1 00:00:00,280 --> 00:00:07,760 Speaker 1: Hi, I'm Ethan Natalman, and this is Psychoactive, a production 2 00:00:07,800 --> 00:00:11,840 Speaker 1: of iHeart Radio and Protozoa Pictures. Psychoactive is the show 3 00:00:11,880 --> 00:00:15,400 Speaker 1: where we talk about all things drugs. But any views 4 00:00:15,440 --> 00:00:20,040 Speaker 1: expressed here do not represent those of iHeart Media, Protozoa Pictures, 5 00:00:20,200 --> 00:00:24,840 Speaker 1: or their executives and employees. Indeed, as an inveterate contrarian, 6 00:00:25,120 --> 00:00:28,000 Speaker 1: I can tell you they may not even represent my own. 7 00:00:28,800 --> 00:00:31,600 Speaker 1: And nothing contained in this show should be used as 8 00:00:31,680 --> 00:00:42,800 Speaker 1: medical advice or encouragement to use any type of drug. Hello, 9 00:00:42,880 --> 00:00:48,879 Speaker 1: Psychoactive listeners. Uh. Today's guest has written a book that 10 00:00:49,080 --> 00:00:53,600 Speaker 1: is creating quite a bush. The book is called Empire 11 00:00:53,920 --> 00:00:59,720 Speaker 1: of Pain, and it looks at the role of one company, 12 00:01:00,040 --> 00:01:04,920 Speaker 1: Produe Pharma, and one family who owned that company, the Sacklers, 13 00:01:05,600 --> 00:01:09,720 Speaker 1: in terms of the role that they played in creating 14 00:01:09,800 --> 00:01:13,679 Speaker 1: what we now widely regard as a massive opioid epidemic 15 00:01:13,760 --> 00:01:17,160 Speaker 1: in America, where almost a half a million people have 16 00:01:17,280 --> 00:01:22,160 Speaker 1: died over the last twenty years from opioid related overdoses. Now, 17 00:01:22,200 --> 00:01:26,120 Speaker 1: Patrick has been a top investigative journalist a writer for 18 00:01:26,160 --> 00:01:28,040 Speaker 1: a long time. He's been writing for The New Yorker 19 00:01:28,120 --> 00:01:31,640 Speaker 1: magazine for the last fifteen years before this book, he 20 00:01:31,720 --> 00:01:34,759 Speaker 1: did three other books. One was on global eavesdropping, one 21 00:01:34,840 --> 00:01:38,080 Speaker 1: was on the Chinatown Underground, one was about a murder 22 00:01:38,080 --> 00:01:41,440 Speaker 1: in Northern Ireland. And he uses these stories and families 23 00:01:41,480 --> 00:01:45,600 Speaker 1: oftentimes to kind of reflect on broader issues that are 24 00:01:45,640 --> 00:01:50,600 Speaker 1: going on. So, Patrick, you and I if we crossed 25 00:01:50,600 --> 00:01:52,880 Speaker 1: paths a few years ago, not in person, but by 26 00:01:53,000 --> 00:01:57,960 Speaker 1: phone when you were writing a story about Washington State's 27 00:01:58,120 --> 00:02:02,240 Speaker 1: efforts to implement the merril On, a legalization initiative that 28 00:02:02,360 --> 00:02:06,120 Speaker 1: I've been involved in in twelve and then I saw 29 00:02:06,160 --> 00:02:08,919 Speaker 1: you had also written these wonderful stories about the capture 30 00:02:09,320 --> 00:02:12,720 Speaker 1: and the pursuit of El Chappo al Chapoozman and notorious 31 00:02:12,760 --> 00:02:15,160 Speaker 1: Mexican drug trafficker. So I think one thing you and 32 00:02:15,200 --> 00:02:19,240 Speaker 1: I share in common is this fascination with drugs and 33 00:02:19,320 --> 00:02:21,799 Speaker 1: drug markets. And just tell me about where you came 34 00:02:21,800 --> 00:02:25,760 Speaker 1: to this fascination front. Yeah, you know, it probably started 35 00:02:25,760 --> 00:02:28,239 Speaker 1: with the with the Mexican side of things. I wrote 36 00:02:28,280 --> 00:02:31,200 Speaker 1: a big piece of cover story for the New York 37 00:02:31,200 --> 00:02:36,320 Speaker 1: Times magazine in about Chappo Goosman and the Cineloa cartel. 38 00:02:36,440 --> 00:02:38,280 Speaker 1: And it's funny to think back, but I had to 39 00:02:38,320 --> 00:02:40,560 Speaker 1: explain to the editors of the New York Times magazine 40 00:02:40,600 --> 00:02:45,040 Speaker 1: who Choppo Goosman was and why it was worth writing 41 00:02:45,040 --> 00:02:47,240 Speaker 1: about him. You know, he has become more of a 42 00:02:47,280 --> 00:02:49,160 Speaker 1: household name and a and a meme, but at the 43 00:02:49,200 --> 00:02:51,400 Speaker 1: time it was not all that well known. And what 44 00:02:51,440 --> 00:02:53,520 Speaker 1: was interesting to me was that there was a tendency 45 00:02:53,600 --> 00:02:57,079 Speaker 1: to talk about the illegal drug trade and the Mexican 46 00:02:57,200 --> 00:03:00,440 Speaker 1: drug syndicates as these criminal organizations, but not to think 47 00:03:00,440 --> 00:03:03,960 Speaker 1: of them as businesses. And I was really chiefly interested 48 00:03:03,960 --> 00:03:06,280 Speaker 1: in them as businesses. So that first piece was I joked, 49 00:03:06,280 --> 00:03:08,840 Speaker 1: it was like a Harvard Business School case study of 50 00:03:08,919 --> 00:03:11,720 Speaker 1: a Mexican drug cartel, and that was how I got 51 00:03:11,720 --> 00:03:14,160 Speaker 1: into it. So I've always been interested in these issues, 52 00:03:14,680 --> 00:03:19,280 Speaker 1: but maybe particularly these questions about listit and illicit markets 53 00:03:19,320 --> 00:03:21,919 Speaker 1: and the convergences between them. You know that the work 54 00:03:21,919 --> 00:03:24,600 Speaker 1: I did on Mexican drug cartels, I was most interested 55 00:03:24,600 --> 00:03:30,960 Speaker 1: in these cartels as multinational commodities enterprises doing billions of 56 00:03:31,000 --> 00:03:36,560 Speaker 1: dollars in business to cater to a predominantly North American market. 57 00:03:37,040 --> 00:03:38,840 Speaker 1: And then in Washington State, I was interested in the 58 00:03:38,880 --> 00:03:42,560 Speaker 1: idea that you can legalize pot with the stroke of 59 00:03:42,560 --> 00:03:45,160 Speaker 1: a pen. But the reality is that there has been 60 00:03:45,200 --> 00:03:49,400 Speaker 1: an underground, a very vibrant underground pot economy for decades. 61 00:03:50,000 --> 00:03:52,720 Speaker 1: So what happens, you know, what are the implications for 62 00:03:53,000 --> 00:03:56,880 Speaker 1: not just sort of taxes and regulation, but marketing for growers, 63 00:03:57,000 --> 00:03:59,440 Speaker 1: for consumers. And then, in a weird way, I kind 64 00:03:59,480 --> 00:04:01,600 Speaker 1: of I worked my way all the way through to 65 00:04:01,720 --> 00:04:07,400 Speaker 1: the purely listit f d a regulated universe of produe pharma, 66 00:04:07,560 --> 00:04:09,720 Speaker 1: which for reasons I'm sure we'll talk about, you know, 67 00:04:09,760 --> 00:04:12,720 Speaker 1: I think the fact that in this case it's a 68 00:04:12,760 --> 00:04:15,440 Speaker 1: family of billionaire philanthropists who aren't going to go to 69 00:04:15,520 --> 00:04:19,960 Speaker 1: jail does nothing in my mind to diminish the um 70 00:04:20,000 --> 00:04:23,040 Speaker 1: the negative consequences of the kind of business there. M 71 00:04:24,440 --> 00:04:26,520 Speaker 1: I'll tell you this. So I'm gonna be perfectly frank 72 00:04:26,520 --> 00:04:28,599 Speaker 1: with you. In reading your book, right, there's this part 73 00:04:28,600 --> 00:04:31,039 Speaker 1: of me that always is reading through the eye of 74 00:04:31,040 --> 00:04:33,839 Speaker 1: the devil's advocate, and there's a part of me saying, 75 00:04:34,080 --> 00:04:37,400 Speaker 1: you know, what are you missing here? What seems unfair? 76 00:04:38,080 --> 00:04:41,240 Speaker 1: You know, this blaming so much of the opioid crisis 77 00:04:41,360 --> 00:04:45,120 Speaker 1: on one family and one company. You know, I've seen 78 00:04:45,160 --> 00:04:47,920 Speaker 1: that over forty years, have been so often with Colombia 79 00:04:48,000 --> 00:04:50,359 Speaker 1: Mexican drug factors being blamed for cocaine or this or 80 00:04:50,400 --> 00:04:52,760 Speaker 1: that or that or this, and so what I want 81 00:04:52,760 --> 00:04:55,000 Speaker 1: to do really is two things, because on the one hand, 82 00:04:55,040 --> 00:04:59,239 Speaker 1: I think you make an incredibly powerful case that produe 83 00:04:59,279 --> 00:05:03,560 Speaker 1: pharma and the sacklers really deserve a huge measure of 84 00:05:03,640 --> 00:05:07,160 Speaker 1: blame and responsibility for what in fact has happened in 85 00:05:07,160 --> 00:05:10,440 Speaker 1: this country over the last twenty years. On the other hand, 86 00:05:10,880 --> 00:05:12,880 Speaker 1: your book was really interesting me because I know some 87 00:05:12,920 --> 00:05:14,960 Speaker 1: of the characters in your book. I mean some of them. 88 00:05:14,960 --> 00:05:17,040 Speaker 1: I've crossed paths with some of them. I even was 89 00:05:17,120 --> 00:05:20,280 Speaker 1: friendly with or worked with a bit. I've been sympathetic 90 00:05:20,360 --> 00:05:25,120 Speaker 1: to the concerns around opia, phobia and the pain community. Uh. 91 00:05:25,160 --> 00:05:26,480 Speaker 1: You know. On the other hand, you know, I also 92 00:05:26,480 --> 00:05:28,280 Speaker 1: got approached by a law firm a couple of years 93 00:05:28,320 --> 00:05:31,000 Speaker 1: ago that was suing all these pharmaceutical companies, and you know, 94 00:05:31,080 --> 00:05:33,360 Speaker 1: did a day's worth of consulting for them as well. 95 00:05:33,440 --> 00:05:36,240 Speaker 1: And I've had my own experiences with pain and my 96 00:05:36,279 --> 00:05:40,120 Speaker 1: own views about where pain management and other things can 97 00:05:40,160 --> 00:05:42,760 Speaker 1: go wrong. So let me first start off by talking 98 00:05:42,839 --> 00:05:46,080 Speaker 1: about the family. I think you said, you know, there 99 00:05:46,080 --> 00:05:48,279 Speaker 1: are ways in which people say, my god, it sounds 100 00:05:48,320 --> 00:05:51,680 Speaker 1: just like that HBO series Succession, except here you have 101 00:05:51,920 --> 00:05:55,359 Speaker 1: the founding members, you know, the older generation born a 102 00:05:55,400 --> 00:05:58,600 Speaker 1: hundred years ago, Arthur and Raymond and Mortimer, and then 103 00:05:58,600 --> 00:06:01,440 Speaker 1: the successive and the ones they're after. Tell me why 104 00:06:01,480 --> 00:06:05,480 Speaker 1: you decided to focus on the family, Well, for a 105 00:06:05,560 --> 00:06:07,200 Speaker 1: number of reasons. I mean, you know, the first thing 106 00:06:07,240 --> 00:06:09,880 Speaker 1: I would say on the issue of blame, as I 107 00:06:09,960 --> 00:06:12,640 Speaker 1: make pretty clear in the book, you have an opioid 108 00:06:12,680 --> 00:06:16,360 Speaker 1: crisis that's lasted for a quarter of a century, half 109 00:06:16,360 --> 00:06:20,080 Speaker 1: a million people dead. Who knows which statistics you should believe, 110 00:06:20,160 --> 00:06:23,640 Speaker 1: but by some estimates to plus million people now struggling 111 00:06:23,640 --> 00:06:27,240 Speaker 1: with addiction to opioids of one sort or another. You 112 00:06:27,279 --> 00:06:30,839 Speaker 1: don't get there through the actions of one family alone, 113 00:06:31,279 --> 00:06:34,120 Speaker 1: or you know, anyone bad actor or any set of 114 00:06:34,120 --> 00:06:37,760 Speaker 1: bad actors. Right, It's incredibly complex, and I think it 115 00:06:37,800 --> 00:06:41,000 Speaker 1: takes a village. You know, there's all kinds of systemic failure. 116 00:06:41,160 --> 00:06:45,839 Speaker 1: There's all kinds of bad pharmaceutical companies, bad doctors, bad regulators, 117 00:06:46,080 --> 00:06:49,000 Speaker 1: and on and on. I do think that the Sacklers 118 00:06:49,000 --> 00:06:51,800 Speaker 1: in their company play a special role as a kind 119 00:06:51,839 --> 00:06:56,599 Speaker 1: of They were one of the first movers in this situation. 120 00:06:56,640 --> 00:06:58,800 Speaker 1: In which I think that there's a great deal of 121 00:06:58,839 --> 00:07:01,839 Speaker 1: blame to go around. I was interested in the origin 122 00:07:01,960 --> 00:07:05,360 Speaker 1: story of this crisis, in how it started, and I 123 00:07:05,400 --> 00:07:08,520 Speaker 1: think they play a really major role in those early days. 124 00:07:08,520 --> 00:07:10,240 Speaker 1: And the Sacklers, you know, we can talk about this, 125 00:07:10,400 --> 00:07:13,400 Speaker 1: I'm sure we will. The Sacklers say in their defense today, 126 00:07:13,520 --> 00:07:15,600 Speaker 1: listen that the opioid crisis today is a heroin and 127 00:07:15,640 --> 00:07:17,840 Speaker 1: fentanel crisis, and we don't you know, we're not in 128 00:07:17,880 --> 00:07:22,040 Speaker 1: that business. This is illegal drugs being purchased on the street. 129 00:07:22,640 --> 00:07:24,720 Speaker 1: That's not what we did. So don't blame us for 130 00:07:24,800 --> 00:07:28,560 Speaker 1: those deaths. But again, the crisis is interesting, right because it, 131 00:07:28,760 --> 00:07:30,920 Speaker 1: as these things do, it starts small and then it 132 00:07:31,000 --> 00:07:33,680 Speaker 1: morphs and it evolves. As for why I focused on 133 00:07:33,720 --> 00:07:36,080 Speaker 1: the family itself, I found the family fascinating. I think 134 00:07:36,160 --> 00:07:40,880 Speaker 1: families are fascinating generally as a subject. It became important 135 00:07:40,920 --> 00:07:43,000 Speaker 1: to me not to write a book that would be 136 00:07:43,040 --> 00:07:46,200 Speaker 1: a straightforward book about the opioid crisis, in part because 137 00:07:46,200 --> 00:07:48,240 Speaker 1: there are a handful of those books out there, some 138 00:07:48,280 --> 00:07:50,840 Speaker 1: of them quite good. I was more interested in a 139 00:07:50,920 --> 00:07:54,760 Speaker 1: kind of multigenerational family saga. If it were the case 140 00:07:54,920 --> 00:07:59,480 Speaker 1: that that you had different generations doing different things. I 141 00:07:59,560 --> 00:08:03,160 Speaker 1: might be less interested, but you get this continuity where 142 00:08:03,560 --> 00:08:06,680 Speaker 1: the original three Sackler brothers are in the farm of 143 00:08:06,760 --> 00:08:10,000 Speaker 1: business and I think have a kind of outsized impact, 144 00:08:10,320 --> 00:08:13,200 Speaker 1: particularly Arthur Sackler, the oldest brother, on the way in 145 00:08:13,240 --> 00:08:16,640 Speaker 1: which drugs are marketed and sold in this country. Arthur Sackler, 146 00:08:16,680 --> 00:08:18,120 Speaker 1: who I devote the first third of the book too. 147 00:08:18,200 --> 00:08:20,920 Speaker 1: He dies before the introduction of OxyContin, but I think 148 00:08:20,920 --> 00:08:23,320 Speaker 1: there's a lot in his life that we can learn 149 00:08:23,400 --> 00:08:25,360 Speaker 1: from in terms of what I would argue is the 150 00:08:25,400 --> 00:08:28,320 Speaker 1: hijacking of medicine by commerce. I think he was very 151 00:08:28,360 --> 00:08:32,600 Speaker 1: instrumental in creating some of the systems that have done 152 00:08:32,600 --> 00:08:35,520 Speaker 1: that that were then used to great effect with OxyContin 153 00:08:35,559 --> 00:08:38,440 Speaker 1: and many other drugs. Yeah. Well, I mean it's interesting 154 00:08:38,440 --> 00:08:40,960 Speaker 1: as I'm reading it, because you're making a link between 155 00:08:41,120 --> 00:08:43,679 Speaker 1: Arthur Sackler, who's kind of, you know, even though he's 156 00:08:43,720 --> 00:08:45,959 Speaker 1: the eldest sibling of the three brothers, but he's also 157 00:08:46,080 --> 00:08:49,160 Speaker 1: kind of a patriarchal figure with the others. He is 158 00:08:49,200 --> 00:08:52,520 Speaker 1: the guiding genius, the dynamo, the one making the major 159 00:08:52,559 --> 00:08:56,160 Speaker 1: investments often times and bringing his brothers along. He's regarded 160 00:08:56,200 --> 00:09:00,240 Speaker 1: as the godfather of medical advertising. He basically it's just 161 00:09:00,400 --> 00:09:04,240 Speaker 1: almost magically vertically integrated. I mean he's got advertising, he's 162 00:09:04,280 --> 00:09:08,600 Speaker 1: got his medical newspapers, he's got the companies collecting the data, 163 00:09:08,679 --> 00:09:11,440 Speaker 1: then they buy the pharmaceutical companies. He's got all of 164 00:09:11,480 --> 00:09:15,920 Speaker 1: these things while at the same time being this extraordinary philanthropist. 165 00:09:16,360 --> 00:09:20,200 Speaker 1: But as you say, he dies um before and his 166 00:09:20,480 --> 00:09:25,480 Speaker 1: family is not involved with Perdue Pharma when OxyContin comes along. 167 00:09:26,120 --> 00:09:29,920 Speaker 1: The other character you focus on is Richard Sackler, who 168 00:09:29,960 --> 00:09:33,280 Speaker 1: is the head of Perdue Pharma and is thet the 169 00:09:33,360 --> 00:09:37,640 Speaker 1: nephew of Arthur, and who really drives this thing forward. 170 00:09:38,120 --> 00:09:40,360 Speaker 1: And I think with Arthur you described a sort of 171 00:09:40,480 --> 00:09:45,520 Speaker 1: mix of idealism and greed. With Richard, is the balance different. 172 00:09:46,720 --> 00:09:51,640 Speaker 1: Um No, actually no, I don't think so. I think, uh, 173 00:09:52,480 --> 00:09:55,320 Speaker 1: Richard is in some ways a less He's a less 174 00:09:55,360 --> 00:10:00,199 Speaker 1: attractive character because he doesn't have his uncle's charm. Arthur 175 00:10:00,240 --> 00:10:01,920 Speaker 1: Sackler was somebody who was a kind of a polymath. 176 00:10:02,000 --> 00:10:04,400 Speaker 1: He was involved in all kinds of different areas, had 177 00:10:04,400 --> 00:10:07,680 Speaker 1: a great charisma. Richard doesn't have any of that. So, 178 00:10:07,760 --> 00:10:08,880 Speaker 1: just to back up for a second, I mean my 179 00:10:08,920 --> 00:10:10,960 Speaker 1: last book, which is about The Troubles in Northern Ireland 180 00:10:11,040 --> 00:10:13,760 Speaker 1: is just steeped in moral ambiguity, and there's not a 181 00:10:13,840 --> 00:10:15,800 Speaker 1: lot of moral ambiguity in this book. I mean, it's 182 00:10:15,800 --> 00:10:18,040 Speaker 1: pretty clear I think to most people reading the book, 183 00:10:18,480 --> 00:10:21,200 Speaker 1: um where I come down. I think these people did 184 00:10:21,320 --> 00:10:24,760 Speaker 1: some bad things. Having said that, I'm not interested in 185 00:10:25,280 --> 00:10:28,800 Speaker 1: caricaturi ish condemnations of people. I just don't. I don't 186 00:10:28,800 --> 00:10:31,000 Speaker 1: really particularly want to spend my time as a journalist 187 00:10:31,040 --> 00:10:33,599 Speaker 1: doing that. I don't know that as a reader I 188 00:10:33,640 --> 00:10:35,640 Speaker 1: would want to read, you know, some kind of a 189 00:10:35,760 --> 00:10:38,440 Speaker 1: screed about the evil of the Sacklers in which they're 190 00:10:38,480 --> 00:10:41,880 Speaker 1: all kind of tapping their fingertips together and planning their 191 00:10:41,880 --> 00:10:45,360 Speaker 1: global domination. I think greed was a big part of 192 00:10:45,400 --> 00:10:49,400 Speaker 1: the cocktail with Richard, but I think idealism was as well. 193 00:10:49,600 --> 00:10:52,880 Speaker 1: You know, opioids are are complicated and fascinating, and people 194 00:10:52,880 --> 00:10:55,880 Speaker 1: have known for thousands of years that drugs derived from 195 00:10:55,880 --> 00:11:00,840 Speaker 1: the opium poppy have tremendous therapeutic benefit. But they've also 196 00:11:00,960 --> 00:11:04,960 Speaker 1: known that that was twinned with certain dangers, among them addiction. 197 00:11:05,800 --> 00:11:08,719 Speaker 1: And part of what's so interesting to me about the 198 00:11:08,720 --> 00:11:11,040 Speaker 1: story of Boxing Content and Richard Sackler in particular is 199 00:11:11,080 --> 00:11:14,280 Speaker 1: that there's a kind of hubris but also in idealism 200 00:11:14,320 --> 00:11:16,880 Speaker 1: in their idea that they're like, that was the problem 201 00:11:16,920 --> 00:11:19,760 Speaker 1: for thousands of years, but we've hacked it, and we 202 00:11:19,840 --> 00:11:24,439 Speaker 1: figured out how to uncouple the therapeutic upsides from the downsides. 203 00:11:25,240 --> 00:11:28,400 Speaker 1: And as a consequence, these drugs that had historically been 204 00:11:28,480 --> 00:11:30,360 Speaker 1: you know, doctors have been a little bit more cautious 205 00:11:30,360 --> 00:11:34,160 Speaker 1: about prescribing them. They should be prescribed, you know, left 206 00:11:34,200 --> 00:11:38,440 Speaker 1: and right, potentially to tens of millions of Americans. I 207 00:11:38,440 --> 00:11:40,720 Speaker 1: don't think it was just greed that drove that, you know, 208 00:11:40,720 --> 00:11:43,160 Speaker 1: I think it was optimism. And where the story gets 209 00:11:43,200 --> 00:11:45,880 Speaker 1: really interesting for me morally is that what happens when 210 00:11:45,920 --> 00:11:48,200 Speaker 1: the world starts to tell you, you know, that you 211 00:11:48,240 --> 00:11:50,880 Speaker 1: were wrong. And so where I would be as an 212 00:11:50,920 --> 00:11:54,199 Speaker 1: ethical matter most unforgiving of of Richard is is actually 213 00:11:54,240 --> 00:11:55,840 Speaker 1: not in the first instance, where you put the drug 214 00:11:55,880 --> 00:11:58,080 Speaker 1: out there and you make kind of fantastical claims for it. 215 00:11:58,120 --> 00:12:01,000 Speaker 1: But it's more what happens and you start hearing that 216 00:12:01,040 --> 00:12:04,160 Speaker 1: actually people are getting addicted to it in significant numbers, 217 00:12:04,360 --> 00:12:07,440 Speaker 1: and in many cass dying. I mean, OxyContin hits the 218 00:12:07,520 --> 00:12:11,440 Speaker 1: market in a roughly seven or so what was so 219 00:12:11,480 --> 00:12:13,840 Speaker 1: special about it and what was the kind of broad 220 00:12:13,880 --> 00:12:16,200 Speaker 1: strokes about the way this thing emerges for better and 221 00:12:16,240 --> 00:12:21,120 Speaker 1: for worse. So OxyContin was a powerful opioid pain killer. 222 00:12:21,240 --> 00:12:25,600 Speaker 1: It's released in ninety six, and it was pure oxycodone, 223 00:12:25,640 --> 00:12:29,280 Speaker 1: which is a very strong opioid, but with a special 224 00:12:29,320 --> 00:12:33,120 Speaker 1: coating which allowed it to disperse into your blood stream 225 00:12:33,240 --> 00:12:35,480 Speaker 1: slowly over the course of a number of hours. And 226 00:12:35,520 --> 00:12:37,079 Speaker 1: so what this meant is that you could have quite 227 00:12:37,120 --> 00:12:42,040 Speaker 1: big doses of oxycodon. Traditionally you would have seen oxycodone 228 00:12:42,040 --> 00:12:44,600 Speaker 1: and drugs like percadan or percocet, but there it's cut 229 00:12:44,640 --> 00:12:46,800 Speaker 1: with a set of menifa or aspirin, which meant that 230 00:12:46,840 --> 00:12:48,959 Speaker 1: there was a limit to how much you could take. 231 00:12:49,080 --> 00:12:52,920 Speaker 1: And so here you could get big sixty eight milligram 232 00:12:53,120 --> 00:12:57,320 Speaker 1: pills of pure oxycodone with that coating. The drugs released 233 00:12:57,320 --> 00:13:01,840 Speaker 1: in nineties six, and you start to see problems almost 234 00:13:01,960 --> 00:13:05,760 Speaker 1: right away. But you eventually have a situation in which 235 00:13:05,800 --> 00:13:10,480 Speaker 1: more and more people are abusing OxyContin by crushing the pills, 236 00:13:10,600 --> 00:13:13,959 Speaker 1: and you can thereby kind of override that slow release 237 00:13:14,000 --> 00:13:16,280 Speaker 1: mechanism and get the full dose sol at once. But 238 00:13:16,360 --> 00:13:19,000 Speaker 1: people are also in a doctor's care just finding that 239 00:13:19,040 --> 00:13:21,240 Speaker 1: they're becoming addicted to the drugs. So more and more 240 00:13:21,240 --> 00:13:27,640 Speaker 1: people start becoming addicted, abusing the drug, overdosing, eventually dying, 241 00:13:28,520 --> 00:13:34,080 Speaker 1: and slowly this kind of controversy builds around OxyContin and 242 00:13:34,160 --> 00:13:37,199 Speaker 1: Produce Pharma. During this period, the company keeps doubling down. 243 00:13:37,600 --> 00:13:41,760 Speaker 1: They never really hesitate in their big marketing push, and 244 00:13:41,800 --> 00:13:44,680 Speaker 1: eventually there's a federal guilty plea in two thousand and 245 00:13:44,760 --> 00:13:49,000 Speaker 1: seven when the company pleads guilty to miss branding the drug, 246 00:13:49,040 --> 00:13:52,200 Speaker 1: to criminal charges of miss branding the drug, essentially having 247 00:13:52,200 --> 00:13:55,520 Speaker 1: made claims about it's safety that turned out to be fraudulent. 248 00:13:56,160 --> 00:13:58,320 Speaker 1: And it's interesting because that's sort of this interesting moment 249 00:13:58,320 --> 00:14:00,640 Speaker 1: in the story where people look back and they think, Okay, well, 250 00:14:00,760 --> 00:14:02,360 Speaker 1: you know, certainly what the company always said was we 251 00:14:02,400 --> 00:14:04,280 Speaker 1: had a few bad apples prior to two thousand and seven, 252 00:14:04,280 --> 00:14:05,800 Speaker 1: we had the guilty plea, and then we really cleaned 253 00:14:05,840 --> 00:14:08,679 Speaker 1: up our act and beefed up our compliance department and 254 00:14:08,720 --> 00:14:12,720 Speaker 1: got religion. In two thousand and ten, they reformulate the drug, 255 00:14:13,080 --> 00:14:19,600 Speaker 1: making it harder to crush the pills, and you fast 256 00:14:19,640 --> 00:14:24,120 Speaker 1: forward to there's a second guilty plea, So it turns 257 00:14:24,120 --> 00:14:27,320 Speaker 1: out that you know, during that period when they supposedly 258 00:14:27,440 --> 00:14:29,600 Speaker 1: were on the straight and narrow, in fact, they had 259 00:14:29,640 --> 00:14:32,400 Speaker 1: been going right back to the old ways of kind 260 00:14:32,400 --> 00:14:36,000 Speaker 1: of zealously over promoting the drug. And so you had 261 00:14:36,000 --> 00:14:39,080 Speaker 1: a second guilty plead to federal criminal charges in late 262 00:14:40,240 --> 00:14:42,960 Speaker 1: covering a period of time that dated back ten years. 263 00:14:43,480 --> 00:14:46,160 Speaker 1: So really this is a kind of a criminal enterprise, 264 00:14:46,240 --> 00:14:48,280 Speaker 1: this organization. You've got the guilty plea in two thousand 265 00:14:48,320 --> 00:14:53,000 Speaker 1: and seven, another one and in between that reformulation in 266 00:14:53,040 --> 00:14:55,760 Speaker 1: two thousand and ten. Mm hmmm, well, you know, let 267 00:14:55,760 --> 00:14:58,240 Speaker 1: me I'll share with you sort of some of my 268 00:14:58,520 --> 00:15:01,520 Speaker 1: history and coming to this isshoe um. And first of all, 269 00:15:01,600 --> 00:15:03,320 Speaker 1: was you know I had it must have been twenty 270 00:15:03,400 --> 00:15:07,200 Speaker 1: years ago. I actually had dinner with Richard Sackler and 271 00:15:07,440 --> 00:15:11,360 Speaker 1: his attorney, Howard, you know, who ends up having complete 272 00:15:11,400 --> 00:15:14,200 Speaker 1: guilty to something or other. And I was introduced by 273 00:15:14,320 --> 00:15:18,200 Speaker 1: Kathy Foley, who was the head of pain Management and 274 00:15:18,240 --> 00:15:21,880 Speaker 1: slow Cattering. And the reason I knew Kathy was that 275 00:15:21,960 --> 00:15:24,600 Speaker 1: when I started my organization, it was initially part of 276 00:15:24,640 --> 00:15:28,240 Speaker 1: George Soros's foundation back in ninety four, and the other 277 00:15:28,320 --> 00:15:31,200 Speaker 1: project that he helped get started simultaneous with mine. We 278 00:15:31,240 --> 00:15:33,960 Speaker 1: were really the first two US projects of soros Is, 279 00:15:34,120 --> 00:15:37,720 Speaker 1: you know, initial philanthropic Empire was a project on death 280 00:15:37,760 --> 00:15:40,840 Speaker 1: and dying with dignity, and he appointed Kathy to be 281 00:15:40,920 --> 00:15:43,240 Speaker 1: the head of that project while she was still head 282 00:15:43,240 --> 00:15:46,120 Speaker 1: of pain management Sloan Cattering, the leading cancer and you 283 00:15:46,120 --> 00:15:49,040 Speaker 1: know hospital in New York. And so I'm kind of 284 00:15:49,120 --> 00:15:51,760 Speaker 1: educating her about drug policy and we're talking. I'm more 285 00:15:51,800 --> 00:15:55,160 Speaker 1: focused on addiction, the pain issues kind of peripheral, you know. 286 00:15:55,240 --> 00:15:57,200 Speaker 1: And at one point she introduced me to Richard around 287 00:15:57,320 --> 00:15:59,400 Speaker 1: two thousand, two thousand one, and the hopes that maybe 288 00:15:59,400 --> 00:16:01,840 Speaker 1: he would become supporter of my organization once it had 289 00:16:01,880 --> 00:16:05,440 Speaker 1: spun out of Sources Foundation. But what was interesting was 290 00:16:05,640 --> 00:16:09,120 Speaker 1: I had been mostly focused on addiction and the ways 291 00:16:09,400 --> 00:16:13,280 Speaker 1: in which opio phobia, the irrational fear of opioids, sometimes 292 00:16:13,280 --> 00:16:16,840 Speaker 1: got in the way of effective addiction treatment. Right. I 293 00:16:16,880 --> 00:16:19,440 Speaker 1: was aware that, for example, in trying, you know, method 294 00:16:19,440 --> 00:16:23,760 Speaker 1: on maintenance was the gold standard of treating drug addiction, 295 00:16:23,840 --> 00:16:26,800 Speaker 1: National Academy of Science, in Student medicine, World Health Organization, 296 00:16:26,960 --> 00:16:28,680 Speaker 1: you know, you name it, you know, all said this 297 00:16:28,720 --> 00:16:31,720 Speaker 1: is the way to do it. But the barriers, the 298 00:16:31,800 --> 00:16:35,360 Speaker 1: stigmatization against method on, the notion that you were just 299 00:16:35,440 --> 00:16:39,880 Speaker 1: substituting one addictive opioid for another in the black community, 300 00:16:39,920 --> 00:16:42,280 Speaker 1: the notion that this was the chemical bracelet of the 301 00:16:42,320 --> 00:16:45,880 Speaker 1: white overlords on the black community, the notion that method 302 00:16:45,920 --> 00:16:48,600 Speaker 1: on should only be used to get you off of heroin, 303 00:16:48,880 --> 00:16:51,520 Speaker 1: but that it should not be a long term maintenance drug. 304 00:16:51,840 --> 00:16:55,040 Speaker 1: You know, meeting people who would say, hey, don't blame 305 00:16:55,040 --> 00:16:58,080 Speaker 1: me for methan on being my daily medication. Um, I'm 306 00:16:58,120 --> 00:17:00,960 Speaker 1: no more a method on addict than diabetic is an 307 00:17:01,000 --> 00:17:03,920 Speaker 1: insulin addict. This is my daily medication. I don't get high, 308 00:17:03,920 --> 00:17:05,840 Speaker 1: and I'm probably gonna take it for the rest of 309 00:17:05,880 --> 00:17:09,200 Speaker 1: my life. So when I come into this pain field, 310 00:17:09,200 --> 00:17:11,680 Speaker 1: which I never fully do, but on the edges of it, 311 00:17:12,040 --> 00:17:14,840 Speaker 1: I'm very conscious of the ways in which, you know, 312 00:17:14,880 --> 00:17:19,679 Speaker 1: opioids can be highly dependent, causing and addictive, but that 313 00:17:19,960 --> 00:17:22,480 Speaker 1: they have a very important role to play. And now 314 00:17:22,560 --> 00:17:24,440 Speaker 1: we even see, you know, now there's this huge push 315 00:17:24,480 --> 00:17:26,359 Speaker 1: to get all the people addicted to drugs onto method 316 00:17:26,400 --> 00:17:29,359 Speaker 1: on abourd Breneurphane. So when I look at the pain field, 317 00:17:29,520 --> 00:17:31,600 Speaker 1: I see, on the one hand, the sense in which 318 00:17:31,600 --> 00:17:35,159 Speaker 1: there's a really legitimate concern that Perdue Pharma and that 319 00:17:35,320 --> 00:17:39,199 Speaker 1: Richard Sackler are tapping into. But what I find so 320 00:17:39,320 --> 00:17:48,080 Speaker 1: persuasive about your book is the incredibly over marketing, aggressive marketing, duplicity, dishonesty, 321 00:17:48,200 --> 00:17:51,359 Speaker 1: line manipulation of regulators, and all this sort of stuff 322 00:17:51,440 --> 00:17:55,919 Speaker 1: which led them to promote an incredibly valuable breakthrough medication, 323 00:17:56,119 --> 00:17:59,640 Speaker 1: oxy content right, which which huge numbers of pain patients 324 00:17:59,680 --> 00:18:02,240 Speaker 1: were feeling. You know, this was the greatest thing that 325 00:18:02,280 --> 00:18:05,840 Speaker 1: ever happened to them. But the company and the Sackler's 326 00:18:05,960 --> 00:18:09,919 Speaker 1: promoted in a way which is grossly disproportionate to its 327 00:18:09,960 --> 00:18:13,639 Speaker 1: appropriate need in the community. So anyway, your reactions to 328 00:18:14,040 --> 00:18:18,040 Speaker 1: my whole riff there, Um, it's hard, right because the 329 00:18:19,440 --> 00:18:24,200 Speaker 1: you know, you use the phrase the phobia, the irrational uh, 330 00:18:24,240 --> 00:18:29,119 Speaker 1: you know, irrational fear, fear of opioids. It's you know, 331 00:18:30,680 --> 00:18:32,359 Speaker 1: with half a million people dead, it's hard for me 332 00:18:32,400 --> 00:18:35,800 Speaker 1: to say it. It's entirely irrational, right. I think that 333 00:18:35,840 --> 00:18:38,840 Speaker 1: these are powerful medications which I think have important therapyic uses. 334 00:18:39,080 --> 00:18:42,480 Speaker 1: I'm not, by any stretch of the imagination of prohibitionists 335 00:18:42,480 --> 00:18:44,840 Speaker 1: really when it comes to any drugs. You know, there 336 00:18:44,880 --> 00:18:48,120 Speaker 1: are some people, including some doctors who think we really 337 00:18:48,119 --> 00:18:51,040 Speaker 1: shouldn't use strong opioids at all for chronic pain and 338 00:18:51,080 --> 00:18:53,119 Speaker 1: what have you. And that's not to me, like, I 339 00:18:53,160 --> 00:18:56,080 Speaker 1: don't even need to get there in this book, because 340 00:18:56,240 --> 00:18:58,719 Speaker 1: those are debates that people are having, and and for me, 341 00:18:58,760 --> 00:19:04,960 Speaker 1: it's a question of marketing, fraudulent marketing, excessive marketing, and 342 00:19:05,240 --> 00:19:08,760 Speaker 1: careless over prescribing. And I don't think at this point 343 00:19:08,800 --> 00:19:13,600 Speaker 1: you would find anyone, including frankly, people like Patty Foley, 344 00:19:13,720 --> 00:19:17,080 Speaker 1: who would dispute the notion that part of the reason 345 00:19:17,160 --> 00:19:20,320 Speaker 1: we got here was because of over prescribing. The Sacklers 346 00:19:20,320 --> 00:19:23,439 Speaker 1: still maintained that at coontin is not iatrogenically, it's just 347 00:19:23,520 --> 00:19:26,119 Speaker 1: it's just not addictive or you know, addictive only one 348 00:19:26,119 --> 00:19:28,639 Speaker 1: percent of the time. I think most people have retired 349 00:19:28,720 --> 00:19:32,960 Speaker 1: that as a conjecture, that particular statistic for me, the 350 00:19:33,200 --> 00:19:35,840 Speaker 1: you know, there's a whole bunch of pieces to this, 351 00:19:36,000 --> 00:19:37,560 Speaker 1: but part of it is that if you have a 352 00:19:37,640 --> 00:19:44,119 Speaker 1: therapy that is powerful, that has tremendous therapeutic upsides but 353 00:19:44,240 --> 00:19:51,320 Speaker 1: also potential downsides, it should be prescribed carefully and marketed carefully, 354 00:19:51,400 --> 00:19:53,560 Speaker 1: and that a situation in which you have an army 355 00:19:53,600 --> 00:19:56,560 Speaker 1: of sales reps going out with a bunch of literature 356 00:19:56,560 --> 00:19:59,960 Speaker 1: that in retrospect turns out to be dodgy, telling physicians 357 00:20:00,080 --> 00:20:04,520 Speaker 1: ends who are not paying specialists that there are no 358 00:20:04,600 --> 00:20:08,480 Speaker 1: side effects to this drug. You know, that's a dangerous situation. 359 00:20:08,520 --> 00:20:10,760 Speaker 1: And I've interviewed plenty of docs who were on the 360 00:20:10,800 --> 00:20:12,640 Speaker 1: receiving end of this, and I think there's a whole 361 00:20:12,640 --> 00:20:15,119 Speaker 1: bunch of problems here, right one of the doctors should 362 00:20:15,240 --> 00:20:18,399 Speaker 1: ideally not be receiving their education in an in a 363 00:20:18,520 --> 00:20:22,200 Speaker 1: new course of therapy purely from the pharmaceutical company that 364 00:20:22,320 --> 00:20:25,840 Speaker 1: is selling the course of therapy. You know, if you're 365 00:20:25,880 --> 00:20:28,720 Speaker 1: a doctor, probably should do a little more due diligence 366 00:20:29,200 --> 00:20:33,119 Speaker 1: than that. The pharma companies and you know, pretty as 367 00:20:33,119 --> 00:20:36,600 Speaker 1: hardly alone here, I think, had a very strong incentive 368 00:20:36,720 --> 00:20:41,560 Speaker 1: to educate physicians about how to get people on these drugs. 369 00:20:42,200 --> 00:20:44,679 Speaker 1: And what I've heard again and again and again, as 370 00:20:44,720 --> 00:20:46,800 Speaker 1: I'm sure you have, is that there was a kind 371 00:20:46,840 --> 00:20:49,440 Speaker 1: of education and how to get people on these drugs, 372 00:20:49,480 --> 00:20:52,920 Speaker 1: but no education and how or when to get them off. 373 00:20:53,160 --> 00:20:55,119 Speaker 1: You know, maybe people should be on them for years, 374 00:20:55,440 --> 00:20:58,280 Speaker 1: maybe they shouldn't, do you taper, how do you go 375 00:20:58,359 --> 00:21:00,960 Speaker 1: about that? And well, the story you hear again and 376 00:21:01,000 --> 00:21:03,159 Speaker 1: again in this case, I've heard it from families and 377 00:21:03,280 --> 00:21:05,879 Speaker 1: people who've who have experienced this firsthand is that you know, 378 00:21:06,119 --> 00:21:08,240 Speaker 1: you go when you get a procedure done and the 379 00:21:08,320 --> 00:21:12,119 Speaker 1: doc writes you a prescription for whatever thirty days of 380 00:21:12,720 --> 00:21:17,080 Speaker 1: an opioid, and you find that your use of it 381 00:21:17,200 --> 00:21:20,439 Speaker 1: is becoming problematic. You start getting nervous because you know 382 00:21:20,520 --> 00:21:22,560 Speaker 1: either it's wearing off and you want to take the 383 00:21:22,720 --> 00:21:26,280 Speaker 1: bills more frequently, or you're finding that you're experiencing withdrawal. 384 00:21:26,520 --> 00:21:29,560 Speaker 1: You go back to the emergency medicine doc who prescribed 385 00:21:29,600 --> 00:21:32,040 Speaker 1: it to you, and the doctor says, well, whoa, whoa, 386 00:21:32,080 --> 00:21:34,200 Speaker 1: I'm not an addiction specialist. My job is to get 387 00:21:34,240 --> 00:21:37,159 Speaker 1: you on here, not to get you off. And I 388 00:21:37,160 --> 00:21:38,800 Speaker 1: think a lot of people end up in a kind 389 00:21:38,840 --> 00:21:42,120 Speaker 1: of perilous situation in which the nature of medicine as 390 00:21:42,119 --> 00:21:44,119 Speaker 1: it is practiced in the United States is such that 391 00:21:44,160 --> 00:21:47,280 Speaker 1: if you offer up a solution that seems like a quick, 392 00:21:47,600 --> 00:21:51,160 Speaker 1: reliable solution with minimal downsides, that will get somebody off 393 00:21:51,160 --> 00:21:53,200 Speaker 1: your schedule so you can then see the next patient. 394 00:21:53,840 --> 00:21:56,240 Speaker 1: A lot of doctors, I think we're very ready to 395 00:21:56,359 --> 00:21:58,760 Speaker 1: do that, and you end up with a huge community 396 00:21:58,760 --> 00:22:01,440 Speaker 1: of people who are kind of orphaned by the system 397 00:22:01,480 --> 00:22:04,919 Speaker 1: because you know, the drugs are having side effects for them, 398 00:22:04,960 --> 00:22:08,320 Speaker 1: and they don't there's no infrastructure for how to help 399 00:22:08,359 --> 00:22:10,560 Speaker 1: them with that, how to help them figure that out. 400 00:22:11,040 --> 00:22:12,560 Speaker 1: There's a whole other thing which we can talk about, 401 00:22:12,600 --> 00:22:14,960 Speaker 1: which is, you know, the big community of pain patients 402 00:22:15,080 --> 00:22:17,280 Speaker 1: now who feel as though the pendulum has swung too 403 00:22:17,320 --> 00:22:21,159 Speaker 1: far in the other direction, that opiophobia is back, that 404 00:22:21,200 --> 00:22:24,600 Speaker 1: their physicians don't want to continue prescribing these medicines that 405 00:22:24,640 --> 00:22:27,000 Speaker 1: they feel they rely on in order to live their lives. 406 00:22:27,520 --> 00:22:29,480 Speaker 1: I get a lot of notes from these people, almost 407 00:22:29,520 --> 00:22:31,800 Speaker 1: invariably they haven't read my book. I mean, there's a 408 00:22:31,800 --> 00:22:34,360 Speaker 1: great deal of nuance in the book, and if you're 409 00:22:34,359 --> 00:22:36,920 Speaker 1: reading it carefully, I think it'd be difficult to to 410 00:22:36,960 --> 00:22:39,719 Speaker 1: say otherwise. But from a distance, it's look, you're bashing 411 00:22:39,720 --> 00:22:43,159 Speaker 1: the sacklers. They sold a life saving medicine. You know, 412 00:22:43,200 --> 00:22:45,800 Speaker 1: you're you're contributing to the stigma. And of course, I 413 00:22:45,800 --> 00:22:47,560 Speaker 1: think if you look closely, part of the reason that 414 00:22:47,600 --> 00:22:49,800 Speaker 1: a lot of these people are stigmatized is precisely because 415 00:22:49,800 --> 00:22:52,920 Speaker 1: of the kind of behavior that you saw it at Purdue, 416 00:22:53,160 --> 00:22:55,440 Speaker 1: you know, I mean, you're right, it is a complex story. 417 00:22:55,440 --> 00:22:58,040 Speaker 1: You don't. On the one hand, right, you know, the 418 00:22:58,119 --> 00:23:02,160 Speaker 1: people who specialize in pain management, they knew that opioids 419 00:23:02,320 --> 00:23:04,800 Speaker 1: were it could be dependent causing, right that if you do, 420 00:23:04,880 --> 00:23:06,440 Speaker 1: if people are on it for any length of time, 421 00:23:06,560 --> 00:23:08,439 Speaker 1: they have to go through some withdrawal if they're going 422 00:23:08,480 --> 00:23:10,400 Speaker 1: to get off of it. That's just sort of part 423 00:23:10,400 --> 00:23:13,119 Speaker 1: of the course, right, And the people are experts in 424 00:23:13,200 --> 00:23:15,159 Speaker 1: this stuff knew that you have to manage that. You 425 00:23:15,200 --> 00:23:18,679 Speaker 1: manage getting on, you manage getting off. And in a way, 426 00:23:18,920 --> 00:23:22,040 Speaker 1: you know, they were frustrated because they are They're seeing 427 00:23:22,400 --> 00:23:25,200 Speaker 1: other doctors and patients and nurses who saying I don't 428 00:23:25,200 --> 00:23:27,680 Speaker 1: want to take opioids, people who are terminally ill on 429 00:23:27,720 --> 00:23:29,720 Speaker 1: their death beds, that I don't want to die an addict. 430 00:23:29,760 --> 00:23:33,160 Speaker 1: You know, evidence that people are dying prematurely because they 431 00:23:33,240 --> 00:23:35,480 Speaker 1: have this you know, you know, fear of morphine or 432 00:23:35,480 --> 00:23:38,160 Speaker 1: this fear of being addicted. They're not making a distinction 433 00:23:38,240 --> 00:23:40,840 Speaker 1: between what it means to be dependent on drugs and 434 00:23:40,880 --> 00:23:44,760 Speaker 1: being addicted to them. But then what you describe is 435 00:23:45,200 --> 00:23:50,040 Speaker 1: basically perdue pharma. It's not just trying to address the 436 00:23:50,119 --> 00:23:53,560 Speaker 1: issue that they were dealing with the pain docs. What 437 00:23:53,720 --> 00:23:56,800 Speaker 1: you describe is them deliberately going not after the pain 438 00:23:56,880 --> 00:24:00,360 Speaker 1: management docs, but going after gps who I know they're 439 00:24:00,359 --> 00:24:03,320 Speaker 1: asked from their elbow about this stuff. What you describe 440 00:24:03,480 --> 00:24:06,639 Speaker 1: is them targeting the biggest prescribers, not people who are 441 00:24:06,680 --> 00:24:10,280 Speaker 1: specialized pain management experts, but people are just shipping the 442 00:24:10,359 --> 00:24:13,879 Speaker 1: stuff out right. What you describe is them lying to 443 00:24:14,040 --> 00:24:18,320 Speaker 1: people about the potential addictiveness of these substances. I mean, 444 00:24:18,359 --> 00:24:21,800 Speaker 1: I think that's where you nail these guys about just 445 00:24:22,000 --> 00:24:26,120 Speaker 1: playing a grossly irresponsible role. That whereas on the one hand, 446 00:24:26,119 --> 00:24:28,840 Speaker 1: and providing a kind of miracle medication for people who 447 00:24:28,880 --> 00:24:32,080 Speaker 1: really do benefit from a long acting pain medication like 448 00:24:32,160 --> 00:24:35,760 Speaker 1: oxy content, they are so grossly over promoting it to 449 00:24:35,880 --> 00:24:39,480 Speaker 1: people who shouldn't be on it that that's where a 450 00:24:39,520 --> 00:24:43,760 Speaker 1: big chunk of this blame wise. Yeah, no question. Look, 451 00:24:44,040 --> 00:24:46,040 Speaker 1: this is a company that has pled guilty to felony 452 00:24:46,119 --> 00:24:50,159 Speaker 1: charges twice uh in two thousand and seven, and and 453 00:24:50,560 --> 00:24:54,359 Speaker 1: I would argue, um, and I think I make the case. 454 00:24:54,400 --> 00:24:56,520 Speaker 1: I opened a pretty compelling way in the book that 455 00:24:56,560 --> 00:24:59,719 Speaker 1: in both instances they actually got off They got off 456 00:24:59,760 --> 00:25:03,000 Speaker 1: pretty easy, particularly compared to the kinds of penalties that 457 00:25:03,040 --> 00:25:06,639 Speaker 1: we visit in this country on poor people of color 458 00:25:06,680 --> 00:25:10,520 Speaker 1: who are involved in the retail drug business on the street. 459 00:25:11,160 --> 00:25:13,840 Speaker 1: I'll put it to this way, when you talk about 460 00:25:13,880 --> 00:25:16,919 Speaker 1: marketing to the wrong docs. You know, I wanted this 461 00:25:16,960 --> 00:25:21,840 Speaker 1: book to be a compelling read for non specialists. I 462 00:25:22,000 --> 00:25:25,320 Speaker 1: you know, I hope it holds water with specialists as well. Um. 463 00:25:25,359 --> 00:25:27,160 Speaker 1: You know, I think there's there's some rigor to it, 464 00:25:27,359 --> 00:25:29,840 Speaker 1: but you make choices right, And I had to remind myself, 465 00:25:29,840 --> 00:25:31,639 Speaker 1: you know, you're not writing an indictment here where you 466 00:25:31,680 --> 00:25:33,440 Speaker 1: want to take every single piece of evidence and put 467 00:25:33,440 --> 00:25:35,240 Speaker 1: it in. What this meant is that I had to 468 00:25:35,240 --> 00:25:37,480 Speaker 1: pick my examples and I had to be pretty judicious 469 00:25:37,480 --> 00:25:39,720 Speaker 1: about it. If you just take a fact pattern, Okay, 470 00:25:39,720 --> 00:25:42,760 Speaker 1: So the fact pattern is there is a clinic, a 471 00:25:42,800 --> 00:25:46,000 Speaker 1: pain clinic that is obviously a pill mill. You have 472 00:25:46,119 --> 00:25:50,640 Speaker 1: a super unethical doctor who is just fire hosing pills 473 00:25:50,720 --> 00:25:54,399 Speaker 1: at the local community. And you know, eventually, in the 474 00:25:54,440 --> 00:25:57,199 Speaker 1: fullness of time, this doctor will lose their license and 475 00:25:57,280 --> 00:26:00,000 Speaker 1: end up going to jail. But before that happens, there 476 00:26:00,000 --> 00:26:02,840 Speaker 1: is a period of time where Perdue is aware of 477 00:26:02,880 --> 00:26:05,920 Speaker 1: what's happening because they have this early warning system, which 478 00:26:05,920 --> 00:26:07,439 Speaker 1: is their own raps who go out and call them 479 00:26:07,440 --> 00:26:09,439 Speaker 1: these doctors and write reports and they come back and 480 00:26:09,640 --> 00:26:11,719 Speaker 1: they tell them about it. You know, it was a 481 00:26:11,720 --> 00:26:14,320 Speaker 1: real struggle for me to think, Okay, I can only 482 00:26:14,359 --> 00:26:16,480 Speaker 1: tell so many of those stories. There were so many 483 00:26:16,560 --> 00:26:19,359 Speaker 1: to pick. It was like a vast buffet of that 484 00:26:19,520 --> 00:26:21,679 Speaker 1: fact pattern where I'm thinking, geez, do I do the 485 00:26:21,680 --> 00:26:24,440 Speaker 1: one of Massachusetts? What about the one in California? Or oh, 486 00:26:24,440 --> 00:26:27,040 Speaker 1: but there's this interesting one over here. It happened again 487 00:26:27,080 --> 00:26:28,719 Speaker 1: and again and again and again and again. So I'll 488 00:26:28,760 --> 00:26:30,120 Speaker 1: tell you what. To me was one of the most 489 00:26:30,119 --> 00:26:33,240 Speaker 1: astonishing data points that I discovered, And it's it's like 490 00:26:33,320 --> 00:26:35,760 Speaker 1: just in the weeds enough that I think most people 491 00:26:36,200 --> 00:26:38,720 Speaker 1: don't necessarily appreciate how crazy it is, how wild it is, 492 00:26:38,760 --> 00:26:43,760 Speaker 1: but you will. So in two and ten, produce reformulates 493 00:26:43,760 --> 00:26:46,600 Speaker 1: oxycontum The whole notion with OxyContin is that you had 494 00:26:46,680 --> 00:26:50,040 Speaker 1: this seal which slowly regulates the dispersal of the drug 495 00:26:50,040 --> 00:26:52,600 Speaker 1: into your bloodstream in theory over the course of twelve hours. 496 00:26:52,600 --> 00:26:54,520 Speaker 1: So there's a lot of evidence that actually doesn't last 497 00:26:54,520 --> 00:26:57,160 Speaker 1: that long for a lot of patients people quickly figured 498 00:26:57,160 --> 00:26:59,080 Speaker 1: out that if you break the seal by chewing it 499 00:26:59,160 --> 00:27:02,280 Speaker 1: or crushing it, you can override that slow release mechanism, 500 00:27:02,359 --> 00:27:04,480 Speaker 1: and then you can smort the pill. Even if you 501 00:27:04,560 --> 00:27:06,520 Speaker 1: just swallow it, or if you shoot it up, you know, 502 00:27:06,520 --> 00:27:10,159 Speaker 1: you get an immediate huge dose of oxy coda. So 503 00:27:10,240 --> 00:27:12,879 Speaker 1: in two thousand and ten, the company reformulates the drug. 504 00:27:13,280 --> 00:27:15,080 Speaker 1: There's pretty good evidence, which I lay out in the book, 505 00:27:15,080 --> 00:27:17,440 Speaker 1: that the timing here is significant because the patent was 506 00:27:17,480 --> 00:27:19,920 Speaker 1: about to run out on the original version, um and 507 00:27:19,960 --> 00:27:22,440 Speaker 1: so they're gonna make this reformulated version. But this is 508 00:27:22,480 --> 00:27:25,199 Speaker 1: the interesting statistic. Two thousands intend they roll out this 509 00:27:25,240 --> 00:27:31,200 Speaker 1: new pill, overnight, nationwide sales of eighty milligram oxy content 510 00:27:31,200 --> 00:27:34,600 Speaker 1: pills drop. So you have to think about this, Right, 511 00:27:34,960 --> 00:27:38,879 Speaker 1: on the one hand, good for Purdue reformulating the pills 512 00:27:38,920 --> 00:27:42,359 Speaker 1: people were abusing those the original version. On the other hand, 513 00:27:42,960 --> 00:27:47,040 Speaker 1: how could that not be sobering to realize that of 514 00:27:47,080 --> 00:27:51,840 Speaker 1: their market for their biggest dose of this drug was 515 00:27:51,880 --> 00:27:54,320 Speaker 1: basically coming from the black market, right. It was people 516 00:27:54,359 --> 00:27:57,600 Speaker 1: who were abusing the drug. It's non medical prescriptions, it's 517 00:27:57,640 --> 00:27:59,960 Speaker 1: pill mills. And this is where it gets really interesting 518 00:28:00,080 --> 00:28:02,159 Speaker 1: me is that you have all these pill mills. The 519 00:28:02,240 --> 00:28:04,359 Speaker 1: company knows that they're pill mills. They actually kept a 520 00:28:04,400 --> 00:28:07,200 Speaker 1: list internally of these bad docstion. What they said is 521 00:28:07,200 --> 00:28:09,639 Speaker 1: that they said, oor, our sales reps wouldn't call on them. 522 00:28:09,640 --> 00:28:10,960 Speaker 1: That's what we would do, is we tell our sales 523 00:28:10,960 --> 00:28:13,200 Speaker 1: report don't call on those on those pill mills. Of course, 524 00:28:13,240 --> 00:28:14,919 Speaker 1: I interviewed sales reps who are like you didn't have 525 00:28:15,000 --> 00:28:17,280 Speaker 1: to call on like they were pretty reliable prescribers. You 526 00:28:17,320 --> 00:28:19,240 Speaker 1: didn't need to go and visit them in order to 527 00:28:19,240 --> 00:28:21,879 Speaker 1: make that happen. What they don't do is report those 528 00:28:22,119 --> 00:28:24,800 Speaker 1: pill mills to the authorities. And and the reason is 529 00:28:24,840 --> 00:28:29,040 Speaker 1: pretty obvious, right if of your profits on your most 530 00:28:29,040 --> 00:28:32,280 Speaker 1: profitable pill are coming from the black market, you have 531 00:28:32,359 --> 00:28:36,399 Speaker 1: a pretty strong incentive not to shut these operations down. 532 00:28:36,840 --> 00:28:38,760 Speaker 1: And so I think that's part of the reason that 533 00:28:38,840 --> 00:28:41,200 Speaker 1: you see the black market persists the way it does 534 00:28:41,400 --> 00:28:43,920 Speaker 1: is with again the mingling of the listit and illicit Yeah. 535 00:28:43,960 --> 00:28:46,440 Speaker 1: I mean, Patrick, I'm almost thinking, you know, you think 536 00:28:46,480 --> 00:28:48,320 Speaker 1: about that article you did in New York or where 537 00:28:48,320 --> 00:28:50,400 Speaker 1: you and I talked some years ago about how Washington 538 00:28:50,480 --> 00:28:53,280 Speaker 1: Stay was transitioning from an illicit market to a legal market. 539 00:28:53,720 --> 00:28:56,240 Speaker 1: And here part of your story is about the transition 540 00:28:56,280 --> 00:29:00,120 Speaker 1: from a legal market into an illegal market. Absolutely right there, 541 00:29:00,160 --> 00:29:03,200 Speaker 1: it's Perdue Farma changing the nature of oxy content so 542 00:29:03,280 --> 00:29:05,480 Speaker 1: that you can't crush it and snort it or inject 543 00:29:05,480 --> 00:29:08,040 Speaker 1: it anymore. It becomes a little gummy bear that you 544 00:29:08,080 --> 00:29:11,280 Speaker 1: can't do much with, or whether it's just doctors now 545 00:29:11,360 --> 00:29:14,840 Speaker 1: beginning to realize you're being pressured to prescribe less, which 546 00:29:14,880 --> 00:29:17,200 Speaker 1: you see is a shift happening. And so one of 547 00:29:17,240 --> 00:29:21,240 Speaker 1: the interesting things about that moment is that Perdue all 548 00:29:21,240 --> 00:29:24,040 Speaker 1: of a sudden, as you say, loses twenty percent of 549 00:29:24,040 --> 00:29:27,080 Speaker 1: its sales because that's the of the market that was 550 00:29:27,120 --> 00:29:30,760 Speaker 1: looking to crush it and use it entirely illegally. Yet 551 00:29:30,760 --> 00:29:33,920 Speaker 1: at the same time that also results in a growth, 552 00:29:34,000 --> 00:29:36,800 Speaker 1: if not an explosion of the market first and heroin 553 00:29:37,240 --> 00:29:39,920 Speaker 1: and then ultimately fentanyl, and it actually leads to an 554 00:29:40,000 --> 00:29:43,360 Speaker 1: increase in the number of over those fatalities right after 555 00:29:43,400 --> 00:29:46,520 Speaker 1: this happens. And so from a policy perspective, it's almost like, Dan, 556 00:29:46,600 --> 00:29:48,280 Speaker 1: if you do, Dan, if you don't, I mean, I 557 00:29:48,320 --> 00:29:50,400 Speaker 1: was reading your thing there. I'm going God with the 558 00:29:50,400 --> 00:29:53,160 Speaker 1: world have been better off if Perdue FARMA had never 559 00:29:53,160 --> 00:29:57,680 Speaker 1: gotten permission to do this non crushable version. I mean, 560 00:29:57,720 --> 00:29:59,560 Speaker 1: I don't look, I don't know. It's hard to say. 561 00:29:59,760 --> 00:30:02,680 Speaker 1: The The counter factual that I'm more I'm more comfortable 562 00:30:02,720 --> 00:30:06,400 Speaker 1: with is had they reformulated earlier. I do think it 563 00:30:06,400 --> 00:30:08,960 Speaker 1: would have made a much bigger difference, you know. In 564 00:30:09,000 --> 00:30:11,480 Speaker 1: fairness to them, they say, it just takes a long 565 00:30:11,520 --> 00:30:14,240 Speaker 1: time to develop these drugs. It also took several years 566 00:30:14,240 --> 00:30:15,800 Speaker 1: for them to get approval from the f d A. 567 00:30:16,160 --> 00:30:19,320 Speaker 1: So you know, I mean the time, the timing with 568 00:30:19,400 --> 00:30:23,600 Speaker 1: the patent does seem worth ruminating. Well, I mean I 569 00:30:23,640 --> 00:30:25,360 Speaker 1: have to say, you know, oftentimes you say on these 570 00:30:25,400 --> 00:30:27,920 Speaker 1: investigations like interms, you follow the money, follow the money, 571 00:30:27,920 --> 00:30:30,160 Speaker 1: follow the money. It's always with the cops and investigators 572 00:30:30,200 --> 00:30:32,560 Speaker 1: always say, and for you, the subtext to follow the 573 00:30:32,600 --> 00:30:34,840 Speaker 1: money has followed the paddic right. I mean you talk 574 00:30:34,880 --> 00:30:37,440 Speaker 1: about they start off with MS content and then they 575 00:30:37,480 --> 00:30:40,880 Speaker 1: go to oxycontent and then reformulated oxycontent. I mean, just 576 00:30:40,960 --> 00:30:43,320 Speaker 1: explain a little bit about the timing of that and 577 00:30:43,360 --> 00:30:46,160 Speaker 1: how that looks from your perspective. Yeah, just that. I mean, 578 00:30:46,240 --> 00:30:49,640 Speaker 1: I I think that this will sound probably a bit naive, 579 00:30:49,960 --> 00:30:52,360 Speaker 1: but to me. There was this interesting thing where any 580 00:30:52,400 --> 00:30:54,640 Speaker 1: time there was a mystery about timing, you know, why 581 00:30:54,640 --> 00:30:57,200 Speaker 1: did it take so long for them to reformulate, or 582 00:30:57,760 --> 00:30:59,400 Speaker 1: why did this happen at that time? Or there was 583 00:30:59,440 --> 00:31:01,080 Speaker 1: this kind of st range thing that I talked about 584 00:31:01,080 --> 00:31:04,120 Speaker 1: at the end of the book where the company wanted 585 00:31:04,160 --> 00:31:07,360 Speaker 1: to get a pediatric indication for OxyContin, but then they said, 586 00:31:07,360 --> 00:31:09,400 Speaker 1: but we don't actually want to sell it. We're just 587 00:31:09,440 --> 00:31:11,160 Speaker 1: doing because the FDA forced us too. But then it 588 00:31:11,160 --> 00:31:13,360 Speaker 1: turns out the FDA didn't really force them to. It 589 00:31:13,400 --> 00:31:15,680 Speaker 1: was more that they were incentivized too, because if they 590 00:31:15,720 --> 00:31:18,560 Speaker 1: got the pediatric indication they would get six months of 591 00:31:18,600 --> 00:31:21,600 Speaker 1: extra patent exclusivity, which at the time, you know, it 592 00:31:21,640 --> 00:31:23,560 Speaker 1: was a billion dollars. So it was just one of 593 00:31:23,600 --> 00:31:25,880 Speaker 1: those interesting things where often if I had a question, 594 00:31:26,640 --> 00:31:29,560 Speaker 1: the more I dug, the more documents I got, it 595 00:31:29,600 --> 00:31:31,240 Speaker 1: was very often the case that the answer was, oh, 596 00:31:31,240 --> 00:31:32,760 Speaker 1: it has to do with the patent. At a company 597 00:31:32,760 --> 00:31:35,760 Speaker 1: like Perdue, where they really only ever had one huge 598 00:31:35,760 --> 00:31:39,280 Speaker 1: blockbuster product, and the whole history of the company, nothing 599 00:31:39,320 --> 00:31:43,400 Speaker 1: ever came close to OxyContin, I interviewed many, many people 600 00:31:43,400 --> 00:31:45,040 Speaker 1: who worked at the company who said that the whole 601 00:31:45,040 --> 00:31:50,240 Speaker 1: business model was protect the patent, extend the patent. I 602 00:31:50,280 --> 00:31:51,920 Speaker 1: had somebody who worked to the company, a senior person 603 00:31:51,920 --> 00:31:53,560 Speaker 1: who worked to the company, who said to me, at 604 00:31:53,600 --> 00:31:55,600 Speaker 1: times it almost felt like it wasn't a farm a 605 00:31:55,640 --> 00:31:58,920 Speaker 1: company at all. It was a small, elite patent law firm, 606 00:31:59,560 --> 00:32:01,920 Speaker 1: like an intial actual property law firm that happened to 607 00:32:01,920 --> 00:32:06,160 Speaker 1: have a little marketing wing on the side. So, um, 608 00:32:06,200 --> 00:32:07,960 Speaker 1: when you talk about the counter factual and you wonder 609 00:32:08,040 --> 00:32:10,520 Speaker 1: what if I think the thing for me is there 610 00:32:10,520 --> 00:32:13,520 Speaker 1: were these really crucial moments early on where the company 611 00:32:13,560 --> 00:32:15,880 Speaker 1: was lying about the drug. They were lying about what 612 00:32:15,920 --> 00:32:18,360 Speaker 1: they knew and when they knew it. And I think 613 00:32:18,400 --> 00:32:20,520 Speaker 1: if there had been a real reckoning in two thousand 614 00:32:20,560 --> 00:32:24,000 Speaker 1: and one, two to two thousand three, if you'd seen 615 00:32:24,040 --> 00:32:29,400 Speaker 1: an earlier reformulation, the population of people who had, you know, 616 00:32:29,560 --> 00:32:33,560 Speaker 1: taken that on ramp to opioids was just smaller at 617 00:32:33,600 --> 00:32:36,520 Speaker 1: that point, and so it could have been that the 618 00:32:36,520 --> 00:32:38,880 Speaker 1: reformulation would have made more of a difference. But by 619 00:32:38,880 --> 00:32:41,000 Speaker 1: the time you get to two thousand and ten, you 620 00:32:41,120 --> 00:32:45,560 Speaker 1: just have a huge population of folks who are struggling 621 00:32:45,720 --> 00:32:48,360 Speaker 1: with these drugs and using them in a in a 622 00:32:48,440 --> 00:32:51,360 Speaker 1: non medical way, and at that point, if you if 623 00:32:51,360 --> 00:32:53,160 Speaker 1: you cut those people off from a source of supply 624 00:32:53,200 --> 00:32:55,960 Speaker 1: that they've counted on, and it's honestly, it's the same thing. 625 00:32:56,360 --> 00:32:58,000 Speaker 1: So you can think about the re formulation. But it 626 00:32:58,040 --> 00:33:00,720 Speaker 1: was also true that by two thousand and ten, a 627 00:33:00,760 --> 00:33:02,880 Speaker 1: lot of the pill mills are getting shut down, a 628 00:33:02,920 --> 00:33:05,600 Speaker 1: lot of docs are getting more careful about prescribing and 629 00:33:05,640 --> 00:33:08,280 Speaker 1: not too I think, push people into the block market. 630 00:33:10,680 --> 00:33:25,480 Speaker 1: We'll be talking more after we hear this ad. There 631 00:33:25,480 --> 00:33:28,120 Speaker 1: are two broader context to what's going on here, and 632 00:33:28,200 --> 00:33:30,600 Speaker 1: there's one which I think you probably could have given 633 00:33:30,640 --> 00:33:32,680 Speaker 1: more attention to, and the other one which I think 634 00:33:32,720 --> 00:33:36,840 Speaker 1: you lay out in spectacular and telling detail. And on 635 00:33:36,920 --> 00:33:39,920 Speaker 1: the first one, you know, there's a context back in 636 00:33:40,000 --> 00:33:44,840 Speaker 1: the nineties that basically, whether we're talking about addiction treatment 637 00:33:45,040 --> 00:33:48,720 Speaker 1: or pain management, both those issues are essentially not being 638 00:33:48,720 --> 00:33:52,960 Speaker 1: taught in medical schools, and most physicians know remarkably little 639 00:33:53,040 --> 00:33:55,760 Speaker 1: about that, much less how to manage opioids, whether putting 640 00:33:55,760 --> 00:33:58,400 Speaker 1: people on or putting people off to those things. What's 641 00:33:58,440 --> 00:34:01,360 Speaker 1: also happening is that the vast majority of what are 642 00:34:01,400 --> 00:34:05,520 Speaker 1: called overdoses are in fact fatal drug combinations. In fact, 643 00:34:05,680 --> 00:34:08,840 Speaker 1: very few people die simply from taking too much heroin 644 00:34:08,960 --> 00:34:11,799 Speaker 1: or too much oxy content. The almost all of those 645 00:34:11,840 --> 00:34:15,960 Speaker 1: overdoses involved people combining it with valley and with benzodiazepines 646 00:34:16,000 --> 00:34:19,040 Speaker 1: with alcohol. And it's only when fentinyl comes along, which 647 00:34:19,040 --> 00:34:23,000 Speaker 1: is fifty times more potent than heroin or oxy or whatever, 648 00:34:23,160 --> 00:34:25,680 Speaker 1: that you see people dropping dead simply from using it. 649 00:34:25,760 --> 00:34:29,160 Speaker 1: One opioid all by itself. Um, the lock zone the 650 00:34:29,239 --> 00:34:32,279 Speaker 1: antidote for an overdose. I mean, my organization started working 651 00:34:32,280 --> 00:34:34,200 Speaker 1: on trying to get that more out there really beginning 652 00:34:34,200 --> 00:34:38,800 Speaker 1: in two thousand, but it's not until about two thousand 653 00:34:38,880 --> 00:34:41,640 Speaker 1: ten or eleven or even the White House, the Drugs 654 00:34:41,640 --> 00:34:43,880 Speaker 1: Ares Office says, oh, we better start getting behind the 655 00:34:43,920 --> 00:34:49,759 Speaker 1: lock zone. So there's this massive misinformation miseducation under education 656 00:34:50,080 --> 00:34:52,640 Speaker 1: that's going out in the community, which provides a context 657 00:34:52,680 --> 00:34:55,239 Speaker 1: and where when you have a company over promoting this 658 00:34:55,360 --> 00:34:57,960 Speaker 1: drug and over marketing and all the insidious ways that 659 00:34:58,000 --> 00:35:01,320 Speaker 1: they did is just going into a says, right to 660 00:35:01,360 --> 00:35:04,680 Speaker 1: magnify this. On the other hand, what you do a 661 00:35:04,680 --> 00:35:09,040 Speaker 1: magnificent job within the book is describing the revolving door 662 00:35:09,080 --> 00:35:12,839 Speaker 1: of government and industry right the swamp the people who 663 00:35:12,880 --> 00:35:14,880 Speaker 1: go to work from f d A or d e 664 00:35:15,000 --> 00:35:16,960 Speaker 1: A or Justice Department. All the next thing you know, 665 00:35:16,960 --> 00:35:20,520 Speaker 1: they're working for Purdue Farma. The members of Congress, the 666 00:35:20,520 --> 00:35:22,520 Speaker 1: the ways in which Purdue farm is able to get 667 00:35:22,520 --> 00:35:26,760 Speaker 1: what it wants by paying and legally bribing people, maybe 668 00:35:26,840 --> 00:35:28,880 Speaker 1: even illegally, we don't know, but I mean, you know 669 00:35:29,000 --> 00:35:32,080 Speaker 1: this sort of really insidious way. And in a culture 670 00:35:32,360 --> 00:35:36,600 Speaker 1: where white collar criminality almost never results in incarceration. So 671 00:35:36,680 --> 00:35:38,920 Speaker 1: the black and brown people are going to prison, you know, 672 00:35:38,960 --> 00:35:42,000 Speaker 1: by the millions, for selling drugs no more dangerous than 673 00:35:42,040 --> 00:35:44,680 Speaker 1: these on the black market, but the white collar folks 674 00:35:44,719 --> 00:35:47,480 Speaker 1: are basically walking away scott free. I don't know if 675 00:35:47,480 --> 00:35:48,799 Speaker 1: you want to just tell some of the most things 676 00:35:48,840 --> 00:35:50,719 Speaker 1: that both shocked you when you were looking at that 677 00:35:50,800 --> 00:35:55,960 Speaker 1: side of things. Oh, I mean, let me say one 678 00:35:55,960 --> 00:35:59,680 Speaker 1: thing about mixing first and fentinyl. You know the general now, 679 00:36:00,400 --> 00:36:02,319 Speaker 1: who knows what's in it? I mean, in fact, you 680 00:36:02,360 --> 00:36:04,640 Speaker 1: buy heroin on the street, who knows what's end? And 681 00:36:04,640 --> 00:36:06,920 Speaker 1: maybe cut with fanel you don't even know it. And 682 00:36:07,000 --> 00:36:12,200 Speaker 1: you talk to drug users. People are aware, they're aware 683 00:36:12,200 --> 00:36:14,239 Speaker 1: of the risks, but they also a lot of the 684 00:36:14,280 --> 00:36:16,680 Speaker 1: time just end up in a situation in which they 685 00:36:16,719 --> 00:36:19,120 Speaker 1: don't have a safer, reliable source of supply, but they 686 00:36:19,200 --> 00:36:22,920 Speaker 1: needed when they started, they were taking a pill and 687 00:36:23,080 --> 00:36:24,600 Speaker 1: you know, not necessarily could have been aficon, could have 688 00:36:24,600 --> 00:36:27,160 Speaker 1: been you know, any number of things, right, but something 689 00:36:27,160 --> 00:36:29,480 Speaker 1: that felt like it had the impermater of the f 690 00:36:29,600 --> 00:36:32,800 Speaker 1: d A. It felt like a kind of a creature 691 00:36:33,000 --> 00:36:35,680 Speaker 1: of a regulated system. It's funny because this is a 692 00:36:35,800 --> 00:36:37,320 Speaker 1: you know, this was one of the things I was 693 00:36:37,360 --> 00:36:40,200 Speaker 1: interested in the in the pot story with Washington State too, right, 694 00:36:40,320 --> 00:36:44,359 Speaker 1: is these questions of like, to what extent does regulation 695 00:36:44,640 --> 00:36:47,040 Speaker 1: mean quality control, you know, in the government kind of 696 00:36:47,040 --> 00:36:50,520 Speaker 1: getting in and evaluating the product in a way that 697 00:36:50,560 --> 00:36:54,640 Speaker 1: you would normally associate with kind of an FDA regulated industry. 698 00:36:55,000 --> 00:36:57,080 Speaker 1: I just it's interesting to me that you I think 699 00:36:57,560 --> 00:37:00,239 Speaker 1: you end up with a lot of people who had 700 00:37:00,280 --> 00:37:03,600 Speaker 1: a certain level of inhibition when they started, and the 701 00:37:03,680 --> 00:37:07,239 Speaker 1: on ramp was a pharmaceutical product which they could kind 702 00:37:07,280 --> 00:37:10,880 Speaker 1: of live with as an experiment because it seemed safe. 703 00:37:11,440 --> 00:37:13,200 Speaker 1: And I think in many instances, these are people who 704 00:37:13,200 --> 00:37:16,560 Speaker 1: wouldn't be mixing on the front end, who wouldn't be 705 00:37:16,840 --> 00:37:19,600 Speaker 1: just you know, taking what they could buy from the 706 00:37:19,640 --> 00:37:23,000 Speaker 1: guy who's the connection that you have in the moment, 707 00:37:23,719 --> 00:37:26,560 Speaker 1: but you get into the grip of these things and 708 00:37:27,520 --> 00:37:30,680 Speaker 1: your judgment can falter, right. I mean, like from the outside, 709 00:37:30,960 --> 00:37:35,319 Speaker 1: as somebody who who is not addicted or dependent, it's 710 00:37:35,360 --> 00:37:37,360 Speaker 1: sometimes hard for me to understand, given what we know 711 00:37:37,440 --> 00:37:41,520 Speaker 1: about fentinel, specifically the risks that some people take. But 712 00:37:41,560 --> 00:37:43,920 Speaker 1: I think the thing to remember is that they you know, 713 00:37:44,080 --> 00:37:46,919 Speaker 1: generally speaking, and that's not the first thing people take. 714 00:37:47,000 --> 00:37:50,359 Speaker 1: It takes a while to get there on the on 715 00:37:50,400 --> 00:37:52,279 Speaker 1: the revolving door. Man, I don't know where to start. 716 00:37:52,360 --> 00:37:55,800 Speaker 1: I mean, I you know, everywhere I looked um and 717 00:37:55,840 --> 00:37:58,480 Speaker 1: again it's not just perdue, but there is so much 718 00:37:58,520 --> 00:38:02,440 Speaker 1: money here. You know, oxycontinent has generated thirty five billion 719 00:38:02,480 --> 00:38:06,320 Speaker 1: dollars in revenue. Since When you have that much money, 720 00:38:06,520 --> 00:38:10,239 Speaker 1: I just think that it affects everything, and that the 721 00:38:10,360 --> 00:38:14,400 Speaker 1: corruption very seldom looks like the kind of standard corruption 722 00:38:14,440 --> 00:38:17,080 Speaker 1: that we think about when we talk about corruption and 723 00:38:17,239 --> 00:38:19,879 Speaker 1: the kind of corruption that gets prosecuted. You know, there's 724 00:38:19,920 --> 00:38:21,840 Speaker 1: a story I tell in the book about Curtis Wright, 725 00:38:21,920 --> 00:38:25,400 Speaker 1: who was the medical examiner at the FDA in charge 726 00:38:25,400 --> 00:38:29,280 Speaker 1: of approving oxycontent but also approving the specific marketing language 727 00:38:29,280 --> 00:38:32,279 Speaker 1: that could be used in the package insert peroxycontent. It 728 00:38:32,360 --> 00:38:34,600 Speaker 1: proves the drug in record time. He signs off on 729 00:38:34,680 --> 00:38:37,000 Speaker 1: this crazy marketing claim that nobody will own it. Now, 730 00:38:37,040 --> 00:38:38,520 Speaker 1: you know, there's this line that goes in the original 731 00:38:38,520 --> 00:38:41,360 Speaker 1: package insert that says that the time release coding is 732 00:38:41,400 --> 00:38:44,080 Speaker 1: believed to reduce the abuse liability of the drug. That is, 733 00:38:44,080 --> 00:38:46,160 Speaker 1: like Visa the other opioids that were on the market 734 00:38:46,160 --> 00:38:50,640 Speaker 1: at that time, priceless marketing claim, no basis in I 735 00:38:50,680 --> 00:38:53,080 Speaker 1: mean is believed. Like what does that even mean? Who 736 00:38:53,080 --> 00:38:55,520 Speaker 1: believes it? Nobody has been able to figure out how 737 00:38:55,520 --> 00:38:57,200 Speaker 1: did that line in and they're just the very idea 738 00:38:57,239 --> 00:38:59,360 Speaker 1: that a line like that makes it into the package insert. 739 00:39:00,120 --> 00:39:02,640 Speaker 1: Twenty five years later, nobody can say who wrote it 740 00:39:02,880 --> 00:39:04,600 Speaker 1: and how it got in there and how it got approved. 741 00:39:04,800 --> 00:39:06,799 Speaker 1: So Curtis right leaves the FDA and a year later 742 00:39:06,880 --> 00:39:08,759 Speaker 1: goes to work at Purdue Farma for three times as 743 00:39:08,800 --> 00:39:13,600 Speaker 1: government salary, and that I continually find shocking. The stacklers 744 00:39:13,640 --> 00:39:16,120 Speaker 1: often defend themselves by saying, you know, we the FDA 745 00:39:16,200 --> 00:39:18,000 Speaker 1: signed off on the stuff we were doing. And I'm like, well, 746 00:39:18,080 --> 00:39:22,160 Speaker 1: if you if you hire the guy right after he leaves, yeah, 747 00:39:22,200 --> 00:39:24,480 Speaker 1: I mean, Patrick, you know, I was watching Last couple 748 00:39:24,520 --> 00:39:27,120 Speaker 1: of Nights, this documentary by Alex Gidney in which you 749 00:39:27,200 --> 00:39:30,560 Speaker 1: feature prominently the crime of the Century, and he describes 750 00:39:30,600 --> 00:39:34,040 Speaker 1: it even more atrocious episode involving the Chief Council of 751 00:39:34,080 --> 00:39:36,320 Speaker 1: d E a working for the Office of Diversion Control, 752 00:39:36,360 --> 00:39:38,640 Speaker 1: who goes to work for the pharmacial companies. And then 753 00:39:38,760 --> 00:39:41,400 Speaker 1: you describe people in the Justice Department and U. S. 754 00:39:41,440 --> 00:39:43,640 Speaker 1: Attorney has been prossing these cases and flip to the 755 00:39:43,719 --> 00:39:46,279 Speaker 1: other side, right, I mean, the revolving door is just 756 00:39:46,400 --> 00:39:48,960 Speaker 1: and and you're talking also, I mean you're a wide 757 00:39:49,040 --> 00:39:51,359 Speaker 1: range of personalities who go to work for Produe Farm 758 00:39:51,360 --> 00:39:54,719 Speaker 1: because on the one hand is one of America's greatest scumbags, 759 00:39:54,800 --> 00:39:57,480 Speaker 1: Rudy Giuliani, but at a point in his life when 760 00:39:57,520 --> 00:40:00,759 Speaker 1: he's actually fairly credible, after he's just become a America's mayor. 761 00:40:01,040 --> 00:40:02,799 Speaker 1: On the other hand, you have Mary Joe White, who 762 00:40:03,000 --> 00:40:05,399 Speaker 1: was the very distinguished former U. S. Attorney in New York, 763 00:40:05,480 --> 00:40:08,000 Speaker 1: the former head of the Securities Exchange Commission. You know, 764 00:40:08,480 --> 00:40:11,520 Speaker 1: everybody answers her phone call and she's out there as 765 00:40:11,880 --> 00:40:14,480 Speaker 1: you know, mis credibility on this sort of thing. But 766 00:40:14,600 --> 00:40:16,880 Speaker 1: you know, there's also an element where you're describing as 767 00:40:16,920 --> 00:40:20,440 Speaker 1: a sort of systemic stink pot of kind of the 768 00:40:20,560 --> 00:40:24,720 Speaker 1: facto corruption, buddyism, chrony capitalism, all this sort of stuff. 769 00:40:25,000 --> 00:40:28,600 Speaker 1: And then there's the quirkiness of personalities. I was wondering 770 00:40:28,640 --> 00:40:32,839 Speaker 1: about the specific personality of Richard Sackler, right, I mean, 771 00:40:32,920 --> 00:40:35,120 Speaker 1: he is the driving force. You point out that he 772 00:40:35,239 --> 00:40:38,120 Speaker 1: kind of learns these lessons from his uncle Arthur in 773 00:40:38,239 --> 00:40:42,160 Speaker 1: terms of marketing, but you also described this thing about 774 00:40:42,440 --> 00:40:44,800 Speaker 1: his you know, best friend in his freshman year of 775 00:40:44,920 --> 00:40:50,279 Speaker 1: college who describes him as sort of lacking in empathy, right, 776 00:40:50,480 --> 00:40:52,759 Speaker 1: And even when you see the things that you know, 777 00:40:52,840 --> 00:40:55,879 Speaker 1: you have these emails where he's saying these absolutely atrocious 778 00:40:56,000 --> 00:40:58,279 Speaker 1: things about people who are addicted to drugs. You know, 779 00:40:58,320 --> 00:41:00,800 Speaker 1: you see the videotape of this testament and there's something 780 00:41:01,160 --> 00:41:03,440 Speaker 1: just off about it. And now obviously he was a 781 00:41:03,520 --> 00:41:06,640 Speaker 1: family enterprise, but he is the driver. And I wonder 782 00:41:06,719 --> 00:41:09,280 Speaker 1: how much you had that feeling like what a different 783 00:41:09,480 --> 00:41:13,560 Speaker 1: human being, maybe done some things differently at the start 784 00:41:13,719 --> 00:41:16,239 Speaker 1: or maybe not, you know, circle the wagons in the 785 00:41:16,320 --> 00:41:19,120 Speaker 1: same way. I mean, what do you think about that? So? Yeah, 786 00:41:19,200 --> 00:41:21,600 Speaker 1: I mean a few things to go back to, what 787 00:41:21,640 --> 00:41:23,560 Speaker 1: I said earlier about how I have no interest in 788 00:41:23,680 --> 00:41:27,400 Speaker 1: caricatures at the human complication and the individual human complication 789 00:41:27,440 --> 00:41:29,799 Speaker 1: and the way it plays out inside a family. All 790 00:41:29,840 --> 00:41:32,480 Speaker 1: of that to me was rich and interesting and worth capturing. 791 00:41:32,520 --> 00:41:36,359 Speaker 1: And I do think that personality drives events a lot 792 00:41:36,400 --> 00:41:38,560 Speaker 1: of the time in history, and and so it's important 793 00:41:38,600 --> 00:41:41,720 Speaker 1: to understand that. I'm also glad you mentioned the college roommate, 794 00:41:41,719 --> 00:41:43,919 Speaker 1: because if you remember, the college roommate didn't just say 795 00:41:44,840 --> 00:41:48,759 Speaker 1: that he lacked empathy. He also said that Richard had 796 00:41:48,800 --> 00:41:52,040 Speaker 1: an infectious enthusiasm. When he had an idea, he would 797 00:41:52,120 --> 00:41:55,000 Speaker 1: just plunge headlong after that idea, and he could lead 798 00:41:55,040 --> 00:41:58,600 Speaker 1: others along in pursuit of that idea. And to me, 799 00:41:58,800 --> 00:42:01,760 Speaker 1: that's part of what explained Bines how all this happened, 800 00:42:01,760 --> 00:42:04,360 Speaker 1: as well, that in his own weird way, he was 801 00:42:04,400 --> 00:42:06,440 Speaker 1: a leader, you know, he had a vision for what 802 00:42:06,600 --> 00:42:08,279 Speaker 1: this drug could be, and he didn't really want to 803 00:42:08,400 --> 00:42:10,920 Speaker 1: let it go. I think that in some ways, if 804 00:42:11,000 --> 00:42:13,759 Speaker 1: if Purdue Farmer had been a public company, the story 805 00:42:13,800 --> 00:42:15,960 Speaker 1: would have played out much differently. I think you could 806 00:42:16,080 --> 00:42:18,040 Speaker 1: very well have gotten up to two thousand and seven 807 00:42:18,080 --> 00:42:20,200 Speaker 1: with the guilty plea in two thousand and seven. But 808 00:42:20,320 --> 00:42:22,120 Speaker 1: I think things would have changed after two thousand and 809 00:42:22,120 --> 00:42:24,520 Speaker 1: seven and a public company. I think all of the 810 00:42:24,760 --> 00:42:27,000 Speaker 1: folks who were associated with the bad stuff that happened 811 00:42:27,040 --> 00:42:29,120 Speaker 1: in the past would have been purged, and instead they 812 00:42:29,160 --> 00:42:32,200 Speaker 1: were kept on. And you know, there was this weird 813 00:42:32,280 --> 00:42:34,640 Speaker 1: I interviewed multiple people who said, who came into the 814 00:42:34,680 --> 00:42:36,440 Speaker 1: company after two thousand and seven, he said, was this 815 00:42:36,520 --> 00:42:38,080 Speaker 1: weird thing We're on the one hand, they're saying, oh, 816 00:42:38,120 --> 00:42:40,720 Speaker 1: there was this guilty plea and now we do things differently. 817 00:42:40,760 --> 00:42:43,000 Speaker 1: And on the other hand, there's this ongoing veneration for 818 00:42:43,120 --> 00:42:45,839 Speaker 1: all the people who did all the stuff that got 819 00:42:45,920 --> 00:42:47,480 Speaker 1: us to the guilty plea. And so there were just 820 00:42:47,520 --> 00:42:50,360 Speaker 1: mixed messages about the culture. And I think this is 821 00:42:50,400 --> 00:42:52,440 Speaker 1: a family business, and it was a business kind of 822 00:42:52,480 --> 00:42:55,880 Speaker 1: created in the image of the family. The one thing 823 00:42:55,920 --> 00:42:57,840 Speaker 1: I would say is I wouldn't put too much of 824 00:42:57,920 --> 00:43:00,120 Speaker 1: it on Richard because there's a bunch of family means 825 00:43:00,120 --> 00:43:03,200 Speaker 1: who were involved from multiple generations. And as a reporter, 826 00:43:03,400 --> 00:43:06,320 Speaker 1: when I started work on this book, I had this 827 00:43:06,480 --> 00:43:09,200 Speaker 1: operating theory, which is I thought I kind of did 828 00:43:09,239 --> 00:43:11,600 Speaker 1: the family tree. I looked at all the different people 829 00:43:11,880 --> 00:43:14,879 Speaker 1: and I said, there's got to be some apostate. There's 830 00:43:14,920 --> 00:43:17,320 Speaker 1: got to be some Sackler who grew up with it. 831 00:43:17,520 --> 00:43:19,839 Speaker 1: They grew up with the money. But they actually think 832 00:43:19,880 --> 00:43:22,879 Speaker 1: that there's something kind of rotten happening. They understand why 833 00:43:23,000 --> 00:43:25,440 Speaker 1: every state in the country is suing the family business 834 00:43:26,200 --> 00:43:28,960 Speaker 1: and half the states are suing the family members themselves. 835 00:43:29,440 --> 00:43:33,759 Speaker 1: And I couldn't find one. And it's remarkable the unanimity 836 00:43:33,960 --> 00:43:36,520 Speaker 1: with which members of the family, who don't agree on 837 00:43:36,640 --> 00:43:40,480 Speaker 1: anything else like this is a worrying family. Often when 838 00:43:40,520 --> 00:43:45,000 Speaker 1: it comes to the utter blamelessness of the Sacklers, they're 839 00:43:45,000 --> 00:43:46,960 Speaker 1: pretty much in agreement. And you see these incredible there's 840 00:43:46,960 --> 00:43:48,399 Speaker 1: a there's a document that I draw in the book 841 00:43:48,440 --> 00:43:51,400 Speaker 1: this amazing um what's app blog that I got access to, 842 00:43:51,440 --> 00:43:53,080 Speaker 1: which is like a family what's app of a sort 843 00:43:53,160 --> 00:43:55,680 Speaker 1: that you know, anybody might have with their family. And 844 00:43:55,800 --> 00:43:58,520 Speaker 1: you have a whole bunch of different descendants of Mortimer 845 00:43:58,600 --> 00:44:01,919 Speaker 1: Sackler texting each other on this what'sapp log In part 846 00:44:02,040 --> 00:44:03,759 Speaker 1: it looks like because they think that that will be 847 00:44:04,080 --> 00:44:06,520 Speaker 1: harder to get a discovery. Of course they were wrong 848 00:44:06,560 --> 00:44:08,400 Speaker 1: about that, which is how I got access to it. 849 00:44:08,880 --> 00:44:11,920 Speaker 1: But um, there's over a year of these texts back 850 00:44:11,960 --> 00:44:16,759 Speaker 1: and forth, and nowhere does any single member say, in 851 00:44:16,880 --> 00:44:20,160 Speaker 1: this private zone of this family, what's up? Hey, jeez? 852 00:44:20,200 --> 00:44:22,400 Speaker 1: Maybe the critics have a point, or not even not 853 00:44:22,520 --> 00:44:25,080 Speaker 1: even something that far, but maybe we should think about 854 00:44:25,160 --> 00:44:28,040 Speaker 1: our own conduct. Is there something we missed? Those types 855 00:44:28,080 --> 00:44:30,880 Speaker 1: of questions that that I'm sure you and I and 856 00:44:30,960 --> 00:44:33,680 Speaker 1: probably others listening, just because you're a normal human being, 857 00:44:33,800 --> 00:44:35,640 Speaker 1: like you think about your own actions and the decisions 858 00:44:35,640 --> 00:44:37,719 Speaker 1: you wonder if you did the right thing. I think 859 00:44:37,800 --> 00:44:41,839 Speaker 1: this is a family that seems largely impervious to that particular. 860 00:44:42,840 --> 00:44:44,719 Speaker 1: You make a very persuasive case about that, But let 861 00:44:44,800 --> 00:44:47,000 Speaker 1: me just press you a bit, right, because it seems 862 00:44:47,040 --> 00:44:49,759 Speaker 1: to me there's almost like these concentric circles right of 863 00:44:49,840 --> 00:44:53,480 Speaker 1: maybe guilty responsibility and that on the one hand, Richard 864 00:44:53,680 --> 00:44:56,359 Speaker 1: is a driving figure. He's basically the CEO, and he's 865 00:44:56,400 --> 00:44:58,480 Speaker 1: got his brother, and he's got two cousins, and there's 866 00:44:58,520 --> 00:45:00,360 Speaker 1: some nephews, and there's a bunch of others in involved 867 00:45:00,400 --> 00:45:02,280 Speaker 1: and there and there are sort of a second circle 868 00:45:02,400 --> 00:45:04,759 Speaker 1: who are bear a large share of the responsibility. They're 869 00:45:04,800 --> 00:45:08,160 Speaker 1: involved in managing and micromanaging the company as well Richard's 870 00:45:08,239 --> 00:45:11,360 Speaker 1: very much the driver. Then you get to the third circle, 871 00:45:11,520 --> 00:45:15,080 Speaker 1: which is sort of the third generation, the younger one, 872 00:45:15,200 --> 00:45:17,479 Speaker 1: and you portrayed one of the characters, a young woman 873 00:45:17,520 --> 00:45:20,880 Speaker 1: who makes I think an award winning documentary about the 874 00:45:20,960 --> 00:45:24,440 Speaker 1: need for criminal justice reform, and the question about well 875 00:45:24,719 --> 00:45:28,879 Speaker 1: should she be held more responsible? And you know, I'm 876 00:45:28,920 --> 00:45:31,120 Speaker 1: thinking about like you think about the families, the Fords, 877 00:45:31,160 --> 00:45:35,080 Speaker 1: the Rockefellers, the big Empires, and eventually the grandchildren's generation 878 00:45:35,200 --> 00:45:37,440 Speaker 1: after the founders dead. You know, they may speak out 879 00:45:37,520 --> 00:45:40,600 Speaker 1: or condemn what their ancestors did, But here you're still 880 00:45:40,680 --> 00:45:43,440 Speaker 1: talking about a family that at least the two branches, 881 00:45:43,520 --> 00:45:45,920 Speaker 1: the Raymond and Mortimer who are involved with Produe Pharma, 882 00:45:46,400 --> 00:45:48,759 Speaker 1: where you know, I wonder why you or I would 883 00:45:48,800 --> 00:45:51,880 Speaker 1: have done in that similar situation, right, I mean, here 884 00:45:51,920 --> 00:45:55,320 Speaker 1: you are still going to your family Christmas or Saders 885 00:45:55,480 --> 00:45:58,440 Speaker 1: or whatever, and this sort of thing. You know, if 886 00:45:58,480 --> 00:46:00,239 Speaker 1: they have nothing to do with the family except having 887 00:46:00,280 --> 00:46:02,600 Speaker 1: benefited from the money and they're out there trying to 888 00:46:02,680 --> 00:46:05,600 Speaker 1: do good in the world, do they have an obligation 889 00:46:05,680 --> 00:46:09,560 Speaker 1: to speak out? And then there's the kind of four circle, right, 890 00:46:09,680 --> 00:46:13,000 Speaker 1: And this is actually about somebody I know Elizabeth Sackler right. 891 00:46:13,080 --> 00:46:15,200 Speaker 1: And Elizabeth Sackler. I've only met her a few times, 892 00:46:15,320 --> 00:46:17,680 Speaker 1: but initially it's about twenty years ago. I was doing 893 00:46:17,760 --> 00:46:20,440 Speaker 1: some fundraising for Drug Policy Alliance. I was in the 894 00:46:20,560 --> 00:46:23,040 Speaker 1: early stages of fundraising, and I was at some group 895 00:46:23,120 --> 00:46:26,440 Speaker 1: of liberal you know, wealthy, wealthy liberals, and in that moment, 896 00:46:26,560 --> 00:46:28,759 Speaker 1: you know, there's a challenge grant and Liz goes, oh, 897 00:46:28,800 --> 00:46:31,040 Speaker 1: I'll give twenty five grants, right, So that was great. 898 00:46:31,080 --> 00:46:34,360 Speaker 1: She makes this contribution and we have dinner thereafter, and 899 00:46:34,440 --> 00:46:36,319 Speaker 1: I try to bring her in in a bigger way 900 00:46:36,360 --> 00:46:38,680 Speaker 1: with Drug Policy Alliance, and I'm not all that successful 901 00:46:38,719 --> 00:46:40,880 Speaker 1: at it, although about ten years ago I get her 902 00:46:41,040 --> 00:46:43,720 Speaker 1: to co chair a fundraising event. We do an art auction, 903 00:46:43,800 --> 00:46:46,279 Speaker 1: and she's at that point chairing the Brooklyn Museum and 904 00:46:46,360 --> 00:46:48,680 Speaker 1: she's bringing in feminist artists and all this sort of stuff, 905 00:46:49,200 --> 00:46:52,239 Speaker 1: and she's pretty alienated from the other wing of the 906 00:46:52,280 --> 00:46:54,440 Speaker 1: family that owns Produe Pharma and they have no for 907 00:46:54,560 --> 00:46:57,439 Speaker 1: profit interests in it. She's the daughter of Arthur, who's 908 00:46:57,480 --> 00:47:00,399 Speaker 1: the kind of godfather of the whole thing, but had 909 00:47:00,440 --> 00:47:02,640 Speaker 1: no direct involvement in Produe Farm and all this sort 910 00:47:02,680 --> 00:47:06,960 Speaker 1: of stuff, and she is actually openly condemning Perdue Farma 911 00:47:07,120 --> 00:47:08,960 Speaker 1: and what they did. I mean, she's putting out the 912 00:47:09,080 --> 00:47:10,840 Speaker 1: statements one oh no, I mean you look, if you 913 00:47:10,920 --> 00:47:13,640 Speaker 1: look her up, she says, he's very hostile statements about it. 914 00:47:13,840 --> 00:47:17,000 Speaker 1: Those statements started just after my New Yorker piece came out. 915 00:47:17,680 --> 00:47:19,960 Speaker 1: But that's when the Sackler family becomes I mean, that's 916 00:47:20,200 --> 00:47:22,160 Speaker 1: you can understand somebody wanted to keep a little profile, 917 00:47:22,239 --> 00:47:26,320 Speaker 1: but nothing in the peace from Elizabeth expressing even a 918 00:47:26,400 --> 00:47:29,400 Speaker 1: whisper of disapproval. And and and if you and you 919 00:47:29,440 --> 00:47:32,439 Speaker 1: should and I won't say what you know, I would 920 00:47:32,480 --> 00:47:35,319 Speaker 1: never divulge too much. But you have to ask whether 921 00:47:35,400 --> 00:47:38,600 Speaker 1: that's because I didn't bother trying to see if she 922 00:47:38,680 --> 00:47:40,759 Speaker 1: had an opinion on it. Well, look, I can also 923 00:47:40,840 --> 00:47:43,399 Speaker 1: imagine that you still at this point you say, it's 924 00:47:43,400 --> 00:47:45,560 Speaker 1: really your article and another one in Esquat, we're gonna 925 00:47:45,560 --> 00:47:47,399 Speaker 1: come out that time that exposed them in that way. 926 00:47:47,800 --> 00:47:50,080 Speaker 1: You can see people wanting to lie low. But when 927 00:47:50,200 --> 00:47:53,120 Speaker 1: she does come out with a pretty strong statement condemning 928 00:47:53,320 --> 00:47:57,120 Speaker 1: UM and then Nan Golden, the artist who is inspired 929 00:47:57,280 --> 00:48:00,120 Speaker 1: by your article to really go after the Sackler is 930 00:48:00,120 --> 00:48:03,399 Speaker 1: an organized public. You know, demonstrations at the museums against them, 931 00:48:03,880 --> 00:48:06,160 Speaker 1: and she looks at with Elizabeth Sacklers when she goes, 932 00:48:06,280 --> 00:48:09,400 Speaker 1: you know, what the hell were there? The whole family's evil, 933 00:48:10,320 --> 00:48:12,520 Speaker 1: And I wonder, like, what do you think, I mean, 934 00:48:12,760 --> 00:48:14,600 Speaker 1: would you agree with my analysis of the sort of 935 00:48:14,640 --> 00:48:17,960 Speaker 1: concentric circles of responsibility. Yeah, the concentered circles is perfect 936 00:48:17,960 --> 00:48:19,960 Speaker 1: because I would say, you know, circle number one would 937 00:48:19,960 --> 00:48:21,879 Speaker 1: be Richard and arguably a few of the other board 938 00:48:21,920 --> 00:48:24,160 Speaker 1: members who are very intimately involved. Then there's kind of 939 00:48:24,200 --> 00:48:26,479 Speaker 1: board members who were on the board but maybe less 940 00:48:26,520 --> 00:48:29,719 Speaker 1: immediately involved, are people like David Sackler, Richard's son, who 941 00:48:30,400 --> 00:48:32,880 Speaker 1: came in a little bit later, but you know, I 942 00:48:32,960 --> 00:48:37,360 Speaker 1: think very instrumental. Then there's, uh, the Sacklers, who have 943 00:48:37,680 --> 00:48:41,160 Speaker 1: you know, stood to benefit made huge fortunes on oxycontent 944 00:48:41,280 --> 00:48:43,120 Speaker 1: but not on the board, and they do other things 945 00:48:43,160 --> 00:48:46,839 Speaker 1: with their life. And then there's the Arthur family. Um yeah, 946 00:48:46,920 --> 00:48:49,839 Speaker 1: I mean to take the mattel An example first, as 947 00:48:49,880 --> 00:48:52,640 Speaker 1: the filmmaker, right, yeah, the filmmaker. I think the reasonable 948 00:48:52,680 --> 00:48:55,480 Speaker 1: people can differ on this, and I mean Josh Sackler, 949 00:48:55,520 --> 00:48:57,960 Speaker 1: who's David's wife, who's a kind of you know, want 950 00:48:57,960 --> 00:49:00,520 Speaker 1: to be fashion designer. She's another good example of this too, 951 00:49:00,640 --> 00:49:04,440 Speaker 1: where there's a guy who's who's involved in um film financing. 952 00:49:04,480 --> 00:49:06,200 Speaker 1: We did an interview with the Hollywood Reporter or a 953 00:49:06,200 --> 00:49:08,319 Speaker 1: while ago, another third generation Sackler, and what he said, 954 00:49:08,360 --> 00:49:10,239 Speaker 1: he literally said something like, Oh, it has nothing to 955 00:49:10,320 --> 00:49:12,279 Speaker 1: do with me. You know, the company, the controversy has 956 00:49:12,320 --> 00:49:14,319 Speaker 1: nothing to do with me. And he has a film 957 00:49:14,360 --> 00:49:17,920 Speaker 1: financing fund and you know, to my knowledge, no independent 958 00:49:18,040 --> 00:49:21,880 Speaker 1: source of income that would would fund that fund. And 959 00:49:22,080 --> 00:49:25,840 Speaker 1: so to me, the interesting thing is the premise that 960 00:49:26,080 --> 00:49:28,560 Speaker 1: you could benefit to the tune of tens, maybe even 961 00:49:28,640 --> 00:49:32,120 Speaker 1: hundreds of millions of dollars from something and say, oh, 962 00:49:32,160 --> 00:49:34,440 Speaker 1: but it has nothing to do with me. It seems 963 00:49:34,480 --> 00:49:36,239 Speaker 1: a little hard to you know, it seems a little 964 00:49:36,239 --> 00:49:38,080 Speaker 1: hard for me to swallow. One of the great themes 965 00:49:38,120 --> 00:49:40,160 Speaker 1: I've always been interested in, and it's one of the 966 00:49:40,200 --> 00:49:42,160 Speaker 1: continuities between this book and the I RA, a book 967 00:49:42,160 --> 00:49:45,080 Speaker 1: that I wrote as denial, and I think, particularly in 968 00:49:45,160 --> 00:49:47,000 Speaker 1: families a lot of the time, what that means is 969 00:49:47,040 --> 00:49:49,800 Speaker 1: that there are questions that don't get asked. So I 970 00:49:49,880 --> 00:49:52,400 Speaker 1: would hazard that for a lot of the third generation Sacklers, 971 00:49:52,440 --> 00:49:54,160 Speaker 1: it probably does feel like it doesn't have anything to 972 00:49:54,200 --> 00:49:56,960 Speaker 1: do with them. You know, there's money that that appears 973 00:49:57,040 --> 00:50:00,520 Speaker 1: in a trust for their benefit, and they've never had 974 00:50:00,560 --> 00:50:02,160 Speaker 1: to worry about that, and they don't ask a lot 975 00:50:02,200 --> 00:50:04,000 Speaker 1: of questions about where it comes from, and they may 976 00:50:04,040 --> 00:50:06,040 Speaker 1: not ask too many questions about the business or what 977 00:50:06,120 --> 00:50:09,520 Speaker 1: it's done. Without getting into too much detail, I can 978 00:50:09,600 --> 00:50:13,000 Speaker 1: tell you that I know with certainty that there are 979 00:50:13,000 --> 00:50:15,680 Speaker 1: a number of Sacklers from multiple generations who just kind 980 00:50:15,719 --> 00:50:18,040 Speaker 1: of don't read the bad press. They didn't read Barry 981 00:50:18,080 --> 00:50:20,239 Speaker 1: Meyer's book Painkiller. They didn't read the coverage in the 982 00:50:20,239 --> 00:50:22,840 Speaker 1: New York Times, didn't read the Big l a time series, 983 00:50:22,880 --> 00:50:26,520 Speaker 1: didn't read Sam ken Jonas's book Dreamland. They certainly probably 984 00:50:26,560 --> 00:50:29,239 Speaker 1: wouldn't be reading my book. Um. But so there's a 985 00:50:29,320 --> 00:50:31,359 Speaker 1: kind of wilful blindness aspect of it right where it's 986 00:50:31,360 --> 00:50:34,000 Speaker 1: one thing to say I have fully engaged with the details. 987 00:50:34,080 --> 00:50:36,040 Speaker 1: This is what David Sackler does. In fairness to him, 988 00:50:36,080 --> 00:50:38,120 Speaker 1: the Third Generations Act. The only third generation one is 989 00:50:38,120 --> 00:50:41,080 Speaker 1: on the board. He says, I've engaged with all the details, 990 00:50:41,120 --> 00:50:43,000 Speaker 1: and I want to have the argument with you. You're wrong, 991 00:50:43,280 --> 00:50:46,279 Speaker 1: you know, you misunderstand our family. It's another thing to say, Oh, 992 00:50:46,440 --> 00:50:48,480 Speaker 1: I'm I've just never been all that curious about that 993 00:50:48,520 --> 00:50:49,759 Speaker 1: side of things. That just take the money and I 994 00:50:49,800 --> 00:50:53,200 Speaker 1: don't ask any questions. My interests lie in in Hollywood. 995 00:50:53,640 --> 00:50:55,480 Speaker 1: That to me seems wrong. I mean, I you know 996 00:50:55,640 --> 00:50:57,480 Speaker 1: I And it's not to say that the blame is 997 00:50:57,520 --> 00:51:01,200 Speaker 1: anywhere near what it would be for a Richard Sackler, 998 00:51:01,280 --> 00:51:03,400 Speaker 1: but I think there is if what you're doing is 999 00:51:04,040 --> 00:51:06,120 Speaker 1: taking the money, no matter what you're spending the money on, 1000 00:51:06,760 --> 00:51:09,719 Speaker 1: and not really engaging at all with the origins of it. 1001 00:51:09,760 --> 00:51:12,560 Speaker 1: So again, this is different from saying I think mistakes 1002 00:51:12,600 --> 00:51:14,760 Speaker 1: were made of our family businesses played guilty to criminal 1003 00:51:14,840 --> 00:51:17,960 Speaker 1: charges twice. There's a huge epidemic which we share some 1004 00:51:18,200 --> 00:51:20,960 Speaker 1: portion of the blame for. I'm going to redirect this 1005 00:51:21,080 --> 00:51:24,080 Speaker 1: money that I've inherited in order to remediate that or 1006 00:51:24,320 --> 00:51:27,320 Speaker 1: xpiate that guilt. Nobody's saying that. What they're saying is 1007 00:51:27,760 --> 00:51:32,000 Speaker 1: I'm interested in film. Mass incarceration is my issue. You 1008 00:51:32,160 --> 00:51:36,279 Speaker 1: know Ethan better than most that to talk about mass 1009 00:51:36,280 --> 00:51:40,479 Speaker 1: incarceration and say we're just gonna cabin the war on drugs, 1010 00:51:40,520 --> 00:51:42,120 Speaker 1: We're not gonna talk about the war on drugs. We're 1011 00:51:42,160 --> 00:51:45,160 Speaker 1: just gonna talk about mass incarceration and exclude the war 1012 00:51:45,239 --> 00:51:47,799 Speaker 1: on drugs as an issue. It's just like the height 1013 00:51:47,840 --> 00:51:50,520 Speaker 1: of intellectual dishonesty. There's no way, Yeah, no, no, I 1014 00:51:50,840 --> 00:51:52,600 Speaker 1: hear your Patrick. I just wonder what you and I 1015 00:51:52,680 --> 00:51:54,480 Speaker 1: would do if we were born into that kind of 1016 00:51:54,560 --> 00:51:56,680 Speaker 1: family and we and we were shamed of it, and 1017 00:51:56,800 --> 00:51:58,400 Speaker 1: we wanted to get on with our lives. We were 1018 00:51:58,440 --> 00:52:00,200 Speaker 1: happy about the money. We want to do good in 1019 00:52:00,239 --> 00:52:02,719 Speaker 1: the world. You know, taking on this means, oh my god, 1020 00:52:02,800 --> 00:52:05,160 Speaker 1: and then I'm gonna go see my family for the 1021 00:52:05,280 --> 00:52:08,640 Speaker 1: next Christmas party or briss or Sader or you name it. 1022 00:52:08,960 --> 00:52:11,440 Speaker 1: And that's that's why I also think that that Arthur generation, 1023 00:52:11,680 --> 00:52:14,359 Speaker 1: because you know, interesting about Arthur, you know, you tell 1024 00:52:14,440 --> 00:52:16,480 Speaker 1: a story about him and valium and how what he 1025 00:52:16,600 --> 00:52:19,359 Speaker 1: does with valium is almost a model for what then 1026 00:52:19,520 --> 00:52:23,120 Speaker 1: Richard and Produce Pharma does with oxycontent, right. I think 1027 00:52:23,200 --> 00:52:26,319 Speaker 1: that's what Nan Golden was getting at when she said, Okay, so, yes, 1028 00:52:26,440 --> 00:52:29,640 Speaker 1: Arthur Sackler died before the introduction of oxycontent, But to 1029 00:52:29,760 --> 00:52:34,960 Speaker 1: suggest that his that his hands were clean, when in fact, 1030 00:52:35,120 --> 00:52:38,600 Speaker 1: you know, uh, he was so instrumental in kind of 1031 00:52:38,800 --> 00:52:41,440 Speaker 1: building the world in which oxycontent could end up doing 1032 00:52:41,480 --> 00:52:44,480 Speaker 1: what it did is disingenuous. My sense is that that's 1033 00:52:44,520 --> 00:52:48,480 Speaker 1: what she was in a hyperbolic way. Yeah, yeah, I 1034 00:52:48,600 --> 00:52:50,839 Speaker 1: think that's right. But I also think about Arthur also 1035 00:52:50,960 --> 00:52:54,000 Speaker 1: fits within a context of mid century and even current 1036 00:52:54,120 --> 00:52:57,840 Speaker 1: day chrony capitalism, that his story maybe not that different 1037 00:52:57,920 --> 00:53:01,680 Speaker 1: from so many other major industry is from banking to oil, 1038 00:53:01,760 --> 00:53:05,279 Speaker 1: to alcohol, tobacco, to consumer goods to you name it, 1039 00:53:05,640 --> 00:53:08,200 Speaker 1: where people figure it out all sorts of of legal 1040 00:53:08,320 --> 00:53:11,480 Speaker 1: and sometimes cause by illegal ways to engage in, you know, 1041 00:53:11,640 --> 00:53:14,560 Speaker 1: forms of vertical integration and their businesses and in which 1042 00:53:14,600 --> 00:53:17,680 Speaker 1: they live these kind of double lives and moral double lives. 1043 00:53:18,160 --> 00:53:20,640 Speaker 1: And it doesn't justify it. I mean, as somebody else 1044 00:53:20,680 --> 00:53:22,879 Speaker 1: who had to spend twenty years of my life, seventy 1045 00:53:22,960 --> 00:53:25,560 Speaker 1: years my raising money from wealthy people from across the 1046 00:53:25,600 --> 00:53:27,960 Speaker 1: political spectrum to try to end the war on drugs, 1047 00:53:28,400 --> 00:53:31,279 Speaker 1: you know, you realize that people are complex, They come 1048 00:53:31,320 --> 00:53:34,240 Speaker 1: from all sorts of different places. Much better the people 1049 00:53:34,320 --> 00:53:36,360 Speaker 1: who want to put their wealth, even if it was 1050 00:53:36,440 --> 00:53:39,000 Speaker 1: ill gotten by their ancestors, the ones who want to 1051 00:53:39,040 --> 00:53:41,640 Speaker 1: put it to reducing incarceration, are ending the drug war 1052 00:53:41,719 --> 00:53:45,040 Speaker 1: or promoting good stuff are so much better human beings 1053 00:53:45,239 --> 00:53:46,880 Speaker 1: than the ones who just want to spend it on 1054 00:53:47,080 --> 00:53:51,040 Speaker 1: yachts and mansions and things like that. And that ratio 1055 00:53:51,080 --> 00:53:54,000 Speaker 1: of how much you're willing to put into meaningful philanthropy 1056 00:53:54,320 --> 00:53:56,200 Speaker 1: as opposed to how much you just want to live 1057 00:53:56,360 --> 00:54:00,000 Speaker 1: lives of luxury. Yeah, I mean, I think again, complicated 1058 00:54:00,000 --> 00:54:02,320 Speaker 1: of issues part of the reason I find them interesting. 1059 00:54:02,440 --> 00:54:03,840 Speaker 1: Believe me, I've spent a lot of time talking to 1060 00:54:03,920 --> 00:54:07,040 Speaker 1: people at museums and universities who are really you know, 1061 00:54:07,120 --> 00:54:08,600 Speaker 1: they're in a real bind about what to do with 1062 00:54:08,640 --> 00:54:11,040 Speaker 1: the Sacklers, and they worry about if they take down 1063 00:54:11,080 --> 00:54:14,040 Speaker 1: the Sackler name, then what kind of precedent does that set, 1064 00:54:14,160 --> 00:54:16,960 Speaker 1: and does it worry other potential future donors and so forth. 1065 00:54:17,040 --> 00:54:20,160 Speaker 1: I think the issue for me is can you stand 1066 00:54:20,480 --> 00:54:23,479 Speaker 1: by it when the truth is out there and known? 1067 00:54:24,440 --> 00:54:26,839 Speaker 1: Or does the sort of happy families we all get 1068 00:54:26,880 --> 00:54:29,440 Speaker 1: along at the family reunion, you know, we will happily 1069 00:54:29,480 --> 00:54:33,400 Speaker 1: accept your money for our foundation or our university. Is 1070 00:54:33,480 --> 00:54:37,359 Speaker 1: that premised on a kind of denial or a sort 1071 00:54:37,360 --> 00:54:41,360 Speaker 1: of a desire to cover up or only whisper about 1072 00:54:41,520 --> 00:54:43,879 Speaker 1: the source of the funds? You know, there have been 1073 00:54:43,960 --> 00:54:46,400 Speaker 1: some more more so in the UK. There have been 1074 00:54:46,440 --> 00:54:49,560 Speaker 1: some institutions, Oxford University among them, where they've really come 1075 00:54:49,560 --> 00:54:51,799 Speaker 1: out in a kind of full throated way and said, hell, yeah, 1076 00:54:51,880 --> 00:54:53,919 Speaker 1: we love the Sacklers, will take more of their money. 1077 00:54:54,280 --> 00:54:57,680 Speaker 1: They're great, they've been great friends to us. And yes, 1078 00:54:57,800 --> 00:54:59,839 Speaker 1: we know that all this reporting is out there, and yes, 1079 00:55:00,040 --> 00:55:02,440 Speaker 1: you know that a lot of people seem to be 1080 00:55:02,560 --> 00:55:05,200 Speaker 1: pretty convinced that this is a family with a you know, 1081 00:55:05,239 --> 00:55:08,800 Speaker 1: a pretty poisonous legacy, but we stand by them. And 1082 00:55:08,840 --> 00:55:10,719 Speaker 1: I actually think there's an argument that an institution could 1083 00:55:10,760 --> 00:55:12,200 Speaker 1: make that you know, people have certainly made it to 1084 00:55:12,239 --> 00:55:14,680 Speaker 1: me in philanthropy that you can take the dirtiest money 1085 00:55:14,719 --> 00:55:17,520 Speaker 1: in the world and give it to me and let 1086 00:55:17,640 --> 00:55:20,000 Speaker 1: me spend it on something good, and that's better than 1087 00:55:20,000 --> 00:55:22,359 Speaker 1: the alternative, which is these people not giving their money away, 1088 00:55:22,400 --> 00:55:24,920 Speaker 1: which I think is what you were saying. That's a powerful, 1089 00:55:25,360 --> 00:55:28,080 Speaker 1: not insurmountable, but a powerful argument to make with the 1090 00:55:28,160 --> 00:55:30,680 Speaker 1: one asterisk that I think you have to first acknowledge 1091 00:55:30,719 --> 00:55:32,799 Speaker 1: that the money is dirty. If the way in which 1092 00:55:32,880 --> 00:55:36,759 Speaker 1: you sort of square the circle is to say dirty. Yes, 1093 00:55:36,880 --> 00:55:39,279 Speaker 1: there's been some reporting, but who can trust the New 1094 00:55:39,360 --> 00:55:41,440 Speaker 1: York Times? You know, really it's a he said, chief 1095 00:55:41,440 --> 00:55:45,080 Speaker 1: said situation. There's two sides to every story. Um, once 1096 00:55:45,160 --> 00:55:47,440 Speaker 1: you start going down that road in order to justify 1097 00:55:47,600 --> 00:55:50,719 Speaker 1: taking the money, you've kind of lost me. And I 1098 00:55:50,800 --> 00:55:52,520 Speaker 1: think that a lot of people, for a long time 1099 00:55:52,719 --> 00:55:55,239 Speaker 1: did just that, even tough. I read about Toughts in 1100 00:55:55,280 --> 00:55:57,000 Speaker 1: the book Toughs of the first university to take the 1101 00:55:57,040 --> 00:55:59,399 Speaker 1: Sackler name down, and they got a lot of good 1102 00:55:59,440 --> 00:56:01,719 Speaker 1: press for you know, the student party was really happy 1103 00:56:01,760 --> 00:56:04,719 Speaker 1: because the students had demanded it. But you know, five 1104 00:56:04,800 --> 00:56:08,040 Speaker 1: years ago, when Sam kenona Is published Dreamland, it was 1105 00:56:08,080 --> 00:56:11,400 Speaker 1: supposed to get assigned as reading for I think incoming students, 1106 00:56:11,719 --> 00:56:15,040 Speaker 1: and the administration quietly scuttled that because they said that 1107 00:56:15,200 --> 00:56:17,400 Speaker 1: that that's just they don't want to create any awkwardness 1108 00:56:17,440 --> 00:56:19,399 Speaker 1: for our donors. So you're not it's not that you're 1109 00:56:19,440 --> 00:56:21,400 Speaker 1: denying the book or you're saying, oh, the book is garbage. 1110 00:56:21,400 --> 00:56:23,239 Speaker 1: What you're saying is the book is out there, it 1111 00:56:23,320 --> 00:56:25,680 Speaker 1: almost hits too hard. We don't want to create any 1112 00:56:25,719 --> 00:56:28,400 Speaker 1: awkwardness for our donors. Yeah, well, you know, so let 1113 00:56:28,440 --> 00:56:30,560 Speaker 1: me take it back to one other issue of the 1114 00:56:30,880 --> 00:56:33,960 Speaker 1: intersection of money here, and you know, you describe this, 1115 00:56:34,040 --> 00:56:36,320 Speaker 1: I think, with some nuance in the book, which is 1116 00:56:36,400 --> 00:56:40,520 Speaker 1: that a mutuality of interest emerges. At some point. You 1117 00:56:40,640 --> 00:56:43,839 Speaker 1: have the people like the Cathy Foley's leading the pain 1118 00:56:43,960 --> 00:56:47,080 Speaker 1: management community, and then a bigger community of people who 1119 00:56:47,120 --> 00:56:49,880 Speaker 1: are living with pain, for whom being having it managed 1120 00:56:49,920 --> 00:56:52,400 Speaker 1: by opioids. The other way is they're doing so successfully 1121 00:56:52,440 --> 00:56:54,839 Speaker 1: and other people are angry at not having their pain right, 1122 00:56:55,280 --> 00:56:59,440 Speaker 1: and there's essentially little to no funding to support those efforts. 1123 00:57:00,040 --> 00:57:05,399 Speaker 1: And then along comes Richard Sackler, who sees this opportunity here. Right. 1124 00:57:05,600 --> 00:57:08,759 Speaker 1: He has a drug MS content and oxy content, and 1125 00:57:08,960 --> 00:57:11,799 Speaker 1: he makes common interests with these folks, and so they say, 1126 00:57:11,840 --> 00:57:14,120 Speaker 1: oh my god, now we have a wealthy family and 1127 00:57:14,160 --> 00:57:17,720 Speaker 1: pharmaceutical company that's willing to get behind our efforts to 1128 00:57:17,960 --> 00:57:21,640 Speaker 1: educate physicians and to change these policies. And he sees 1129 00:57:21,680 --> 00:57:25,560 Speaker 1: somebody whose interests are advancing his own, and in a way, 1130 00:57:26,160 --> 00:57:28,520 Speaker 1: it's a dance, right, And to some extent, the pain 1131 00:57:28,600 --> 00:57:32,360 Speaker 1: management community gets taken for a ride when it turns 1132 00:57:32,400 --> 00:57:35,080 Speaker 1: out that the Sacklers and Produce Pharma want to market 1133 00:57:35,200 --> 00:57:37,600 Speaker 1: this drug in a way that is not at all 1134 00:57:37,720 --> 00:57:40,440 Speaker 1: what they intended. And at the same time there is 1135 00:57:40,600 --> 00:57:43,080 Speaker 1: this need for more education on this stuff and more 1136 00:57:43,240 --> 00:57:45,680 Speaker 1: to do the right find find the balance right. And 1137 00:57:45,760 --> 00:57:47,960 Speaker 1: in America, we tend to swing between these polls, you know, 1138 00:57:48,040 --> 00:57:51,000 Speaker 1: either it's all opiophobia or it's opioids are fine if 1139 00:57:51,080 --> 00:57:53,720 Speaker 1: ex oxy content. And now we're swinging back the other way. 1140 00:57:55,280 --> 00:57:57,160 Speaker 1: Let's take a break here and go to an egg. 1141 00:58:07,640 --> 00:58:09,440 Speaker 1: You had towards the end of the book the story 1142 00:58:09,680 --> 00:58:13,160 Speaker 1: about when uh Perdue Pharma is obliged to make a 1143 00:58:13,240 --> 00:58:16,280 Speaker 1: big settlement in Oklahoma, right, I mean bigger than in 1144 00:58:16,360 --> 00:58:17,960 Speaker 1: most other states that they don't want to be a 1145 00:58:18,000 --> 00:58:20,200 Speaker 1: model for others, and the money is all going to 1146 00:58:20,320 --> 00:58:22,920 Speaker 1: go to drug treatment and all this sort of stuff. 1147 00:58:23,400 --> 00:58:27,320 Speaker 1: And my thought was, what a goddamn waste, because from 1148 00:58:27,360 --> 00:58:30,560 Speaker 1: everything I know about Oklahoma, there is almost nothing really 1149 00:58:30,640 --> 00:58:34,160 Speaker 1: innovative going on about drug treatment in Oklahoma, you know, 1150 00:58:34,240 --> 00:58:37,600 Speaker 1: and that their approach to drugs is an abstinence only, backward, 1151 00:58:37,720 --> 00:58:41,560 Speaker 1: anti scientific approach. And I'm thinking, if only that money 1152 00:58:41,720 --> 00:58:45,160 Speaker 1: could be spent on, for example, instead of focusing just 1153 00:58:45,280 --> 00:58:49,160 Speaker 1: on addiction treatment, maybe focusing on the proper management of 1154 00:58:49,240 --> 00:58:53,320 Speaker 1: pain in our society, maybe teaching GPS, maybe getting that 1155 00:58:53,360 --> 00:58:56,600 Speaker 1: out so it's not just Center of Disease Control CDC guidelines, 1156 00:58:56,800 --> 00:59:00,240 Speaker 1: but actually educating people because my fear here is that 1157 00:59:00,640 --> 00:59:04,080 Speaker 1: with all the backlash first against the big pharma, in 1158 00:59:04,120 --> 00:59:05,720 Speaker 1: which your book plays a key role and is a 1159 00:59:05,840 --> 00:59:08,000 Speaker 1: very important and necessary thing to happen, and not just 1160 00:59:08,040 --> 00:59:10,560 Speaker 1: against Purdue Pharma, but the Johnson and Johnson's and then 1161 00:59:10,600 --> 00:59:12,960 Speaker 1: Malon Cross and the endos and all the other ones. Right, 1162 00:59:13,280 --> 00:59:16,560 Speaker 1: but meanwhile, here's fentonel. You know, here's heroin. There's no 1163 00:59:16,720 --> 00:59:19,640 Speaker 1: way to have a supply side solution to the fentinel problem, 1164 00:59:19,800 --> 00:59:21,880 Speaker 1: right the drug is just too hard to really prevent 1165 00:59:22,040 --> 00:59:25,040 Speaker 1: from being made available. The question is is how does 1166 00:59:25,120 --> 00:59:28,960 Speaker 1: one most effectively point these resources? And my fear is 1167 00:59:29,040 --> 00:59:31,160 Speaker 1: the way that all these settlements are happening right now, 1168 00:59:31,680 --> 00:59:34,720 Speaker 1: it's gonna land up doing relatively little to address the 1169 00:59:34,800 --> 00:59:37,600 Speaker 1: problem that we got ourselves into in the first place. 1170 00:59:37,920 --> 00:59:40,360 Speaker 1: I think this is one of the big fears with tobacco. 1171 00:59:40,480 --> 00:59:42,120 Speaker 1: You know a lot of a lot of this money 1172 00:59:42,200 --> 00:59:44,520 Speaker 1: ended up just in the general funds for the States, 1173 00:59:44,760 --> 00:59:48,880 Speaker 1: so you know, your other helping repay highways um and 1174 00:59:49,200 --> 00:59:52,080 Speaker 1: totally disconnected from what's going on. You know. The tricky 1175 00:59:52,120 --> 00:59:54,240 Speaker 1: thing with the Sacklers in particular and Purdue, is that 1176 00:59:54,480 --> 00:59:59,840 Speaker 1: there's so much skepticism about money that went into education 1177 01:00:00,000 --> 01:00:04,320 Speaker 1: on pain management. I think appropriate skepticism that anything that 1178 01:00:04,640 --> 01:00:08,000 Speaker 1: even resembled that cosmetically, even if it was much smarter 1179 01:00:08,520 --> 01:00:12,160 Speaker 1: and you know, devoid of commercial interests, I think would 1180 01:00:12,200 --> 01:00:16,000 Speaker 1: probably raise hackles um but I but I listen to 1181 01:00:16,240 --> 01:00:18,600 Speaker 1: you know, what's so sad about this situation is that 1182 01:00:18,680 --> 01:00:21,720 Speaker 1: you have a public health crisis that's cost trillions of dollars, 1183 01:00:22,000 --> 01:00:25,160 Speaker 1: and because of the country we live in, it's going 1184 01:00:25,200 --> 01:00:29,280 Speaker 1: to get resolved with money. You know, that's money on 1185 01:00:29,360 --> 01:00:32,360 Speaker 1: the way in, money on the way out, and there's 1186 01:00:32,400 --> 01:00:34,640 Speaker 1: no sum of money that's going to be satisfying a 1187 01:00:34,840 --> 01:00:36,480 Speaker 1: because you know, in the case of the Sacklers or 1188 01:00:36,480 --> 01:00:38,400 Speaker 1: any of these companies, you know they're walking away having 1189 01:00:38,440 --> 01:00:40,040 Speaker 1: made much more. If you put it against the money 1190 01:00:40,120 --> 01:00:44,040 Speaker 1: that they made through the fraudulent activity, it's you know, 1191 01:00:44,120 --> 01:00:47,360 Speaker 1: deppennies on the dollar. But also because when you think 1192 01:00:47,360 --> 01:00:50,280 Speaker 1: about the costs, right and the human toll at the 1193 01:00:50,360 --> 01:00:52,400 Speaker 1: end of the day, the opioid business, as much as 1194 01:00:52,480 --> 01:00:54,880 Speaker 1: it's had this catastrophic impact, it's not like the tobacco 1195 01:00:54,960 --> 01:00:58,280 Speaker 1: industry there's less money just in total to work with, 1196 01:00:58,480 --> 01:01:01,120 Speaker 1: so you're not going to see settlements on the scale 1197 01:01:01,160 --> 01:01:04,480 Speaker 1: that you have with tobacco. And then finally, there are 1198 01:01:04,560 --> 01:01:06,400 Speaker 1: real questions about how that money is gonna get spent. 1199 01:01:06,920 --> 01:01:10,400 Speaker 1: And you know, I think those should be a big 1200 01:01:10,480 --> 01:01:12,920 Speaker 1: concern for people, and I think that you know, if 1201 01:01:12,920 --> 01:01:14,400 Speaker 1: you've read my book, there are a few places where 1202 01:01:14,440 --> 01:01:16,800 Speaker 1: you get these headlines where that mean meant. The easiest 1203 01:01:16,880 --> 01:01:19,320 Speaker 1: example to talk about would be just a few months 1204 01:01:19,320 --> 01:01:22,520 Speaker 1: ago in late and the Trump administration, they announced an 1205 01:01:22,560 --> 01:01:26,760 Speaker 1: eight billion dollar fine with criminal sanctions against Purdue Farma, 1206 01:01:26,760 --> 01:01:30,000 Speaker 1: an eight billion dollar settlement. And of course people see 1207 01:01:30,040 --> 01:01:32,360 Speaker 1: that and they think, wow, good for DJ. They really 1208 01:01:32,400 --> 01:01:35,080 Speaker 1: stuck it to Purdue. And you have to know the 1209 01:01:35,120 --> 01:01:37,240 Speaker 1: story to know that PREDU doesn't have eight billion dollars, 1210 01:01:37,360 --> 01:01:39,120 Speaker 1: and the sacklers who do have eight billion dollars they 1211 01:01:39,160 --> 01:01:41,040 Speaker 1: weren't gonna be kicking in. So it's just like a 1212 01:01:41,200 --> 01:01:45,480 Speaker 1: fake number that gets repeated again and again in headlines. 1213 01:01:45,520 --> 01:01:47,960 Speaker 1: And to me, at my most cynical, I worry that 1214 01:01:48,080 --> 01:01:50,120 Speaker 1: this is the way it's gonna work, right, is that 1215 01:01:50,200 --> 01:01:53,080 Speaker 1: you get authorities who want to kind of squeeze just 1216 01:01:53,320 --> 01:01:55,560 Speaker 1: enough as much as they can in the way of 1217 01:01:55,680 --> 01:01:57,320 Speaker 1: money out, and then they want to put out press 1218 01:01:57,440 --> 01:01:59,720 Speaker 1: releases to look like they've done their job in the 1219 01:01:59,760 --> 01:02:03,080 Speaker 1: press us. Frankly, it's complicit because it repeats these phony 1220 01:02:03,160 --> 01:02:05,720 Speaker 1: numbers and the public says, oh, look at them, sort 1221 01:02:05,760 --> 01:02:08,160 Speaker 1: of sticking to the And so I do think that 1222 01:02:08,400 --> 01:02:10,800 Speaker 1: watching that money carefully is important because I think, you know, 1223 01:02:10,920 --> 01:02:14,280 Speaker 1: questions about how it's spent. Once the Daniue mall has 1224 01:02:14,280 --> 01:02:16,680 Speaker 1: appeared to play out, you know, once all of the companies, 1225 01:02:16,680 --> 01:02:19,480 Speaker 1: all the settlements, all the deals are done, that's when 1226 01:02:19,520 --> 01:02:22,280 Speaker 1: people need to really get vigilant about where do those 1227 01:02:22,320 --> 01:02:26,280 Speaker 1: dollars go? Yeah, yeah, Well, Patrick, I tell you I 1228 01:02:26,280 --> 01:02:27,840 Speaker 1: got to the end of your book and my blood 1229 01:02:27,920 --> 01:02:31,040 Speaker 1: is boiling when you read about Purdue Farmer taking what 1230 01:02:31,200 --> 01:02:34,840 Speaker 1: forty billion dollars of revenue and then the Sacklers taking 1231 01:02:34,880 --> 01:02:37,640 Speaker 1: out over ten billion dollars and putting it into offshore 1232 01:02:37,680 --> 01:02:40,240 Speaker 1: accounts so that they can make the company go bankrupt 1233 01:02:40,320 --> 01:02:43,439 Speaker 1: and thereby avoid any responsibility. And the way they gain 1234 01:02:43,560 --> 01:02:45,720 Speaker 1: the system and reach to members of Congress and the 1235 01:02:45,840 --> 01:02:48,640 Speaker 1: Justice Department, and that last little bit about the bankruptcy 1236 01:02:48,760 --> 01:02:51,000 Speaker 1: court up in Westchester, which is where you live, where 1237 01:02:51,040 --> 01:02:53,160 Speaker 1: I grew up, and there's a way in which Purdue 1238 01:02:53,200 --> 01:02:55,680 Speaker 1: Farmer can pick the judge they want who's known to 1239 01:02:55,760 --> 01:02:59,080 Speaker 1: be sympathetic to, you know, bankruptcy arguments that are gonna favor. 1240 01:02:59,160 --> 01:03:01,680 Speaker 1: Then the utter a corruption of the thing is just 1241 01:03:01,760 --> 01:03:06,240 Speaker 1: absolutely infuriating. Anyway, I have to say your book is fantastic. 1242 01:03:06,280 --> 01:03:08,760 Speaker 1: It is a fantastic page turner. I mean, I read 1243 01:03:08,800 --> 01:03:10,840 Speaker 1: it over the past week. I've loved it, and I'm 1244 01:03:10,880 --> 01:03:12,680 Speaker 1: sure that people who are much more removed from this 1245 01:03:12,800 --> 01:03:14,520 Speaker 1: issue than you are going to love it as well. 1246 01:03:15,000 --> 01:03:17,320 Speaker 1: I hope you keep writing on this drugs. Do you 1247 01:03:17,360 --> 01:03:19,480 Speaker 1: have plans for other drug writing this one? We'll see. 1248 01:03:19,480 --> 01:03:21,760 Speaker 1: I'll probably do something very different next, but but I 1249 01:03:22,240 --> 01:03:25,080 Speaker 1: never stay away for long. But listen, it's great to 1250 01:03:25,160 --> 01:03:27,720 Speaker 1: see you here, and thank you very much for this book, 1251 01:03:27,720 --> 01:03:29,760 Speaker 1: Thank you for taking the time, Thanks for having me. 1252 01:03:30,840 --> 01:03:34,600 Speaker 1: Psychoactive is a production of I Heart Radio and Protozoa Pictures. 1253 01:03:35,040 --> 01:03:38,320 Speaker 1: It's hosted by me Ethan Naedelman. It's produced by Katcha 1254 01:03:38,400 --> 01:03:42,560 Speaker 1: Kumkova and Ben Kibrick. The executive producers are Dylan Golden, 1255 01:03:42,760 --> 01:03:46,800 Speaker 1: Ari Handel, Elizabeth Geesus, and Darren Aronovski for Protozoa Pictures, 1256 01:03:47,280 --> 01:03:50,360 Speaker 1: Alice Williams and Matt Frederick for I Heart Radio, and 1257 01:03:50,520 --> 01:03:54,320 Speaker 1: me Ethan Nadelman. Our music is by Ari Blusian and 1258 01:03:54,520 --> 01:03:58,840 Speaker 1: especial thanks to Avi Brio, Sep Bianca, Grimshaw and Robert Beatty. 1259 01:04:00,080 --> 01:04:02,720 Speaker 1: If you'd like to share your own stories, comments, or ideas, 1260 01:04:03,160 --> 01:04:06,439 Speaker 1: please leave us a message at eight three three seven 1261 01:04:06,520 --> 01:04:13,560 Speaker 1: seven nine four sixty. That's one eight three three psycho zero. 1262 01:04:14,480 --> 01:04:17,840 Speaker 1: You can also email us as psychoactive at protozoa dot 1263 01:04:17,880 --> 01:04:21,120 Speaker 1: com or find me on Twitter at Ethan Natalman. And 1264 01:04:21,200 --> 01:04:23,160 Speaker 1: if you couldn't keep track of all this, find the 1265 01:04:23,240 --> 01:04:24,640 Speaker 1: information in the show notes