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‘American Pain’ Review: A Gripping Documentary Portrait of Twin Kings of the Pill Mill Hill

Documentarian Darren Foster’s Tribeca premiere tells a grotesque tale of bodybuilding Florida brothers, lethal opioid exploitation, sky-high profits and absurdly slack state oversight.

American Pain
Courtesy of Motto Pictures

Though it’s been consistently overshadowed by more dramatic breaking news stories, few issues have dealt 21st-century U.S. society such a crippling blow as the opioid crisis. There have been documentaries about afflicted communities, irresponsible pharmaceutical manufacturers and misguided or corrupt prescribing physicians, as well as fictive depictions and bestselling print exposés like Patrick Redden Keefe’s “Empire of Pain: The Secret History of the Sackler Dynasty.” But it’s hard to think of a prior chronicle quite so luridly indicting as “American Pain.”

A serious muckrake after the relatively softball exercise of 2018 crowdpleaser “Science Fair” (which was co-directed with Cristina Costantini), Darren Foster’s second feature draws on his long-term opioid-related TV reporting to paint a particularly horrible kind of all-American success story. Its principal figures are twin South Florida brothers whose ruthless exploitation of weak regulation and an addiction epidemic made them, for a time, the nation’s single largest “pill mill.”

Complete with stripper girlfriends, tank-sized SUVs and other juvenile-fantasy accoutrements of “living large” on other people’s suffering, this is a garishly compelling tale whose protagonists remain — even after lengthy prison sentences — stubbornly unapologetic. Initially slated for CNN broadcast and HBO Max streaming release, this Tribeca premiere is reportedly now weighing theatrical release options prior to home-viewing exposure.

After a brief teaser of Federal-raid freakouts to come, and a range of appalled soundbites (“The George brothers didn’t start the opioid crisis, but they sure as hell poured gasoline on the fire”), we commence a biographical introduction to the central duo — partly narrated by one of them, via telephone from behind bars. Christopher and Jeffrey George shared their mother’s womb, no doubt already commencing their inseparable, competitive and volatile relationship before birth in 1980.

Raised in upscale West Palm Beach enclave Wellington, they lacked for nothing, yet began building rap sheets for offenses both petty and alarming well before legal maturity. As noted by their father, a building industry magnate, strings were pulled so they usually got off with a community-service wrist slap. Once their mother remarried, a stepfather (among the more sympathetic figures here) “noticed early on that they were a little… difficult.” Especially after that time they started a forest fire.

Shifting shared athleticism towards bodybuilding, the two turned that pursuit into business with their first official partnership, a “hormone replacement clinic” front for illegal steroid sales. But they were told “the real money” was in pain pills. So taking advantage of Florida’s amazingly lax licensing at the time, they swiftly set themselves up as proprietors of an ostensible pain clinic that had a line around the block on its very first day. Doctors were easily found to rubber-stamp prescriptions for those “in pain,” equipment bought (like an MRI scanner) to make the diagnoses look legit enough. Save for suspected undercover cops, no one was turned away, and the state’s lack of any monitoring database meant that little stopped patrons (whether addicts, dealers or both) from stockpiling oxycodone and other drugs for resale. People were soon driving across multiple state lines to load up, then resell at inflated cost back home — if they didn’t nod off and die in a wreck on the way back, a common occurrence.

As operations expanded and profits grew astronomical, naturally the Georges’ establishments began to attract some unwanted attention — from various governmental investigators, jealous copycat entrepreneurs, snooping journalists and unhappy strip-mall neighbors. Among those last was a tech store owner who happily filled the brothers’ computer and security-camera needs. Little did they realize John Friskey had lost a son to opioids, which fueled his supplying law enforcement with damning evidence via the equipment he’d installed.

That’s just one of several neat plot twists in a saga that would easily lend itself to miniseries-scaled dramatization. The spyware resulted in considerable damning audio and footage, duly incorporated here. Yet until it all came tumbling down, the Georges and their team seemed to believe themselves invincible. Their hubris and greed were bottomless, their morality nonexistent. Refusing to accept any responsibility whatsoever, they let their mother (herself relatively innocent, or at least naive) go to prison, though that didn’t stop them heading there as well. After a decade’s incarceration, the one brother now freed shrugs off all harm done — about 3000 deaths occurred among their in-person clinic customers alone — as the addicts’ own fault. Indeed, it’s notable that the sole interviewees who seem chastened are those from the least privileged backgrounds, one of them admitting, “I was a scumbag.”

The siblings themselves are mostly seen and heard in archival material, the story in which they “star” largely told by a colorful cast of skeevy co-conspirators, bodacious ex-girlfriends, dogged reporters, FBI and DEA personnel, one entire family of long-distance Kentucky drug runners, and so on. With so much jaw-dropping information revealed on the business side of things, “American Pain” pays comparatively little attention to numerous intriguing sideshow elements, such as Chris apparently being an “avowed white supremacist.” We don’t learn much at all about Jeff, who left most toil to his workaholic bro while he enjoyed a glam lifestyle, for which one buddy dubbed him “the Paris Hilton of West Palm Beach.”

Landing between the terrain of “The Wolf of Wall Street” and “Pain & Gain,” this grotesque account of filthy lucre built on ruined lives sprinkles believe-it-or-not details (garbage bags o’ cash, doctors packing guns under lab coats, a personal helicopter purchase) amidst a headlong editorial pace. Larger-than-life yet shallower than nail polish, most of the main figures here remain detestable: By the time one ex-squeeze admits she lied to Chris George just to vindictively feed his paranoia, we can only think, “Of course she did. Who else would he attract?” Wisely, then, the film opts for an overall tone of incredulous comedy, underlined by a one-finger-at-the-Casio-keyboard score from Jeff Morrow that frames this as a tale about bratty children in hulking adult bodies.

‘American Pain’ Review: A Gripping Documentary Portrait of Twin Kings of the Pill Mill Hill

Reviewed online, June 26, 2022. (In Tribeca—Documentary Spotlight.) Running time: 105 MIN.

  • Production: (Docu) A CNN Films, HBO Max presentation in association with Time Studios of a Motto Pictures, Muck media production in association with Fishbowl Films. (International sales: CNN Films, New York City.) Producers: Darren Foster, Julia Goldman, Christopher Clements, Carolyn Hepburn, Diane Becker. Executive producers: Amy Entelis, Courtney Sexton. Co-producers: Sara Goldblatt, Melanie Miller.
  • Crew: Director: Darren Foster. Camera: Jeff Hutchens. Editors: Robert Nassau, Brian J. Anton. Music: Jeff Morrow.
  • With: John Paul George, Denice George, Michael Haggerty, Derik Nolan, Dianna Pavnik, Zach Rose, Nicholas “Alex” Gonzales, John Friskey, Janet Colbert, Anthony Pineda, Carmel Cafiero, Dana Angelino, Louis Fisher, Matt Goodnow, Whitney Summitt, Michael “Red” Johnston, Teresa “Pat” Sandlin, Jennifer Turner, Kurt McKenzie, Michael Burt, Bruce Savell.