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In American Pain, which arrives on Max after screening at the Tribeca Film Festival in 2022, director Darren Foster tracks the story of Chris and Jeff George, beefy twin brothers whose network of “pill mills” in South Florida worked the state’s weak regulatory system to distribute opioids at an alarming rate to basically anybody who wanted them. Alarming enough to alert local and federal authorities, who put together a case to quash the George brothers’ operation and their live large, consequence-free lifestyle. “Nobody put more pills on the streets than they did,” the feds say in American Pain. “Nobody.”
The Gist: After a youth full of mischief, fights, and trouble in West Palm Beach, Florida, anabolic steroids enthusiast Chris George caught a case for importing the stuff illegally from somewhere in Eastern Europe. It was a felony rap, but he got work release, and Chris went to work for his wealthy father’s construction company, where he even appeared on an episode of Extreme Home Makeover before drifting into a barely legal front operation to sell steroids alongside his twin brother Jeff. But this was 2008, and another kind of pill proved more popular – roxies, or m-boxes, a generic form of oxycodone that Chris hired accredited doctors to move quickly through storefront pain clinics in the Broward County area. Lines of patients formed immediately, and soon the word was out. Low-level drug dealers from Kentucky “sponsored” busloads of people, whose quickie prescriptions they flipped to sell in bulk on the street. Buy pills for $3, sell them for $20. And at his clinic, Chris George’s patient numbers escalated as his pill mill methods and Florida’s lax database practices pushed oxy access into the stratosphere. It was an assembly line, Chris tells the filmmakers over the phone from federal prison. And by 2009, American Pain was pushing three million pills out the door annually.
Chris hired his pals to manage American Pain, aggro dudes in Affliction t-shirts who barked at the assembled patients like the clinic was a DMV. He supplemented his staff with attractive women he found on Craigslist, and finished the circle with licensed doctors who would nevertheless spend less than five minutes with a patient before prescribing hundreds of highly-addictive pain pills. And when a further layer of legitimacy was required – MRI scans – it was a simple matter to arrange for that through a compensated provider. Cash by the trashcan load was rolling in with no attention paid to what happened outside the clinic’s doors, and that included not caring about the ugly overdoses and destructive car accidents stemming from patient pickups at American Pain. Chris laughed it off, stored money in his mother’s attic, bought Lambos, big houses, and ridiculous custom trucks. “When things are going good, you don’t wanna stop. And there was no reason to stop at that time.” But of course, there was.
On the surface, the authorities who were surveilling American Pain knew, Chris’s operation was legit. Real doctors with real DEA control numbers, and millions of dollars in product rolling in from name-brand wholesalers. So where was the crime? It took methodical undercover work, and phone taps, and admissions from Chris caught on tape about shaking down competitors, but by 2010 the FBI believed they had enough to act. And that’s when they moved in to rip Chris George’s big life apart.
What Movies Will It Remind You Of? Award-winning filmmaker Alex Gibney exposed the role of politics and giant pharmaceutical companies in the opioid epidemic with his two-part documentary The Crime of the Century, and Max also features the Oscar-nominated All the Beauty and the Bloodshed, about photographer Nan Goldin’s journey from opioid addiction to Big Pharma activist. And there are parallels to Chris George’s safes full of pill mill cash and blase disregard for the human cost of his actions in the quasi-true bro-down fever dream told by Todd Phillips in 2016’s War Dogs, where Jonah Hill and Miles Teller play Florida-based DIY gun runners.
Performance Worth Watching: As Chris George’s pain clinic fiefdom expands to ludicrous levels of assembly line human destruction, it’s easy to start wondering if anyone will be able to expose it, which is why it’s great when Carmen Cafiero shows up. American Pain was “shady times a million,” the WSVN TV investigative reporter says, and she and her crew become a wonderfully-nagging thorn in Chris’ side as they repeatedly confront him and his staff with questions and cameras.
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Memorable Dialogue: Cafiero wasn’t the only one watching Chris George – FBI special agents Kurt McKenzie and Jennifer Turner are a steadfast presence in American Pain as they describe how they methodically built their case. “We had to prove that the MRI, the patient files, and examinations were window dressing,” McKenzie says, “that allowed them to deal drugs legally.”
Sex and Skin: Dianna Pavnick was working as a dancer at a West Palm Beach strip club when she originally met Chris George, and American Pain includes a few photos of the antics the eventually married couple got up to on boats and at parties. But the documentary’s truly bananas strip club twist occurs when Chris contracts with an accomplice to open up a script-friendly mobile MRI facility…in the parking lot of a strip club. “While you’re waiting for your MRI, you go in there and get a few lap dances. When they’re ready, they’d come in there and get you.”
Our Take: It’s pretty easy to build your own case about Chris George’s awfulness right from the beginning of American Pain, when old VHS footage appears of him and twin brother Jeff teaming up to beat the crap out of an opposing player in pee wee hockey. But it becomes a strength of the doc to not have to really do too much convincing. From the frat house environment he established in his pain clinics – when was the last time you saw throwing stars and taser battles in a medical office? – and his mistreatment of women, including girlfriend, eventual wife, and finally ex-wife Dianna – she refers to him as a “jackwagon” in an interview – Chris fashioned himself as a forever selfish kingpin whose rampant entrepreneurship took priority over everything else in his life, including the welfare of the “patients” that lined up daily for their bottles of oxy. (He repeatedly dismisses them as “pain clinic people.”) This was a guy who had plans to buy his own bank before the feds busted him, because the ill-gotten cashflow that supported his obnoxious lifestyle was too much of a hassle.
Chris George wanted to close the loop, as he fully admits to the makers of American Pain. Building a bank? Howabout his own pharmacy, too? Sure; he also says he wanted to install his opioid assembly line nationwide, and damn the profound collateral damage. There’s no doubt that this is a story of unchecked personal greed. But it also makes you wonder how his operation was able to get so out of hand, and who else was able to profit from that. American Pain cites a few eye-popping numbers – Walgreens, for instance, distributed 12 billion oxy pills in Florida between 2006 and ‘12, with Chris’s clinic as a high-percentage customer. If it is immediately apparent to anyone watching that this guy and his business practices were completely awful, where were the checks on that from pharma providers or even the state of Florida? In American Pie, larger forces loom just outside of the frame. And worst of all, to the very end of the doc, Chris George remains entirely unapologetic.
Our Call: STREAM IT. American Pain is a wild ride as Chris George and his crew’s pill mill pushing rakes in cash even as it spits out victims. And while it’s satisfying to see them brought to justice, a bitterness remains, because it’s one sad episode on the front end of a much bigger, darker, and still ongoing story.
Johnny Loftus is an independent writer and editor living at large in Chicagoland. His work has appeared in The Village Voice, All Music Guide, Pitchfork Media, and Nicki Swift. Follow him on Twitter: @glennganges
