Saturday, 18 August 2018 / TRUTH-OUT.ORG

Origins of the Opioid Crisis: Purdue Pharma Knew of OxyContin Abuse in 1996 but Covered It Up

Friday, June 01, 2018 By Amy Goodman, Democracy Now! | Video Interview
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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.

TRANSCRIPT

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 Timesfor 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 DEAofficials, 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.

[break]

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.

This piece was reprinted by Truthout with permission or license. It may not be reproduced in any form without permission or license from the source.

Amy Goodman

Amy Goodman is the host and executive producer of Democracy Now!, a national, daily, independent, award-winning news program airing on more than 1,100 public television and radio stations worldwide. Time Magazine named Democracy Now! its "Pick of the Podcasts," along with NBC's "Meet the Press."

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Origins of the Opioid Crisis: Purdue Pharma Knew of OxyContin Abuse in 1996 but Covered It Up

Friday, June 01, 2018 By Amy Goodman, Democracy Now! | Video Interview
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Media

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.

TRANSCRIPT

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 Timesfor 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 DEAofficials, 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.

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Amy Goodman

Amy Goodman is the host and executive producer of Democracy Now!, a national, daily, independent, award-winning news program airing on more than 1,100 public television and radio stations worldwide. Time Magazine named Democracy Now! its "Pick of the Podcasts," along with NBC's "Meet the Press."