Authors try to avoid writing the same book twice. I couldn’t.
My book “Pain Killer” first came out in 2003. It was the first one to tell the story of OxyContin; its maker, Purdue Pharma; and the company’s wealthy and secretive owners, the Sackler family. The book appeared at the dawn of the opioid epidemic and the sun quickly set on it. A year after publication, it went out of print.
To say I was disappointed is an understatement. I thought “Pain Killer” told an important story about the chaos unleashed when the best intentions of doctors to solve a problem — in this case, pain — get hijacked by the drug industry. The book’s account alone of Raymond Sackler, a little-known but pivotal figure who transformed drug marketing and compromised medical practice in the process, struck me as worth the price of admission.
Book buyers didn’t agree and I was given an opportunity every author dreads — the chance to buy remaindered copies of the book for $1 apiece. There wasn’t even interest in a paperback, and the book’s original publisher returned all rights back to me. (In time, that proved to be a blessing, but it sure didn’t feel like it then.)
Fast forward several years to a May night in 2007. The scene is a Mexican restaurant in Roanoke, Va. Over dinner, the local United States attorney, John Brownlee, shows me the draft of a press release he plans to issue the next day, announcing a development that will make the front page of newspapers like the New York Times. Purdue Pharma and three of its top executives had agreed to plead guilty to charges in connection with the company’s deceptive promotion that OxyContin was less prone to abuse and addiction than traditional opioids.
According to the release, at a planned press conference Brownlee would personally thank me for writing about OxyContin, both as a New York Times reporter and as the author of “Pain Killer.” I was flattered, but asked him to delete the reference because I was reporting on the story and didn’t want to be part of it.
Still, I was happy that my work had had an impact, and after leaving the restaurant, I made a long drive to Abingdon, Va., a quaint town in the far western part of the state. It is home to the federal courthouse where the three Purdue Pharma executives would enter their pleas the following morning. Defense lawyers had asked Brownlee not to alert the news media to the plea deal until the three executives were back on a corporate jet returning to Stamford, Conn., where Purdue Pharma is based. But he had made one exception. As the three executives approached the courthouse, a New York Times photographer and I popped out from behind parked cars. The trio and their lawyers did not look happy to see us.
In the years that followed, the pace of the opioid epidemic accelerated and morphed. No longer was it limited to prescription painkillers like OxyContin but increasingly included heroin and deadly counterfeit versions of fentanyl. A wave of new books about the crisis appeared, most notably “Dreamland,” by Sam Quinones. “Pain Killer” became a touchstone often cited in these accounts. Some people even began describing the book as “prescient,” which I can assure you I am not.
During those years, I turned my attention to a range of other subjects, including the case of a CIA consultant who had mysteriously disappeared in Iran. But not long ago, I came into possession of a document about Purdue Pharma and OxyContin that changed everything, including what I thought I knew about the story.
It was a confidential 120-page report written by the U.S. Department of Justice team of prosecutors working for John Brownlee. Their investigation of OxyContin had culminated in the 2007 plea deal.
Under that agreement, the three Purdue Pharma executives had pled guilty to a misdemeanor that held them liable only as the drug maker’s “responsible” officers and did not accuse them of any wrongdoing. But the report showed that prosecutors had recommended charging the men with serious felonies. It was also filled with a treasure trove of internal Purdue Pharma emails and records that offered a detailed look at what Purdue knew about OxyContin’s abuse and when the company knew it.
Sadly, all that evidence was buried when top Justice Department officials in the George W. Bush administration refused to back prosecutors’ calls to indict the Purdue officials.
A decade later, lawmakers are now proposing that drug company executives found guilty of illegally marketing painkillers should be imprisoned. States and cities have filed lawsuits against Purdue Pharma and other opioid makers. Museums and institutions that received donations from members of the Sackler family involved with Purdue Pharma are facing scrutiny over those gifts.
It struck me that the information unearthed by the Justice Department prosecutors can help inform those efforts. The mountain of evidence contained in the report also brings the story of OxyContin and Purdue Pharma full circle by providing an extraordinary inside look at the secretive drug maker’s early knowledge about OxyContin abuse and addiction. What prosecutors believed they had unearthed was a corporate cover-up with massive public health consequences.
Given all this new information, it was clear to me that I had to write “Pain Killer” again. Like I said, authors would rather avoid writing the same book twice. But sometimes you have to.
Barry Meier is a Pulitzer Prize-winning journalist and the author of “Pain Killer: An Empire of Deceit and the Origins of America’s Opioid Epidemic” (Random House, May 2018).
This case highlights exactly why regulatory agencies and regulations are needed. The agencies were there but lobbying and lawyering I guess were able to overpower them. Now Trump admin would do away with many of the regs that might prevent this sort of tragedy. It’s all well and good to let entrepreneurs be entrepreneurs, but people have to consider more carefully when regulation makes sense.
Thank you, for not only bringing your book back, but bringing it to my attention. I look forward to reading about all that you have found out! As Jeffrey Feingold admits to be taken in by the OxyContin “myth”, he obviously wasn’t the only physician duped ~ although I do have to wonder, question really, the credentials of someone claiming to be a physician who can’t spell better than a fifth grader, doesn’t realize the subject is OxyContin, not oxytocin, and fails to to take responsibilty for his own prescribing practices of OxyContin that led to his incarceration, to be who he says he is to begin with. That being said…..
I know many physicians in my area who are getting slammed by DEA to get their patient prescriptions for OxyContin, and oxycodone down, WAY down or preferably non-existant, and if not, face their wrath! My BIGGEST problem with the DEA’s heavy-handed approach to this, is not that they’re getting a great amount of OxyContin off the market and out of the hands of a lot of people who will or might become addicted and possibly overdose, it’s the people who have, and live (suffer) with, unrelenting, intractable, legitimate, non-cancer pain issues. Take someone for example, who has RSD/CRPS (Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome), the very rare condition that is rated by the McGill University International Pain Index as being “the most painful condition known to mankind”. For anyone who has this debilitating condition, their lives are forever changed, even if they can get a diagnosis! Up until very recently a vast majority of physicians didn’t even know what was, let alone know how to treat it. Those patients would be left struggling, visiting anywhere between five to ten physicians before they might get a diagnosis. For those who didn’t one, the picture became very, very bleak, which has led to the number one cause of death among this group being suicide, for the sole reason that their pain was literally THAT overwhelming. For those lucky enough to actually get a diagnosis, the treatment options were still lacking because the etiology of RSD/CRPS, even to this day, is still unknown. Thanks to the NIH and other government and private researchers there is some research and even clinical trials being undertaken that, hopefully, someday, will uncover the cause and implement some treatment protocols, but currently, the only avenue patients have had, has been strong pain medications, usually opioid based, to give them ANY chance of relief. I say chance, because in many, many cases the opioids don’t even begin to relieve the pain that RSD/CRPS causes, so those who can actually afford it are seeking other treatments as well. Invasive procedures like dorsal column stimulators, internal morphine drug pumps, chemical or surgical sympathectomies/ablations. Some have traveled out of the country seeking relief with drugs and procedures not approved in the U.S., and there have even been a few who risked being put into months long ketamine induced comas, and still others turned to street drugs.
The people who are unfortunate enough to have RSD/CRPS aren’t looking for a “high” and they’re definitely not “drug seekers”. They are “relief seekers”. In fact, the vast majority of these folks are the MOST compliant in terms of their treatment protocols. I believe the DEA’s across the board, hardline, no exceptions stance to the “Opioid Crisis” is going to be devastating to those who have RSD/CRPS more than anything. They have so few affordable options to them to begin with and while it may be true that even the opioids don’t take away all of their debilitating pain, don’t they, at the very least, deserve whatever little relief they CAN get? Exceptions MUST be made, both for the patient with an RSD/CRPS diagnosis AND their physician who prescribes their medication. As I mentioned early on, RSD/CRPS is RARE, most patients see between 5 to 10 physicians (over the course of several years) before they even get a diagnosis and treatment options are limited. Without exceptions, I’m afraid we’ll see many of those patients being forced to seek relief from other, more dangerous, sources, ie; drug peddlers, or even worse, taking their own lives.
I as a doctor in AZ, nievely believed the Sackler lies that oxytocin wasn’t as addictive for my patients. I was sent to federal prison and now I can’t get a decent paying job.
https://caselaw.findlaw.com/us-9th-circuit/1311668.html
I think all drugs should be over the counter; but really, exchanging drugs for someone to paint your house?? That one made me smile
Oxytocin or Oxycontin?
You sound like one of those anti medication Scientologists. Nice that the author thinks their work is important
I think that they sound like someone who finally feels rightfully acknowledged.