Origins of the Opioid Epidemic


An explosive New York Times report has revealed that manufacturers of the drug OxyContin knew it was highly addictive as early as 1996, the first year after the drug hit the market. The Times published a confidential Justice Department report this week showing that Purdue Pharma executives were told OxyContin was being crushed and snorted for its powerful narcotic, but still promoted it as less addictive than other opioid painkillers. This report is especially damning because Purdue executives have testified before Congress that they were unaware of the drug’s growing abuse until years after it was on the market. Today, drug overdoses are the leading cause of death for Americans under age 50. While President Trump claimed Tuesday that numbers relating to opioid addiction are “way down,” the latest statistics show there was an increase of opioid-related deaths and overdoses during Trump’s first year in office. According to the Centers for Disease Control and Prevention, drug overdose deaths involving opioids rose to about 46,000 for the 12-month period that ended October 2017, up about 15 percent from October 2016. The epidemic has been so widespread that life expectancy is falling in the United States for the first time in 50 years. We speak with Barry Meier, the reporter who broke this story for the Times, headlined “Origins of an Epidemic: Purdue Pharma Knew Its Opioids Were Widely Abused.” Meier was a reporter at The New York Times for nearly three decades and was the first journalist to shed a national spotlight on the abuse of OxyContin. His book “Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic” was published this week in an updated and expanded edition.

AMY GOODMAN: Today we spend the hour looking at the ongoing opioid epidemic and how it spread across the United States. Drug overdoses are now the leading cause of death for Americans under the age of 50. But during a speech on Tuesday, President Trump claimed “the numbers are way down.” He spoke in Nashville, Tennessee.

PRESIDENT DONALD TRUMP: We got $6 billion for opioid and getting rid of that scourge that’s taking over our country. And the numbers are way down. We’re getting the word out. Bad, bad stuff. You go to the hospital. You have a broken arm. You come out. You’re a drug addict with this crap. It’s way down. We’re doing a good job with it. But we got $6 billion to help us with opioid.

AMY GOODMAN: In fact, the latest statistics show there was an increase of opioid-related deaths and overdoses during Trump’s first year in office. According to the Centers for Disease Control and Prevention, drug overdose deaths involving opioids rose to about 46,000 for the 12-month period that ended October 2017, up about 15 percent from October 2016. The epidemic has been so widespread that life expectancy is falling in the United States for the first time in 50 years.

Meanwhile, the White House says it’s about to launch a series of public service announcements next week on opioid dangers, aimed at young people. The ads were developed with Kellyanne Conway, Trump’s point person on opioids.

This comes as The New York Times published a confidential Justice Department report this week that found manufacturers of the drug OxyContin had access to information showing it was addictive as early as 1996, the first year after the drug hit the market. Purdue Pharma executives were told OxyContin was being crushed and snorted for its powerful narcotic, but still promoted it as less addictive than other opioid painkillers. This report is especially damning because Purdue executives have testified before Congress that they were unaware of the drug’s growing abuse until years after it was on the market.

Well, for more, we’re joined by Barry Meier, the reporter who broke this story for The New York Times, which is headlined “Origins of an Epidemic: Purdue Pharma Knew Its Opioids Were Widely Abused.” Barry Meier was a reporter at The New York Times for nearly 30 years, the first journalist to shed a national spotlight on the abuse of OxyContin. His book Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic was published this week in an updated and expanded edition. He’s won the Pulitzer Prize and two George Polk Awards for his past reporting on the intersection of business, medicine and public health.

Barry Meier, welcome to Democracy Now!

BARRY MEIER: Thank you, Amy. A pleasure.

AMY GOODMAN: It’s great to have you with us. Well, talk about this latest Justice document that you just got a hold of.

BARRY MEIER: Right. So, the basic outlines are this. As you noted, Purdue Pharma has claimed that it first became aware of OxyContin’s growing abuse in early 2000. That was about four years after its introduction. In fact, what this document showed is that the company had extensive information about OxyContin’s abuse in 1997, 1998, 1999.

AMY GOODMAN: Twenty years ago.

BARRY MEIER: Yes, and concealed that information, didn’t tell the FDA, didn’t tell doctors, didn’t tell patients. And this was a very damning report. I mean, the crimes were so significant that the prosecutors, who spent four years investigating the company, recommended that three top executives of Purdue Pharma be indicted on a—for a series of felony crimes, like conspiracy to defraud the United States, false statements and things of that nature. Unfortunately, their efforts were blocked by top administration officials within the Justice Department.

AMY GOODMAN: So, explain what actually took place.

BARRY MEIER: What took place is the following. Purdue Pharma was given permission to market OxyContin as less prone to abuse and addiction than competing narcotics. I mean, this sort of was like a gift—

AMY GOODMAN: Like drugs like Vicodin and others.

BARRY MEIER: Yes, exactly. It was a gift from the FDA. They took that gift, and they ran with it. They told doctors not only that it might be less prone to abuse and addiction, but that it would be less prone to abuse and addiction. In 2007, they admitted, basically, lying to doctors, lying to patients, by misrepresenting what they had been allowed to say.

What we didn’t know was that during the course of the investigation that led to that confession, the federal government had also uncovered information to show that not only had they mismarketed the drug, they were aware, almost from the beginning, that people were abusing OxyContin, significantly abusing OxyContin, and they concealed that information. Had they sent a warning about that to the public, OxyContin would have never become a billion-dollar drug, and thousands of peoples of lives—thousands of lives wouldn’t have been affected by it.

AMY GOODMAN: We’re going to talk about the origins of OxyContin, the Sackler family. We’re going to talk about how this drug company grew. But right now, your book came out like over 15 years ago, Pain Killer.

BARRY MEIER: Right.

AMY GOODMAN: That’s before the company was indicted and the corporate officials were indicted. Talk about Rudolph Giuliani—now once again in the headlines because he is Trump’s attorney—his role in the rise of OxyContin, in preventing a serious prosecution of this company.

BARRY MEIER: Well, Rudolph Giuliani was hired in 2002. A lot of the reporting I did for the Times in 2001 was aimed at the overaggressive marketing of OxyContin by Purdue Pharma, as well as, you know, the growing reports, public reports, about the drug’s abuse. They then came under scrutiny by the FDA, by the DEA, and they felt that they needed a public defender—a fixer, if you will. The person they brought in to do that was Rudolph Giuliani. And so he went in, with his reputation as a former prosecutor, mayor and so forth, and began—

AMY GOODMAN: It was right—I mean, you’re talking about right after the 2001 September 11th attacks, when he was called “America’s Mayor.”

BARRY MEIER: Exactly. And sort of he took that reputation, and he sold it to corporations. And one of the corporations he sold it to was Purdue Pharma. And so, he became their sort of front man, if you will, their fixer, went to meet with DEA officials, with other officials, and basically spouted the company’s line. I mean, I have no idea what Rudy knew about what was in the company’s files, whether he was privy to the information that prosecutors later discovered. But he became, essentially, the person who tried to smooth things over with government officials.

AMY GOODMAN: And was particularly powerful because he was a cancer survivor himself—

BARRY MEIER: Absolutely.

AMY GOODMAN: —and spoke about what it means to reduce pain.

BARRY MEIER: Exactly. And, you know, he made a very compelling argument. I mean, this drug has valuable uses. It’s needed in certain situations. But, you know, what Purdue had done was to basically market this drug as a cure-all for all kinds of pain. And with the vast availability of the drug, it poured out onto the streets, and that led to this wave of abuse and addiction.

AMY GOODMAN: So, who were the officials in Washington, the political appointees in the Justice Department, who intervened? And this also goes to the whole story of West Virginia and a really crusading prosecutor who took this case on.

BARRY MEIER: Right. So, basically, there were people at the very—at the senior levels of the Criminal Division. Alice Fisher was then the head of the Criminal Division.

AMY GOODMAN: This is under George W. Bush.

BARRY MEIER: Correct. And Alberto Gonzales was the head—was the—

AMY GOODMAN: Attorney general.

BARRY MEIER: —attorney general at that time. So, essentially, what happened was, in September of 2006, this very small group of prosecutors, as you noted, in far western Virginia, forwarded a report, a confidential report, to the Justice Department recommending that serious felony indictments be brought against the executives of Purdue. That report contained extensive exhibits, emails, records, that they planned to present to a grand jury to support the call for their indictments. It was backed by the local U.S. attorney there, and man by the name of John Brownlee. And it was backed, in fact, by mid-level officials within Justice Department headquarters.

But on October 11, 2006, two weeks before these prosecutors were scheduled to go before a grand jury and seek these indictments, there was an 11th hour meeting at the Justice Department. Purdue brought in its high-powered legal defense team, met with top Justice Department officials, like Alice Fisher. And after that meeting, there was a chill on the case. And basically, people like John Brownlee were told, “We are not going to give you the resources to support this prosecution. You’re on your own, if you want to do it.” And Brownlee had no resources. He had this small group of people who had spent four years, you know, 24 hours a day, investigating this company. They were facing a company of unlimited financial and legal firepower. And they really had no choice but to settle the case at that point.

AMY GOODMAN: I mean, the story of West Virginia is astounding. As you write in your New York Times piece, “Starting in 2007, the year of the settlement, distributors of prescription drugs sent enough pain pills to West Virginia over a five-year period to supply every man, woman and child … with 433 of them.” This is according to a report in the Charleston Gazette-Mail. And we’re going to talk about West Virginia as ground zero and exactly what happened to these communities, with Barry Meier, author of Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic. It’s just out this week. Stay with us.

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AMY GOODMAN: “Puppet Charm” by Two Ton Boa, here on Democracy Now! I’m Amy Goodman. Our guest for the hour is Barry Meier, the Pulitzer Prize-winning former New York Times journalist, whose book is out again. Well, it’s expanded, it’s updated. But this is particularly relevant. The book is called Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic. It came out in 2003. Fifteen years, what a difference it makes in this country. How many deaths are we talking about? I mean, you have this incredible description of the death toll, writing, “In 2016, 64,000 Americans died from drug overdoses. That number equals the population of cities such as Portland, Maine; Lynchburg, Virginia; and Santa Fe, New Mexico. It was as if, in one year, a plague had entered one of these towns and killed every single inhabitant.”

BARRY MEIER: You know, we’re in the midst of the greatest public health disaster of the 21st century. It started out with the drug like OxyContin, and it has morphed, since then, into a kind of hydra-headed beast. On the one hand, you have the misuse and abuse of prescription drugs. And on the other hand, you have this growing death toll from counterfeit versions of drugs like fentanyl. So we’re in this very, very complicated situation. And, you know, the kind of policies that the government is now proposing may not get us out of it. I mean, we’re going to need a real extreme effort to get out of it.

AMY GOODMAN: We’re talking about, in 20 years, 250,000 people have died.

BARRY MEIER: That’s just from prescription painkillers alone. That’s from legal drugs. That’s from drugs that companies are allowed to produce, sell legally, and that are prescribed by doctors. And that alone is a stunning, startling figure.

AMY GOODMAN: So, I want to go to an ad from Purdue Pharma. This is from, oh, 1998, the ad to market OxyContin. It features Dr. Alan Spanos of North Carolina.

DR. ALAN SPANOS: There’s no question that our best, strongest pain medicines are the opioids. But these are the same drugs that have a reputation of causing addiction and other terrible things. Now, in fact, the rate of addiction amongst pain patients who are treated by doctors is much less than 1 percent. They don’t wear out. They go on working. They do not have serious medical side effects. And so, these drugs, which, I repeat, are our best, strongest pain medications, should be used much more than they are for patients in pain.

AMY GOODMAN: So, that is an ad put out by Purdue Pharma, the maker of OxyContin. Barry Meier?

BARRY MEIER: Well, you know, there was—in the late 1990s, there was a movement to promote—you know, treat pain much more aggressively than it had been in the past. A lot of that movement was funded by Purdue Pharma, people like Dr. Alan Spanos. And there were these tropes, if you will, that the addiction rate is less than 1 percent. It was a total lie. There was no basis for that figure. But it was repeated, repeated, repeated, and it sort of got ingrained into the medical culture. And as a result of that, doctors prescribed more and more of these drugs, you know, in good belief.

AMY GOODMAN: The guy he was talking about?

BARRY MEIER: Dr. Spanos. In fact, that video—they made another video, I believe, with Dr. Spanos that involved a patient. And that patient wasn’t even on OxyContin. He was on a totally ’nother drug, it came out. So, I mean, it was this massive public relations campaign, that was funded, in large part, by Purdue Pharma, to sell OxyContin.

AMY GOODMAN: Talk about the growth of Purdue Pharma. Talk about the Sackler family, what was unusual about this company, what also makes it so difficult to investigate.

BARRY MEIER: Well, the Sackler family is a fascinating family. As you know, their names are, you know, on every museum in the United States—here in New York at the Metropolitan, and at the National Gallery in Washington.

AMY GOODMAN: Their names are on wings. Their names are very prominent.

BARRY MEIER: On the elevators, on everything, you name it.

AMY GOODMAN: But when it comes to the drug, where they make their fortune—

BARRY MEIER: Right.

AMY GOODMAN: —we don’t see their name.

BARRY MEIER: Right. And not only that, the—there were three brothers, Arthur, Raymond and Mortimer. Arthur was the eldest. And he was sort of this kind of, I guess, you know, evil genius, if you will. He invented the modern-day drug advertising industry. All the ads that we see on TV today or in print are kind of the result of Arthur Sackler’s genius, or lack thereof, as you see it. And he kind of wedded together the pharmaceutical industry and the medical profession. He made doctors shills for drug companies. He created medical journals that were really kind of fake medical journals, because drug advertisers had to pay to get their studies into those medical journals. So he created all these deceptive marketing and advertising practices that are commonplace today. He died in 1986, before OxyContin was created.

But to get his brothers into the drug industry, he bought this tiny little firm called Purdue Frederick, that was located here in New York, in Greenwich Village, as it turned out. They basically sold a lot of kind of crazy stuff. And eventually, in the mid-1990s, they decided to get into the pain medication business. They first bought a drug called MS Contin, which was a long-acting form of morphine, and they marketed it mainly to cancer specialists, where the drug was very, very valuable in dealing with cancer pain. But then, in the mid-1990s, as this drive to treat pain more aggressively began to unfold, they began to sell OxyContin, which is a long-acting form of the narcotic oxycodone. And this became the most aggressive, high-powered marketing campaign for a prescription narcotic in drug industry history. It was financed with Sackler money. The Sacklers were the principal beneficiaries of it. There were something like $31 billion worth of OxyContin sales in subsequent years. And the Sacklers became, I believe, the 14th or 15th richest family in the United States.

AMY GOODMAN: I want to go to 1998. Purdue Pharma distributes another video, featuring seven patients who used OxyContin to deal with chronic pain. One of the patients was named Johnny Sullivan.

JOHNNY SULLIVAN: I got my life back now. Now I can enjoy every day that I live. I can really enjoy myself. And before, even a good day was hell. I mean, I couldn’t enjoy nothing. But now I can enjoy myself. That’s when I say it’s wonderful. I look at the future the same way a young guy, 25-, 30-year-old, would.

AMY GOODMAN: After appearing in that promotional video for Purdue Pharma, Johnny Sullivan became a severe addict to OxyContin and other opioids. In 2008, he died in a car crash when he fell asleep at the wheel. His wife said, because of his addiction, he would often nod off. Barry?

BARRY MEIER: You know, this drug, for some patients, has been a godsend. But for many, many others, it has turned into a nightmare. We focus a lot about—on the subject of addiction, and rightly so. But not long ago, I interviewed a pain specialist, who had been sort of on the bandwagon promoting these drugs when they first came out. And he said to me, “You know, addiction is not the real problem with these drugs. It’s not the only problem with these drugs.” These drugs caused patients to emotionally opt out of life, you know, to become couch potatoes, to become withdrawn, to reject their family members and lose social contact. They had all other—they have all other kinds of troubling side effects. And so, you know, there is now a generation of patients who, effectively, are emotionally dependent upon these drugs.

AMY GOODMAN: A spokesperson for Purdue Pharma said in a statement, in response to your article in The New York Times, his company is “involved in efforts to address opioid abuse,” and, quote, “Suggesting that activities that last occurred more than 16 years ago are responsible for today’s complex and multifaceted opioid crisis is deeply flawed.” Your response?

BARRY MEIER: You know, I’m not a $600-an-hour lawyer. I don’t come up with, you know, statements like that. But let me put it in simple terms. Purdue Pharma violated the trust of doctors and patients. It lied to them. The Justice Department discovered reams of information, which, in their minds, showed that this company also concealed extraordinarily powerful information pointing to the abuse of these drugs, early—early on, when it was first marketed.

AMY GOODMAN: What was the lie to the doctors?

BARRY MEIER: The lie was that OxyContin would be less prone to abuse and addiction than competing painkillers. They admitted that they had told that lie in 2007, and paid $600 million in fines. I mean, that was a drop in the bucket where OxyContin sales were concerned. But they admitted that they had lied.

AMY GOODMAN: You write about how Purdue sales reps used a chart to convince doctors that OxyContin was more stable than a traditional narcotic, even though the FDA had told Purdue that the information they were giving out was bogus.

BARRY MEIER: That was just one of many lies that they used. I mean, the entire predicate of the company’s marketing campaign was based on a lie. I mean, that’s the simplest way of putting it. The Food and Drug Administration had given them permission to say, “This drug might be less prone to abuse and addiction.” They trained their sales reps to say it was less prone to abuse and addiction. Sales reps would go—and sales reps didn’t know what the reality was, but they would go to doctors and pharmacists and say, “You know, you can’t inject OxyContin. You can’t extract the oxycodone from OxyContin and inject it, because like the junkie will get a heart attack, they’ll drop over and die. This is a safe drug. This is much safer.” It was all an incredible lie. And at the same time, the company was concealing what was probably the most significant information they needed to tell doctors, which was this drug was being widely abused.

AMY GOODMAN: Who is Laura Nagel?

BARRY MEIER: Laura Nagel was the head—a key figure within the DEA at the time of this episode. She was in charge of the division of DEA that went after the diversion of legal drugs onto the street. It wasn’t sort of the narcs, you know, the guys who busted people for selling heroin or cocaine, but it was the diversion division which dealt with the misuse of prescription drugs.

AMY GOODMAN: And what did she do?

BARRY MEIER: She was a hero. She was a fighter. She saw what was going on. She realized that this company, A, was overly aggressively—you know, was promoting this drug, you know, to the nines, that people were dying from this drug. She tried to call them to account. And they essentially unleashed as much legal and lobbying firepower on her to basically try to roll her over.

AMY GOODMAN: And what happened?

BARRY MEIER: She basically backed off, just like everyone else in those days who came up against Purdue Pharma.

AMY GOODMAN: So, let’s talk about ground zero, West Virginia. What was happening in some of these towns, in some of these small, independent drugstores—

BARRY MEIER: Right.

AMY GOODMAN: —that were bringing in how much of this drug?

BARRY MEIER: They were bringing in huge amounts of this drug, I mean, tens and tens of millions of pills, annually, of this drug.

AMY GOODMAN: How did it start in West Virginia?

BARRY MEIER: I mean, OxyContin was being distributed to West Virginia, to Virginia and other states. Drugstores were prescribing it. But, you know, you had doctors there that were essentially running what are called pill mills. People would come in to the doctor and say, “Doctor, I hurt, I have pain.” “OK, fine, let me just write you a prescription. Oh, and, you know, OxyContin works really well for me, for my pain.” So, you had these doctors who were writing prescriptions for drugs at the request of the patient, which is, you know, a rare situation. And so then these patients, who are often drug abusers, would go to the pharmacy and get the prescriptions filled. Sometimes I—and, you know, in my travels on this story, I would go to small towns where the doctor had a pharmacy in his office. So he would write the prescription, you’d go next door to a pharmacy that he owned, and they would dispense the drug. So, you know, millions of these pills were being dispensed. They were ending up on the street. And these horror shows of crime and abuse and separated families and everything else would follow.

AMY GOODMAN: I’m looking at a piece, that you refer to in your piece. This is in the West Virginia Gazette-Mail. And it says, “In Southern West Virginia, many of the pharmacies that received the largest shipments of prescription opioids were small, independent drugstores like ones in Raleigh and Wyoming counties that ordered 600,000 to 1.1 million oxycodone pills a year. Or they were locally owned pharmacies in Mingo and Logan [counties], where wholesalers distributed 1.4 million to 4.7 million hydrocodone pills annually. By contrast, the Wal-Mart at Charleston’s Southridge Centre, one of the retail giant’s busiest stores in West Virginia, [was shipped] about 5,000 oxycodone and 9,500 hydrocodone pills each year.”

BARRY MEIER: Yeah. I mean, it’s startling. I think what—you know, one of the things that happened when the Justice Department did not crack down, really, on Purdue Pharma is it sent a signal that, “Drug companies, drug distributors, you can ship these drugs in whatever quantity you want, to wherever you want, and the worst that you’re going to face is a fine.” So they viewed it as a cost of doing business. There was never going to be any accountability for the corporate executives. It wasn’t going to be like the dealer or the drug addict who was going to end up in prison. All the corporate executives were going to have to pay was a small fine. And that was going to be a fraction of the profits that they were going to make by shipping huge quantities of the drugs to places like West Virginia.

AMY GOODMAN: This is Democracy Now! I’m Amy Goodman. Our guest is Barry Meier, author of Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic. Tell us the story of Dr. Art Van Zee.

BARRY MEIER: You know, Art Van Zee is kind of the hero of my book. He’s a man I met him when I was reporting for the Times back in the early 2000s. He’s a small-town doctor. He lives in a town called Pennington Gap in very western Virginia, near the Kentucky border. And I met him. He was a—he’s a gracious, lovely person. He reminded me of kind of a Doctors Without Borders, but here in the U.S., you know, working in Appalachia, in an area that desperately needed medical care.

He realized that his town was being overrun by OxyContin abuse. He saw kids being addicted to it, went to the hospital on emergency visits. And he decided, eventually, that he had to do something. He couldn’t stand quiet and let this unfold. And he tried to lead a small-town campaign to get the FDA to pull this drug off the market, or at least to crack down on this drug. And Pain Killer kind of follows his saga and the saga of other people in the town, a wonderful nun there by the name of Sister Beth, who sort of try try to take on this huge, powerful drug company and hold it to account.

AMY GOODMAN: And so, what happened to Dr. Art Van Zee?

BARRY MEIER: You know, Art Van Zee, like Laura Nagel, eventually got shouted down, got ignored. I mean, there was this rather pivotal Senate hearing, where he comes and he pleads with these senators to do something about this drug. And Chris Dodd, the Democratic senator from Connecticut at the time, starts raking him over the coals and sounds like he’s, you know, badgering him with talking points that had been given to him by Purdue Pharma. And lo and behold, when I started looking at campaign finance records and other documents, it turned out that Chris Dodd had met with Purdue Pharma prior to this hearing, and Purdue—and Chris Dodd had gotten a $10,000 contribution from Purdue Pharma shortly afterward. So, Purdue Pharma, you know, was spreading money around and going after its critics and co-opting them throughout this entire period. I mean, the U.S. attorney in Maine, who first sounded a public alarm about this—

AMY GOODMAN: First one in the country.

BARRY MEIER: In the country, in 2001. He went immediately onto the payroll of Purdue Pharma and became one of its biggest defenders. In fact, I found documents that suggested that he was discussing a job with them even before he left public office. He swore up and down that that wasn’t the case. But, in fact, there are emails, Purdue Pharma’s own emails, suggesting that he had reached out to them to discuss job opportunities.

AMY GOODMAN: Explain the nature of the settlement in 2007. Can the company—can individuals in the company be held criminally responsible today, what, 200,000 deaths later, in the last 20 years, though they would argue, “That’s not all us”?

BARRY MEIER: Right. So, the settlement was twofold. The company, Purdue Pharma, as a company, pled guilty to a felony charge called misbranding, which was essentially misrepresenting the drug, and paid $600 million in fines. The three executives, top executives, of the company pled guilty to a misdemeanor version of that charge. It was a sort of weird charge, because it only held him liable in their roles as corporate executives. It did not accuse them personally of any wrongdoing. They paid around—about $34 million in fines. But what we came to discover, and what was in the Times in the other day and in the expanded version of the book, is that the prosecutors on the case wanted to charge them also with very serious felonies, that could have put them in jail, had that case gone forward.

AMY GOODMAN: And talking about holding people responsible, you write about how those that do drugs together, a husband, could be found guilty of murdering his wife, etc. Talk about that.

BARRY MEIER: Well, you know, we have a different standard of justice in this country. One standard is for the person who gets caught with, you know, some drugs in their pocket. Another standard is for the person who’s caught selling drugs. And another standard is for the executives of corporations that allow these drugs to get into the wrong hands of people, or knowingly are aware that these drugs are being abused, and don’t say anything. And, you know, there seems to be very little punishment that those kinds of individuals face.

AMY GOODMAN: But what do people face on the ground, who are doing drugs?

BARRY MEIER: They face their—they face spending the rest of their life in prison.

AMY GOODMAN: Explain.

BARRY MEIER: You know, they can be sent away for 10 years, for 20 years. They can have their lives destroyed, whereas the corporate executives don’t see their bonuses going down. They don’t see their lives being ruined. They just go on with their lives.

AMY GOODMAN: Earlier this year, New York Mayor Bill de Blasio announced that New York would sue manufacturers and distributors of prescription opioids to account for their part in the city’s ongoing deadly opioid epidemic. Firms named in the suit include Purdue Pharma, Johnson & Johnson and McKesson Corporation.

MAYOR BILL DE BLASIO: This is a man-made crisis if ever there was one, fueled by corporate greed, fueled by the actions of big pharmaceutical companies that hooked millions of Americans on opioids to begin with. And some of them still are addicted to prescription drugs, and others have migrated to heroin. But we know where it began for so many people. And, bluntly, it was so a very few people could profit, and, obviously, the horrible actions of criminals who sell drugs and profit in death, as well. That combination has led to where we are today. We need to remember that those origins at the root of this problem means it’s a problem that can be defeated. We can fight back against the big pharmaceutical companies. We can fight back against the criminals who peddle drugs. We can change in so many ways, including changing the entire culture around this issue, so we can help people.

AMY GOODMAN: So that’s New York Mayor Bill de Blasio. More than 60 U.S. cities in over a dozen states are now suing Big Pharma over opioids. What does this mean?

BARRY MEIER: Well, this could have happened a long time ago, Amy. You know, what’s startling to me is, as someone who’s watched this over almost two decades, is the issue of, you know, why did we wait this long to do this. We could have done this in 2003, in 2007, in 2010, in 2012. We have allowed this to morph into this horrible situation. It’s a good thing that it’s happening now. And I really do hope that these cities and states carry through and get to the truth, and not walk away with a simple settlement the way the Justice Department did in 2007. The only way that this problem is really going to be solved is if we really understand what happened, if the truth about what happened comes out. I mean, the fact that, you know, this confidential memo has now come out adds to the truth of what we know.

AMY GOODMAN: And again, say what is the essential point in this confidential memo.

BARRY MEIER: The essential point is that Purdue Pharma has claimed, from day one, and still claims today, that it first became aware of OxyContin’s growing abuse in 2000. This memo shows that prosecutors believe that they were aware of the drug’s abuse for years before that and concealed that information.

AMY GOODMAN: And what about the lawsuits of New York and 60 other cities and towns? What are they trying to accomplish with these lawsuits? What’s the premise of them?

BARRY MEIER: They’re trying to get money. They’re trying to get money to pay for some of the medical costs that they’ve had to absorb as a result of prescription drug overdoses and addictions. It’s very similar to the tobacco lawsuits, which I also covered for the Times. It’s essentially taxpayers have borne the brunt of the healthcare costs related to prescription painkillers. Purdue Pharma hasn’t paid for it. Johnson & Johnson hasn’t paid for it. These drug distributors haven’t paid for it. They’ve only profited from it. So now these states and towns are trying to recover some of the costs from the people who profited from this trade.

AMY GOODMAN: Barry Meier, what about the American Medical Association?

BARRY MEIER: It’s funny you should bring that up. The American Medical Association has been, over time, one of the big stumbling blocks to the solution of this problem. Back in 2001, I met a wonderful doctor, Dr. Nathaniel Katz. And he argued that doctors should be required to undergo some type of mandatory training as a condition for prescribing prescription drugs like OxyContin, like six hours of training, eight hours of training. You could do it on your home. You could do it through some sort of, you know, thing on the internet. Very simple.

The AMA fought this tooth and nail, as recently as the Obama administration. The White House Office of Drug Policy wanted to propose a law to make this happen. AMA lobbyists came to officials of the White House and to the—you know, to the Obama administration, and said, “If you do this, we will fight you tooth and nail. We will not allow this to happen. This is too much of a burden for our members. They don’t have six hours or eight hours to spend looking at information on how to prescribe these drugs more safely.” So, I think they have a lot on their shoulders here. You know, they basically blocked taking a very simple step, that would have been—would have provided tremendous good for patients and for doctors.

AMY GOODMAN: So, the Sacklers didn’t put their name on the drug company and are a very secretive family when it comes to that, but very public when it comes to supporting the big museums, like you said, the Met in New York and the Sackler Wing. Do you think, given that these big art institutions and universities around the country get federal funding, that they should have their name stripped from these wings?

BARRY MEIER: Well, that’s a—you know, that’s really up to the institutions and these medical schools to decide, you know.

AMY GOODMAN: Explain the medical school connection.

BARRY MEIER: Well, you know, they fund a lot of medical schools. They fund a lot of educational programs at medical schools. You know, there’s been a lot—you know, there was a wonderful piece that Christopher Glazek did in Esquire and Patrick Keefe did in The New Yorker about the Sacklers. And, you know, I wrote about them extensively in Pain Killer. They’ve now become the face of this problem. And so, you know, museums and—

AMY GOODMAN: Maybe name the wings after the victims of their drugs.

BARRY MEIER: Well, either that or have information about their donors.

AMY GOODMAN: So, next week begins the big push. The White House, in conjunction with the Ad Council, will be debuting public service messages that “should shock the conscience,” they say. What do you think needs to be done?

BARRY MEIER: Well, I think that we have a two-headed beast that we’re dealing with. One thing that is being done—and, unfortunately, it’s come about a decade too late, but it’s being done now—is a reassessment of the use of drugs like OxyContin in the treatment of medical conditions. As I said, it’s a valuable drug, but there are many other ways to treat pain and treat common types of pain that are just as effective as the use of pain pills. And employers and unions need to make sure that their members and employees are getting the best possible pain treatment, not pills, which are profitable for drug companies and cheap for insurers. So that’s one side of the problem.

AMY GOODMAN: We have 15 seconds.

BARRY MEIER: The other side of the problem is the illegal side, and that’s really a law enforcement enforcement issue, you know, cracking down on companies—countries like China and Mexico, that ship the chemicals that are used to make these horrible and dangerous illegal street drugs.

AMY GOODMAN: Well, I want to thank you for being with us, Barry Meier, author of Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic, just out this week, updated and expanded, Pulitzer Prize-winning journalist formerly with The New York Times.

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