Speaker 1: Hi, I'm Ethan Natalman, and this is Psychoactive, a production
Speaker 1: of iHeart Radio and Protozoa Pictures. Psychoactive is the show
Speaker 1: where we talk about all things drugs. But any views
Speaker 1: expressed here do not represent those of iHeart Media, Protozoa Pictures,
Speaker 1: or their executives and employees. Indeed, as an inveterate contrarian,
Speaker 1: I can tell you they may not even represent my own.
Speaker 1: And nothing contained in this show should be used as
Speaker 1: medical advice or encouragement to use any type of drug. Hello,
Speaker 1: Psychoactive listeners. Uh. Today's guest has written a book that
Speaker 1: is creating quite a bush. The book is called Empire
Speaker 1: of Pain, and it looks at the role of one company,
Speaker 1: Produe Pharma, and one family who owned that company, the Sacklers,
Speaker 1: in terms of the role that they played in creating
Speaker 1: what we now widely regard as a massive opioid epidemic
Speaker 1: in America, where almost a half a million people have
Speaker 1: died over the last twenty years from opioid related overdoses. Now,
Speaker 1: Patrick has been a top investigative journalist a writer for
Speaker 1: a long time. He's been writing for The New Yorker
Speaker 1: magazine for the last fifteen years before this book, he
Speaker 1: did three other books. One was on global eavesdropping, one
Speaker 1: was on the Chinatown Underground, one was about a murder
Speaker 1: in Northern Ireland. And he uses these stories and families
Speaker 1: oftentimes to kind of reflect on broader issues that are
Speaker 1: going on. So, Patrick, you and I if we crossed
Speaker 1: paths a few years ago, not in person, but by
Speaker 1: phone when you were writing a story about Washington State's
Speaker 1: efforts to implement the merril On, a legalization initiative that
Speaker 1: I've been involved in in twelve and then I saw
Speaker 1: you had also written these wonderful stories about the capture
Speaker 1: and the pursuit of El Chappo al Chapoozman and notorious
Speaker 1: Mexican drug trafficker. So I think one thing you and
Speaker 1: I share in common is this fascination with drugs and
Speaker 1: drug markets. And just tell me about where you came
Speaker 1: to this fascination front. Yeah, you know, it probably started
Speaker 1: with the with the Mexican side of things. I wrote
Speaker 1: a big piece of cover story for the New York
Speaker 1: Times magazine in about Chappo Goosman and the Cineloa cartel.
Speaker 1: And it's funny to think back, but I had to
Speaker 1: explain to the editors of the New York Times magazine
Speaker 1: who Choppo Goosman was and why it was worth writing
Speaker 1: about him. You know, he has become more of a
Speaker 1: household name and a and a meme, but at the
Speaker 1: time it was not all that well known. And what
Speaker 1: was interesting to me was that there was a tendency
Speaker 1: to talk about the illegal drug trade and the Mexican
Speaker 1: drug syndicates as these criminal organizations, but not to think
Speaker 1: of them as businesses. And I was really chiefly interested
Speaker 1: in them as businesses. So that first piece was I joked,
Speaker 1: it was like a Harvard Business School case study of
Speaker 1: a Mexican drug cartel, and that was how I got
Speaker 1: into it. So I've always been interested in these issues,
Speaker 1: but maybe particularly these questions about listit and illicit markets
Speaker 1: and the convergences between them. You know that the work
Speaker 1: I did on Mexican drug cartels, I was most interested
Speaker 1: in these cartels as multinational commodities enterprises doing billions of
Speaker 1: dollars in business to cater to a predominantly North American market.
Speaker 1: And then in Washington State, I was interested in the
Speaker 1: idea that you can legalize pot with the stroke of
Speaker 1: a pen. But the reality is that there has been
Speaker 1: an underground, a very vibrant underground pot economy for decades.
Speaker 1: So what happens, you know, what are the implications for
Speaker 1: not just sort of taxes and regulation, but marketing for growers,
Speaker 1: for consumers. And then, in a weird way, I kind
Speaker 1: of I worked my way all the way through to
Speaker 1: the purely listit f d a regulated universe of produe pharma,
Speaker 1: which for reasons I'm sure we'll talk about, you know,
Speaker 1: I think the fact that in this case it's a
Speaker 1: family of billionaire philanthropists who aren't going to go to
Speaker 1: jail does nothing in my mind to diminish the um
Speaker 1: the negative consequences of the kind of business there. M
Speaker 1: I'll tell you this. So I'm gonna be perfectly frank
Speaker 1: with you. In reading your book, right, there's this part
Speaker 1: of me that always is reading through the eye of
Speaker 1: the devil's advocate, and there's a part of me saying,
Speaker 1: you know, what are you missing here? What seems unfair?
Speaker 1: You know, this blaming so much of the opioid crisis
Speaker 1: on one family and one company. You know, I've seen
Speaker 1: that over forty years, have been so often with Colombia
Speaker 1: Mexican drug factors being blamed for cocaine or this or
Speaker 1: that or that or this, and so what I want
Speaker 1: to do really is two things, because on the one hand,
Speaker 1: I think you make an incredibly powerful case that produe
Speaker 1: pharma and the sacklers really deserve a huge measure of
Speaker 1: blame and responsibility for what in fact has happened in
Speaker 1: this country over the last twenty years. On the other hand,
Speaker 1: your book was really interesting me because I know some
Speaker 1: of the characters in your book. I mean some of them.
Speaker 1: I've crossed paths with some of them. I even was
Speaker 1: friendly with or worked with a bit. I've been sympathetic
Speaker 1: to the concerns around opia, phobia and the pain community. Uh.
Speaker 1: You know. On the other hand, you know, I also
Speaker 1: got approached by a law firm a couple of years
Speaker 1: ago that was suing all these pharmaceutical companies, and you know,
Speaker 1: did a day's worth of consulting for them as well.
Speaker 1: And I've had my own experiences with pain and my
Speaker 1: own views about where pain management and other things can
Speaker 1: go wrong. So let me first start off by talking
Speaker 1: about the family. I think you said, you know, there
Speaker 1: are ways in which people say, my god, it sounds
Speaker 1: just like that HBO series Succession, except here you have
Speaker 1: the founding members, you know, the older generation born a
Speaker 1: hundred years ago, Arthur and Raymond and Mortimer, and then
Speaker 1: the successive and the ones they're after. Tell me why
Speaker 1: you decided to focus on the family, Well, for a
Speaker 1: number of reasons. I mean, you know, the first thing
Speaker 1: I would say on the issue of blame, as I
Speaker 1: make pretty clear in the book, you have an opioid
Speaker 1: crisis that's lasted for a quarter of a century, half
Speaker 1: a million people dead. Who knows which statistics you should believe,
Speaker 1: but by some estimates to plus million people now struggling
Speaker 1: with addiction to opioids of one sort or another. You
Speaker 1: don't get there through the actions of one family alone,
Speaker 1: or you know, anyone bad actor or any set of
Speaker 1: bad actors. Right, It's incredibly complex, and I think it
Speaker 1: takes a village. You know, there's all kinds of systemic failure.
Speaker 1: There's all kinds of bad pharmaceutical companies, bad doctors, bad regulators,
Speaker 1: and on and on. I do think that the Sacklers
Speaker 1: in their company play a special role as a kind
Speaker 1: of They were one of the first movers in this situation.
Speaker 1: In which I think that there's a great deal of
Speaker 1: blame to go around. I was interested in the origin
Speaker 1: story of this crisis, in how it started, and I
Speaker 1: think they play a really major role in those early days.
Speaker 1: And the Sacklers, you know, we can talk about this,
Speaker 1: I'm sure we will. The Sacklers say in their defense today,
Speaker 1: listen that the opioid crisis today is a heroin and
Speaker 1: fentanel crisis, and we don't you know, we're not in
Speaker 1: that business. This is illegal drugs being purchased on the street.
Speaker 1: That's not what we did. So don't blame us for
Speaker 1: those deaths. But again, the crisis is interesting, right because it,
Speaker 1: as these things do, it starts small and then it
Speaker 1: morphs and it evolves. As for why I focused on
Speaker 1: the family itself, I found the family fascinating. I think
Speaker 1: families are fascinating generally as a subject. It became important
Speaker 1: to me not to write a book that would be
Speaker 1: a straightforward book about the opioid crisis, in part because
Speaker 1: there are a handful of those books out there, some
Speaker 1: of them quite good. I was more interested in a
Speaker 1: kind of multigenerational family saga. If it were the case
Speaker 1: that that you had different generations doing different things. I
Speaker 1: might be less interested, but you get this continuity where
Speaker 1: the original three Sackler brothers are in the farm of
Speaker 1: business and I think have a kind of outsized impact,
Speaker 1: particularly Arthur Sackler, the oldest brother, on the way in
Speaker 1: which drugs are marketed and sold in this country. Arthur Sackler,
Speaker 1: who I devote the first third of the book too.
Speaker 1: He dies before the introduction of OxyContin, but I think
Speaker 1: there's a lot in his life that we can learn
Speaker 1: from in terms of what I would argue is the
Speaker 1: hijacking of medicine by commerce. I think he was very
Speaker 1: instrumental in creating some of the systems that have done
Speaker 1: that that were then used to great effect with OxyContin
Speaker 1: and many other drugs. Yeah. Well, I mean it's interesting
Speaker 1: as I'm reading it, because you're making a link between
Speaker 1: Arthur Sackler, who's kind of, you know, even though he's
Speaker 1: the eldest sibling of the three brothers, but he's also
Speaker 1: kind of a patriarchal figure with the others. He is
Speaker 1: the guiding genius, the dynamo, the one making the major
Speaker 1: investments often times and bringing his brothers along. He's regarded
Speaker 1: as the godfather of medical advertising. He basically it's just
Speaker 1: almost magically vertically integrated. I mean he's got advertising, he's
Speaker 1: got his medical newspapers, he's got the companies collecting the data,
Speaker 1: then they buy the pharmaceutical companies. He's got all of
Speaker 1: these things while at the same time being this extraordinary philanthropist.
Speaker 1: But as you say, he dies um before and his
Speaker 1: family is not involved with Perdue Pharma when OxyContin comes along.
Speaker 1: The other character you focus on is Richard Sackler, who
Speaker 1: is the head of Perdue Pharma and is thet the
Speaker 1: nephew of Arthur, and who really drives this thing forward.
Speaker 1: And I think with Arthur you described a sort of
Speaker 1: mix of idealism and greed. With Richard, is the balance different.
Speaker 1: Um No, actually no, I don't think so. I think, uh,
Speaker 1: Richard is in some ways a less He's a less
Speaker 1: attractive character because he doesn't have his uncle's charm. Arthur
Speaker 1: Sackler was somebody who was a kind of a polymath.
Speaker 1: He was involved in all kinds of different areas, had
Speaker 1: a great charisma. Richard doesn't have any of that. So,
Speaker 1: just to back up for a second, I mean my
Speaker 1: last book, which is about The Troubles in Northern Ireland
Speaker 1: is just steeped in moral ambiguity, and there's not a
Speaker 1: lot of moral ambiguity in this book. I mean, it's
Speaker 1: pretty clear I think to most people reading the book,
Speaker 1: um where I come down. I think these people did
Speaker 1: some bad things. Having said that, I'm not interested in
Speaker 1: caricaturi ish condemnations of people. I just don't. I don't
Speaker 1: really particularly want to spend my time as a journalist
Speaker 1: doing that. I don't know that as a reader I
Speaker 1: would want to read, you know, some kind of a
Speaker 1: screed about the evil of the Sacklers in which they're
Speaker 1: all kind of tapping their fingertips together and planning their
Speaker 1: global domination. I think greed was a big part of
Speaker 1: the cocktail with Richard, but I think idealism was as well.
Speaker 1: You know, opioids are are complicated and fascinating, and people
Speaker 1: have known for thousands of years that drugs derived from
Speaker 1: the opium poppy have tremendous therapeutic benefit. But they've also
Speaker 1: known that that was twinned with certain dangers, among them addiction.
Speaker 1: And part of what's so interesting to me about the
Speaker 1: story of Boxing Content and Richard Sackler in particular is
Speaker 1: that there's a kind of hubris but also in idealism
Speaker 1: in their idea that they're like, that was the problem
Speaker 1: for thousands of years, but we've hacked it, and we
Speaker 1: figured out how to uncouple the therapeutic upsides from the downsides.
Speaker 1: And as a consequence, these drugs that had historically been
Speaker 1: you know, doctors have been a little bit more cautious
Speaker 1: about prescribing them. They should be prescribed, you know, left
Speaker 1: and right, potentially to tens of millions of Americans. I
Speaker 1: don't think it was just greed that drove that, you know,
Speaker 1: I think it was optimism. And where the story gets
Speaker 1: really interesting for me morally is that what happens when
Speaker 1: the world starts to tell you, you know, that you
Speaker 1: were wrong. And so where I would be as an
Speaker 1: ethical matter most unforgiving of of Richard is is actually
Speaker 1: not in the first instance, where you put the drug
Speaker 1: out there and you make kind of fantastical claims for it.
Speaker 1: But it's more what happens and you start hearing that
Speaker 1: actually people are getting addicted to it in significant numbers,
Speaker 1: and in many cass dying. I mean, OxyContin hits the
Speaker 1: market in a roughly seven or so what was so
Speaker 1: special about it and what was the kind of broad
Speaker 1: strokes about the way this thing emerges for better and
Speaker 1: for worse. So OxyContin was a powerful opioid pain killer.
Speaker 1: It's released in ninety six, and it was pure oxycodone,
Speaker 1: which is a very strong opioid, but with a special
Speaker 1: coating which allowed it to disperse into your blood stream
Speaker 1: slowly over the course of a number of hours. And
Speaker 1: so what this meant is that you could have quite
Speaker 1: big doses of oxycodon. Traditionally you would have seen oxycodone
Speaker 1: and drugs like percadan or percocet, but there it's cut
Speaker 1: with a set of menifa or aspirin, which meant that
Speaker 1: there was a limit to how much you could take.
Speaker 1: And so here you could get big sixty eight milligram
Speaker 1: pills of pure oxycodone with that coating. The drugs released
Speaker 1: in nineties six, and you start to see problems almost
Speaker 1: right away. But you eventually have a situation in which
Speaker 1: more and more people are abusing OxyContin by crushing the pills,
Speaker 1: and you can thereby kind of override that slow release
Speaker 1: mechanism and get the full dose sol at once. But
Speaker 1: people are also in a doctor's care just finding that
Speaker 1: they're becoming addicted to the drugs. So more and more
Speaker 1: people start becoming addicted, abusing the drug, overdosing, eventually dying,
Speaker 1: and slowly this kind of controversy builds around OxyContin and
Speaker 1: Produce Pharma. During this period, the company keeps doubling down.
Speaker 1: They never really hesitate in their big marketing push, and
Speaker 1: eventually there's a federal guilty plea in two thousand and
Speaker 1: seven when the company pleads guilty to miss branding the drug,
Speaker 1: to criminal charges of miss branding the drug, essentially having
Speaker 1: made claims about it's safety that turned out to be fraudulent.
Speaker 1: And it's interesting because that's sort of this interesting moment
Speaker 1: in the story where people look back and they think, Okay, well,
Speaker 1: you know, certainly what the company always said was we
Speaker 1: had a few bad apples prior to two thousand and seven,
Speaker 1: we had the guilty plea, and then we really cleaned
Speaker 1: up our act and beefed up our compliance department and
Speaker 1: got religion. In two thousand and ten, they reformulate the drug,
Speaker 1: making it harder to crush the pills, and you fast
Speaker 1: forward to there's a second guilty plea, So it turns
Speaker 1: out that you know, during that period when they supposedly
Speaker 1: were on the straight and narrow, in fact, they had
Speaker 1: been going right back to the old ways of kind
Speaker 1: of zealously over promoting the drug. And so you had
Speaker 1: a second guilty plead to federal criminal charges in late
Speaker 1: covering a period of time that dated back ten years.
Speaker 1: So really this is a kind of a criminal enterprise,
Speaker 1: this organization. You've got the guilty plea in two thousand
Speaker 1: and seven, another one and in between that reformulation in
Speaker 1: two thousand and ten. Mm hmmm, well, you know, let
Speaker 1: me I'll share with you sort of some of my
Speaker 1: history and coming to this isshoe um. And first of all,
Speaker 1: was you know I had it must have been twenty
Speaker 1: years ago. I actually had dinner with Richard Sackler and
Speaker 1: his attorney, Howard, you know, who ends up having complete
Speaker 1: guilty to something or other. And I was introduced by
Speaker 1: Kathy Foley, who was the head of pain Management and
Speaker 1: slow Cattering. And the reason I knew Kathy was that
Speaker 1: when I started my organization, it was initially part of
Speaker 1: George Soros's foundation back in ninety four, and the other
Speaker 1: project that he helped get started simultaneous with mine. We
Speaker 1: were really the first two US projects of soros Is,
Speaker 1: you know, initial philanthropic Empire was a project on death
Speaker 1: and dying with dignity, and he appointed Kathy to be
Speaker 1: the head of that project while she was still head
Speaker 1: of pain management Sloan Cattering, the leading cancer and you
Speaker 1: know hospital in New York. And so I'm kind of
Speaker 1: educating her about drug policy and we're talking. I'm more
Speaker 1: focused on addiction, the pain issues kind of peripheral, you know.
Speaker 1: And at one point she introduced me to Richard around
Speaker 1: two thousand, two thousand one, and the hopes that maybe
Speaker 1: he would become supporter of my organization once it had
Speaker 1: spun out of Sources Foundation. But what was interesting was
Speaker 1: I had been mostly focused on addiction and the ways
Speaker 1: in which opio phobia, the irrational fear of opioids, sometimes
Speaker 1: got in the way of effective addiction treatment. Right. I
Speaker 1: was aware that, for example, in trying, you know, method
Speaker 1: on maintenance was the gold standard of treating drug addiction,
Speaker 1: National Academy of Science, in Student medicine, World Health Organization,
Speaker 1: you know, you name it, you know, all said this
Speaker 1: is the way to do it. But the barriers, the
Speaker 1: stigmatization against method on, the notion that you were just
Speaker 1: substituting one addictive opioid for another in the black community,
Speaker 1: the notion that this was the chemical bracelet of the
Speaker 1: white overlords on the black community, the notion that method
Speaker 1: on should only be used to get you off of heroin,
Speaker 1: but that it should not be a long term maintenance drug.
Speaker 1: You know, meeting people who would say, hey, don't blame
Speaker 1: me for methan on being my daily medication. Um, I'm
Speaker 1: no more a method on addict than diabetic is an
Speaker 1: insulin addict. This is my daily medication. I don't get high,
Speaker 1: and I'm probably gonna take it for the rest of
Speaker 1: my life. So when I come into this pain field,
Speaker 1: which I never fully do, but on the edges of it,
Speaker 1: I'm very conscious of the ways in which, you know,
Speaker 1: opioids can be highly dependent, causing and addictive, but that
Speaker 1: they have a very important role to play. And now
Speaker 1: we even see, you know, now there's this huge push
Speaker 1: to get all the people addicted to drugs onto method
Speaker 1: on abourd Breneurphane. So when I look at the pain field,
Speaker 1: I see, on the one hand, the sense in which
Speaker 1: there's a really legitimate concern that Perdue Pharma and that
Speaker 1: Richard Sackler are tapping into. But what I find so
Speaker 1: persuasive about your book is the incredibly over marketing, aggressive marketing, duplicity, dishonesty,
Speaker 1: line manipulation of regulators, and all this sort of stuff
Speaker 1: which led them to promote an incredibly valuable breakthrough medication,
Speaker 1: oxy content right, which which huge numbers of pain patients
Speaker 1: were feeling. You know, this was the greatest thing that
Speaker 1: ever happened to them. But the company and the Sackler's
Speaker 1: promoted in a way which is grossly disproportionate to its
Speaker 1: appropriate need in the community. So anyway, your reactions to
Speaker 1: my whole riff there, Um, it's hard, right because the
Speaker 1: you know, you use the phrase the phobia, the irrational uh,
Speaker 1: you know, irrational fear, fear of opioids. It's you know,
Speaker 1: with half a million people dead, it's hard for me
Speaker 1: to say it. It's entirely irrational, right. I think that
Speaker 1: these are powerful medications which I think have important therapyic uses.
Speaker 1: I'm not, by any stretch of the imagination of prohibitionists
Speaker 1: really when it comes to any drugs. You know, there
Speaker 1: are some people, including some doctors who think we really
Speaker 1: shouldn't use strong opioids at all for chronic pain and
Speaker 1: what have you. And that's not to me, like, I
Speaker 1: don't even need to get there in this book, because
Speaker 1: those are debates that people are having, and and for me,
Speaker 1: it's a question of marketing, fraudulent marketing, excessive marketing, and
Speaker 1: careless over prescribing. And I don't think at this point
Speaker 1: you would find anyone, including frankly, people like Patty Foley,
Speaker 1: who would dispute the notion that part of the reason
Speaker 1: we got here was because of over prescribing. The Sacklers
Speaker 1: still maintained that at coontin is not iatrogenically, it's just
Speaker 1: it's just not addictive or you know, addictive only one
Speaker 1: percent of the time. I think most people have retired
Speaker 1: that as a conjecture, that particular statistic for me, the
Speaker 1: you know, there's a whole bunch of pieces to this,
Speaker 1: but part of it is that if you have a
Speaker 1: therapy that is powerful, that has tremendous therapeutic upsides but
Speaker 1: also potential downsides, it should be prescribed carefully and marketed carefully,
Speaker 1: and that a situation in which you have an army
Speaker 1: of sales reps going out with a bunch of literature
Speaker 1: that in retrospect turns out to be dodgy, telling physicians
Speaker 1: ends who are not paying specialists that there are no
Speaker 1: side effects to this drug. You know, that's a dangerous situation.
Speaker 1: And I've interviewed plenty of docs who were on the
Speaker 1: receiving end of this, and I think there's a whole
Speaker 1: bunch of problems here, right one of the doctors should
Speaker 1: ideally not be receiving their education in an in a
Speaker 1: new course of therapy purely from the pharmaceutical company that
Speaker 1: is selling the course of therapy. You know, if you're
Speaker 1: a doctor, probably should do a little more due diligence
Speaker 1: than that. The pharma companies and you know, pretty as
Speaker 1: hardly alone here, I think, had a very strong incentive
Speaker 1: to educate physicians about how to get people on these drugs.
Speaker 1: And what I've heard again and again and again, as
Speaker 1: I'm sure you have, is that there was a kind
Speaker 1: of education and how to get people on these drugs,
Speaker 1: but no education and how or when to get them off.
Speaker 1: You know, maybe people should be on them for years,
Speaker 1: maybe they shouldn't, do you taper, how do you go
Speaker 1: about that? And well, the story you hear again and
Speaker 1: again in this case, I've heard it from families and
Speaker 1: people who've who have experienced this firsthand is that you know,
Speaker 1: you go when you get a procedure done and the
Speaker 1: doc writes you a prescription for whatever thirty days of
Speaker 1: an opioid, and you find that your use of it
Speaker 1: is becoming problematic. You start getting nervous because you know
Speaker 1: either it's wearing off and you want to take the
Speaker 1: bills more frequently, or you're finding that you're experiencing withdrawal.
Speaker 1: You go back to the emergency medicine doc who prescribed
Speaker 1: it to you, and the doctor says, well, whoa, whoa,
Speaker 1: I'm not an addiction specialist. My job is to get
Speaker 1: you on here, not to get you off. And I
Speaker 1: think a lot of people end up in a kind
Speaker 1: of perilous situation in which the nature of medicine as
Speaker 1: it is practiced in the United States is such that
Speaker 1: if you offer up a solution that seems like a quick,
Speaker 1: reliable solution with minimal downsides, that will get somebody off
Speaker 1: your schedule so you can then see the next patient.
Speaker 1: A lot of doctors, I think we're very ready to
Speaker 1: do that, and you end up with a huge community
Speaker 1: of people who are kind of orphaned by the system
Speaker 1: because you know, the drugs are having side effects for them,
Speaker 1: and they don't there's no infrastructure for how to help
Speaker 1: them with that, how to help them figure that out.
Speaker 1: There's a whole other thing which we can talk about,
Speaker 1: which is, you know, the big community of pain patients
Speaker 1: now who feel as though the pendulum has swung too
Speaker 1: far in the other direction, that opiophobia is back, that
Speaker 1: their physicians don't want to continue prescribing these medicines that
Speaker 1: they feel they rely on in order to live their lives.
Speaker 1: I get a lot of notes from these people, almost
Speaker 1: invariably they haven't read my book. I mean, there's a
Speaker 1: great deal of nuance in the book, and if you're
Speaker 1: reading it carefully, I think it'd be difficult to to
Speaker 1: say otherwise. But from a distance, it's look, you're bashing
Speaker 1: the sacklers. They sold a life saving medicine. You know,
Speaker 1: you're you're contributing to the stigma. And of course, I
Speaker 1: think if you look closely, part of the reason that
Speaker 1: a lot of these people are stigmatized is precisely because
Speaker 1: of the kind of behavior that you saw it at Purdue,
Speaker 1: you know, I mean, you're right, it is a complex story.
Speaker 1: You don't. On the one hand, right, you know, the
Speaker 1: people who specialize in pain management, they knew that opioids
Speaker 1: were it could be dependent causing, right that if you do,
Speaker 1: if people are on it for any length of time,
Speaker 1: they have to go through some withdrawal if they're going
Speaker 1: to get off of it. That's just sort of part
Speaker 1: of the course, right, And the people are experts in
Speaker 1: this stuff knew that you have to manage that. You
Speaker 1: manage getting on, you manage getting off. And in a way,
Speaker 1: you know, they were frustrated because they are They're seeing
Speaker 1: other doctors and patients and nurses who saying I don't
Speaker 1: want to take opioids, people who are terminally ill on
Speaker 1: their death beds, that I don't want to die an addict.
Speaker 1: You know, evidence that people are dying prematurely because they
Speaker 1: have this you know, you know, fear of morphine or
Speaker 1: this fear of being addicted. They're not making a distinction
Speaker 1: between what it means to be dependent on drugs and
Speaker 1: being addicted to them. But then what you describe is
Speaker 1: basically perdue pharma. It's not just trying to address the
Speaker 1: issue that they were dealing with the pain docs. What
Speaker 1: you describe is them deliberately going not after the pain
Speaker 1: management docs, but going after gps who I know they're
Speaker 1: asked from their elbow about this stuff. What you describe
Speaker 1: is them targeting the biggest prescribers, not people who are
Speaker 1: specialized pain management experts, but people are just shipping the
Speaker 1: stuff out right. What you describe is them lying to
Speaker 1: people about the potential addictiveness of these substances. I mean,
Speaker 1: I think that's where you nail these guys about just
Speaker 1: playing a grossly irresponsible role. That whereas on the one hand,
Speaker 1: and providing a kind of miracle medication for people who
Speaker 1: really do benefit from a long acting pain medication like
Speaker 1: oxy content, they are so grossly over promoting it to
Speaker 1: people who shouldn't be on it that that's where a
Speaker 1: big chunk of this blame wise. Yeah, no question. Look,
Speaker 1: this is a company that has pled guilty to felony
Speaker 1: charges twice uh in two thousand and seven, and and
Speaker 1: I would argue, um, and I think I make the case.
Speaker 1: I opened a pretty compelling way in the book that
Speaker 1: in both instances they actually got off They got off
Speaker 1: pretty easy, particularly compared to the kinds of penalties that
Speaker 1: we visit in this country on poor people of color
Speaker 1: who are involved in the retail drug business on the street.
Speaker 1: I'll put it to this way, when you talk about
Speaker 1: marketing to the wrong docs. You know, I wanted this
Speaker 1: book to be a compelling read for non specialists. I
Speaker 1: you know, I hope it holds water with specialists as well. Um.
Speaker 1: You know, I think there's there's some rigor to it,
Speaker 1: but you make choices right, And I had to remind myself,
Speaker 1: you know, you're not writing an indictment here where you
Speaker 1: want to take every single piece of evidence and put
Speaker 1: it in. What this meant is that I had to
Speaker 1: pick my examples and I had to be pretty judicious
Speaker 1: about it. If you just take a fact pattern, Okay,
Speaker 1: So the fact pattern is there is a clinic, a
Speaker 1: pain clinic that is obviously a pill mill. You have
Speaker 1: a super unethical doctor who is just fire hosing pills
Speaker 1: at the local community. And you know, eventually, in the
Speaker 1: fullness of time, this doctor will lose their license and
Speaker 1: end up going to jail. But before that happens, there
Speaker 1: is a period of time where Perdue is aware of
Speaker 1: what's happening because they have this early warning system, which
Speaker 1: is their own raps who go out and call them
Speaker 1: these doctors and write reports and they come back and
Speaker 1: they tell them about it. You know, it was a
Speaker 1: real struggle for me to think, Okay, I can only
Speaker 1: tell so many of those stories. There were so many
Speaker 1: to pick. It was like a vast buffet of that
Speaker 1: fact pattern where I'm thinking, geez, do I do the
Speaker 1: one of Massachusetts? What about the one in California? Or oh,
Speaker 1: but there's this interesting one over here. It happened again
Speaker 1: and again and again and again and again. So I'll
Speaker 1: tell you what. To me was one of the most
Speaker 1: astonishing data points that I discovered, And it's it's like
Speaker 1: just in the weeds enough that I think most people
Speaker 1: don't necessarily appreciate how crazy it is, how wild it is,
Speaker 1: but you will. So in two and ten, produce reformulates
Speaker 1: oxycontum The whole notion with OxyContin is that you had
Speaker 1: this seal which slowly regulates the dispersal of the drug
Speaker 1: into your bloodstream in theory over the course of twelve hours.
Speaker 1: So there's a lot of evidence that actually doesn't last
Speaker 1: that long for a lot of patients people quickly figured
Speaker 1: out that if you break the seal by chewing it
Speaker 1: or crushing it, you can override that slow release mechanism,
Speaker 1: and then you can smort the pill. Even if you
Speaker 1: just swallow it, or if you shoot it up, you know,
Speaker 1: you get an immediate huge dose of oxy coda. So
Speaker 1: in two thousand and ten, the company reformulates the drug.
Speaker 1: There's pretty good evidence, which I lay out in the book,
Speaker 1: that the timing here is significant because the patent was
Speaker 1: about to run out on the original version, um and
Speaker 1: so they're gonna make this reformulated version. But this is
Speaker 1: the interesting statistic. Two thousands intend they roll out this
Speaker 1: new pill, overnight, nationwide sales of eighty milligram oxy content
Speaker 1: pills drop. So you have to think about this, Right,
Speaker 1: on the one hand, good for Purdue reformulating the pills
Speaker 1: people were abusing those the original version. On the other hand,
Speaker 1: how could that not be sobering to realize that of
Speaker 1: their market for their biggest dose of this drug was
Speaker 1: basically coming from the black market, right. It was people
Speaker 1: who were abusing the drug. It's non medical prescriptions, it's
Speaker 1: pill mills. And this is where it gets really interesting
Speaker 1: me is that you have all these pill mills. The
Speaker 1: company knows that they're pill mills. They actually kept a
Speaker 1: list internally of these bad docstion. What they said is
Speaker 1: that they said, oor, our sales reps wouldn't call on them.
Speaker 1: That's what we would do, is we tell our sales
Speaker 1: report don't call on those on those pill mills. Of course,
Speaker 1: I interviewed sales reps who are like you didn't have
Speaker 1: to call on like they were pretty reliable prescribers. You
Speaker 1: didn't need to go and visit them in order to
Speaker 1: make that happen. What they don't do is report those
Speaker 1: pill mills to the authorities. And and the reason is
Speaker 1: pretty obvious, right if of your profits on your most
Speaker 1: profitable pill are coming from the black market, you have
Speaker 1: a pretty strong incentive not to shut these operations down.
Speaker 1: And so I think that's part of the reason that
Speaker 1: you see the black market persists the way it does
Speaker 1: is with again the mingling of the listit and illicit Yeah.
Speaker 1: I mean, Patrick, I'm almost thinking, you know, you think
Speaker 1: about that article you did in New York or where
Speaker 1: you and I talked some years ago about how Washington
Speaker 1: Stay was transitioning from an illicit market to a legal market.
Speaker 1: And here part of your story is about the transition
Speaker 1: from a legal market into an illegal market. Absolutely right there,
Speaker 1: it's Perdue Farma changing the nature of oxy content so
Speaker 1: that you can't crush it and snort it or inject
Speaker 1: it anymore. It becomes a little gummy bear that you
Speaker 1: can't do much with, or whether it's just doctors now
Speaker 1: beginning to realize you're being pressured to prescribe less, which
Speaker 1: you see is a shift happening. And so one of
Speaker 1: the interesting things about that moment is that Perdue all
Speaker 1: of a sudden, as you say, loses twenty percent of
Speaker 1: its sales because that's the of the market that was
Speaker 1: looking to crush it and use it entirely illegally. Yet
Speaker 1: at the same time that also results in a growth,
Speaker 1: if not an explosion of the market first and heroin
Speaker 1: and then ultimately fentanyl, and it actually leads to an
Speaker 1: increase in the number of over those fatalities right after
Speaker 1: this happens. And so from a policy perspective, it's almost like, Dan,
Speaker 1: if you do, Dan, if you don't, I mean, I
Speaker 1: was reading your thing there. I'm going God with the
Speaker 1: world have been better off if Perdue FARMA had never
Speaker 1: gotten permission to do this non crushable version. I mean,
Speaker 1: I don't look, I don't know. It's hard to say.
Speaker 1: The The counter factual that I'm more I'm more comfortable
Speaker 1: with is had they reformulated earlier. I do think it
Speaker 1: would have made a much bigger difference, you know. In
Speaker 1: fairness to them, they say, it just takes a long
Speaker 1: time to develop these drugs. It also took several years
Speaker 1: for them to get approval from the f d A.
Speaker 1: So you know, I mean the time, the timing with
Speaker 1: the patent does seem worth ruminating. Well, I mean I
Speaker 1: have to say, you know, oftentimes you say on these
Speaker 1: investigations like interms, you follow the money, follow the money,
Speaker 1: follow the money. It's always with the cops and investigators
Speaker 1: always say, and for you, the subtext to follow the
Speaker 1: money has followed the paddic right. I mean you talk
Speaker 1: about they start off with MS content and then they
Speaker 1: go to oxycontent and then reformulated oxycontent. I mean, just
Speaker 1: explain a little bit about the timing of that and
Speaker 1: how that looks from your perspective. Yeah, just that. I mean,
Speaker 1: I I think that this will sound probably a bit naive,
Speaker 1: but to me. There was this interesting thing where any
Speaker 1: time there was a mystery about timing, you know, why
Speaker 1: did it take so long for them to reformulate, or
Speaker 1: why did this happen at that time? Or there was
Speaker 1: this kind of st range thing that I talked about
Speaker 1: at the end of the book where the company wanted
Speaker 1: to get a pediatric indication for OxyContin, but then they said,
Speaker 1: but we don't actually want to sell it. We're just
Speaker 1: doing because the FDA forced us too. But then it
Speaker 1: turns out the FDA didn't really force them to. It
Speaker 1: was more that they were incentivized too, because if they
Speaker 1: got the pediatric indication they would get six months of
Speaker 1: extra patent exclusivity, which at the time, you know, it
Speaker 1: was a billion dollars. So it was just one of
Speaker 1: those interesting things where often if I had a question,
Speaker 1: the more I dug, the more documents I got, it
Speaker 1: was very often the case that the answer was, oh,
Speaker 1: it has to do with the patent. At a company
Speaker 1: like Perdue, where they really only ever had one huge
Speaker 1: blockbuster product, and the whole history of the company, nothing
Speaker 1: ever came close to OxyContin, I interviewed many, many people
Speaker 1: who worked at the company who said that the whole
Speaker 1: business model was protect the patent, extend the patent. I
Speaker 1: had somebody who worked to the company, a senior person
Speaker 1: who worked to the company, who said to me, at
Speaker 1: times it almost felt like it wasn't a farm a
Speaker 1: company at all. It was a small, elite patent law firm,
Speaker 1: like an intial actual property law firm that happened to
Speaker 1: have a little marketing wing on the side. So, um,
Speaker 1: when you talk about the counter factual and you wonder
Speaker 1: what if I think the thing for me is there
Speaker 1: were these really crucial moments early on where the company
Speaker 1: was lying about the drug. They were lying about what
Speaker 1: they knew and when they knew it. And I think
Speaker 1: if there had been a real reckoning in two thousand
Speaker 1: and one, two to two thousand three, if you'd seen
Speaker 1: an earlier reformulation, the population of people who had, you know,
Speaker 1: taken that on ramp to opioids was just smaller at
Speaker 1: that point, and so it could have been that the
Speaker 1: reformulation would have made more of a difference. But by
Speaker 1: the time you get to two thousand and ten, you
Speaker 1: just have a huge population of folks who are struggling
Speaker 1: with these drugs and using them in a in a
Speaker 1: non medical way, and at that point, if you if
Speaker 1: you cut those people off from a source of supply
Speaker 1: that they've counted on, and it's honestly, it's the same thing.
Speaker 1: So you can think about the re formulation. But it
Speaker 1: was also true that by two thousand and ten, a
Speaker 1: lot of the pill mills are getting shut down, a
Speaker 1: lot of docs are getting more careful about prescribing and
Speaker 1: not too I think, push people into the block market.
Speaker 1: We'll be talking more after we hear this ad. There
Speaker 1: are two broader context to what's going on here, and
Speaker 1: there's one which I think you probably could have given
Speaker 1: more attention to, and the other one which I think
Speaker 1: you lay out in spectacular and telling detail. And on
Speaker 1: the first one, you know, there's a context back in
Speaker 1: the nineties that basically, whether we're talking about addiction treatment
Speaker 1: or pain management, both those issues are essentially not being
Speaker 1: taught in medical schools, and most physicians know remarkably little
Speaker 1: about that, much less how to manage opioids, whether putting
Speaker 1: people on or putting people off to those things. What's
Speaker 1: also happening is that the vast majority of what are
Speaker 1: called overdoses are in fact fatal drug combinations. In fact,
Speaker 1: very few people die simply from taking too much heroin
Speaker 1: or too much oxy content. The almost all of those
Speaker 1: overdoses involved people combining it with valley and with benzodiazepines
Speaker 1: with alcohol. And it's only when fentinyl comes along, which
Speaker 1: is fifty times more potent than heroin or oxy or whatever,
Speaker 1: that you see people dropping dead simply from using it.
Speaker 1: One opioid all by itself. Um, the lock zone the
Speaker 1: antidote for an overdose. I mean, my organization started working
Speaker 1: on trying to get that more out there really beginning
Speaker 1: in two thousand, but it's not until about two thousand
Speaker 1: ten or eleven or even the White House, the Drugs
Speaker 1: Ares Office says, oh, we better start getting behind the
Speaker 1: lock zone. So there's this massive misinformation miseducation under education
Speaker 1: that's going out in the community, which provides a context
Speaker 1: and where when you have a company over promoting this
Speaker 1: drug and over marketing and all the insidious ways that
Speaker 1: they did is just going into a says, right to
Speaker 1: magnify this. On the other hand, what you do a
Speaker 1: magnificent job within the book is describing the revolving door
Speaker 1: of government and industry right the swamp the people who
Speaker 1: go to work from f d A or d e
Speaker 1: A or Justice Department. All the next thing you know,
Speaker 1: they're working for Purdue Farma. The members of Congress, the
Speaker 1: the ways in which Purdue farm is able to get
Speaker 1: what it wants by paying and legally bribing people, maybe
Speaker 1: even illegally, we don't know, but I mean, you know
Speaker 1: this sort of really insidious way. And in a culture
Speaker 1: where white collar criminality almost never results in incarceration. So
Speaker 1: the black and brown people are going to prison, you know,
Speaker 1: by the millions, for selling drugs no more dangerous than
Speaker 1: these on the black market, but the white collar folks
Speaker 1: are basically walking away scott free. I don't know if
Speaker 1: you want to just tell some of the most things
Speaker 1: that both shocked you when you were looking at that
Speaker 1: side of things. Oh, I mean, let me say one
Speaker 1: thing about mixing first and fentinyl. You know the general now,
Speaker 1: who knows what's in it? I mean, in fact, you
Speaker 1: buy heroin on the street, who knows what's end? And
Speaker 1: maybe cut with fanel you don't even know it. And
Speaker 1: you talk to drug users. People are aware, they're aware
Speaker 1: of the risks, but they also a lot of the
Speaker 1: time just end up in a situation in which they
Speaker 1: don't have a safer, reliable source of supply, but they
Speaker 1: needed when they started, they were taking a pill and
Speaker 1: you know, not necessarily could have been aficon, could have
Speaker 1: been you know, any number of things, right, but something
Speaker 1: that felt like it had the impermater of the f
Speaker 1: d A. It felt like a kind of a creature
Speaker 1: of a regulated system. It's funny because this is a
Speaker 1: you know, this was one of the things I was
Speaker 1: interested in the in the pot story with Washington State too, right,
Speaker 1: is these questions of like, to what extent does regulation
Speaker 1: mean quality control, you know, in the government kind of
Speaker 1: getting in and evaluating the product in a way that
Speaker 1: you would normally associate with kind of an FDA regulated industry.
Speaker 1: I just it's interesting to me that you I think
Speaker 1: you end up with a lot of people who had
Speaker 1: a certain level of inhibition when they started, and the
Speaker 1: on ramp was a pharmaceutical product which they could kind
Speaker 1: of live with as an experiment because it seemed safe.
Speaker 1: And I think in many instances, these are people who
Speaker 1: wouldn't be mixing on the front end, who wouldn't be
Speaker 1: just you know, taking what they could buy from the
Speaker 1: guy who's the connection that you have in the moment,
Speaker 1: but you get into the grip of these things and
Speaker 1: your judgment can falter, right. I mean, like from the outside,
Speaker 1: as somebody who who is not addicted or dependent, it's
Speaker 1: sometimes hard for me to understand, given what we know
Speaker 1: about fentinel, specifically the risks that some people take. But
Speaker 1: I think the thing to remember is that they you know,
Speaker 1: generally speaking, and that's not the first thing people take.
Speaker 1: It takes a while to get there on the on
Speaker 1: the revolving door. Man, I don't know where to start.
Speaker 1: I mean, I you know, everywhere I looked um and
Speaker 1: again it's not just perdue, but there is so much
Speaker 1: money here. You know, oxycontinent has generated thirty five billion
Speaker 1: dollars in revenue. Since When you have that much money,
Speaker 1: I just think that it affects everything, and that the
Speaker 1: corruption very seldom looks like the kind of standard corruption
Speaker 1: that we think about when we talk about corruption and
Speaker 1: the kind of corruption that gets prosecuted. You know, there's
Speaker 1: a story I tell in the book about Curtis Wright,
Speaker 1: who was the medical examiner at the FDA in charge
Speaker 1: of approving oxycontent but also approving the specific marketing language
Speaker 1: that could be used in the package insert peroxycontent. It
Speaker 1: proves the drug in record time. He signs off on
Speaker 1: this crazy marketing claim that nobody will own it. Now,
Speaker 1: you know, there's this line that goes in the original
Speaker 1: package insert that says that the time release coding is
Speaker 1: believed to reduce the abuse liability of the drug. That is,
Speaker 1: like Visa the other opioids that were on the market
Speaker 1: at that time, priceless marketing claim, no basis in I
Speaker 1: mean is believed. Like what does that even mean? Who
Speaker 1: believes it? Nobody has been able to figure out how
Speaker 1: did that line in and they're just the very idea
Speaker 1: that a line like that makes it into the package insert.
Speaker 1: Twenty five years later, nobody can say who wrote it
Speaker 1: and how it got in there and how it got approved.
Speaker 1: So Curtis right leaves the FDA and a year later
Speaker 1: goes to work at Purdue Farma for three times as
Speaker 1: government salary, and that I continually find shocking. The stacklers
Speaker 1: often defend themselves by saying, you know, we the FDA
Speaker 1: signed off on the stuff we were doing. And I'm like, well,
Speaker 1: if you if you hire the guy right after he leaves, yeah,
Speaker 1: I mean, Patrick, you know, I was watching Last couple
Speaker 1: of Nights, this documentary by Alex Gidney in which you
Speaker 1: feature prominently the crime of the Century, and he describes
Speaker 1: it even more atrocious episode involving the Chief Council of
Speaker 1: d E a working for the Office of Diversion Control,
Speaker 1: who goes to work for the pharmacial companies. And then
Speaker 1: you describe people in the Justice Department and U. S.
Speaker 1: Attorney has been prossing these cases and flip to the
Speaker 1: other side, right, I mean, the revolving door is just
Speaker 1: and and you're talking also, I mean you're a wide
Speaker 1: range of personalities who go to work for Produe Farm
Speaker 1: because on the one hand is one of America's greatest scumbags,
Speaker 1: Rudy Giuliani, but at a point in his life when
Speaker 1: he's actually fairly credible, after he's just become a America's mayor.
Speaker 1: On the other hand, you have Mary Joe White, who
Speaker 1: was the very distinguished former U. S. Attorney in New York,
Speaker 1: the former head of the Securities Exchange Commission. You know,
Speaker 1: everybody answers her phone call and she's out there as
Speaker 1: you know, mis credibility on this sort of thing. But
Speaker 1: you know, there's also an element where you're describing as
Speaker 1: a sort of systemic stink pot of kind of the
Speaker 1: facto corruption, buddyism, chrony capitalism, all this sort of stuff.
Speaker 1: And then there's the quirkiness of personalities. I was wondering
Speaker 1: about the specific personality of Richard Sackler, right, I mean,
Speaker 1: he is the driving force. You point out that he
Speaker 1: kind of learns these lessons from his uncle Arthur in
Speaker 1: terms of marketing, but you also described this thing about
Speaker 1: his you know, best friend in his freshman year of
Speaker 1: college who describes him as sort of lacking in empathy, right,
Speaker 1: And even when you see the things that you know,
Speaker 1: you have these emails where he's saying these absolutely atrocious
Speaker 1: things about people who are addicted to drugs. You know,
Speaker 1: you see the videotape of this testament and there's something
Speaker 1: just off about it. And now obviously he was a
Speaker 1: family enterprise, but he is the driver. And I wonder
Speaker 1: how much you had that feeling like what a different
Speaker 1: human being, maybe done some things differently at the start
Speaker 1: or maybe not, you know, circle the wagons in the
Speaker 1: same way. I mean, what do you think about that? So? Yeah,
Speaker 1: I mean a few things to go back to, what
Speaker 1: I said earlier about how I have no interest in
Speaker 1: caricatures at the human complication and the individual human complication
Speaker 1: and the way it plays out inside a family. All
Speaker 1: of that to me was rich and interesting and worth capturing.
Speaker 1: And I do think that personality drives events a lot
Speaker 1: of the time in history, and and so it's important
Speaker 1: to understand that. I'm also glad you mentioned the college roommate,
Speaker 1: because if you remember, the college roommate didn't just say
Speaker 1: that he lacked empathy. He also said that Richard had
Speaker 1: an infectious enthusiasm. When he had an idea, he would
Speaker 1: just plunge headlong after that idea, and he could lead
Speaker 1: others along in pursuit of that idea. And to me,
Speaker 1: that's part of what explained Bines how all this happened,
Speaker 1: as well, that in his own weird way, he was
Speaker 1: a leader, you know, he had a vision for what
Speaker 1: this drug could be, and he didn't really want to
Speaker 1: let it go. I think that in some ways, if
Speaker 1: if Purdue Farmer had been a public company, the story
Speaker 1: would have played out much differently. I think you could
Speaker 1: very well have gotten up to two thousand and seven
Speaker 1: with the guilty plea in two thousand and seven. But
Speaker 1: I think things would have changed after two thousand and
Speaker 1: seven and a public company. I think all of the
Speaker 1: folks who were associated with the bad stuff that happened
Speaker 1: in the past would have been purged, and instead they
Speaker 1: were kept on. And you know, there was this weird
Speaker 1: I interviewed multiple people who said, who came into the
Speaker 1: company after two thousand and seven, he said, was this
Speaker 1: weird thing We're on the one hand, they're saying, oh,
Speaker 1: there was this guilty plea and now we do things differently.
Speaker 1: And on the other hand, there's this ongoing veneration for
Speaker 1: all the people who did all the stuff that got
Speaker 1: us to the guilty plea. And so there were just
Speaker 1: mixed messages about the culture. And I think this is
Speaker 1: a family business, and it was a business kind of
Speaker 1: created in the image of the family. The one thing
Speaker 1: I would say is I wouldn't put too much of
Speaker 1: it on Richard because there's a bunch of family means
Speaker 1: who were involved from multiple generations. And as a reporter,
Speaker 1: when I started work on this book, I had this
Speaker 1: operating theory, which is I thought I kind of did
Speaker 1: the family tree. I looked at all the different people
Speaker 1: and I said, there's got to be some apostate. There's
Speaker 1: got to be some Sackler who grew up with it.
Speaker 1: They grew up with the money. But they actually think
Speaker 1: that there's something kind of rotten happening. They understand why
Speaker 1: every state in the country is suing the family business
Speaker 1: and half the states are suing the family members themselves.
Speaker 1: And I couldn't find one. And it's remarkable the unanimity
Speaker 1: with which members of the family, who don't agree on
Speaker 1: anything else like this is a worrying family. Often when
Speaker 1: it comes to the utter blamelessness of the Sacklers, they're
Speaker 1: pretty much in agreement. And you see these incredible there's
Speaker 1: a there's a document that I draw in the book
Speaker 1: this amazing um what's app blog that I got access to,
Speaker 1: which is like a family what's app of a sort
Speaker 1: that you know, anybody might have with their family. And
Speaker 1: you have a whole bunch of different descendants of Mortimer
Speaker 1: Sackler texting each other on this what'sapp log In part
Speaker 1: it looks like because they think that that will be
Speaker 1: harder to get a discovery. Of course they were wrong
Speaker 1: about that, which is how I got access to it.
Speaker 1: But um, there's over a year of these texts back
Speaker 1: and forth, and nowhere does any single member say, in
Speaker 1: this private zone of this family, what's up? Hey, jeez?
Speaker 1: Maybe the critics have a point, or not even not
Speaker 1: even something that far, but maybe we should think about
Speaker 1: our own conduct. Is there something we missed? Those types
Speaker 1: of questions that that I'm sure you and I and
Speaker 1: probably others listening, just because you're a normal human being,
Speaker 1: like you think about your own actions and the decisions
Speaker 1: you wonder if you did the right thing. I think
Speaker 1: this is a family that seems largely impervious to that particular.
Speaker 1: You make a very persuasive case about that, But let
Speaker 1: me just press you a bit, right, because it seems
Speaker 1: to me there's almost like these concentric circles right of
Speaker 1: maybe guilty responsibility and that on the one hand, Richard
Speaker 1: is a driving figure. He's basically the CEO, and he's
Speaker 1: got his brother, and he's got two cousins, and there's
Speaker 1: some nephews, and there's a bunch of others in involved
Speaker 1: and there and there are sort of a second circle
Speaker 1: who are bear a large share of the responsibility. They're
Speaker 1: involved in managing and micromanaging the company as well Richard's
Speaker 1: very much the driver. Then you get to the third circle,
Speaker 1: which is sort of the third generation, the younger one,
Speaker 1: and you portrayed one of the characters, a young woman
Speaker 1: who makes I think an award winning documentary about the
Speaker 1: need for criminal justice reform, and the question about well
Speaker 1: should she be held more responsible? And you know, I'm
Speaker 1: thinking about like you think about the families, the Fords,
Speaker 1: the Rockefellers, the big Empires, and eventually the grandchildren's generation
Speaker 1: after the founders dead. You know, they may speak out
Speaker 1: or condemn what their ancestors did, But here you're still
Speaker 1: talking about a family that at least the two branches,
Speaker 1: the Raymond and Mortimer who are involved with Produe Pharma,
Speaker 1: where you know, I wonder why you or I would
Speaker 1: have done in that similar situation, right, I mean, here
Speaker 1: you are still going to your family Christmas or Saders
Speaker 1: or whatever, and this sort of thing. You know, if
Speaker 1: they have nothing to do with the family except having
Speaker 1: benefited from the money and they're out there trying to
Speaker 1: do good in the world, do they have an obligation
Speaker 1: to speak out? And then there's the kind of four circle, right,
Speaker 1: And this is actually about somebody I know Elizabeth Sackler right.
Speaker 1: And Elizabeth Sackler. I've only met her a few times,
Speaker 1: but initially it's about twenty years ago. I was doing
Speaker 1: some fundraising for Drug Policy Alliance. I was in the
Speaker 1: early stages of fundraising, and I was at some group
Speaker 1: of liberal you know, wealthy, wealthy liberals, and in that moment,
Speaker 1: you know, there's a challenge grant and Liz goes, oh,
Speaker 1: I'll give twenty five grants, right, So that was great.
Speaker 1: She makes this contribution and we have dinner thereafter, and
Speaker 1: I try to bring her in in a bigger way
Speaker 1: with Drug Policy Alliance, and I'm not all that successful
Speaker 1: at it, although about ten years ago I get her
Speaker 1: to co chair a fundraising event. We do an art auction,
Speaker 1: and she's at that point chairing the Brooklyn Museum and
Speaker 1: she's bringing in feminist artists and all this sort of stuff,
Speaker 1: and she's pretty alienated from the other wing of the
Speaker 1: family that owns Produe Pharma and they have no for
Speaker 1: profit interests in it. She's the daughter of Arthur, who's
Speaker 1: the kind of godfather of the whole thing, but had
Speaker 1: no direct involvement in Produe Farm and all this sort
Speaker 1: of stuff, and she is actually openly condemning Perdue Farma
Speaker 1: and what they did. I mean, she's putting out the
Speaker 1: statements one oh no, I mean you look, if you
Speaker 1: look her up, she says, he's very hostile statements about it.
Speaker 1: Those statements started just after my New Yorker piece came out.
Speaker 1: But that's when the Sackler family becomes I mean, that's
Speaker 1: you can understand somebody wanted to keep a little profile,
Speaker 1: but nothing in the peace from Elizabeth expressing even a
Speaker 1: whisper of disapproval. And and and if you and you
Speaker 1: should and I won't say what you know, I would
Speaker 1: never divulge too much. But you have to ask whether
Speaker 1: that's because I didn't bother trying to see if she
Speaker 1: had an opinion on it. Well, look, I can also
Speaker 1: imagine that you still at this point you say, it's
Speaker 1: really your article and another one in Esquat, we're gonna
Speaker 1: come out that time that exposed them in that way.
Speaker 1: You can see people wanting to lie low. But when
Speaker 1: she does come out with a pretty strong statement condemning
Speaker 1: UM and then Nan Golden, the artist who is inspired
Speaker 1: by your article to really go after the Sackler is
Speaker 1: an organized public. You know, demonstrations at the museums against them,
Speaker 1: and she looks at with Elizabeth Sacklers when she goes,
Speaker 1: you know, what the hell were there? The whole family's evil,
Speaker 1: And I wonder, like, what do you think, I mean,
Speaker 1: would you agree with my analysis of the sort of
Speaker 1: concentric circles of responsibility. Yeah, the concentered circles is perfect
Speaker 1: because I would say, you know, circle number one would
Speaker 1: be Richard and arguably a few of the other board
Speaker 1: members who are very intimately involved. Then there's kind of
Speaker 1: board members who were on the board but maybe less
Speaker 1: immediately involved, are people like David Sackler, Richard's son, who
Speaker 1: came in a little bit later, but you know, I
Speaker 1: think very instrumental. Then there's, uh, the Sacklers, who have
Speaker 1: you know, stood to benefit made huge fortunes on oxycontent
Speaker 1: but not on the board, and they do other things
Speaker 1: with their life. And then there's the Arthur family. Um yeah,
Speaker 1: I mean to take the mattel An example first, as
Speaker 1: the filmmaker, right, yeah, the filmmaker. I think the reasonable
Speaker 1: people can differ on this, and I mean Josh Sackler,
Speaker 1: who's David's wife, who's a kind of you know, want
Speaker 1: to be fashion designer. She's another good example of this too,
Speaker 1: where there's a guy who's who's involved in um film financing.
Speaker 1: We did an interview with the Hollywood Reporter or a
Speaker 1: while ago, another third generation Sackler, and what he said,
Speaker 1: he literally said something like, Oh, it has nothing to
Speaker 1: do with me. You know, the company, the controversy has
Speaker 1: nothing to do with me. And he has a film
Speaker 1: financing fund and you know, to my knowledge, no independent
Speaker 1: source of income that would would fund that fund. And
Speaker 1: so to me, the interesting thing is the premise that
Speaker 1: you could benefit to the tune of tens, maybe even
Speaker 1: hundreds of millions of dollars from something and say, oh,
Speaker 1: but it has nothing to do with me. It seems
Speaker 1: a little hard to you know, it seems a little
Speaker 1: hard for me to swallow. One of the great themes
Speaker 1: I've always been interested in, and it's one of the
Speaker 1: continuities between this book and the I RA, a book
Speaker 1: that I wrote as denial, and I think, particularly in
Speaker 1: families a lot of the time, what that means is
Speaker 1: that there are questions that don't get asked. So I
Speaker 1: would hazard that for a lot of the third generation Sacklers,
Speaker 1: it probably does feel like it doesn't have anything to
Speaker 1: do with them. You know, there's money that that appears
Speaker 1: in a trust for their benefit, and they've never had
Speaker 1: to worry about that, and they don't ask a lot
Speaker 1: of questions about where it comes from, and they may
Speaker 1: not ask too many questions about the business or what
Speaker 1: it's done. Without getting into too much detail, I can
Speaker 1: tell you that I know with certainty that there are
Speaker 1: a number of Sacklers from multiple generations who just kind
Speaker 1: of don't read the bad press. They didn't read Barry
Speaker 1: Meyer's book Painkiller. They didn't read the coverage in the
Speaker 1: New York Times, didn't read the Big l a time series,
Speaker 1: didn't read Sam ken Jonas's book Dreamland. They certainly probably
Speaker 1: wouldn't be reading my book. Um. But so there's a
Speaker 1: kind of wilful blindness aspect of it right where it's
Speaker 1: one thing to say I have fully engaged with the details.
Speaker 1: This is what David Sackler does. In fairness to him,
Speaker 1: the Third Generations Act. The only third generation one is
Speaker 1: on the board. He says, I've engaged with all the details,
Speaker 1: and I want to have the argument with you. You're wrong,
Speaker 1: you know, you misunderstand our family. It's another thing to say, Oh,
Speaker 1: I'm I've just never been all that curious about that
Speaker 1: side of things. That just take the money and I
Speaker 1: don't ask any questions. My interests lie in in Hollywood.
Speaker 1: That to me seems wrong. I mean, I you know
Speaker 1: I And it's not to say that the blame is
Speaker 1: anywhere near what it would be for a Richard Sackler,
Speaker 1: but I think there is if what you're doing is
Speaker 1: taking the money, no matter what you're spending the money on,
Speaker 1: and not really engaging at all with the origins of it.
Speaker 1: So again, this is different from saying I think mistakes
Speaker 1: were made of our family businesses played guilty to criminal
Speaker 1: charges twice. There's a huge epidemic which we share some
Speaker 1: portion of the blame for. I'm going to redirect this
Speaker 1: money that I've inherited in order to remediate that or
Speaker 1: xpiate that guilt. Nobody's saying that. What they're saying is
Speaker 1: I'm interested in film. Mass incarceration is my issue. You
Speaker 1: know Ethan better than most that to talk about mass
Speaker 1: incarceration and say we're just gonna cabin the war on drugs,
Speaker 1: We're not gonna talk about the war on drugs. We're
Speaker 1: just gonna talk about mass incarceration and exclude the war
Speaker 1: on drugs as an issue. It's just like the height
Speaker 1: of intellectual dishonesty. There's no way, Yeah, no, no, I
Speaker 1: hear your Patrick. I just wonder what you and I
Speaker 1: would do if we were born into that kind of
Speaker 1: family and we and we were shamed of it, and
Speaker 1: we wanted to get on with our lives. We were
Speaker 1: happy about the money. We want to do good in
Speaker 1: the world. You know, taking on this means, oh my god,
Speaker 1: and then I'm gonna go see my family for the
Speaker 1: next Christmas party or briss or Sader or you name it.
Speaker 1: And that's that's why I also think that that Arthur generation,
Speaker 1: because you know, interesting about Arthur, you know, you tell
Speaker 1: a story about him and valium and how what he
Speaker 1: does with valium is almost a model for what then
Speaker 1: Richard and Produce Pharma does with oxycontent, right. I think
Speaker 1: that's what Nan Golden was getting at when she said, Okay, so, yes,
Speaker 1: Arthur Sackler died before the introduction of oxycontent, But to
Speaker 1: suggest that his that his hands were clean, when in fact,
Speaker 1: you know, uh, he was so instrumental in kind of
Speaker 1: building the world in which oxycontent could end up doing
Speaker 1: what it did is disingenuous. My sense is that that's
Speaker 1: what she was in a hyperbolic way. Yeah, yeah, I
Speaker 1: think that's right. But I also think about Arthur also
Speaker 1: fits within a context of mid century and even current
Speaker 1: day chrony capitalism, that his story maybe not that different
Speaker 1: from so many other major industry is from banking to oil,
Speaker 1: to alcohol, tobacco, to consumer goods to you name it,
Speaker 1: where people figure it out all sorts of of legal
Speaker 1: and sometimes cause by illegal ways to engage in, you know,
Speaker 1: forms of vertical integration and their businesses and in which
Speaker 1: they live these kind of double lives and moral double lives.
Speaker 1: And it doesn't justify it. I mean, as somebody else
Speaker 1: who had to spend twenty years of my life, seventy
Speaker 1: years my raising money from wealthy people from across the
Speaker 1: political spectrum to try to end the war on drugs,
Speaker 1: you know, you realize that people are complex, They come
Speaker 1: from all sorts of different places. Much better the people
Speaker 1: who want to put their wealth, even if it was
Speaker 1: ill gotten by their ancestors, the ones who want to
Speaker 1: put it to reducing incarceration, are ending the drug war
Speaker 1: or promoting good stuff are so much better human beings
Speaker 1: than the ones who just want to spend it on
Speaker 1: yachts and mansions and things like that. And that ratio
Speaker 1: of how much you're willing to put into meaningful philanthropy
Speaker 1: as opposed to how much you just want to live
Speaker 1: lives of luxury. Yeah, I mean, I think again, complicated
Speaker 1: of issues part of the reason I find them interesting.
Speaker 1: Believe me, I've spent a lot of time talking to
Speaker 1: people at museums and universities who are really you know,
Speaker 1: they're in a real bind about what to do with
Speaker 1: the Sacklers, and they worry about if they take down
Speaker 1: the Sackler name, then what kind of precedent does that set,
Speaker 1: and does it worry other potential future donors and so forth.
Speaker 1: I think the issue for me is can you stand
Speaker 1: by it when the truth is out there and known?
Speaker 1: Or does the sort of happy families we all get
Speaker 1: along at the family reunion, you know, we will happily
Speaker 1: accept your money for our foundation or our university. Is
Speaker 1: that premised on a kind of denial or a sort
Speaker 1: of a desire to cover up or only whisper about
Speaker 1: the source of the funds? You know, there have been
Speaker 1: some more more so in the UK. There have been
Speaker 1: some institutions, Oxford University among them, where they've really come
Speaker 1: out in a kind of full throated way and said, hell, yeah,
Speaker 1: we love the Sacklers, will take more of their money.
Speaker 1: They're great, they've been great friends to us. And yes,
Speaker 1: we know that all this reporting is out there, and yes,
Speaker 1: you know that a lot of people seem to be
Speaker 1: pretty convinced that this is a family with a you know,
Speaker 1: a pretty poisonous legacy, but we stand by them. And
Speaker 1: I actually think there's an argument that an institution could
Speaker 1: make that you know, people have certainly made it to
Speaker 1: me in philanthropy that you can take the dirtiest money
Speaker 1: in the world and give it to me and let
Speaker 1: me spend it on something good, and that's better than
Speaker 1: the alternative, which is these people not giving their money away,
Speaker 1: which I think is what you were saying. That's a powerful,
Speaker 1: not insurmountable, but a powerful argument to make with the
Speaker 1: one asterisk that I think you have to first acknowledge
Speaker 1: that the money is dirty. If the way in which
Speaker 1: you sort of square the circle is to say dirty. Yes,
Speaker 1: there's been some reporting, but who can trust the New
Speaker 1: York Times? You know, really it's a he said, chief
Speaker 1: said situation. There's two sides to every story. Um, once
Speaker 1: you start going down that road in order to justify
Speaker 1: taking the money, you've kind of lost me. And I
Speaker 1: think that a lot of people, for a long time
Speaker 1: did just that, even tough. I read about Toughts in
Speaker 1: the book Toughs of the first university to take the
Speaker 1: Sackler name down, and they got a lot of good
Speaker 1: press for you know, the student party was really happy
Speaker 1: because the students had demanded it. But you know, five
Speaker 1: years ago, when Sam kenona Is published Dreamland, it was
Speaker 1: supposed to get assigned as reading for I think incoming students,
Speaker 1: and the administration quietly scuttled that because they said that
Speaker 1: that that's just they don't want to create any awkwardness
Speaker 1: for our donors. So you're not it's not that you're
Speaker 1: denying the book or you're saying, oh, the book is garbage.
Speaker 1: What you're saying is the book is out there, it
Speaker 1: almost hits too hard. We don't want to create any
Speaker 1: awkwardness for our donors. Yeah, well, you know, so let
Speaker 1: me take it back to one other issue of the
Speaker 1: intersection of money here, and you know, you describe this,
Speaker 1: I think, with some nuance in the book, which is
Speaker 1: that a mutuality of interest emerges. At some point. You
Speaker 1: have the people like the Cathy Foley's leading the pain
Speaker 1: management community, and then a bigger community of people who
Speaker 1: are living with pain, for whom being having it managed
Speaker 1: by opioids. The other way is they're doing so successfully
Speaker 1: and other people are angry at not having their pain right,
Speaker 1: and there's essentially little to no funding to support those efforts.
Speaker 1: And then along comes Richard Sackler, who sees this opportunity here. Right.
Speaker 1: He has a drug MS content and oxy content, and
Speaker 1: he makes common interests with these folks, and so they say,
Speaker 1: oh my god, now we have a wealthy family and
Speaker 1: pharmaceutical company that's willing to get behind our efforts to
Speaker 1: educate physicians and to change these policies. And he sees
Speaker 1: somebody whose interests are advancing his own, and in a way,
Speaker 1: it's a dance, right, And to some extent, the pain
Speaker 1: management community gets taken for a ride when it turns
Speaker 1: out that the Sacklers and Produce Pharma want to market
Speaker 1: this drug in a way that is not at all
Speaker 1: what they intended. And at the same time there is
Speaker 1: this need for more education on this stuff and more
Speaker 1: to do the right find find the balance right. And
Speaker 1: in America, we tend to swing between these polls, you know,
Speaker 1: either it's all opiophobia or it's opioids are fine if
Speaker 1: ex oxy content. And now we're swinging back the other way.
Speaker 1: Let's take a break here and go to an egg.
Speaker 1: You had towards the end of the book the story
Speaker 1: about when uh Perdue Pharma is obliged to make a
Speaker 1: big settlement in Oklahoma, right, I mean bigger than in
Speaker 1: most other states that they don't want to be a
Speaker 1: model for others, and the money is all going to
Speaker 1: go to drug treatment and all this sort of stuff.
Speaker 1: And my thought was, what a goddamn waste, because from
Speaker 1: everything I know about Oklahoma, there is almost nothing really
Speaker 1: innovative going on about drug treatment in Oklahoma, you know,
Speaker 1: and that their approach to drugs is an abstinence only, backward,
Speaker 1: anti scientific approach. And I'm thinking, if only that money
Speaker 1: could be spent on, for example, instead of focusing just
Speaker 1: on addiction treatment, maybe focusing on the proper management of
Speaker 1: pain in our society, maybe teaching GPS, maybe getting that
Speaker 1: out so it's not just Center of Disease Control CDC guidelines,
Speaker 1: but actually educating people because my fear here is that
Speaker 1: with all the backlash first against the big pharma, in
Speaker 1: which your book plays a key role and is a
Speaker 1: very important and necessary thing to happen, and not just
Speaker 1: against Purdue Pharma, but the Johnson and Johnson's and then
Speaker 1: Malon Cross and the endos and all the other ones. Right,
Speaker 1: but meanwhile, here's fentonel. You know, here's heroin. There's no
Speaker 1: way to have a supply side solution to the fentinel problem,
Speaker 1: right the drug is just too hard to really prevent
Speaker 1: from being made available. The question is is how does
Speaker 1: one most effectively point these resources? And my fear is
Speaker 1: the way that all these settlements are happening right now,
Speaker 1: it's gonna land up doing relatively little to address the
Speaker 1: problem that we got ourselves into in the first place.
Speaker 1: I think this is one of the big fears with tobacco.
Speaker 1: You know a lot of a lot of this money
Speaker 1: ended up just in the general funds for the States,
Speaker 1: so you know, your other helping repay highways um and
Speaker 1: totally disconnected from what's going on. You know. The tricky
Speaker 1: thing with the Sacklers in particular and Purdue, is that
Speaker 1: there's so much skepticism about money that went into education
Speaker 1: on pain management. I think appropriate skepticism that anything that
Speaker 1: even resembled that cosmetically, even if it was much smarter
Speaker 1: and you know, devoid of commercial interests, I think would
Speaker 1: probably raise hackles um but I but I listen to
Speaker 1: you know, what's so sad about this situation is that
Speaker 1: you have a public health crisis that's cost trillions of dollars,
Speaker 1: and because of the country we live in, it's going
Speaker 1: to get resolved with money. You know, that's money on
Speaker 1: the way in, money on the way out, and there's
Speaker 1: no sum of money that's going to be satisfying a
Speaker 1: because you know, in the case of the Sacklers or
Speaker 1: any of these companies, you know they're walking away having
Speaker 1: made much more. If you put it against the money
Speaker 1: that they made through the fraudulent activity, it's you know,
Speaker 1: deppennies on the dollar. But also because when you think
Speaker 1: about the costs, right and the human toll at the
Speaker 1: end of the day, the opioid business, as much as
Speaker 1: it's had this catastrophic impact, it's not like the tobacco
Speaker 1: industry there's less money just in total to work with,
Speaker 1: so you're not going to see settlements on the scale
Speaker 1: that you have with tobacco. And then finally, there are
Speaker 1: real questions about how that money is gonna get spent.
Speaker 1: And you know, I think those should be a big
Speaker 1: concern for people, and I think that you know, if
Speaker 1: you've read my book, there are a few places where
Speaker 1: you get these headlines where that mean meant. The easiest
Speaker 1: example to talk about would be just a few months
Speaker 1: ago in late and the Trump administration, they announced an
Speaker 1: eight billion dollar fine with criminal sanctions against Purdue Farma,
Speaker 1: an eight billion dollar settlement. And of course people see
Speaker 1: that and they think, wow, good for DJ. They really
Speaker 1: stuck it to Purdue. And you have to know the
Speaker 1: story to know that PREDU doesn't have eight billion dollars,
Speaker 1: and the sacklers who do have eight billion dollars they
Speaker 1: weren't gonna be kicking in. So it's just like a
Speaker 1: fake number that gets repeated again and again in headlines.
Speaker 1: And to me, at my most cynical, I worry that
Speaker 1: this is the way it's gonna work, right, is that
Speaker 1: you get authorities who want to kind of squeeze just
Speaker 1: enough as much as they can in the way of
Speaker 1: money out, and then they want to put out press
Speaker 1: releases to look like they've done their job in the
Speaker 1: press us. Frankly, it's complicit because it repeats these phony
Speaker 1: numbers and the public says, oh, look at them, sort
Speaker 1: of sticking to the And so I do think that
Speaker 1: watching that money carefully is important because I think, you know,
Speaker 1: questions about how it's spent. Once the Daniue mall has
Speaker 1: appeared to play out, you know, once all of the companies,
Speaker 1: all the settlements, all the deals are done, that's when
Speaker 1: people need to really get vigilant about where do those
Speaker 1: dollars go? Yeah, yeah, Well, Patrick, I tell you I
Speaker 1: got to the end of your book and my blood
Speaker 1: is boiling when you read about Purdue Farmer taking what
Speaker 1: forty billion dollars of revenue and then the Sacklers taking
Speaker 1: out over ten billion dollars and putting it into offshore
Speaker 1: accounts so that they can make the company go bankrupt
Speaker 1: and thereby avoid any responsibility. And the way they gain
Speaker 1: the system and reach to members of Congress and the
Speaker 1: Justice Department, and that last little bit about the bankruptcy
Speaker 1: court up in Westchester, which is where you live, where
Speaker 1: I grew up, and there's a way in which Purdue
Speaker 1: Farmer can pick the judge they want who's known to
Speaker 1: be sympathetic to, you know, bankruptcy arguments that are gonna favor.
Speaker 1: Then the utter a corruption of the thing is just
Speaker 1: absolutely infuriating. Anyway, I have to say your book is fantastic.
Speaker 1: It is a fantastic page turner. I mean, I read
Speaker 1: it over the past week. I've loved it, and I'm
Speaker 1: sure that people who are much more removed from this
Speaker 1: issue than you are going to love it as well.
Speaker 1: I hope you keep writing on this drugs. Do you
Speaker 1: have plans for other drug writing this one? We'll see.
Speaker 1: I'll probably do something very different next, but but I
Speaker 1: never stay away for long. But listen, it's great to
Speaker 1: see you here, and thank you very much for this book,
Speaker 1: Thank you for taking the time, Thanks for having me.
Speaker 1: Psychoactive is a production of I Heart Radio and Protozoa Pictures.
Speaker 1: It's hosted by me Ethan Naedelman. It's produced by Katcha
Speaker 1: Kumkova and Ben Kibrick. The executive producers are Dylan Golden,
Speaker 1: Ari Handel, Elizabeth Geesus, and Darren Aronovski for Protozoa Pictures,
Speaker 1: Alice Williams and Matt Frederick for I Heart Radio, and
Speaker 1: me Ethan Nadelman. Our music is by Ari Blusian and
Speaker 1: especial thanks to Avi Brio, Sep Bianca, Grimshaw and Robert Beatty.
Speaker 1: If you'd like to share your own stories, comments, or ideas,
Speaker 1: please leave us a message at eight three three seven
Speaker 1: seven nine four sixty. That's one eight three three psycho zero.
Speaker 1: You can also email us as psychoactive at protozoa dot
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Speaker 1: if you couldn't keep track of all this, find the
Speaker 1: information in the show notes