Last Podcast On The Left - Prescription for Pain: An Interview with Philip Eil

Episode Date: August 31, 2024

Henry & Eddie sit down with journalist and author Philip Eil to discuss his latest book Prescription for Pain and the story of his father's former classmate Dr. Paul Volkman, the Chicago Physician who received four life sentences for illegally distributing pills that led to the deaths of multiple people. Subscribe to SiriusXM Podcasts+ on Apple Podcasts to listen to ad-free new episodes and get exclusive access to bonus content.

Hello, Last Podcast on the Left listeners. Welcome to the Patreon interview series, My God Today. It's very exciting. My name is Henry Zabrowski. I'm sitting here with Ed Larson. How you doing, buddy? You looking good? Feeling good.

Good, good, good. Hopefully not too good. No. Because that might mean you're on something. I mean, well, I have to take medicine. But good prescribed medicine. Yes That doesn't necessarily make you feel good. It makes you feel neutral If I don't even know I take it because it's for my cholesterol. That's a very good thing

But today we're talking ham strong. Yeah as it should now this this story I find This is very interesting and it's very very thick and it's sort of about obviously it's huge issues involving pharmaceutical like and it's very, very thick and it's sort of about, obviously it's huge issues involving pharmaceutical, like kind of like manipulation of these various systems, but also just straight up almost serial murder. Like this heads into true crime area. We have the author, Philip Ayl, who wrote the book, Prescription for Pain, How a Once Promising Doctor Became the Pill Mill Killer.

It is, it's out there, it's on every, you can get it on Amazon, you can get it any other place, right? Anywhere you buy books. I love it. And this is about the doctor, quote unquote evil doctor, Paul Volkman, who ran a essential, like a pill mill.

Now, I really wanna know the exact, so first of all, thank you for being here. Thank you for having me. It's a pleasure to be here,. Hopefully it will continue to be so Much like Eddie's cholesterol medication now my question is is I know like my parents are from Florida So my mom used to get like doctors used to toss oxys at her for headaches. You know what I mean? She literally had a walk-in closet of pharmaceuticals that just kind of fell out of her pocketbook

at any given time. Now, but what's the difference between a straight up, I'm gonna say too friendly doctor and a pill mill? That's a good question. Years ago, I came across this article from a, I think it was a law enforcement magazine for law enforcement in Kentucky that defined a pill mill. And maybe after the pod finishes recording, I can track that down for you. But honestly, the clinics I'm writing about in this book are a pretty good case study.

I think what makes a pill mill is kind of a cluster of factors. You've got not necessarily affiliated with local hospitals or educational institutions. You've got cash only in this case. In this case, you've got clinics that were patrolled by armed guards. In this case, you've got clinics that don't really offer a wide variety of medical services, don't even prescribe necessarily a wide variety of prescription medications. Paul Volkman, the doctor I wrote this book about, was really prescribing three different medications, opiate painkillers, muscle relaxers, and sedatives like Valium, and he stuck to that combination pretty closely.

In this case, and in the case of a few different clinics in the part of the country where these crimes took place, southern Ohio, also across the border in Kentucky, this clinic was owned by somebody who wasn't a medical professional, didn't have any medical training whatsoever. This woman, Denise Huffman, had worked in fast food restaurants, she had worked in factories, hadn't gone to college. So, you have this kind of cluster of characteristics that I think makes up a pill mill. In this case, and in other cases, local pharmacies pretty quickly saw the kind of prescriptions that were coming out of this clinic and said, no way, we're not gonna fill these.

We don't want anything to do with it. So that was another characteristic of what made this a pill mill. So when you go to a pill mill, this is not just for my own education, but if you go to a pill mill, like you still have to get a prescription and take it to a pharmacy to fill it,

or do you go and purchase it there like it's the weed store? Well, I spoke to somebody who had gone to the... So one of the things that interested me about this story, I got interested in this case because my dad went to medical school with the guy at the heart of the story. Yeah.

So I was particularly interested in this one doctor and what on earth happened to him where he- And I liked your position of why does my dad go this way and why did he go this way? Totally, I was drawn in by this one doctor. But when I pulled the thread of this doctor's story, I learned that in this part of Appalachian, Ohio and across the river in Kentucky,

these clinics were pretty old news. They had been around, they had seen cycles of doctors go to prison for prescription drug dealing and another doctor and another clinic owner would just kind of take up the torch. So folks down there were really familiar with this kind of operation. And one person told me that you go into these clinics, she said, and I'm paraphrasing, you would see your uncles, your cousins, your neighbors, you wouldn't necessarily talk to them. As she said, everyone kind of knew what they were in for, what they were there for. And it was kind of this charade or kind of play acting at a legitimate medical scenario. Oftentimes the doctors would

require things like MRI readouts, but before Volkman arrived on the scene, there was also a robust black market for fake MRI scans. So it was all kind of like pretending to be a medical clinic and it doesn't say pill mill on the door. It'll say some, it'll have some generic name like such and such health services or the clinic I wrote about was Tri-State Healthcare. These kind of generic vaguely medical names. But if you talk to folks down there, everyone knows what's really going on.

The people in the legitimate medical world know what's going on. The people who go to the clinic know what's going on. The people in the legitimate medical world know what's going on. The people who go to the clinic know what's going on. And it kind of keeps on going until law enforcement does something about it. Yeah. You kind of see this thing happening now with marijuana prescriptions. Now it was something that was how they used to do it in California before it became totally legally or the gray market. Yeah. And now in Florida, you're seeing legal. Oh, yeah. The gray market. Yeah.

And now in Florida, you're seeing a lot of this too. And I know that marijuana is obviously much different than Oxycontin, but it's still something that's very prevalent. Yeah. I mean, in both cases you've got, I mean, one of the things that fascinated me about this story is the things that Volkman was prescribing are these so-called controlled substances, medications like oxycodone or Valium. And they're these really kind of weird, they exist in this kind of legal limbo

when you think about it. If I have a prescription for oxycodone and I am stopped by a law enforcement officer and he finds my pills, then I have the prescription, that's completely legal. If I don't have a prescription and I've got oxycodone or Ritalin or another controlled substance in my pocket, that's a crime. So, marijuana is somewhat similar in that depending on where you are in the country, we have these different laws. In some places, it's legal with a medical card, in some places, it's not. And when you have these situations like gray markets you describe, people will go to great lengths to work their way around the system or to manipulate that system. Now in the case of Paul Volkman, is it fair to say he sort of failed his way into this

environment? I would say that's accurate, yes. How does somebody like Paul Volkman get to this position where they just become a drug dealer? Because honestly, it sounds like he was doing real well. Yeah, people loved him. He had a buddy who said he thought he was going to read about him getting the Nobel Prize. Yeah, man, for good times, dude.

Correct, correct. And I should note, as I always do, both for the purposes of the story and for fairness, Paul Volkman is sitting in a federal prison serving four consecutive life terms in Arizona right now and still maintains that he was a legitimate doctor, that he was never a drug dealer, that he was acting in his patient's best interest following, you know, his medical training and so on. Now, a lot of people, myself included, don't buy that. Having looked into it, the jury didn't buy it, prosecutors didn't buy it, but he claims. So I just want to state that for the record.

The question that you posed at the beginning of how does a guy with such promise, this was a guy who was a high school valedictorian, who received a partial scholarship to go to college, who like my dad received a full scholarship paid for by the federal government to get an MD PhD from the University of Chicago. What on earth happens to him for him to find his way to a cash only pain clinic in Southern Ohio,

writing scripts all day long and having his patients die at remarkable rates in their 30s and 40s. Because that's how he got the consecutive life sentences, right? Is that they connected these deaths to him. Correct. Prosecutors charged him with playing a role. It wasn't murder or manslaughter. It was drug dealing with death or injury resulting.

That was the charge. 14 different patients were listed on the indictment. He was convicted of dealing drugs to the majority of them. And in four cases, the jury held him directly responsible for a patient's death. And so those four consecutive life sentences, one corresponded with each of those deaths. But to your point about failure, what initially drew me in is I didn't know what happened in between those

two dates of graduating alongside my dad from the University of Chicago with an MD-PhD in 1975 to being indicted for prescription drug dealing by the federal government in 2007. And not just being indicted, but being arrested at his kind of upscale Lake Shore Drive apartment in Chicago with a doorman at $4,500 a month in rent. And it's really kind of posh part of town. So I hear these two facts,

and this was many years ago now, I'm 23 years old, just starting out in journalism. I had recently read in cold blood and I'm filled with that energy. Yeah, you're ready to go. Exactly. I'm ready to go. And this wild story falls into my lap.

And my dad, like virtually everyone else from Volkman's early life, had fallen out of touch with his old classmate and couldn't account for what happened in the interim three decades. So a 23-year-old me decides, this is a crazy story. I'm going to pursue this. And it took me 15 years, but I ultimately put it all together. And that's the book that came out earlier this year. I also really like that you spent the time with Volkman to talk to him, to get his perspective, because I think that that's, as a person who loves true crime, my favorite is the criminal's perspective because I like to hear what they thought because there's

something about the idea. No one thinks they're the villain. And, and you know, Paul Volkman is exhibit A of people who don't think they're the villains. Literally. I mean, one thing that, another thing that fascinated me about this case was yes, in legal terms, uh, the trial was about

guilty or not guilty, but Paul Volkman doesn't just claim he's not guilty. He actually thinks we should doesn't just claim he's not guilty. He actually thinks we should be applauding him for what he was doing. He thinks he was helping vulnerable people who had treatment and resistant pain conditions, and that he was the only one, in his words, brave or sympathetic or educated enough to know that these people needed opiate medications. So yeah, your listeners might not be surprised that Paul Volkman is a bit of an arrogant guy. He has no shortage of self-confidence. And there are many ways in the course of writing this book that I benefited from that arrogance and ego. And I think foremost was his agreement to speak to me at great length, including 15 hours of in-person

recorded interviews before his trial took place. Oh yeah. I often say that, you know, had he told his defense lawyers, hey, there's this graduate student who wants to talk to me for 15 hours with a tape recorder running. You think I should do it. They would have said no. What the living fuck are you doing? Yeah. Are you high now? But he did. And because he didn't listen to that, I mean, he continued to speak to me after his conviction with written letters, with emails, depending on which jail or prison he was in. So the kind of backbone of this book is the story of Paul Volkman about what happened in his life. But I always told, you know, I'm a journalist. I'm

not, you know, Paul Volkman's ghostwriter or somebody who's sympathetic to him, it was my job to listen to his kind of wildly implausible tale that he was just the victim of bad luck and other people's corruption or other people's bad intentions over the course of his life and to see whether there was any truth to that. And so the book I've often described it as just kind of one long, meticulous fact check of this guy's story. And perhaps no big surprise, I didn't find his story particularly reliable, but his story is in there because at every turn I wanted people to hear his explanation for why his clinics accepted only cash or why he was working with this woman who dropped out of high school owning his clinic, why his patients had died know with such frequency so on and so forth

I Mean it what level is it a crime? I mean, I know it is a crime, but I actually wonder what the distinct line is between just being bad at being a doctor and Being a serial killer. Like, you know, like they talk about this, like with Paul Volkman, I think it's obvious. It seems that he was he getting high in his own supply.

You know, it's funny. I think the book would have been a lot shorter if the explanation for Volkman's behavior was some sort of classic predictable vice. Like he was a drug addict or he was an alcoholic or he had a gambling problem or he was trading pills for sex. But I didn't really find any of those things. What I really found was a guy. Wait a second, you can trade pills for sex? That's incredible. What I found instead was a guy who was just acting out of his own sober psychology, which

was twisted in its own way. What this book became was a psychological profile, not a profile of a guy, you know, in the throes of addiction or some other compulsion. So he did all of this sober. So he did all of this legitimately. So he did all of this legitimately, like it wasn't just greed. Cause like what's the M.O.? Like where's the why?

What's the why? You know what I mean? Is it just money? So the cynical book promoter in me says, well you gotta read the book. But I know. Yeah, yeah, yeah, you should. No, please, no.

Our audience loves the book. I wish there were, or maybe I know. Yeah, yeah, yeah, you should. No, please. No, our audience loves the book. Yeah. I wish there were, or maybe I don't wish, but I didn't find a simple answer. Right? Sure. Because Volkman's life was this kind of domino effect, right? Like he doesn't go into pain management out of a cash only pain clinic in 2003. If he had not been sued for malpractice and lost his malpractice insurance prior and become desperate for any kind of medical employment, he doesn't lose

his malpractice insurance if he hadn't had a number of malpractice cases over the course of 20 years that kind of added up, whether they were jury verdicts, there were some, others were insurance settlements against him in favor of plaintiffs. He doesn't even find his way into pediatrics or emergency medicine where he is potentially faces these malpractice lawsuits. If he doesn't wash out of medical research in the first place, he and my dad weren't really even trained to be the kind of doctors who see patients every day.

They were MDPHDs, which means they were really training to be researchers. They were, you know, when you're a medical researcher and I myself had to kind of do some research, do some reporting on what exactly is a medical researcher and I myself had to kind of do some research, do some reporting on what exactly is a medical researcher. I mean, Anthony Fauci is kind of, he's been in charge of at a very high level of medical research in this country. Yeah, he's like the Gandalf of medical research right now. Exactly. Medical research, you're not really seeing patients for

the most part. You're doing research, you're studying new treatments, you're studying new medications, and you're publishing, and you're based in an academic environment, and you're helping kind of push the medical field of knowledge forward. And that's just the circumstances in Paul Volkman's life that I had to dig into. There are also circumstances which were equally fascinating to me of the historical context of this book. The crime takes place between 2003 and 2006, kind of in the heyday of the post-Oxycontin years before the crackdown on pills and before the opiate epidemic changed over to heroin and subsequently fentanyl. And all of this, or most of this took place in a town, Portsmouth, Ohio, which I had never heard of before this story.

Um, it kind of down on its lock town, kind of in the little area where the rust belt and Appalachia overlap. And this was a place that even before Volkman arrived in 2003, had earned the nickname of the Oxycontin Capital of the World. When I pulled the thread of what happened to this wayward former classmate of my dad, I found this incredibly complex and tangled story that couldn't be neatly summarized. I think it's, you know, I mean, if you were to maybe boil it down to one word, it might be psychology, Volkman psychology, which, you know, is, you know, narcissistic tendencies, a lack of empathy, uh, stubbornness

to, you know, let's say not stop his clinic when the DEA raids it or when the local cops raid it. This all sounds like persistence to me. You know what I mean? I mean, I see, I'm hearing a lot of negative words being applied to this. It sounds like somebody who's really going for it. What is the difference between Paul Volkman and someone like Conrad Murray? Well, in one sense, Conrad Murray is more famous because the person who died is more

famous. You think about these things when you write a book and when you market a book and try to sell a book and it's like, who knows about this? And Conrad Murray, you can say, oh, that was Michael Jackson's doctor. I mean, that's not really the answer. So Conrad Murray, I mean, that's, uh, not really the answer. So Conrad Murray, I mean, the, the substances are different. Um, I don't know, I didn't look particularly closely to that case, but it was, he was giving, um, Michael Jackson, what was it? Propofol?

Yeah. He used to ask for his milk. He'd be like, Oh, come on, can you make me some milk? I want to go to sleep. Right. Right. I mean, so actually, it's interesting to compare and contrast the two, because what you have there was a kind of concierge doctor to somebody who was unfathomably rich and couldn't say, was perhaps, or certainly… Well, he felt compelled to not say no. Right. And there, you know, I dug into various I dug into various detours along the way, and Elvis's doctor was charged with crimes after his death. He was actually acquitted. Howard Hughes had a doctor, I think, nearby. That's a whole trend in US history of doctors who were close to famous people who died before

their time. Volkman was a case of different substances. He was prescribing pills to these people, but people on the far other end of the socioeconomic spectrum. Yes. People who were poor, who were in a forgotten part of the country and even a forgotten part of the state of Ohio, a place that was perennially lowest on per capita income, on health outcomes, on life expectancy among Ohio's 88 counties. And some people have rightly asked, why was it that alarm bells weren't going off for the opioid epidemic earlier on when people in places like Appalachia were dying? Why did it take for this to drift upward to people in the middle and upper class for us to really get serious about it? One difference between this and Conrad Murray is

wealth and fame and the utter opposite of that. And I think that perhaps led to, I mean, I know for that that Volkman looks down on his patients to an extent because he referred to them as hillbillies in an email that was submitted at his trial. That's not a thing you say, I don't think, when you see the folks you're treating as full human beings.

Yeah, it was a full like depersonalization. He viewed them as just sort of, you know, their source of income and giving him his narcissistic supply of being a doctor. Was he providing drug dealers with pills? Yeah, like what's the real like with something like a pill mill to get employees for a pill mill, like for these type of people that are running these things or being like, you know, the armed guards, these people, is that the criminal element? Like, is that like a thing that he brings

people in or are these just guides? Is it everybody? Is everybody addicted to drugs that are sort of working there? You know? Well, I mean, one remarkable moment in the trial testimony that I thought was deeply incriminating was I forget whether it was the mother, Denise, who owned and ran the clinic or her daughter, who was also indicted. But at one point, the prosecutor asked one of them, were you a patient of Dr. Volkman's when you were working there? And she said, yes. And he then rang off like three or four or five other family members slash employees, all of whom were patients of Volkman while working there.

Super sketchy situation. Um, Volkman would claim whether you believe it or not, that he was. Entirely convinced, uh, that his actions were on the level and that the people whom he was prescribing to were pain patients in need of these medications. I think I find that very, very hard to believe for a number of reasons. One, the incentives for turning around and selling pills in a place like Portsmouth, Ohio in the early 2000s were overwhelming. This again was a really poor burnt out former industrial town that had been poor for decades.

And these clinics were, you'll hear people say an economic engine for just about everyone involved. Yeah. They were money in the pocket of the doctor. They were money in the pocket of the owners, and they were money in the pocket of the patients. Some of whom would take some pills, others of whom would, it would just turn around and sell them all. You also heard about things in the trial testimony of people sponsoring other patients, paying for their, um, visit fee to the doctor and then getting a cut of the pills that they were prescribed afterward. Um, so you have this kind of,

there was a lot of testimony during the trial, uh, about people who were selling pills. I think this might sound shocking, but I think we need to take a second look at the healthcare industry. I feel like there's something off here. I feel like this might be, I mean, maybe it's me as a comedian kind of just smelling something off. Do you notice a pattern? Yeah.

When I was reading about this, do you think that in this world and while you were researching this, did you ever see any connection to the body part industry as well or the organ industry as well? Cause there's also a whole world of open market body part and organ sales that have come up in the, of the last couple of years. Like I remember if you've ever seen these cases of people washing off torsos in a parking lot and why doing all these things, cause they're doing organ harvesting, but it's like, they're all like,

I'm just an employee. Meanwhile, they're hitting an armless, headless torso with a hose in a parking lot, just like, you know, I'm just getting paid here, buddy. This is happening in America? Yes, happening in America. I went down a lot of roads in my research, a lot of roads, and there's probably an entire whole book

that I cut from this book, but I did not go down the Oregon harvesting road for whatever reason. It just seems like it's a whole other, like, well, that's very serious. I mean, yeah, mainly what I was struck by and what I think one of the, um, most incriminating facts toward Volkman is if you sit with Paul Volkman in his apartment in Chicago and listen to his story of why he was under indictment, and I did this for many hours, he's so smart and he has so many answers and he's so highly qualified that you can almost find it plausible as far-fetched as it is. But if you go down to this part of Ohio, they will tell you that three, four,

five doctors were convicted of similar crimes before this guy and four, five, six, seven doctors were convicted of similar crimes after Volkman. So really he is part of this kind of slow motion 20 year crime wave down there. Wow. So even though, you know, I never heard necessarily about organ donation, although I will say, I heard people say that these pain clinics were kind of a, um, a spinoff from a diet pill clinics in an earlier era that this had, this problem had like, you know, changed its complexion over the years in the 80s or 90s. It was sketchy

diet pill clinics, and then later on it became these pain clinics. I remember distinctly talking to a TV news reporter when I first went to Portsmouth and asking him if he had heard of Volkman. And he said something to me like, you know, Volkman's just a long list, and a name and a long list of names to me. I've seen this happen so many times. It's also, I guess that what you just said was so illuminating to me. I didn't even think about it like that,

about how everybody's kind of getting a little piece of it too. Like the patients are getting some of the money. Like they are getting, cause I was like looking at that, like how in the living hell would you live if you were taking 200 to 600 pills a month? Like how would you... like that's death, right? Like I don't know what the...

I don't know what the extent... Comes to Oxycontin, that's death. Yeah, like so they're selling them, they're moving them, they're selling them as well. So this is like, it is part of why it's perpetuating almost in a way, is because everybody's kind of making it's perpetuating almost in a way is because everybody's kind of making a little piece off of it. Yeah. Um, and if you believe bulk man, which I don't necessarily, I mean, some people

say the law enforcement is taking a cut as well. I never saw evidence of that, but certainly there was allegations of that left and right. There's a chapter in my book where I tell, I mean, I tell the stories of many of the folks who passed away, one of whom, um, I spoke with his, uh, stepson who described the many reasons why his stepdad went to these pain clinics. He did have real pain and he had, you know, he could back it up with medical documentation.

He also definitely liked to take the pills for recreational purposes. He also used the money to sell some of them. And there was even a fourth reason he said his stepdad liked the pills because he was a social guy and they brought, you know, he brought his friends around, he could give pills away when he had them. So, um, in that one story was an example of the many, I say in that chapter, there were many reasons why a person might go to a pain clinic in Southern Ohio in 2003 and this guy basically checked off every one of them.

It feels like this might sound kind of hacky, but it's not just physical pain. It's like a spiritual pain. It's almost like a, the idea of someone who's looking for that, like something that's extremely heartbreaking to me about the idea that one of the factors is that it brings me friends. Yeah. Well, it's a party drug at some point. Now I want to talk about something that happened to me in my own personal life.

And I think you might have some insight to. Going back to the same time period, 2003, 2004, a former vice principal of mine at Olympic Heights High School in Boca Raton, Florida, Kevin McKinney, was arrested with 500 OxyContin by a federal agent outside the school and he was selling them. And when they got back to this house, they had hundreds of more pills there. And you know, three students, four students from my school died of oxycontin overdose during that time period. And, but like, how does someone who's not a professional doctor get his hands on that many pills? Well, what year was this?

2000, he was arrested in 2003, but he had been doing it for like five or six years. I mean, if things were bad in Ohio and they certainly were, they were arguably worse for pill mills and pain clinics in South Florida. Wow. Right here, literally like talking big to right the spot. I mean, you know, there's a book about this by John Temple called American Pain, which was turned into a documentary. I remember, you know, visiting my great aunt and grandmother who lived in

Pompano Beach, not far from Boca Raton. Yeah, he actually lived in Deerfield, the guy who got arrested. Yeah, but these these clinics, I mean, I'm sure you remember if you lived there around that time, they were just everywhere in South Florida. And you had people driving from states quite far away, sometimes Ohio down to Florida on these like, hill mill tourism excursions and going back up. pill mill tourism excursions and going back up. So how does a guy like that get his hands on that many pills? I don't know the specifics, but I do know that there were lots and lots of sketchy pain clinics that had basically

opened a spigot to just unleash enormous amounts of controlled substances into places like South Florida, Southern Ohio. And if he wasn't getting them from one clinic alone, which is likely or possible, I mean, Volkman's patients, family members told me the size of the pill bottles that their family members walked away from were just enormous. These like six, eight inch things. I know my mom literally had pill bottles that were this big. They were like seven inches long.

It's also taken quite a while for states to catch up with their prescription drug monitoring things. So you hear about doctor shopping where for a time before these electronic monitoring systems were set up, people could hop from one clinic to another and just walk away with those kinds of pills. Or maybe they were going in as a group and these people were funneling pills back to this guy. I mean, the common denominator is that these pills were just flowing so easily in places like Florida and Ohio during these years. It's, it's horrifying to think about. And in that way, um, that is also why the fentanyl and the heroin crises we're dealing with, the ball started rolling on that with the pills.

And, um, you know, we're, we're dealing with downstream consequences still of things that were going on that long ago. Aren't the consequences a lot of these black markets too? How in the living fuck do you maybe get the real stuff all the time? Isn't there any sort of thing where you're getting stuff that's not Oxy? It's something else, but it looks like an Oxy and it's in a thing that says Oxy. Like how often does that happen? I think the creepier thing to contemplate,

I didn't hear anything in Volkman's case about counterfeit pills. The creepier and more unsettling thing to contemplate is when local pharmacies stopped filling his prescriptions, which was a few months into his arrival in Ohio, he and his clinic owner submitted an application to the pharmacy board of Ohio and launched an on-site pharmacy, an on-site dispensary. And that continued for like two years. So this meant that patients could receive their script, the paper, and then have it filled under the same roof. And the reason that I bring this up is that place was getting supplied by pharmaceutical suppliers for years. Who I know from the investigative documents did raise red flags about the size of some of the

orders this clinic was putting in. But it was like, hi, hey, hey, sorry, something's happening. Apparently, it continued to fill the orders. And here is where you see, I think it's interesting to look at all of the different people and entities that have been sued in the civil litigation side of the opiate epidemic, to see where all of the places for accountability go. You see pharmaceutical companies, of course, you see pharmaceutical suppliers, companies I didn't even know had anything to do with opiates, like Johnson and Johnson, paying out enormous amounts of civil litigation fees because they were apparently probably not paying out the money that they were paying out. And so, you know, I think that's the biggest thing that we're seeing. And I think that's the biggest thing that we're seeing is that, you know, anything to do with opiate. It's like Johnson and Johnson, paying out enormous amounts of

civil litigation fees because they were apparently providing raw materials. So a lot of people, putting aside even the counterfeit stuff, a lot of people and companies were making a lot of money for a long time, you know, flow of prescription pain medication. How much, I mean, Volkman obviously was the guy who wrote the scripts, but how much blame do you put on companies like Johnson and Johnson, Pfizer and Ely? Well, I started this book in 2009 and wound up publishing it in 2024. I wasn't working on it nonstop the whole time. There were a lot of detours and along way, I saw a lot of books come out about the opiate epidemic that I think cast some of that blame around books like Painkiller by Barry Meyer or Empire of Pain by Patrick Radden Key for Dreamland

by Sam Canones, which point of finger at the Purdue Pharma and the Sackler family, I think certainly they deserve a whole lot of the responsibility. But it wasn't just them. There's another book called Drug Dealer MD by Anna Lemke out of Stanford, I believe. And her book is really interesting because she makes a convincing case of just how many different places bear some responsibility. The FDA fell down on the job. Academic medicine fell down on the job. Regulators, private, public pain advocacy organizations, some of which were like, you know, astroturf organizations on behalf of Purdue Pharma, you know, failed patients.

So, I mean, the blame is just so wide. There are so many, I mean, McKinsey, we now know, has issued kind of a vague apology for their work helping Purdue Pharma market and sell Oxycontin more effectively. It's kind of astonishing. I mean, I'm based in Rhode Island, the state that's headquarters of CVS Pharmacy, and CVS has paid out for this. So it's pretty alarming to think of all of the different places that share some of the responsibility. And one thing I do remind people, it's maybe obvious, but the opioid epidemic was not a natural disaster. It was not an earthquake. It was not a tornado.

It was an entirely manmade crisis that we are still dealing with the fallout from. So when you have a manmade crisis, as a journalist, I would say that deserves a lot of books and that deserves a really close look for who we can hold accountable and how we can hopefully learn from this to not have something like this happen again. And all this happened because we made weed illegal. I do sort of believe it in some ways where you're like, there are ways to handle this. We're in this extremely toxic place with pain because everybody's, the medical health industries and shambles, people don't know what to do.

I know it, but how do we move on from this? What do we do now? How do we fix it? Phil, do you have the floor is yours? Let's talk to Michael Keaton. Can Michael Keaton help? He's doing his best. Oh man, I think, you know, I've done a lot of interviews about this book, but I think you're the first ones to ask me what do we do now.

Yeah, you fix it now if you could please. Thank you. Well, so here's my, you know, I always offer the disclaimer that I'm a journalist and not a doctor. That's not a cop out. That's just, you know, me. It's just life. Yeah. Yeah. Yeah. If you asked me my prescription, I say, take two shots of tequila and call me in the morning. Come on. I would say, I don't, if you're looking for the answer to the opiate epidemic, you know, to solve it in this podcast, I wish we could do that. I know, but I will say

that there are some exciting things happening in my home state. I'm often frustrated by the politics in my home state. But there are some things that Rhode Island is kind of leading the way on. We have launched a safe injection program, safe injection site where people can who are IV drug users can use drugs in a safe environment. I think that whole kind of world of destigmatizing addiction, needle exchanges, we also have a program with things like good Samaritan laws that provide legal cover for people who call 911

when somebody overdoses and make sure those people don't face the people that are by criminal prosecution. I think we still have a long ways to go in terms of de-stigmatizing addiction and the things that come with it. Another thing that occurred to me recently is just like, back to the things you said about the health system, how on earth can we expect to get our, to expect to fix a problem of this magnitude, this opiate epidemic and still require people to pay for rehab and medical services?

Like it seems like so self-defeating. Like to me, like, of course, if we were serious about stuff in the opioid epidemic, we'd make rehab free. Yeah, sure. You'd make all the pills free. You other ways to do either you'd be like hey, let's not make it like This illegal black market. We wouldn't allow them to exist We could just make it so you get the stuff that you needed right so I mean one You know it's not even I have to fight tooth and nail to get my blood pressure medication

Hundreds of boxes at a time meanwhile I have to beg to get my own Lassart blood pressure medication. Like this is one of these things. People are buying like hundreds of oxys at a time. Meanwhile, I have to beg to get my own Lysartan. And I was like, I have to have this. I don't even want this. I mean, maybe a baby step toward Medicare for all, which I do think is a pretty good idea would be free rehabilitation for anybody who needs it. This is common stuff. I sound like some wild-eyed revolutionary by saying it. There's my best answer. Destigmatize drug use. Continue to destigmatize drug use and make rehabilitation free and easier to access. This applies less to the perpetrators, but you know, drug users, you know,

stop criminalizing lower level nonviolent drug crimes. Not crimes like Volkman's, I'm not saying this guy belongs. No, no, no, no, no. We worked for Last Prisoner Project, the whole goal is there was like 40,000 people still in jail for cannabis based crimes, trying to get them out because if I can go to an Apple store and buy weed in Los Angeles, you shouldn't be in jail for it.

Yeah. That's how I feel. Don't arrest the users, arrest the sellers. Yes. Phil, thank you so much for talking to us today. Thank you so much for having me. This is Philip Aile. You got the book, Prescription for Pain, how a once promising doctorcame the Pill Mill Killer.

It is out there. Wherever books are available, we always say go to your local. I like going to your local. I actually really, what's awesome about this book is the fact that for our listeners, for me, I have like a, I have a political block sometimes in my brain. When things get too political, I have a hard time understanding kind of the ins and outs. But when you put it in a true crime context, I can understand. So this is one of those where I think it's a really good book for people to sort of understand this issue that you wouldn't normally read about the like something that you wouldn't

read necessarily about the Oxycontin crisis otherwise. And I think that this is awesome. And it's a great way to explain what the hell's going on. Thank you so much. The amazing folks in my publisher steered forth in putting together the jacket. They wrote this at the top of the back. The opioid epidemic is a true crime story.

Yes. I don't know. Well, actually, I mean, that was part of my book proposal. Yeah, sure. Yeah, that's it right there. I I mean, that was part of my book proposal. Yeah, sure. Yeah, that's it right there. I am so pleased that you guys appreciated the book and it's such a pleasure and an honor to be here.

Thank you so much for having me on. Absolutely. Any other plugs you want to get? Oh, I don't know. The first thing that popped into my head is I'm a cat guy. So like adopt cats. Yeah, adopt a cat. Adopt cats.

Adopt don't shop. Exactly. That's the best I got. This is the one thing I have to sell right now. Yeah, adopt a cat. Adopt a cat. Adopt don't shop. Yeah. Exactly. That's the best I got. This is the one thing I have to sell right now. Other than that, it's just like save the cats. You got to pick up from Bob Barker and it's all about neutering. Exactly.

God, I realize that now. That was a weird way to sign off every one of his shows. Yeah. Make sure to neuter animals. I'm going to neuter your pets. Yeah. Phil, thank you so much, man. shows yeah make sure to do the animals Phil thank you so much man thanks for having me guys good to meet you buddy yeah good talking man continue this kind of work man yeah this is great this is super very interesting very serious yes I mean well it's it's killing lots of people it's not good no it's good. I think people should stretch more

Yeah, you know gotta help yoga help my back. It's a weird thing I feel like everything's best in moderation You know if you find yourself doing these type of drugs on a regular basis You need to really look inside yourself unless you are an incredible amount of pain and you need to manage that but even then These these destroy your livers you destroy your kidneys your pancreas fucking smoke weed I Agree, I know this is a good acupuncture Yeah

And if you you know if you see someone in your family all the sudden like has like a bunch of Xanax Just check in with them. Yeah, you know just like make sure that they're not see how much you're selling per pill. Yeah Just check in with them. Yeah. You know, just like make sure that they're not... See how much you're selling per pill. Yeah. I think we've learned a lot today. Yes, but please.

Yeah. Check on your others. Yeah, no, it was good to finally get a little bit of like closure and idea. I didn't realize that South Florida was so bad in that time period, even though like we would just, my friends would just show up with bottles of pills and stuff like that occasionally. Oh no, my mom, was it was the pills were just thrown around It kind of makes sense with all those old people He might have been easier to get away with writing that many scripts like that not raise some flags, but

You know it was a very upsetting time I remember we lost like twin brothers exactly one year apart from each other from Oxycontin damn I lost like the most popular kid in school, passed away in college from Oxycontin. Oh yes, this is very close to you. Yeah, yeah, yeah. And so I was very happy to do this interview and learn about this guy. And I can't wait to buy the book, not just read the copy they gave us. Well, good work.

Thank you so much. Thank you for listening. And we'll see you soon.