Americans have a pain problem. As does healthcare. We might be at an impasse: patients and federal dollars both demand pain control, and yet narcotic deaths continue to exponentially rise, with most users reporting their gateway drug was a prescribed painkiller. Personally, I’m in the Dread Pirate Roberts school of philosophy: “Life is pain, Highness! Anyone who says differently is selling something.” I do believe we are in pain, but I think instead of attempting to interpret the signals, we’re trying to silence the noise. Narcotics are the physiological equivalent of telling someone to “shut up.” Don’t get me wrong; they absolutely have their use and as a cancer nurse, I see first hand why they are needed. But I also know that some people will experience pain no matter how many narcotics are pushed in them, and I’ve come to believe ‘pain’ is more than a reflection of a noxious nerve stimulus.
I picked up American Pain thinking I was going to get a medical/drug exposé along the lines of Martin Shkreli, the pharmaceutical-company C.E.O., who boosted a HIV drug over 5,000 percent, from $13.50 a tablet to $750. Alas, what it is about is two brothers, Chris and Jeff George, and their friend, Derik Nolan, opening a pain clinic in Florida in the late 2000 and making a ton of money selling oxycodone and Xanax. It reads like this:
Construction, tattoos, steroids, oxycodone, oxy, oxy, oxy, oxy, strippers, storefront clinic, doctors, oxy, oxy, oxy, oxy, oxy, oxy, oxy, oxy, cash, safes, bank, oxy, oxy, oxy, oxy, oxy, oxy, oxy, oxy, oxy, money in garbage bags, junkies, Mountain Dew, oxy, oxy, oxy, oxy, oxy, Kentucky, shooting up, bouncers, oxy, oxy, oxy, Range Rovers, partying, drug testing, oxy, oxy, oxy, oxy, zombies, junkies, clinics, oxy, oxy, oxy, oxy, oxy, oxy, houses, property, wiretaps, oxy, oxy, oxy, oxy, oxy oxy, oxy, oxy, oxy, oxy.
Still, there was about a twenty page section that panned some informational gold. Oxycontin is the long-acting form of an older drug, and an enterprising drug company was seeking to capitalize on their expiring patent. Heavy “educational” campaigns helped doctors and consumers how their pain was being under-treated. Strategic differentiation between ‘psychological addiction’ and ‘physical dependence’ was propagated. And, quite shockingly, the revelation that the DEA meets with drug companies to decide and approve the amount of narcotics allowed to be manufactured annually. The end result was overdose deaths quadrupling in eight years and killing more people than cocaine and heroin combined. All this is truly fascinating stuff, but it’s over quickly so that Temple can return to the drama of the American Pain Clinic.
I take issue with his approach, because though Temple relates a FBI agent is told to, “follow the money,” this journalism fails to do the same thing. Sure, these owners of the clinic were getting rich–Chris George had 4 million in cash stashed at his mom’s house when he was busted–but you know who else was getting rich? A lot of people. Strangely, the tale leaves that out. Manufacturers. The pharmaceutical company. Lawyers. Bankers. Corporations that rented space to the clinics. No doubt the lobbyists. Governments–these clinics were legal and paid taxes. The lawmakers that didn’t regulate clinics or create patient drug registries as their state dispensed more oxycodone than the rest of the nation combined. There’s a whole lot of people complicit in this racket, and I don’t think the Kentucky “hillbillies,” as Nolan and Temple so generously call them, are the ones making the real dough–though they are the ones paying the price for overdoses.
Still, this might have been an interesting tale. However, sentence construction is staccato-like, resulting in a narrative that jars. Sentences are mostly factual statements strung together, with insight only from Derik, and that limited–and I mean that in the psychological sense as well as all the commentary that comes from him only emphasizes his good-time attitude and willful ignorance. While I suppose it is technically a more honest journalism, the author then relies on prejudices of the reader to draw assumptions, courtesy of class prejudices. Anecdotes like Nolan’s father killing his mother and step mother, Florida construction boom, stripper-junkie girlfriends, homemade fireworks, etc. seek to drive the point home. Nuance is not Temple’s forte.
This is a topic worthy of some serious journalism, but instead it’s caught up in the tale of some young, canny dudes out to make serious bucks. Worse, instead of really investigating the true crime–a manufactured epidemic of pain and the addictive drugs to ‘cure’ it–it settles for self-righteous judgement and economic prejudices. I can’t honestly recommend it, as only the factual sections saved it from the DNF pile.