreatment of pain is recognized as a serious public health problem,” and Chris liked the sound of that line, filed it away to use later.
    The document said painkillers like oxycodone could only be prescribed or dispensed for a “legitimate medical purpose.” And there’s where things got really fuzzy. The policy said there were no

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