Everyone is familiar with the following scenario: A dull ache in your low back suddenly turns into stabbing pain. It’s interfering with your daily routine, and makes it hard to even sleep at night. After dealing with the pain for several weeks, you’ve had enough and decide to see a medical doctor to get some prescription painkillers. Before you know it, you’re relying on the painkillers on a daily basis, since you can’t go back to dealing with the pain. Because the painkillers didn’t actually fix your back pain. The medications are just numbing it. And before you know it, you’ve been taking them for several years.
It’s an all-to-familiar scenario that is affecting Americans across the country. Drug Enforcement Administration figures show dramatic rises between 2000 and 2010 in the distribution of oxycodone, the key ingredient in OxyContin, Percocet and Percodan. Some places saw sales increase sixteenfold. The increases have coincided with a wave of overdose deaths, pharmacy robberies and other problems in New Mexico, Nevada, Utah, Florida and other states. Opioid pain relievers, the category that includes oxycodone and hydrocodone, caused 14,800 overdose deaths in 2008 alone, and the death toll is rising, the Centers for Disease Control and Prevention says. Across the U.S., pharmacies received and ultimately dispensed the equivalent of 69 tons of pure oxycodone and 42 tons of pure hydrocodone in 2010, the last year for which statistics are available. That’s enough to give 40 5-mg Percocets and 24 5-mg Vicodins to every person in the United States.
Below is an excerpt from a recent article by Felix Gilette, a staff writer for Bloomberg Businessweek, exposing a side of prescription painkillers that few Americans get to ever see (or hear about from their medical doctors):
Christopher George and his twin brother Jeffrey opened their first pain clinic in a strip mall on the outskirts of Fort Lauderdale in 2008. There were a couple of rooms and a handful of doctors. No appointment was necessary.
It was a good year to be in the business of servicing people in pain. The economy was tanking. The real estate market was in free fall. People were losing their homes, businesses, savings, and jobs, and looking for an escape from their discomfort. The George brothers ran an ecumenical clinic. Their doctors didn’t discriminate among the causes of human suffering—be it back pain, fibromyalgia, toothaches, cancer, depression, divorce, boredom, mental illness, unemployment, hip replacement, or withdrawal symptoms.
Just about everyone who came through their doors walked away with the same remedy: a prescription for a month-long supply of powerful opioids. More often than not, the pills were small and blue—generic, immediate-release oxycodone-hydrochloride, which everyone called “roxies.” The customers often left satisfied and frequently returned. Thousands of businesses participate in the multi-step process by which the opium derivatives are harvested in India, Turkey, and Australia, turned into dozens of different generic and brand-name narcotic medications, distributed throughout the U.S., and resold to individuals via prescriptions. There’s lots of money to be made along the way. In 2011, U.S. sales of prescription painkillers amounted to $9 billion, according to IMS Health.
Opioids are not only profitable, they’re addictive and dangerous. They can depress respiration. Take too many or mix them with other drugs, such as alcohol, and a patient can stop breathing altogether. According to the Centers for Disease Control and Prevention, 14,800 Americans died from overdosing on opioids in 2008, the most recent year data is available—more than the number of deaths from heroin or cocaine.
Most opioids are Schedule II drugs, subject to regulatory restrictions from state and federal agencies. But the regulations are not always clear. Sell too many, too fast, with too much marketing or too little discretion, and suddenly the veil of social acceptability is yanked away. The resulting exposure can be perilous. Those who cross over the sometimes hazy line separating legal from illegal handling of the pills often watch as federal agents suspend their licenses, seize their products, and arrest them in high-profile busts with gothic code names. Recent crackdowns have included Operation Snake Oil, Operation Pill Nation, and Operation Juice Doctor 2.
In the spring of 2010, the George brothers were the target of Operation Oxy Alley. Local and federal cops raided their businesses, confiscated their opioids, and seized millions of dollars of assets, including safes full of cash stashed away in their mom’s attic, according to prosecutors. In August 2011 the Department of Justice unsealed a five-count indictment outlining a range of charges, from racketeering to possession with intent to distribute controlled substances, against 32 individuals, including 13 doctors and one wholesaler involved with the Georges’ clinics. From 2008 to 2010, according to the federal agents, the George twins were the largest illegal dispensers of oxycodone in the U.S.
In the fall of 2011, Jeffrey George pleaded guilty to one count of racketeering conspiracy, a federal charge in which the members of an organization can be held responsible for crimes committed on behalf of the organization. He is serving a 15½-year sentence. He is also currently awaiting sentencing in a separate state criminal action in which he pleaded guilty to second-degree murder in the overdose death of a pain clinic patient. His lawyer did not respond to an interview request. Christopher George pleaded guilty to one count of racketeering conspiracy. He is now serving 17½ years in prison. The twins’ mother, Denice Haggerty, pleaded guilty to one count of conspiracy to commit wire fraud and is now serving a 30-month sentence.
To move large amounts of prescription painkillers in America,you need somebody to write the prescriptions. You need doctors. Hiring doctors to sell drugs is easy, says George. He found his doctors by posting ads on Craigslist. At their peak, when they were running the largest pill mill operation in the U.S., the George twins had roughly a dozen doctors working for them.
George says not a single doctor he interviewed ever turned down a job offer. Although he was always younger than the doctors he was interviewing—he was in his late twenties at the time—George says he made a professional impression. “I had such a big office; it was an easy sell,” says George. “They didn’t walk into some hole-in-the-wall place. The hours were good. The pay was good.”
What the jobs lacked in prestige, they made up for in wages. According to George’s indictment, doctors at his clinics were paid a flat fee for each opioid prescription they wrote—typically, $75 to $100 a pop. To help maximize their efficiency, doctors were given prescription stamps they could use quickly, over and over. It was common for physicians at American Pain to see 100 patients a day, he says. At that rate a doctor would earn roughly $37,500 a week—or $1.95 million a year.
One of the doctors George eventually hired was a plastic surgeon named Patrick Graham. A police wiretap captured a conversation between George and Dr. Graham that touched on the topic of employee compensation. “You make a lot more money doing this than you do doing plastic surgery,” said Dr. Graham, according to court documents. In October 2011, Dr. Graham, 64, pleaded guilty to one count of conspiracy to commit money laundering. He is now serving a four-year sentence. His lawyer declined to comment.
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If you are currently suffering from chronic pain, whether it be back pain, neck pain or headaches, chiropractic may very well be the drug-free solution for you. Countless patients at Georgia Clinic of Chiropractic (Augusta, GA) often comment on how much they wish they hadn’t spent so much money on prescription medications before they had pursued a healthier alternative such as chiropractic. Many are able to return to their lifestyles and routines prior to their injury or health condition after undergoing chiropractic care. We want you to remain in control of your own healthcare–not the pharmaceutical companies, not the medical providers and not even your well-intended friends who slip you their own prescription medications. That’s why our consultations are always free, and treatments are always explained in detail beforehand, so that you are the one at the helm of your own health.
The Georgia Clinic of Chiropractic Blog is written by Dr. Mark Huntsman.
Georgia Clinic of Chiropractic is conveniently located off Furys Ferry Rd in Martinez, Georgia and provides quality chiropractic care to the Augusta, Martinez, and Evans communities. Visit our main website at www.georgia-clinic.com.