Prescription for Pain

How a Once-Promising Doctor Became the "Pill Mill Killer"

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Pub Date 9 Apr 2024 | Archive Date 15 Feb 2024

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Description

An obsessive true crime investigation of a bizarre and unlikely perpetrator, who’s serving the opioid epidemic’s longest term for illegal prescriptions — four life sentences

Written in the tradition of I'll Be Gone in the Dark and True Crime Addict, combining Dopesick's heart rending portrayal of the epidemic's victims with Empire of Pain's examination of its perpetrators


This haunting and propulsive debut follows a journalist’s years-long investigation into his father's old classmate: former high school valedictorian Paul Volkman, who once seemed destined for greatness after earning his MD and his PhD from the prestigious University of Chicago, but is now serving four consecutive life sentences at a federal prison in Arizona.

Volkman was the central figure in a massive “pill mill” scheme in southern Ohio. His pain clinics accepted only cash, employed armed guards, and dispensed a torrent of opioid painkillers and other controlled substances. For nearly three years, Volkman remained in business despite raids by law enforcement and complaints from patients’ family members. Prosecutors would ultimately link him to the overdose deaths of 13 patients, though investigators explored his ties to at least 20 other deaths.

This groundbreaking book is based on 12 years of correspondence and interviews with Volkman. Eil also traveled to 19 states, interviewed more than 150 people, and filed a Freedom of Information Act lawsuit against the Drug Enforcement Administration that led to the release of nearly 20,000 pages of trial evidence.

The American opioid epidemic is, like this book, a true crime story. Through this one doctor’s story, an era of unfathomable tragedy is brought down to a tangible, and devastating, human scale.
An obsessive true crime investigation of a bizarre and unlikely perpetrator, who’s serving the opioid epidemic’s longest term for illegal prescriptions — four life sentences

Written in the tradition...

Advance Praise

“After discovering his father’s one-degree-of-separation from Dr, Paul Volkman — the infamous ‘Pill Mill Killer’ sentenced to four consecutive life terms for his leading role in the country’s deadly opioid epidemic — journalist Phil Eil plunged into an investigation of the sensational case. The result is this eye-opening, immensely readable work of first-person reportage. Told at a galloping pace, his book not only takes the reader inside the seamy but highly lucrative world of cash-on-the-barrelhead painkiller prescribers but explores the mindset of a once-promising physician who — even while persuading himself that he was relieving his patients of suffering — turned himself into a dispenser of death.” — Harold Schechter, author of The Serial Killer Files

"Prescription for Pain offers an intimate exploration into the life and mindset of one of the nation’s most prolific opioid prescribers. Like a painkiller-epidemic version of Walter White, a long list of resentments drives Dr. Paul Volkman, including beefs with his family, former bosses, malpractice lawyers, and his more-accomplished med-school classmates. Employing crisp and bracing language, author Philip Eil’s book draws upon voluminous research and years of interviews and correspondence with Volkman and many others. Eil bends over backward to give Volkman his say, but the resulting portrait is no less damning for it." — John Temple, author of American Pain: How a Young Felon and His Ring of Doctors Unleashed America's Deadliest Drug Epidemic

"Eil's impeccable investigative skills and unshakeable integrity anchor the reader through this haunting account of a seminal pill mill case. Subtle and immersive, Prescription for Pain does not shy away from the disintegration of Dr. Volkman's humanity; nevertheless, Eil succeeds in capturing the flickers of life, love, and hope left in Volkman's wake." — Charlotte Bismuth, author of Bad Medicine: Catching New York's Deadliest Pill Pusher.

“A feat of reporting and empathy, Eil unravels a mystery: how did a once-promising physician end up a convicted killer? Prescription for Pain is the best of what true crime can be: attempting to understand violence while centering victims and impact. Comprehensive and impressively researched, Prescription for Pain untangles with a fine-tooth comb the devastation that descended upon Portsmouth, Ohio at the hands of Dr. Volkman. A profound achievement and important contribution to the literature of the opioid epidemic.” — Elizabeth Greenwood, author of Playing Dead: A Journey Through the World of Death Fraud

“Prescription for Pain is true crime at its finest: a genre-expanding, ethical, and rigorous examination of criminality and unintended murder which enlarges our understanding of American despair. This deeply-researched narrative transforms the sprawling story of one corrupt and delusional doctor into a compelling read that grapples with issues of the limits of medical responsibility, the duty of care, and the ‘problem from hell’ that is drug addiction. Resisting the urge to diagnose or categorize Paul Volkman as just another narcissist or sociopath, Eil instead allows Volkman himself to show the reader who he really is: a dangerous and extremely powerful man who defies easy description.” — Jean Murley, author of The Rise of True Crime: 20th-Century Murder and American Popular Culture

“After discovering his father’s one-degree-of-separation from Dr, Paul Volkman — the infamous ‘Pill Mill Killer’ sentenced to four consecutive life terms for his leading role in the country’s deadly...


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ISBN 9781586423827
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PAGES 416

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Featured Reviews

Fascinating journalistic expose of a man, Paul Volkman, who went from being an esteemed physician to opening pain clinics in the midwest, dispensing many thousands of painkillers and anxiety drugs which results in deaths from overdoses.

The author is the son of a doctor who knew Volkman in school but that is immaterial to the story. He interviews employees, vicitms, patients and their families, and law enforcement personnel trying to get to the heart of the story. He presents an unbiased picture of Volkman through interviews with Volkman himself and people close to him.

A composite of the pain clinics that proliferated in Appalachia and surrounding areas, how they came to be, and the attempt to shut them down.

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Philip Eil's Prescription for Pain was a thoroughly researched book about a fascinating criminal. The subject of Eil's book, Paul Volkman, was an extraordinarily polarizing figure with extreme opinions whose career path took a series of critical turns culminating in a criminal conviction. Eil does a fantastic job of portraying Volkman and the events of his medical career through multiple lenses, allowing the reader to gather as full a picture as possible.

What was truly well-done about this book was the ways in which Eil took the time to contextualize the story. Eil provided a detailed (but relevant) backstory of Volkman, included social and political contexts for the geographic areas discussed, and included all the necessary information to feel as if I understood each player in the story. Further, Eil took the time to include aftermaths not only of the people involved in Volkman's story, but the places involved in Eil's story, allowing the reader to really feel that the book has come full-circle.

I will note that this book is incredibly dense, and the first chapter or so is a little slow. However, both of these factors are worth it if you're interested in the story!

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This book is a must-read for fans of true crime! The story of Paul Volkman, the Pill Mill Doctor, is astonishing not in its complexity, but rather in how staunchly Volkman proclaimed (and continues to proclaim) his innocence even after all the facts are laid out against him. Eil examines every aspect of Volkman's life, trial, and sentencing clearly through in-depth research, interviews, and personal accounts. The author includes fair amount of background information, but that information adds to the context of the book's events rather than bogging it down in minutae. There are several jaw-dropping moments in the book, and hearing Volkman's own take on how the events of his life unfolded had me flip-flopping between empathy (could he really have had his patients' best interests at heart?) and condemnation (how could he have thought his actions were justified?) Put this one on your TBR list, because it's going to knock your socks off!

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I recently had the privilege of gaining early access to "Prescription for Pain: How a Once-Promising Doctor Became the 'Pill Mill Killer'" through NetGalley, and I wanted to take a moment to share my thoughts with you.

First and foremost, I want to express my gratitude for the opportunity to read this compelling work before its official release. The narrative's ability to weave together the complexities of the central characters and the broader societal issues surrounding the opioid crisis is truly commendable. Your storytelling prowess has left an indelible impact on me as a reader.

The empathy with which you approached the characters, even those who had committed grave mistakes, is a testament to your skill as a writer. It allowed me to connect with the story on a deeper level, fostering a profound understanding of the human experience in the face of adversity.

Moreover, your exploration of the opioid crisis was handled with sensitivity and depth, shedding light on the devastating consequences of unchecked prescription practices. It is evident that extensive research and dedication went into crafting a narrative that is not only gripping but also serves as a poignant commentary on a pressing societal issue.

The pacing of the book was masterfully executed, keeping me engaged from start to finish. The careful balance between suspense and insightful commentary on legal and ethical dimensions added an extra layer of depth to the narrative.

As a reader, "Prescription for Pain" prompted me to reflect on broader issues within our healthcare system and the responsibilities of medical professionals. Your work has the power to inspire change and foster important conversations on accountability in the face of public health crises.

In conclusion, I want to extend my sincere appreciation for your contribution to literature and the thought-provoking journey you provided through this book. I look forward to its official release, and I am confident that it will resonate with a wide audience.

Thank you once again for this enriching literary experience.

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As an addictions counselor, and someone who watched friends and family members struggle with an addiction to opioids, I have been on a lifelong journey to find out just WHAT is behind it all. Loved every single minute of this book

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Thank you to NetGalley for my ARC. This novel tells the story of Mr. Volkman and his pain clinics which left a trail of victims and suffering. Although nonfiction, the story of Paul Volkman sometimes read like fiction. It is truly shocking what he was able to get away with for so long.

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This was very interesting. I'm not usually a true crime person but these are complex events that strengthen my knowledge as a human but also as an addictions counselor. Some passages felt a bit wordy even though the information itself was beneficial. This was well-researched and presented the author as an authority over the topic. I have been in the background watching as we have seen policy changes for the opioid crisis, but it was very beneficial to have the added depth that the author brought to this adding another layer to my knowledge base. This is a book that was thought-provoking and something that I will think about and likely refer back to from time to time.

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Can doctors be blamed for the opioid crisis?

What if a doctor prescribes narcotics to a patient who then dies a few days later from an overdose? Would you hold the doctor accountable?

What if said doctor established a clinic prescribing opioids with the sole goal of making money? What if these prescriptions were for insubordinate amounts of pills per person, in some cases for 600-800 pills per month?

This is the subject matter Philip Eil addresses in “Prescription for Pain”.

In his masterpiece, the author tells the story of Paul Volkman, the central figure of a cash-only pain clinic in impoverished Southern Ohio.

“It is the story of a man who was trained to be a medical scientist, but who wound up traversing multiple medical specialties, working in dozens of hospitals across the Midwest, and facing multiple malpractice lawsuits, before becoming what one news outlet dubbed “The Pill Mill Killer.”

In 2004, Volkman was the largest single purchaser of oxycodone in the United States. How did he get to that point when acquaintances from college expected to read about a future Nobel Prize in the newspaper? How did Volkman, once known for his high achieving personality, now face four consecutive life terms in prison?

The book does an outstanding job at describing Volkman’s bizarre demise into criminal persecution starting with his early success and the ultimate desperation that led him to run several “pill mills”. The research in the book is incredibly thorough, to the point that the author attempted to file a Freedom of Information Act lawsuit against the DEA in order to obtain detailed information about all deceased patients.

The way Volkman is described in the text reminds me of the traits observed in a number of personality disorders, notably the narcissistic kind. From the first page to the end, we are repeatedly told that Volkman does not appear to have any insight into his role as a quasi serial killer in the ~39 overdose deaths, nor does he show any remorse for its victims and describes them as “poor hillbillies” instead. In his eyes, the “death waiver” his patients signed took care of the possibility for negative outcomes. His erratic relationship with the truth seems to extend to his inner beliefs, causing him to see himself as a world class physician and heroic savior as well as a victim of outlandish conspiracies put up by the DEA.

The author creates an immensely detailed image not only of Volkman's trajectory, but also of the economic background that made the Tristate area between Southern Ohio, Kentucky, and West Virginia into a “Store Front Narcotic Outlet” with the highest overdose rate in the country. The scandal around Purdue Pharma along with their marketing hype around pseudoaddiction, opiophobia, and pain as the “Fifth Vital Sign” is also weaved into the narrative.

“By early 2010, the prescription drug abuse crisis had gotten so bad that the Scioto County health commissioner [...] declared a formal state of emergency.”

Eil transitions seamlessly between these background sections and Volkman's story. It really speaks for the excellent writing of the book that I never lost interest and couldn't put the book down despite the incredible amount of detail that's introduced. Well done!

I'm immensely grateful that I received an advance reader's copy of this extraordinary piece of investigative journalism. A lot of work and soul went into this book through the author's hard work, and it shows. I learned so much. Thank you Phillip Eil, Netgalley, and Steerforth Press for giving me the opportunity to review this book. It'll come out on April 9, 2024.

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An unflinching look at the opioid epidemic and one man who's greed and egotistical view of himself and his life directly caused the deaths of many, many people.

I found Dopesick and Empire of Pain absolutely fascinated so I was really excited when I saw this book. It did not disappoint and I found it well written and really insightful. A hard read but important nevertheless.

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Prescription for Pain by journalist Philip Eil is the incredible and disturbing true story of "pill mills" and their contribution to the opioid epidemic in the United States, specifically those run by Paul Volkman as pain clinics in Ohio.

The author spent years fastidiously researching and investigating this story to which he has a connection as his father knew Volkman in medical school. Volkman discovered pediatrics wasn't as lucrative as pharmacology and decided to take a risky path as narcissists often do.

Eil's findings are astonishing. He includes many statistics and facts and is careful to say some information is based on human memories which is not infallible. But the crux remains true.

Now in his 70s, Volkman is in prison serving four life sentences for his many crimes involving drugs. When speaking with the author he maintains he was trying to help those with pain have access to medications which actually worked. As a chronic pain sufferer myself, the quantities, doses and drug combinations he prescribed are beyond appalling. He prescribed hundreds and hundreds of pills to his patients each month, the highest opioid prescriber at the time. As very few pharmacists would place themselves in an illegal position, Volkman even opened up his own pharmacy. People would drive great distances to see him (or not) and get their drugs. The situation was so dangerous that armed guards were present. Payment was cash only. So many red flags!

Not only did patients quickly become addicted (many sold their medications even to their own children to make money for their next re-stock) but sicker and several died shortly after seeing Volkman. A few also suffered from medical procedural errors made by Volkman but lawsuits didn't stick. Volkman had one goal. Money can be a powerful motivator. He prescribed 75% of his patients the same alarming cocktail and many family members would find their loved ones dead. Such preventable tragedy. Yet Volkman justified his actions.

Perspectives of Volkman's family members, especially his daughter, give great insight.

This book is equal parts fascinating and frightening. Though quite long and detailed, it is a must for those intrigued by the topic.

My sincere thank you to Steerforth Press and NetGalley for providing me with a digital copy of this engrossing book.

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I am so glad that I got the chance to read this book. As a person who suffers from chronic pain and several chronic illnesses I am all too familiar with the subject and history of pill mills and how they have contributed to the "opiod epidemic" as it is referred to. These places where people pay a fee and a prescription is handed over to them has systematically ruined the much needed treatment for pain patients and even those that do not suffer from pain but those that have injuries or even need surgeries. People cannot even get treatment for surgical pain due to the contribution of these pill mill doctors and their unscrupulous practices. Philip Eli did a fantastic job in bringing to light for people who are not familiar with just what pill mills are, how they came to be and what needed to be done because of the harm is was causing to people. We follow the story of how one Dr. Volkman, who was probably a good doctor at one time, fell into the trap of how much money he could get by running one of these mills and how dark his practices got after that. I think many people who need more information on the subject would definitely benefit from a read of this. I also think pain patients and those of us that now suffer to find adequate treatment because of situations like this would enjoy the read.

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Thank you NetGalley for giving me the chance to read this book ahead of time in exchange for a review. It didn't disappoint! Must read!!

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I almost feel wrong saying i enjoyed this book because it was truly deeply disturbing but it was thorough and i did feel like the victims of Volkman were treated respectfully in the telling of their stories which sometimes does not happen with people who are suffering from addiction.

it was truly shocking how long his operation was able to continue after being raided multiple times in multiple locations and being the largest single purchaser of oxycodone in the United States in 2004.

the more i read from interviews with the man himself the more i felt that not only is he completely delusional he is also a monster who made worse the lives of everyone he has ever come into contact with.

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Thank you to the publisher and author for an ARC of this fabulous non-fiction title.

I have always been intrigued and shocked with how the opioid addiction came to fruition. I’ve read books and watched documentaries on the Sackler Family, so I consider myself well-versed in how this all got started. However, I hadn’t read about a specific person ourside of the Sackler family who helped move the epidemic along — until now.

The detail in Prescription For Pain is unmatched. There are so many voices, including those of Volkman’s family. It’s disturbing how many people can be affected by one person’s decision and greed.

And greed is exactly what is at the crux of Prescription For Pain. Volkman started out ok and wanted to help children as a pediatrician, but he then found a way to make more money as a physician: Pills.

Highly recommended for anyone who wants to learn more about the opioid epidemic.

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It’s not easy being a doctor. Doctors have a lot riding on them, and being around sickness must be very taxing, both mentally and physically. I have nothing but respect for the profession.

That said, it also comes with a major responsibility to serve the populace. Noblesse oblige, I guess?

Prescription for pain is an investigative true crime book that delves into the case of John Volkman, a doctor and PhD serving 4 life sentences for prescribing deadly combinations of drugs to hundreds of patients, that resulted in the overdose related deaths of at least 13 people (official number).

What was sad was these patients were in their mid 30s and 50s, popping an average of 20 pills daily. A treacherous cocktail of Oxy, Xan*x, and other heavy pa*nkillers/ sedat*ves/ muscle relaxants.

On paper, Volkman was a brilliant man. He did prove to be careless, causing a string of lawsuits in his early practice as a pediatrician. In spite of this, he was allowed to continue working in the medical community. Somewhere down the line, this blew up.

The book takes a deep dive into the Opioid epidemic, especially in the tristate area of Ohio, Kentucky and West Virginia, that forever altered the course of a generation. The backgrounds of of pain clinics is also explored, introducing us to the research of pain medicine, something that would prove to be a both profitable and deadly period in medical history. The book is heavily detailed, well researched and written. Eil asks the right questions to different people, trying his best to stay unbiased.
The manufacturers made the pills.
The doctors prescribed them.
The patients abus*d them.
This became a norm and medical associations and the DEA were unaware until they got tipped off. It took a series of deaths and patterns to connect them before the government was able to act on it. Not before it affected hundreds, maybe thousands of lives.

Who would you blame?

Only read this if you have the stomach and patience for it.

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Prescription for Pain by Philip Eil is one of the most compelling and fascinating true crime books I have read in recent years. It is an in depth examination of the story of disgraced former doctor Paul Volkman, a man who is currently serving four consecutive life sentences in prison for his involvement in irresponsible prescribing of opiates and other medications at a pain management clinic he ran. The author has done a huge amount of research over a period of more than a decade including interviewing the man himself as well as the families of the people who suffered at least in part as a consequence of his greed .
The story is almost incredible, especially to me as I work as a pharmacist ( albeit in another country) and seeing his prescribing practices would immediately raise red flags - and as it turns out those flags were indeed raised several times by other doctors and by pharmacists who would not accept prescriptions from his clinics. Incredible though it may seem the clinic was investigated and even raided several times over a period of several years before charges were finally brought.
As I said the book goes into great detail, not just about Volkman's work in the pain clinics and his subsequent trial, but rather right back to his time at medical school and his early years in practice where at one point he was refused insurance due to the number of negligence cases against him. Because licencing worked at a federal level he was able to move from state to state until he finally found a home working in a clinic in southern Ohio, a cash only operation where he saw a huge number of patients and issued prescriptions for thousands and thousands of pills, often with little to no clinical examination . While the detail is fascinating, it does mean that the book is dense, especially at first, but to be honest I soon found myself drawn in and before long I was completely captivated. While Volkman is the focus of the book the author does also examine the social and cultural issues that contributed to the problem of opioid addiction, particularly in that area and also spent time with the families of the victims so that he could tell their stories too.
I feel like this is essential reading for anyone with an interest in the subject and it is a book that I will be recommending to both colleagues and friends.
I read and reviewed an ARC courtesy of NetGalley and the publisher, all opinions are my own.

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