James Hill is a former senior editor for The Washington Post News Media Services.

As its name implies, “American Pain” makes for some painful — yet fascinating — reading.

Painful because the creation of a drug-pushing empire disguised as a prescription painkiller operation should never have been allowed to happen. Painful because people with licenses to practice medicine answered ads on Craigslist and became part of the charade. Painful because pharmaceutical companies kept pushing to expand the number of opiates allowed to be prescribed. And painful because the Drug Enforcement Administration kept allowing that supply to grow, even as the toll from opiate abuse became not only common knowledge but a national disgrace.

John Temple’s thoroughly reported examination of how twin brothers with a love for anabolic steroids stumbled into a gold mine selling Oxycodone and other opiates is a story of both American entrepreneurship run amok and the difficulties of shutting down a rogue operation even when it has become clear that someone is breaking the law.

Temple, a professor of journalism at West Virginia University, focuses on the George twins, Jeff and Chris, and their friend Derik Nolan. Together, exploiting loopholes amid a lax regulatory environment, the three started what became a multimillion-dollar industry in South Florida pushing medications prescribed by doctors who worked at pain clinics. The bulk of the empire-building fell to Chris George and Nolan, who was brought on to provide some muscle around the office but ended up being a version of chief operating officer of the enterprise.

‘American Pain: How a Young Felon and His Ring of Doctors Unleashed America's Deadliest Drug Epidemic’ by John Temple (Lyons)

What an empire it was. Originally named the South Florida Pain Clinic, and advertising on billboards, in free weeklies and on the Internet, what morphed into American Pain lured thousands of “zombies,” mostly from Kentucky, West Virginia and Tennessee, down the interstates or by cheap flights (one was nicknamed the Oxy Express) to get a fix. It also created a thriving copycat industry. As Temple notes, by November 2009, there were 115 pain clinics in Broward County alone.

A more astonishing number: “By the height of the state’s pill mill rush, Florida doctors were purchasing nine times more Oxycodone than doctors in other states. That’s nine times more than the other forty-nine states combined.”

As newspapers and a local television reporter began to investigate, it became clear that these pill mills were in jeopardy. The feds swept in, and many of the pushers, including the George twins and Nolan, were given long prison sentences. In Appalachia, Oxycodone is no longer the heroin du jour. Rather, heroin itself has become the drug of choice.

“American Pain” offers a window into America’s drug-addiction epidemic. It’s a painful sight, but sometimes seeing the ugly is preferable to burying our heads in the sand.

American Pain
How a Young Felon and His Ring of Doctors Unleashed America’s Deadliest Drug Epidemic

By John Temple

Lyons. 299 pp. $26.95