American Cartel
Scott Higham and Sari Horwitz
23 min
8 Key Points
4.5 RateWhat's inside?
Dive into the gripping investigation of the opioid crisis, uncovering the corruption and greed within the pharmaceutical industry that has impacted millions of American lives.
You'll learn
1. How Big Pharma plays a part in the opioid crisis2. Legal drama in the opioid industry3. How opioids are messing with America4. Government's role in the opioid mess5. Real-life stories from the opioid crisis6. How to fight back against the opioid crisis.Key points
01The Birth of an Epidemic
The late 1990s marked a turning point in American healthcare, with the introduction of a new painkiller, OxyContin, by Purdue Pharma. Owned by the Sackler family, Purdue Pharma's revolutionary product was touted as a time-released version of the opioid oxycodone, promising a low risk of addiction and effective pain management for 12 hours, a duration unmatched by any other painkiller on the market. This marked the genesis of what would later become a national health crisis. Purdue Pharma's aggressive marketing campaign for OxyContin was unprecedented. The company targeted a wide range of healthcare providers, from oncologists dealing with severe cancer pain to general practitioners, dentists, and others treating common conditions like back pain and arthritis. The company's strategy was not limited to traditional advertising. They used promotional videos, paid speaking engagements, and sponsored research to convince the medical community of OxyContin's safety and efficacy. In 1996, Purdue Pharma hosted over 40 national pain-management and speaker-training conferences at lavish resorts, with more than 5000 physicians, pharmacists, and nurses in attendance. These all-expenses-paid symposiums were part of a broader strategy to create a favorable perception of OxyContin. The company also created a lucrative bonus system that incentivized sales representatives to increase OxyContin prescriptions, further fueling its widespread use. However, the claims about OxyContin's low addiction risk were misleading. By the early 2000s, reports of addiction and overdose related to OxyContin began to surface. The crisis was particularly severe in rural areas like Appalachia, where many patients became addicted after being prescribed the drug for legitimate medical reasons. The fallout from this was devastating, with the death toll from opioid overdoses beginning to rise sharply. In 1999, there were approximately 8,000 opioid-related deaths in the United States. By 2002, that number had nearly doubled to over 15,000. Despite these alarming figures, Purdue Pharma continued to aggressively market OxyContin until 2007, when the company and three of its top executives pleaded guilty to federal charges of misbranding the drug. They were ordered to pay a fine of $634.5 million. However, the damage had already been done, and the opioid crisis continued to escalate. The birth of the opioid epidemic can be traced back to these events. The aggressive marketing and misleading claims about OxyContin's addiction risk created a perfect storm, leading to widespread addiction and thousands of deaths. The story of OxyContin serves as a stark reminder of the devastating consequences when profit is prioritized over patient safety. It underscores the need for rigorous oversight of pharmaceutical companies and the importance of accurate, transparent information about the risks and benefits of prescription drugs.
02The Rise of the Cartel
The late 1990s marked a significant turning point in the American pharmaceutical industry with the introduction of OxyContin, a powerful opioid painkiller, by Purdue Pharma. The company's aggressive marketing campaign, which falsely claimed a low risk of addiction, set the stage for an unprecedented opioid crisis that would grip the nation for decades to come. This event was not just a product launch, but the birth of a cartel-like operation that would involve pharmaceutical companies, distributors, and pharmacies in a complex web of complicity and profit. Purdue Pharma's misleading claims about OxyContin's addiction risk were not just a marketing strategy, but a calculated move that would lead to over $30 billion in sales. This event underscores the power of misinformation in driving industry profits, even at the cost of public health. The company's subsequent conviction and $600 million fine, one of the largest pharmaceutical settlements in U.S. history, serves as a stark reminder of the consequences of corporate greed. However, the responsibility for the opioid crisis does not rest solely with Purdue Pharma. Distributors such as McKesson Corporation and Cardinal Health played a significant role in the proliferation of opioids. Despite being aware of the addictive nature of these drugs, they continued to distribute large quantities, often ignoring suspicious orders. This event highlights the systemic failure in the supply chain, where profit took precedence over ethical considerations. Pharmacies, too, were complicit in the crisis. The case of the Sav-Rite Pharmacy in Kermit, West Virginia, which dispensed millions of opioid pills in a town with a population of just 400, is a chilling example of the extent of the problem. The conviction of the pharmacy's owner, James Wooley, underscores the role of pharmacies in the opioid crisis and the need for stricter regulation. The attempts by these entities to suppress information about the addictive nature of opioids further exacerbated the crisis. The investigation launched by the Drug Enforcement Administration (DEA) into McKesson Corporation for failing to report suspicious orders of opioids is a testament to the lengths these companies would go to protect their profits. The company's ability to avoid serious penalties by hiring former DEA officials and launching a lengthy legal battle underscores the power dynamics at play and the challenges in holding these entities accountable. In conclusion, the rise of the opioid industry in the United States was not a simple case of supply and demand, but a complex operation involving various entities, each playing a role in the proliferation of opioids. The events detailed above provide a sobering account of the power of corporate greed, the failure of regulatory systems, and the devastating consequences of the opioid crisis. The rise of this cartel-like operation serves as a stark reminder of the need for transparency, accountability, and ethical considerations in the pharmaceutical industry.
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03The Government's Blind Eye
04The Human Toll
05The Fight Back Begins
06The Battle Intensifies
07The Fall of the Cartel
08Conclusion
About Scott Higham and Sari Horwitz
Scott Higham and Sari Horwitz are Pulitzer Prize-winning investigative journalists for The Washington Post. They have extensively covered topics like the opioid crisis, criminal justice, and national security. Their collaborative work has resulted in impactful stories and books, including "American Cartel."