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Dec. 24, 2021 - The Megyn Kelly Show
01:39:28
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The Spark of a Personal Journey 00:14:35
Welcome to the Megyn Kelly Show, your home for open, honest, and provocative conversations.
Hey everyone, I'm Megyn Kelly.
Welcome to the Megyn Kelly Show.
It is the end of true crime Christmas week here on the show.
And we have a very different kind of crime story to bring to you today.
Have you heard about the Sackler family?
By the end of this show, you will.
You'll know their story well.
And the story of the opioid crisis in America.
It's stunning, it is devastating, and it is indeed criminal.
I was so moved by the recent Hulu series, Dopesick.
If you haven't seen this, you must, you must, that I wanted to do a show on it.
And today, I'm very, very happy to be joined in just a bit by the Author of the book that inspired the series, as well as separately the creator of the series, Dopesick.
Danny Strong is the director, executive producer of Dopesick, and he joins me now.
Danny, thank you so much for being here.
You're the creator, you're the showrunner.
And let me just kick it off with you know, we're going to get into it, but it's basically about how the opioid crisis in America unfolded.
What attracted you to that subject matter?
Well, first off, thanks so much for having me on your show.
And, you know, I'm so thrilled you watched the show and we're so taken by it.
So it's all very appreciated.
It all began when a producer named John Goldwyn, who's a really terrific producer, he came to me and said, Do you want to write and direct a movie on the opioid crisis?
And I had read this New Yorker article by Patrick Radin Keith that came out in 2017 that basically blew the story up as far as the Sackler family's involvement with Purdue Pharma, with OxyContin.
In a very damning way.
I think that that article was a major turning point in sort of the history of the opioid crisis and who was ultimately responsible for sparking it and setting the flames and then keeping that fire going for at least a decade, if not longer.
And so I went back and I had reread the article and I read very closely this time as far as a potential adaptation or not adaptation, but just as a research.
And I was.
Fascinated, stunned, shocked, appalled.
I then went on and got some books that had already been written on the opioid crisis a book called Painkiller, a book called Dreamland.
My horror grew even more.
And I just thought, I have to do this.
I have to figure out a way to dramatize this story for as big an audience as I can, because this is one of the most stunning crime stories in the history of the country.
And at the time, this was 2008.
18, when I was really deep diving into it.
And Purdue Pharma and OxyContin, the prescribing had started to come down in the United States, but they were now using their same dishonest, manipulative, false techniques, advertising techniques, and marketing techniques in foreign countries.
So when I first started, I had viewed the show as a warning to the rest of the world that Purdue Pharma is coming to lie to you and to addict you to OxyContin.
So that's sort of what sparked the journey.
You come by your storytelling skills, honestly.
It's funny because when I saw your name, I'm like, I know that name, I know that name.
And I know you've worked with Jay Roach, who was, of course, the director of the movie Bombshell, which I have a connection to.
I have nothing to do with the movie, but there was a person playing me in it.
But that's not how I knew you.
It was from Gilmore Girls.
There you go.
Which you were on for a while, playing Doyle McMaster.
But you've also written several big movies, right?
Game Change, Recount.
And you wrote The Butler.
You're a co writer and maybe producer on Empire as well.
I mean, like a lot of big hits in your past.
Good stuff.
Thank you.
But this is like, this is your project.
So it's got to feel different to you in a way.
Yeah, it was.
I knew that I would be doing heavy lifting.
I had directed an independent film before that had gotten into Sundance, which was very exciting.
But this was on a much, much bigger scale as far as creating, show running.
I knew I was going to be directing the last couple episodes.
And it was great to just sort of take the reins of it.
And partly, Why I felt like, okay, this is a good project for me to do that with for my first time was because I was so passionate about it and I was so enraged by what had happened.
And it seemed like, well, if you're gonna, you know, for me, I always worry, I always go to worst case scenario, right?
You know, what's gonna happen if the whole thing's a disaster and a massive failure?
And so I thought, well, if this thing explodes in my face, I'd rather go down swinging on something that I feel really, really passionate about.
This feeling is what makes you a success.
They say that there was a Kaiser poll.
That said, 56% of Americans either know someone who is an addict or who died from addiction.
I feel like it's probably even higher than that.
I have someone, I've revealed to my audience that someone in my family, my family of origin, fell into the opioid crisis.
And when a family member falls into it, the entire family falls into it, as you know from being the storyteller of this series.
I wondered whether you had any personal experience that made you want to do the show.
I didn't.
And I'm so fortunate to be able to say that sentence.
I don't know anyone close to me that had an opioid use disorder.
I myself have not fallen down any kind of rabbit hole like that.
The rabbit hole I fell down was the rabbit hole of the crimes of Purdue Pharma and the culpability of the Sackler family.
And that was a rabbit hole that a number of people have fallen down.
You know, when I start talking about this to To different people that have written books on them who may have had a personal experience with addiction or a family or friends that has.
But what we all have in common is once you start deep diving into what happened, you can't believe it.
You can't believe what this company did and how literally a group of, I don't know, 20 people, 30 people from one family made billions and billions of dollars off of the suffering.
Of an entire nation.
And, you know, when you talk about how the whole family gets affected by this when it happens to one person, it's so true.
You know, everyone talks about the statistics of now it's over 700,000 people have died from some type of opioid overdose since the crisis essentially began.
However, that number doesn't even begin to tell the story of the families that are devastated, the family members that.
That lose years of their life of suffering, of loved ones who have fallen into this, and the people that are still alive that didn't die from an overdose, but are either still struggling with opioid use disorder or lost years of their life to it.
And are now just trying to put the pieces back together.
I mean, the sort of victims of it continue to splinter on and on and on in a way that's extremely profound.
I know many people think that the homeless issue that is plaguing so many major American cities is heavily sparked by the opioid crisis and people that have fallen into opioid use disorder.
No, it's so true because even if you're one of the quote lucky ones who doesn't get killed by an overdose, I mean, I've seen it happen firsthand, it changes you, it changes a person.
It can at least radically to where the person you knew is all but gone, replaced by someone else who's a stranger to you, who you have to get to know, and who that person, him or herself, has to get to know.
It's just like a new version of you that doesn't tend to be new and improved.
Like these drugs do so much lasting damage, and then the drugs you have to take to get off of them and stay off of them can do damage as well.
It's just a cycle that even if you manage to pull yourself out of it, it's very hard to shake the effects of it.
And the movie.
And the book and this whole series of sort of research and writings about it are an attempt at accountability, at storytelling and explanation.
How did it happen and accountability?
And what I loved about it, Danny, is when you go through it, you don't know you're part of a national story, right?
You just think, oh my God, something terrible is happening in my family or to my people.
And it took years, I think, for most of us who were sucked into it to realize, oh my God, this was a thing.
This was a national epidemic.
And now this is the next piece, which is caused by.
Specific individuals because it was.
And I agree with your demonization of the Sacklers, who we'll get into.
So let's talk about the film itself because you basically, the characters are fictional, right?
So you made them up.
Some of them.
But they're loosely based, yes, on real life.
Well, some are not even loosely based, some are just the actual people.
I mean, the Sackler family, I use the real names.
And then the key prosecutors out of the Western District of Virginia, the U.S. Attorney there and two of his prosecutors, those are real people as well.
And then the people in the town, Finch Creek, that is, it's a fictional name, Finch Creek.
I wanted to do this sort of every town, USA, Appalachia concept to have a couple of people be our victims that represented, you know, millions of people in that case.
The star originally in the sort of beginning episodes is a young female minor.
Named Betsy, played by Caitlin Deaver, who suffers an injury.
She's the daughter of a minor as well.
She lives with her parents.
She's not a drug addict.
She's not an alcoholic.
She's a sweet, dreamy faced young minor.
It's just such an interesting job for a young woman like that.
Sympathetic character for sure.
And I love that you chose her because this was representative of, I think, the opioid crisis for most people.
These weren't back alley deals, these were people who were prescribed.
A drug by a doctor they trusted to treat an injury that was real.
And then the spiral came.
Yeah, absolutely.
And partly why I did this approach was because this is where Purdue Pharma, that was their phase one areas where they targeted, which were rural areas filled with people that had a higher prescription rate of opioids because they just got injured a lot on the job.
So miners, loggers, farmers.
Those were basically the three areas that Purdue Pharma initially targeted.
And so it was in southwestern Virginia, eastern Kentucky, and rural Maine were kind of the ground zero spots.
And I chose Appalachia and I chose mining.
I thought it was very sort of emblematic of sort of our iconic view of how this all began.
And I started watching YouTube videos of different people in these areas.
And these YouTube videos, it's a technique I use for research because there's something so authentic about them.
They're often amateur videos that are just taken by real people trying to put some kind of short subject documentary together about their lives.
And I was so taken by so many of the miners and the pride they had and what they did, and that there was this sort of magical connection to the mountains, the Blue Ridge Mountains, the mountains in Appalachia.
And, you know, when I went on a research trip up there, I understood where that connection came from because they're really beautiful.
It's just this very beautiful part of the country and very sort of isolated and on its own.
So it seemed to me, oh, this is a great way into the story.
And I, you know, in one of the videos, I saw this young woman who was a minor being interviewed.
She struck me as someone who seemed like she was a lesbian.
And I thought, wow, that's really interesting being a lesbian in a very, you know, conservative part of the country where that may not be as accepted as, say, it is in New York City where I live.
And I just wanted to explore these different issues.
And so, what happens when the issue begins, her arc begins about her sexuality and what that means to her and her family.
But it quickly takes a left hand turn when the drug use completely consumes it and takes it over.
And that was so very much kind of the early stages of me putting this together.
And I do want to throw a huge shout out to Beth Macy and her incredible book, Dope Sick.
We ended up getting teamed up after I'd come up with these initial ideas.
And I read the book and I loved it.
And Beth has been an incredible part of the project and the process.
She was in the writer's room.
Her and I kept doing interviews all the way throughout the entire process.
So she gets it.
It's a big shout out to dope sick author Beth Macy.
And anyone listening to this, if you've seen the show and you haven't read the book yet, I highly recommend it.
Yeah, she's coming up next.
So they're going to meet her momentarily.
But she does get it.
I mean, she sort of, her book is not totally dissimilar from Hillbilly Elegy by JD Vance.
You know, it just takes a hard, honest, and sometimes unfavorable view of Appalachia and what's happened there.
And it's not critical of the people, it's just, There's joblessness and there's disability claims and there's globalization and there are all sorts of things that have affected this part of the country that gets ignored too often.
And then people are like, How did Trump get in office?
And it's like, Well, it's complicated, but it's understandable if you take the time.
Beyond the Criminal Company 00:15:19
Okay.
So you've got Betsy is one of our main stars.
And then you've got Dr. Samuel Fenix, right?
Yeah.
Just want to make sure I'm pronouncing it right because I know I'm a Sam.
And that's played by Michael Keaton.
And this character, Is trying to help his community.
He loves West Virginia.
He loves Appalachia.
He loves the minors.
He's trying to help.
But like so many doctors in the opioid crisis, really didn't, right?
He was pulled in by Purdue Pharma, as so many real life doctors were.
And it's dazzling, snazzy drug reps who are saying all sorts of things about this drug, which is so exciting that they fooled even the doctors, which was a critical part of their plan.
Yeah, 100%.
I think there's this perception of that all doctors that prescribed Oxycontin were evil pill mill doctors that were essentially legal drug dealers.
And those people certainly did exist.
And there were many pill mills and a number of people that have been arrested and gotten massive jail sentences.
30 years, 25 years.
However, I believe that the majority of the doctors prescribing Oxycontin were not that.
They were completely well intentioned doctors that believed what Purdue Pharma had told them.
And even the sales reps at Purdue Pharma believed, at least initially, the information that they were given.
There was basically this elaborate con in which Purdue Pharma, well, I'll start with these independent pain societies.
These independent pain societies were creating this new movement.
That pain has been wildly under treated in this country, and that opioids are much safer than we have perceived them for decades.
And that this movement went so far as to term pain as the new fifth vital sign.
So, this was a huge campaign that was happening late 80s into the mid 90s into the late 90s, right?
During this whole period that coincided with Purdue Pharma coming up with a new opioid that they were marketing as non addictive, which tied into the national movement.
Of yes, and opioids are much safer.
And then these pain societies would put out studies.
Certain doctors would write articles that would end up in these really respected medical news journals.
And it gave this elaborate appearance that there's a whole new movement in medication and in pain treatment.
And what we have learned is that these pain societies were not independent, they were partially or fully, in some cases, funded by Purdue Pharma.
The doctors that were writing articles.
were funded by Purdue Pharma.
And in some cases, the periodicals that these articles would come out in were funded by Purdue Pharma.
So it was like an elaborate shell game, a con.
And then when you go back in time to the 1950s and the 1960s, there was a man who basically created all of this, this entire elaborate shell game of having fake studies being written about by doctors on your payroll, put in periodicals that are also on your payroll that you would then use that to convince doctors of whatever you're trying to convince them.
And this man, Was Arthur Sackler, the uncle of Richard Sackler, who was the godfather of Oxycontin, right?
So you see, oh no, this is what the family, they've been doing this for the last 50 years.
This is just their playbook.
And when you get into that, that this is a generational scam, I view it as sort of like pharmagrifters.
They're a family of pharmagrifters, right?
And then it goes back generations.
It gets to be incredibly fascinating that there's this long history of it.
And quite devious.
You know, this is covered in the book Dope Sick, but there's another book called Empire of Pain that came out not too long ago that goes into Arthur Sackler in the 50s and the 60s in such exquisite detail.
I call it Charles Dickens in Hell.
I mean, it's very devious and quite fascinating the entire family history of what they've done.
Obviously, the Sacklers and Purdue Pharma are, they do not come out favorably in the movie or the book or life.
They're pretty good.
Their lives are pretty damn good.
I'll tell you, the biggest villain right after them is the FDA.
And you will not believe how Purdue Pharma managed to convince all these doctors that Oxycontin was less addictive, that the doctors could feel totally comfortable prescribing it to young minors who may have hurt their backs and so on.
Freeform, just go for it.
It's totally safe.
How did they do it?
With the help of a complicit FDA, which the movie exposes brilliantly.
We have more with Danny after this quick break.
Don't go away.
So, Danny, before I get to FDA, Richard Sackler, can you help me?
I love this actor.
Michael, is it Stolberg?
Stolberg.
Stolberg.
Okay, because I always see it written and I never hear it spoken.
I loved him in Boardwalk Empire.
He was totally brilliant in that series.
He was in Woody Allen's Blue Jasmine, many other films.
You'll recognize him.
He's such a good villain.
He's amazing at being a villain.
So, he plays Richard Sackler.
And Richard Sackler, what you learn is more than any other Sackler, and that's saying something.
Is hugely ambitious.
He's incredibly driven and he's also very smart.
But he was determined once he created this baby, OxyContin, because a patent on another drug they owned was running out, Purdue Pharma, and they needed a new star in the Purdue Pharma family, and OxyContin was it.
So he was determined to make sure it got marketed out there, that the sales were exponential.
And here's just a clip from the movie.
This is Soundbite One of Michael Stobarg as Richard Sackler.
Listen.
The board doesn't seem to understand I'm trying to make this a blockbuster drug, which I can't do without more sales reps.
Dr. Richard, with all these new sales reps, we won't even have enough doctors for them to target.
IMS is about to release a 3.0 version that tracks daily prescriptions instead of quarterly.
So, if we double our sales force, we can use this data to target doctors prescribing Lortab and Vicodin.
and flip them to Oxycontin.
The upgrade is a million dollars.
Do you know who created the IMS database?
Arthur Sackler.
It's been kept secret for years, but this is a family invention that was sold off years ago.
And now you're telling me we should deny all this data that only exists because of my fucking uncle?
Purchase the upgrade and increase the sales force.
Thank you.
And that's exactly what they did.
And that sales force went out there and did his bidding in a way that was pretty sickening.
It was pretty gross.
Yeah, absolutely.
I mean, first off, thanks for all your compliments for Michael's performance.
I think he is unbelievable in this show.
And it's funny, he plays all these villains in person.
He's literally.
The sweetest guy you'll ever meet.
Yeah, he's so sweet.
And Michael Keaton and Caitlin Deaver both give staggering performances.
They were actually just nominated for Critics' Choice Awards for their performances.
Right.
So, as was the series, right?
It's just an incredible group of people.
So, I just want to give my love to them and my entire cast, who I think is amazing.
You know, one of the things that I'm.
Mara Winningham, she was amazing too.
Pardon?
Mara Winningham, amazing.
She plays Betsy's mother.
I've got to be it.
Come on.
It's Mara Winningham.
She's unbelievable, right?
Everything.
She's great in everything.
Yeah.
Yeah.
And Rosario Dawson, too, is just a killer.
She's Rosario Dawson plays the badass DEA agent who will not be shut up.
She's just like, she's a dog with a bone.
And while everybody's like, shut up, go away, Purdue Pharma is very powerful and rich, she just doesn't give a damn.
She just continues on them.
Not having it, not having it.
And a really cool person, too.
But so one of the things I really wanted to do with Richard Sackler, right, is he's so demonized in everything you read and so despised by so many people.
And then I was able to.
Interview a number of people that knew him and worked with him, and they seem to hate him even more than the people.
I thought you were taking a different turn there.
Yeah, he's not like the most loved individual when you know him one on one.
What was important to me was, well, what really made him tick?
What's really going on here?
Is it just money?
Because it's hard for me to believe that it's just money because he's already rich.
They're already rich before Oxycontin even existed, right?
So I went on a deep dive to do everything I could to try to figure out.
So, what makes this guy tick?
And I went to the extent of, I did a therapy session where I role played that I was Richard Sackler.
I'd never done anything like this before.
And a friend of mine, The really successful screenwriter and his wife is a therapist, and he had done this with her.
So he was like, Why don't you try doing a session with my wife where you roleplay Richard Zachler?
And it was incredible to try to get under the skin of this person.
And I think that Stuhlbarg did a great job of that as well, and that there's some really interesting layers to what's happening here.
He grew up with this famous uncle that we discussed earlier, and I think he desperately didn't want to be a dilettante.
He wanted to prove.
That he could succeed on his own.
And what he ends up doing is he ends up succeeding probably beyond anyone's wildest expectations and maybe the most successful person in the history of this family as far as the revenue that he brought in.
But that drive to succeed, well, it had consequences.
And those consequences were the opioid crisis and the devastation that it brought to this country.
And if you were to point to one individual most responsible for it, I think the blame has to go directly to Richard Sackler.
And I think that these many of these books that have been written.
They backed that up.
This isn't my own conclusion.
It's sort of the historical record at this point.
Yeah, I think Beth Macy is going to say that too that it's not that Oxycontin was the only drug being abused during the opioid crisis, but it was certainly patient zero, if you will.
It was the biggest and most important and most effective and widespread.
And the way they did it is indicative of how many problems there were with the system, including the FDA.
They're supposed to be on our side.
That's supposed to be a government watchdog that looks out for the little guy.
But in the same way, so many people have been distrusting many government agencies over the past 10 years or so, this agency is on that page too, because they weren't looking out for the little guy.
They looked out for Purdue.
And in particular, a guy named Dr. Curtis Wright at the FDA.
Well, why don't you tell us what they did for OxyContin and then what happened to Dr. Wright?
This story is one of the first jaw droppers of the opioid crisis.
Origin story when you start to research it.
So, one of the most effective tools that Purdue Pharma had in marketing the drug and getting doctors to feel comfortable that this opioid was less addictive than other opioids was because the FDA granted them a label that said that was the case.
It was an unprecedented label that essentially said that this drug is less addictive than other opioids.
And so, a doctor seeing this label, being told this, it was a major part of the sales pitch.
Well, that's going to really make them feel much more comfortable trying it.
Besides that elaborate shell game that I talked about earlier, this is what takes it over the edge in a very significant way.
And the wording of this warning label was highly unusual.
It barely makes sense.
It's a little confusing.
It says, you know, is believed, Oxycontin is believed to reduce the abuse liability of the drug because, or the time release system is believed to reduce the abuse liability of the drug.
Well, believed, believed by who?
Who believes it?
You know, Megan, do you believe it?
Do I believe it?
I mean, it doesn't even say.
Who believes it?
And so when you scratch the surface, so how could this unprecedented label?
That gave them a blank check to say that the drug was less addictive.
Well, how does that come to be?
Well, clearly there were studies that were done that showed that was a get.
No, there were no studies.
It was the time mechanism that was able to just this time release system convince the FDA of the case.
Well, what happened was the guy that approved this label, Curtis Wright, he goes and 18 months later gets a job at Purdue Pharma for $400,000 a year.
I'm guessing he was making about $100,000 a year at the FDA.
So the appearance of corruption is so staggering.
I still feel like there needs to be a major investigation into Curtis Wright and the failures at the FDA.
And rule change.
They should not be allowed to take jobs with Big Pharma within 10 years of leaving the FDA.
Yeah.
And I think that's one of the reasons why I thought this story is so profound because.
It goes beyond a criminal company and it goes beyond the dishonesty of a few people.
It ends up tying into the very broken nature of our government's relationship with private industry.
And that if someone could have a job at the FDA in which they are directly overseeing pharma companies, and then they can immediately go work for those pharma companies, the revolving door, you end up with situations like what happened here.
And I think that it's not even just Curtis Wright, but The FDA stayed really lenient on Purdue Pharma for many years, siding with them over and over and over again.
And how could Curtis Wright's massive salary and job not have some sort of influence on these future decisions where people are working at the FDA thinking either A, there's a job for me at Purdue Pharma when I get out, or B, a job at a consulting company that can be hired by Purdue Pharma?
Or in one case, a person was put on a board at Tufts University.
That Purdue Pharma was in charge of that board, right?
Pharma Reps and Lenient FDA 00:08:19
And being put on these boards, well, that's really helpful for the person's career.
So there's all sorts of goodies to be had for your career, your future, your pocketbook by playing ball with Purdue Pharma.
And I think that looking at the revolving door, coming up with new rules that could not enable someone to oversee their warning label and then go work for them within 18 months, she could have got to work for them the next day.
It's obvious.
It's so clear, right?
When you spell it out, what happened.
Just as a compliment to all of this reporting and discussion, 60 Minutes did a piece not long ago taking a deep dive on all of this.
It was in 2019.
And they interviewed a whistleblower from within Big Pharma.
This guy himself was a Big Pharma kind of guy.
He was selling drugs, I mean, legal drugs.
His name was Ed Thompson.
And he was telling 60 Minutes that when Oxy was first approved in 1995, it was based on science.
1995, this is the very first time we've met OxyContin.
It was based on science that only showed it was safe and effective when used.
Short term.
Okay.
But six years later in 2001, pressured by big pharma and pain sufferers, the FDA made a fateful decision and expanded the use of Oxycontin to just about anybody with chronic ailments.
Anybody with chronic ailments, like back pain, arthritis, could now use it.
And 60 Minutes got their hands on a court order that would demand the production of the documents.
It showed there were secret meetings between the FDA in which they bowed to Purdue Pharma's demands to ignore the lack of scientific data and change the label to you can use this.
Around the clock for an extended period of time.
Ed Thompson said it opened the floodgates.
It was the point of no return for the FDA.
They were in bed.
Under the covers, naked, next to the Sacklers for the duration.
And as you point out now, not just because of Oxy, but 700,000 Americans are dead.
I mean, yes, Oxycontin and other opioids did help some people.
We should point that out.
But those in charge knew it was also extremely deadly and they denied it at every turn.
Yeah, and Oxycontin has real, there's some real good use for Oxycontin in opioids, severe pain, cancer pain.
Post surgery treatment, it's very effective for it.
But Purdue Pharma had already had a drug, MS Cotton, that did that.
And they knew how much money you could make by having a drug for severe pain, for cancer treatment, for post surgery treatment.
And it's a pretty small market.
But by opening it up to chronic pain, and here was the other element to it it wasn't just chronic pain, but moderate pain, right?
Because it's now non addictive, it could be used for all sorts of ailments.
Like wisdom teeth surgery or migraine headaches, or all sorts of things that an addictive narcotic never should have been used for.
And that combination of that and using it for chronic pain, which meant you had to be on it on an ongoing basis, you know, opened it up this skyrocketing of addiction and overdoses.
And I will put another there is another category too of people, which are people with severe chronic pain that have been able to effectively use OxyContin to treat their chronic pain.
That now can't get access to it either.
So now there's like another set of victims because of the dishonesty that occurred in the marketing and promotion of this drug.
The other villain inside of Purdue Pharma, in addition to the other Sacklers who are 100% on board with this drug, they were just worried about how much money it would make.
They weren't worried about people's health from the sound of it, was the drug reps.
Now, the drug reps are the people who go out to the doctors.
And try to convince them that this is a great drug and that they should prescribe it to all their patients.
And the film does a great job of showing people the pressure on them by their top guy to push, push, push.
We're making bigger, bigger pills of Oxy, more and more Oxy in each pill.
The answer, if you're starting to feel withdrawal, is not less Oxycontin, it's more Oxycontin.
That's your body telling you you need Oxycontin.
And the drug reps, I mean, basically, they were told do whatever you need to do, push, push, push.
Like you've got to get.
Not necessarily people hooked, but you've got to push this drug and you've got to sort of convince people to push it no matter what you have to give them.
I'm trying to look for the exact soundbite we have.
Oh, is it SAT2?
Okay, listen, SAT2.
Make your doctors feel special.
Get dolled up.
Take them to expensive dinners.
Offer to fill up their car with gas just to get 10 minutes to pitch.
It bribed the receptionist with a Manny Petty.
So she'll let you in the office.
But you have to get to know your doctors, which is why we will give you full psychological profiles on each of them.
If they've got kids, get them tickets to Disney World.
If they're going through a divorce, get them laid.
Whatever it takes to win their friendship and their trust.
They were important, really important.
Oh, yeah.
They were a very, very significant part of the process.
And what Purdue did, they did a couple things that was very important.
Clever and very devious.
One was, it was the first time where, in selling a class two narcotic, where people's bonuses.
Were tied into the number of milligrams that they sold.
So the more milligrams that they sold, the higher the bonus they got.
Then they also went out of their way to not hire people that had a background in opioids or in narcotics, because one could argue those people would have been suspicious of the claim that it was less addictive than other opioids.
And I interviewed a number of Purdue Pharma reps, former Purdue Pharma reps, and there's been a lot written about them.
And the sort of theme that comes up frequently is they believed what they were told.
They believed the studies.
But then at a certain point, it becomes clear to them that it's not true.
And I remember I asked one of them, I said, What was the moment?
What was the moment where you realized, oh, there is something very wrong with this drug?
And he had, he had, he remembered the exact moment of what it was.
He said it was when he pulled up to a pain clinic and it looked like a tailgate party out front.
That there were a massive amount of people grilling meat, hanging out, beer.
It was like a giant party outside of a pain clinic when everyone was waiting to go get their Oxycontin.
So they were definitely culpable at a certain point, even though Purdue did go out of their way to try to trick the pharma reps as well.
Well, yeah.
I mean, if they could be sincere and earnest in the pitch, so much the better, right?
Not everybody has that acting ability, right?
Like the people in your cast, most people would have to actually believe it in order to be effective at selling it.
The series does a great job of painting the relationship between Michael Keaton's character, this well meaning West Virginian doctor, and one of those sales reps.
The character's name is Billy Cutler, played by Will Poulter.
And Billy is sort of this he's a fresh faced kid who's trying to make it and get a good salary and so on.
And he starts off believing in the drug.
And you sort of see that change over time.
And his relationship with Michael Keaton is very good.
And that changes over time.
And even Michael Keaton is touting the drug.
As a doctor to his community early on in the film, saying, you know, trust me, you guys, these are good people.
I know you're good people.
Come by pain, honestly, and I'm going to help you fix it, honestly.
And by the end of the movie, there's a tumultuous exchange between Michael Keaton's doctor character and this Billy Cutler character, the drug rep, where you can feel the deterioration, you can feel the crisis that they are in, that the nation is in.
Billy Cutler's Changing Beliefs 00:02:03
It's Soundbite Nine.
No, no, sorry.
Forgive me.
It's.
Yeah, it's down by eight.
Take a listen.
So poison, Billy.
What's that?
That's all it says.
So poison.
That's what you do.
That's just poison.
No, doc.
Yeah, that's what it is.
Yeah, it's poison.
I can talk you through it, doc.
It's a new concept.
It's all in here.
These are good, hardworking people.
These are good, hardworking people.
And you have FDA labeled this.
Doc, anything in here that you don't understand, I can talk to you.
Okay.
Get out.
Get out.
All right.
No!
Doc, it's him!
Gilly!
You gotta get going.
Don't ever come back.
Doc, get out of here.
Doc, get out of here.
Please.
No!
You run back.
There's these levels.
I'll fucking kill you.
Yeah, I'll fucking kill you myself!
The anger, you're feeling it yourself as an audience member by that point in the series.
Yeah.
Yeah.
No, I mean, that was, I remember when I was writing that scene and I hadn't planned on him punching him.
And then I wrote the scene and I felt like it didn't capture.
The true rage of what this doctor would be going through.
And so I rewrote it with him punching him and it becoming the sort of melee that it turns into.
And there's a number of moments throughout the show that are, in many ways, my rage and my anger.
And some of the dialogue that people say is very much a product of the anger that I have about what happened.
And there's something, you know, I feel so fortunate that I'm able to express that anger to millions of people in the work that I do.
It's a very unusual situation to be in.
And I remember someone asked me, so do you get it out of your system?
Rage Behind the Rewritten Scene 00:08:47
Are you released in a therapeutic way?
And I said, no, but it does feel good.
It's a temporary release.
I can relate to my job too, frankly.
But I appreciate outlets like yours for helping me do it without having to be firsthand involved in it.
So, what happened?
What happened to Purdue Pharma?
What happened to this company, to Richard Sackler?
That's the part that outrages Danny the most, from what I read.
And that's where we're going to pick it up right after this quick break on where they are.
Now.
And remember, folks, you can catch the Megan Kelly Show live on Sirius XM Triumph Channel 111 every weekday at noon East and the full video show and clips by subscribing to our YouTube channel, youtube.comslash Megan Kelly.
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Joining me today, Danny Strong, executive producer and creator of the very powerful Hulu series, Dope Sick, about the Sackler family and the opioid crisis.
And I guess now would be a good time to ask you what dope sick means.
I just sort of blindly started watching it, not even asking that question.
And then it gets explained in the series.
It is a thing.
What is it?
Yeah.
So, dope sick is the condition one feels that has an opioid use disorder, the withdrawal pain they feel.
That is so severe and staggering that they feel like they're gonna die if they're not able to get their next fix of some type of opioid.
And it's so all empowering, all overwhelming.
People will turn their back on everything in their life to not get dope sick their family, their children, their jobs.
This is how people end up living under a bridge in a tent, is because that withdrawal pain.
Overwhelms every sense of their body, soul, et cetera.
And it's one of the deviousness, the diabolical nature of opioids when you become addicted to them is that they hijack your brain.
They change your brain chemistry.
So, the sort of stereotype or the perception that many people have is that someone who's addicted to opioids, that they can't get off, they're weak.
They're maybe lazy and they just want to get high.
They're losers.
They're junkies.
It's a lot of judgment.
But when you dig into it, what you learn is oh, no, their brain has been hijacked and they cannot live without it.
And that's what makes it so uniquely difficult to overcome opioid use disorder.
And that's where the word dope sick comes from.
Yeah.
It's another word it's like they're kidnapped.
They've been kidnapped by this drug, the real person.
And it's so hard to get them back no matter how much the ransom you pay.
So the series takes us through the progression that one of the characters has and that the country has as well.
Which is past Oxycontin, the next drug of choice is heroin.
It's sort of the gateway to heroin.
And then in more modern times, illicit fentanyl, which is where we are now.
This is what people are dealing with currently.
And it's incredibly hard to get off of.
One pill can kill you.
Sorry, go ahead.
Yeah, what were you saying?
Oh, I was just saying fentanyl is so dangerous.
Literally one pill can kill you.
I mean, that's how severe and dangerous this whole crisis has become.
Yep.
So the progression happens for one of the characters and it happens for the nation too.
And in the meantime, you're asked, you're shown the effort by some law enforcement agents.
You mentioned the West Virginia prosecutors.
Certain people at the higher levels of the federal government were on the good guy's side and certain people were not.
It's never fully explained what was happening, but we're led to believe that Purdue Pharma had connections even there.
They hired Rudy Giuliani.
He knew how to work the government.
This is at the height of his popularity right after 9 11.
He tried to work his magic on Purdue's behalf, used his good name on their behalf, which is just, oh, it hurts.
And ultimately, the civil lawsuits and finally the criminal prosecutions against Purdue Pharma got us where, Danny?
Well, the criminal prosecutions.
So, and that's where the show ends.
The season basically ends around 2007, which is a settlement that Purdue Pharma has with the U.S. government.
Three executives plead to misdemeanors.
And does From this settlement in which the company pleads to a felony, $600 million in fines.
So, is this, do they change their ways?
Are they reformed by this settlement?
The answer is a definitive no.
In fact, and this is where for me, I start to think that these people are sociopaths because they have had this massive investigation against them.
They have pled guilty to a felony.
There is so much data at this Point in 2007 of overdoses, crime rates, communities devastated.
Do they change their ways?
Do they make any sort of adjustments?
No, they hit the gas and they sell even harder and they triple their sales in two years.
And like I said, that's where I start to think, oh, oh, they're literally sociopaths where they just do not care.
They don't care about any of the damage that they're causing.
They are just trying to make as much money as possible.
So then that brings us now to 2021.
In 2020, Lo and behold, they have to plead guilty to two more sets of felonies.
And instead of $600 million in fines, it's $8.5 billion in fines.
Partly this settlement was because they blew off the safeguards of the 2007 settlement.
The company goes into bankruptcy.
They end up getting this very favorable judgment in which the Sackler family will pay out, I believe it was $3.5 million.
$4.5, right?
Yeah.
Yeah, billion dollars in fines.
However, they are now immune to all future civil litigation.
However, here's where it gets a little interesting, or very interesting, depending on your point of view, is that they are not immune to criminal liability.
And they could still be prosecuted, the Sackler family.
And there was a big rally outside the Justice Department just a few days ago, filled with activists, filled with Rick Mountcastle, the real prosecutor who we dramatize in the show, was there, gave a speech.
I actually gave a speech.
There were three former US, three former Justice Department prosecutors giving a speech to push the Justice Department.
To file criminal charges against members of the Sackler family.
So this isn't over.
And now the common belief has always been amongst I don't know who, but that this will never happen.
They'll never be charged.
However, there is a push now.
I think that the TV show has put a lot of attention on it and given it some momentum.
And it's really emboldened the activists who threw this rally.
And supposedly there's going to be a Justice Department meeting in the next week with the lawyer for these activists and some of the activists.
And they're better.
They better meet with them because literally Purdue Pharma certainly has met with the Justice Department many times.
So I would think these activists should be able to get this meeting.
But so there is a push right now for criminal charges.
There is a huge sense amongst these activists that justice has not been served, that the company has now pled guilty to three felonies, but no individuals have.
And the company didn't make these decisions, individuals made these decisions.
And the Sacklers paid money toward that bankruptcy settlement.
Purdue, but they still have plenty of money.
It's not unlike the Epstein case with justice on the wrong side for a lot of years and now getting it right.
Danny Strong, thank you so much for being here and for telling this story and all the best with it.
Oh, thank you so much, Megan.
I had a great time talking about this with you.
Heroin Crisis and Corporate Exploitation 00:08:35
So thank you so much for having me here.
All the best.
Take care.
Up next, the journalist who wrote the book Dope Sick, Beth Macy.
Don't go away.
Joining me now, Beth Macy, journalist and author who wrote the book Dope Sick, which was recently adapted into the TV series that you've been hearing us talk about.
Beth, thank you so much for being with us today.
I loved your book and I love your work.
And I think you have this sage ability to see things that the rest of us can't necessarily see.
So we're lucky to have journalists like you.
That's okay.
Thank you.
That's the truth.
I mean, you saw something here when it came to these small, distressed communities.
In Appalachia, and similarities that were in all of these towns, and then similar ways of dealing with the problems.
So, first, can you just describe sort of what were some of the problems they shared that sort of preceded the opioid crisis?
So, one of the factors about where the crisis first broke out was the fact that Purdue Pharma bought data that showed them which communities were sort of rife to be exploited by their products.
That is, They picked the communities in America.
These tended to be distressed rural towns where the jobs were going away.
And these were places that had furniture factory making, coal mining, logging, fishing.
So you first see the crisis erupting in places like Southwest Virginia, West Virginia, rural Maine, because Purdue knew that doctors in those communities were already prescribing competing opioids at a higher rate.
With their FDA label that we now know is quite in question, they went out and they tried with the reps, they tried to flip the doctors from prescribing Percocet, Vicodin, Loritab to Oxycontin, which they said was safer because of this continuous release mechanism.
And they got the doctors to flip thanks to that FDA insert, which was completely bought and paid for by Purdue Pharma, to the great expense of really lower.
Not even, I mean, maybe lower to middle income Americans to begin with, and then it's spread and spread and spread.
I know you write about.
A study that took a look at the life expectancy of people in these regions and how, like, the difference between the bottom fifth in terms of income and wealth and the top fifth in income and wealth in this country is huge.
It's something like a difference of 13 years in life expectancy.
And so these people really have been overlooked by a system that has been focused on globalization, that's been trying to kill coal, and no one's been paying any attention to them.
And then Purdue Pharma did and managed to manipulate their very doctors to sort of turn on them without understanding that's what they were doing.
Right.
And that was a real double whammy.
If you've already lost the majority of your job, some of the communities I was reporting on for my first book, Factory Man, which came out in 2014, which is about the aftermath of globalization.
As I was wrapping up that reporting, I was starting to hear things like we've got a heroin crisis in.
Martinsville, Virginia.
We're talking like a tiny town about an hour south of me here in Roanoke, Virginia.
And I didn't understand it at the time, nor did most journalists, that the Oxycontin story was so related to the heroin epidemic story because they're basically chemical cousins.
And when the drugs start to get harder to get, more expensive around 2010, 2012, you and I may not have known that Oxycontin and heroin were chemical cousins, but the cartels did.
And so they bring them in.
And start converting people to heroin because it's cheaper, it's easier to get.
And they know that one's fear of becoming dope sick, that is, this excruciating feeling of withdrawal that they all say is like the worst flu times 100, really is one hell of a good business model.
And can you explain what the cartels, which we already know are evil, do to the drug in order to make sure the clientele gets hooked and keeps coming back?
Well, first, they just.
I remember the story from a young woman named Tess Henry that I followed for Dope Sick.
And she could pinpoint the month that the DEA started cracking down.
Hydrocodone products had been up scheduled, I think it was like 2014.
And she said all of a sudden, she couldn't get the pills on the black market from her dealer.
And so he personally showed her how to snort heroin, which you think heroin, yuck, you know, if you're her, which she did at first.
But really, if you're snorting in a line, it was just the same as she had been snorting the pills.
And once, because with opioids, you need more and more in order not to get dope sick.
Then, when the snorting, the heroin didn't work, her dealer taught her how to shoot it up.
And that, you know, times a million across our country, that's the way it went down.
And now we have fentanyl poisoning the drug supply because it's smaller, more potent, and easier to smuggle in.
In the book, you write about how they would, they'll sort of pack the initial dose with some extras, and you get this big high and you love it.
And then you come back and they lower the dosage in your next delivery.
So then you start to get the feeling you need the next hit sooner, you pay more, you know, and now they've got you.
I mean, now you're a customer for life.
Is heroin a lot cheaper than Oxycontin?
And I mean, obviously, you don't get a prescription for it, so you just get it like on the streets, but it's more accessible and it's cheaper.
Absolutely.
It's a lot cheaper.
And forgive me, I don't remember exactly how much it's going for right now.
But of course, fentanyl is in all of the drugs right now.
So you're getting people overdosing.
With cocaine that's laced with fentanyl, MDMA drugs.
And these are so much easier to get on the black market than the treatment, the medicines, the medication assisted treatment that science says is the gold standard of care for treating people with opioid use disorder.
I mean, that's it's so much easier to just go out and get dope again rather than it is to be treated like a human being with a medical condition in our healthcare system.
And so you get hooked on something like Oxycontin, thanks to Purdue and its fancy marketing skills and its manipulation of the FDA and doctors and its own sales reps.
And then, when you either run out of money or the ability to get more prescriptions, once the government cracked down on these pill pushers, then where are you?
Because you're still addicted and you can't get your drug anymore.
So you turn to heroin or you turn to fentanyl and you have a high likelihood of dying.
I mean, that's the thing.
So we didn't solve the opioid crisis by cracking down on some of these characters.
No, absolutely.
Nor did we solve the opioid crisis by reducing prescriptions, even.
A lot of people thought that would help with overdoses, and maybe it does help with not starting new cases, but for the people who are already addicted, that horse is long out of the barn.
So that's why we need to make these addiction treatments and modalities so much more accessible than they are.
Yeah.
Well, we'll get to the treatment in just a little bit, but the book, also the series based on the book, Does a great job of showing you how it can corrupt your life, how it can corrupt the life of somebody who is innocent, you know, who is well meaning, who is not, I don't know, you know how it is when you grow up, at least in the 70s, you talked about people who got addicted to drugs, you think of somebody who was kind of dirty, kind of a dirtbag, you know, like, oh, gross, who does drugs?
That's not what happened with the opioid crisis.
Addiction Corrupting Innocent Lives 00:02:51
And it's one of the things I love about the storytelling because it accurately represents that, you know, whatever, moms, daughters, you know, innocent high school kids getting sucked.
Into this.
The path in the movie of the main star takes us, her name is Betsy, played by Caitlyn Deaver, takes us to a really low moment when her parents figure out she's still on drugs.
They've tried to get her rehab and she's still on drugs.
And if you've ever had an addict in your family, you've been through something like this because they don't get clean right away.
First time they try, you go through this over and over lies and sneaking and cheating with more and escalating to other drugs.
And it's captured.
Powerfully in what we have labeled as Soundbite Nine.
Watch.
Must hold all of it.
You've been going to AA.
This is where I get my pills.
What?
Hey, hold on.
Dad?
You get your goddamn pills.
Dad, no, no, no.
The only thing you care about is your hands off of me.
Holy goddamn pills!
No, you can't finish your pet.
Uh-huh.
Right here.
You stole your mom's precious heirlooms for this trash.
Huh?
Get in there.
Dad!
Thank you, Matt!
Mattie!
Daniel!
Oh, no!
Daniel!
What, what, I hate you.
I hate you.
I hope you burn it out.
My God, it's upsetting to watch.
I mean, it's upsetting to watch because it's too realistic.
And I know you.
It's too realistic.
And I've heard from parents who have been triggered by watching it, who are on Twitter warning other parents.
I mean, this is such a common story.
Folks like this stealing from their relatives.
Parents Watching Their Children Fall 00:08:02
You know, they've been stigmatized and made to feel ashamed.
And parents, many of whom, just like Betsy's parents, don't really understand the science behind.
Opioid use disorder.
So they too are ashamed.
I mean, I was talking to somebody at the rally just Friday night who works with families in Massachusetts.
And she said people will still call her and they're dealing with it in their family.
And they'll want to meet her four towns over from where she lives because they're so stigmatized by the hoax that the Sacklers did on families in America, stigmatizing the wrong people.
The thought of the doctor telling an innocent patient who comes in there, Ernestly seeking the treatment of pain.
And the way they pitched Oxy as non addictive and totally safe.
And first they'd give you, you know, these small units.
And then when the small units, and they were supposed to last, they were supposed to last overnight even.
And then people said, well, they're not lasting.
They're not lasting.
I need help.
And Purdue said, well, let's call that breakthrough pain.
That's breakthrough pain.
And the way we're going to address that is with, take a guess, more Oxycontin.
And then they kept making the pills bigger and bigger.
And even the initial dosages.
Given to the patients, it would be bigger and bigger.
And all I can think watching that scene is you know, imagine saying to a patient who came in for minor back pain, just looking for some relief, I'll give you this drug.
It will turn you into a bomb.
You will become a human bomb that will blow up your entire family, your life as you know it, all of your loved ones.
It will turn you into a thief, into a liar, into a felon, and possibly into a dead corpse.
Here you go.
That's the warning that these drugs should have had on them.
Absolutely.
Absolutely.
And I say this to physicians' groups, maybe not quite that forcefully as you, Megan, but I will say that 5,000 of you went out to fancy resorts, courtesy of Purdue Pharma, and learned how to become good prescribers of their drug.
They took gifts, they took fancy dinners.
And when journalists aren't even allowed to go to take somebody out for lunch, right?
And yet these doctors that make a lot of money already are taking these free trips.
They've been coming paid speakers for the company.
And what I say to doctors is, I know you were lied to, but you helped get us into this mess and you need to help get us out.
And what's the answer to that?
How can they?
So we know that not everyone responds the same to addiction.
We know that a person with heroin addiction, a typical person, it's going to take them five to six treatment attempts and over eight years to get just one year of sobriety.
So that's one thing we have to realize that this is a Chronic relapsing disease.
We know that buprenorphine and methadone, which people call MAT for medication assisted treatment, reduce overdose deaths by 50 to 60% or more in some cases.
But that also, it's really important to get people housing and social supports and counseling along with this.
These are all things we don't do very well in this country as we see the homelessness rate skyrocketing.
And many of the young people that I followed in my book ended up in prison, ended up doing sex work, living homeless.
I mean, people who were doctors' kids, people who were civic leaders' kids.
Wealth didn't protect anyone in this case.
In fact, because of the stigma attached to wealthier families, In some cases, it made it worse.
People would send their kids away to these abstinence only rehabs, spend a fortune for them.
A lot of middle class families would remortgage their homes to send them to exactly the kind of treatment that science says doesn't really work for opioid use disorder.
And you've seen that in the Keaton story when he's there, I forget if it's episode six or seven, he's like, Hey, you've been back here a lot, right?
In rehab.
And the guy says, Yeah, five or six times.
And he says, You know, but it worked.
It worked for me finally.
And he says, Well, were you alcohol?
And he says, Yeah, alcohol.
So we know that the rehab works better for abstinence only modalities, work better than for opioids, which you really, most people need the medication assisted treatment.
See, that's another thing that we didn't know when going through this, right?
Like, I remember being one of the, you know, you got to go cold turkey, you know, you got to let this person hit rock bottom.
I don't reveal who it was in my family because I don't have the permission of the person or the person's other family members.
But, you know, I was of the mind of like tough love.
You know, you can't keep picking up the pieces.
You can't give this person the home that they lost because of all the lies and all the drugs and all the bankruptcies and all.
You can't do that.
You know, like let them deal with the loss of natural consequences.
And it's only now with some distance that I start to see it's just not that simple.
And you can't really apply the rules you may have thought applied to a disease like alcoholism.
And you could.
Take issue with my plan, even there, to this addiction.
That's absolutely right.
And I saw that over and over and over again.
And it's still happening.
You know, parents are sort of beating their heads against the wall and they're being told, many of them are being told that that's the way to do it.
I tell the story of this mom in my new book, Raising Lazarus, which comes out next August, who had this critical moment where she knew her son was going to die if he didn't get help.
And her best friend had a teenage daughter who had cancer.
And she said, I'm going to treat him the way Lisa treats Amelia.
I'm not going to just kick him out of the house.
I'm going to feed him.
If he comes home and he's high, I'm not going to engage, but I'm also not going to be cruel.
And then we're going to have a conversation the next day.
And I'm not giving up on him.
And she says, now he's six years into sobriety.
She says her only regret was that she hadn't approached.
His addiction, like the medical condition it was, much sooner.
Wow.
It's so hard that she's a strong woman because, unlike the cancer patient, this patient is lying and cheating and stealing and bankrupting other family members.
And, you know, you're angry with them, right?
It's like you have to check your anger because what you really want is to solve it.
You know, you don't want to just punish.
It's not about retribution.
It's like, I want this all to stop.
And the way to stop.
Is your friend's approach, but man, it's so hard.
You're right.
And they mess up your Christmas dinner and your Thanksgiving dinner, and they hurt everyone you love.
Everyone you love.
Yeah.
Yeah.
I will never forget with Tess, who was the young woman I followed the most in Dope Sick.
She would disappear and live homeless, and then she'd come home every now and then.
And the last Thanksgiving they had together, she had hurt her siblings so much that, and they were very much kind of had come up in tough love that they were just done with her.
And even though she made the whole meal, she did all the shopping.
And her mom just sent me a picture the other day after Thanksgiving.
She goes, Remember this?
It was Tess's last.
She called it the thankless Thanksgiving.
She made the whole meal and no one thanked her.
And, you know, shortly after she had another breakdown and, you know, she went back out in the streets.
And, you know, I know her mother wishes she would have acted sooner with love.
And she now says, you know, Rock Bottom has a basement, the basement has a trapdoor.
Pharmacies Settled for Liability 00:12:15
I wish I knew now what I knew then what I knew now.
It's a good line.
Coming up, we're going to talk about how the system is not positioned.
Not at all, to help people who find themselves addicted to opioids get out of it and get their lives straight and clean.
To the contrary, it's built, I think, to keep them down, and it does a really effective job at it.
We'll pick it up there with Beth Macy coming up right after this.
So, Beth, just to take a step back, the book does a good job of explaining how we've had some shifts as a country.
This isn't the first time that we've been, I guess, dope sick.
And you talk about how one of the things that struck me in the book was that you talked about how they used to.
It was, I'm looking at my note here, in 1899, Bear, Bear, as in Bear Aspirin, was cranking out a ton of heroin a year and selling it in 23 countries.
And you write that in the U.S., cough drops and even baby soothing syrups were laced with heroin.
So this is in the late 1800s.
We were giving heroin to our babies.
Yeah.
So this kind of comes about.
As the result of Civil War wounds and women who had lost their families.
And heroin is actually introduced by Bayer as a cure for morphinism, which is doctors would give morphine away along with needles to patients and have them use them as needed.
And of course, just as then, even though then it was much lighter dosage than the heroin we have certainly of now is.
But people would need more and more.
And then when the Harrison Narcotics Act came along in 1914, outlawing most of the black market uses of the drug, people then went to the black market.
And so that's when there became this dichotomy between legitimate white market users who were prescribed and so called black market users.
So for most of the 1900s until 1996, when Purdue comes out with OxyContin, we knew that opioids. were addictive and should only be used in the instances of cancer, end of life, post surgery, but just for a few days, because doctors were rightly worried about addiction, which we've known for centuries actually.
And yet, Purdue managed to flip the narrative, not just for Oxycontin, but through the pain societies that they funded a lot of, and through things like the Joint Commission, which they had a role in.
You know, things like consumer surveys where patients would, you know, give a hospital a bad thing.
You see that playing out in the show when our character Randy is in the hospital for prostate cancer.
They just shifted that narrative right away and it all blew up again.
So, in other words, just to add to that, you're saying, because this is portrayed in the film and the movie too, that if you go to the hospital and you have a negative experience and you give them a bad rating because they didn't address your pain, that hurts the hospital.
And so, there was a big push started by OxyContin to Purdue to get doctors and nurses on it.
If you feel pain, there's no more like just dealing with it.
And there's no more like, all right, well, let's titrate it.
A little bit, you know, it's give them why not?
Why not more?
Why not more Oxycontin?
And if you're worried about it, here's the special FDA label that says don't worry about it.
But like there was a consumerist response to this pain problem that the hospitals had to worry about because they are, after all, businesses.
Absolutely.
They could lose the ratings, they could lose reimbursements from Medicare and Medicaid if they didn't treat a person's pain.
And still today, I was at the ER with a friend not long ago.
You still see that rate your pain scale with the smiley faces one to 10.
So, there are still elements of it, although I think most doctors and nurses are much wiser about it.
And one of the things we've done since the mid 90s, the mid to the early aughts, is we've gotten around the problem of doctor jumping, right?
I don't know what the technical term for it is, but I get a prescription from Dr. Smith for Oxycontin and he fills it, but he knows only to give me 30 days worth or one.
Back then, they were giving a few refills.
But then I go to Dr. Jones because Dr. Smith's not going to give me any more when I ran out of it after a week.
And I get one from him, and then I get one from this other female doctor.
You can't do that anymore, right?
Technically, you're not supposed to be able to do that.
All the states now have, they're called PDMPs, prescription monitoring programs.
I think only one state is a holdout, but you see Michael Keaton doing that at the height of his addiction.
He's in the corner of far Southwest Virginia, and it's just a half hour drive to get to Tennessee and this way to Kentucky, this way to West Virginia.
And they would really take advantage of that.
And you also see in the show this idea that, oh, they're cutting down, they're cutting back on prescribing at home, but people would rent vans to drive down.
They called it, what did they call it?
The Pillbilly Express or the Oxycontin Express.
They would drive down to Florida, which had no restrictions at the time.
And you would see these strip mall office setups with doctors prescribing without hardly even doing exams.
And they would be running pharmacies out their back.
Door.
I mean, sometimes in like the equivalent of a food truck, you know?
Because you could get rich as a doctor by doing that.
You could get rich as a doctor by doing that.
And by the way, one of the things that's happened in the news recently, just a couple of weeks ago, was a judgment of liability against CVS, Walgreens, and Walmart for their role in the opioid crisis, their pharmacies, and a couple of other ones like Rite Aid and another had settled.
So they were also swept in, in just indiscriminately filling all these prescriptions when.
And Mourna's just talking about mild abuse, but in abuse of these drugs that should have been obvious to any pharmacy, then yet they turned a blind eye because they too made a lot of money off of this.
Absolutely.
That's right.
And what you have now, and every time I do an interview, I'll hear from the chronic pain community.
And they're angry because a lot of folks who are actually on stable dosages of legit pain medications are being abandoned as well.
And so you see some of those folks.
Either suffering in pain or going to the black market and getting heroin laced with fentanyl or committing suicide.
So that's a concern too, but that's directly because of the actions of Purdue.
Making it so overprescribed to start with that it's hard to suss out for some doctors who's legit and who isn't.
But so just a nod to the fact that there are other unintended victims of this today.
And I hear from them a lot.
The lawsuits started to come against Purdue as people started to feel it, as communities started to put together that entire towns were falling apart and found themselves addicted.
I mean, in particular in Appalachia.
And the big one we mentioned a minute ago with Danny Strong was the 2007 settlement with Purdue, where the three executives pleaded guilty to, was it a felony?
It was a felony?
Yes.
Yeah, to a felony.
No, I'm sorry.
The executives pleaded guilty to misdemeanors.
They were on probation for a few years.
They had fines, but the company made it.
And then the holding company, not Purdue Pharma, rather, but Purdue Frederick, pleaded guilty to a felony.
Now, if Purdue Pharma would have Pleaded guilty.
I mean, their lawyers were so ahead of everybody else on this.
They cunningly knew that Purdue Pharma wouldn't be able to continue to sell Oxycontin if it had a felony.
So they did the deal with the holding company Purdue Frederick.
And it was allowed.
And by the way, none of those executives was last named Sackler.
It was three other guys.
Absolutely.
Yes, absolutely.
And if you talk to the activists now, because Danny and I were just with a bunch of them on Friday at this rally on December 3rd, they didn't even know the name Sackler back then.
And think about that.
Like, you know, you've got all these museums and wings and whatnot, but back then, if you went to the Purdue Farmer website, you wouldn't even see the name Sackler on anything.
They were very clever.
And as word that these lawsuits were coming up, they cleverly, you know, resigned from their board positions and, you know, in a way allowed their philanthropy to sort of cloak their villainy.
So, how did they come back?
You know, we were just talking with Danny about how.
They, I think, tripled their sales within a couple of years.
They went forward, the Sacklers and Purdue, like nothing had ever happened.
That's right.
Well, a lot of the government regulators that should have been monitoring their corporate integrity agreement I mean, corporate integrity agreement, the very phrase is kind of laughable when you see how they just continued to do what they were doing before.
Up their sales.
Richard Sackler personally went on sales calls at least one time that we know of, and they hired McKinsey to double down, to sell, sell, sell.
And we don't have structures in place to make sure that the proper checks are happening, such that in 2020, the company pleads guilty to more felonies, which are basically the same kind of fraudulent behaviors.
In between those two times, I mean, when would you say we became aware of the opioid crisis?
You know, we as a nation had the national consciousness that this was a thing.
That's a really good question.
In 2015, the Nobel winning economist Anne Case and Angus Deaton wrote about a bombshell study, it was on the cover of Time magazine, Deaths of Despair.
So we realized that for the first time in American history since World War I, our life expectancy was going down.
And it was going down largely due to opioid overdose.
Alcoholism related diseases like cirrhosis of the liver into suicide.
But by far the biggest of those three factors was opioids.
You had Sam Canoni's book Dreamland, which came out in 2016, I believe.
My book came out in 2018.
And then the lawsuits started happening.
And a lot of those, most of the suits ended up over 2,600 lawsuits were brought by cities and counties and state governments.
They ended up in the multi district litigation under the direction of Judge Polster in Cleveland.
But Purdue was able to pull their case out by filing bankruptcy.
And where did they file bankruptcy?
Not in a location where they actually conduct business, but they filed it in the jurisdiction of a bankruptcy judge named Robert Drain, who is known for being one of the minority of judges who allows what's called a third party release, which is like a bankruptcy loophole.
They file in White Plains because they know Drain is one of the few judges that allows the Sackler to attach to get civil immunity from further litigation.
In exchange for their settlement.
Yeah, and just to make clear, this is an issue because the Sacklers individually were not filing for bankruptcy.
Civil Immunity for Billionaires 00:10:14
They're billionaires.
Just Purdue Pharma was.
But they wanted to sort of glom on to their company and say, oh, and no lawsuits against us and no more criminal, no trouble for us of any kind because we've contributed $4 billion or we've contributed to this massive bankruptcy settlement.
But they basically, but that was back funded, as I understand, by Purdue anyway.
So it's all fungible.
These are still going to be billionaires.
And now, if this goes through, they can't be sued.
So, if you take that 10.4 and then you let them pay off the four and a half over nine years, by the way, they have nine years to pay it.
So, with investments at the going rate, they could be richer at the end of the nine years than they are right now.
I mean, where is the justice in that?
Oh my gosh, they're clever.
I mean, that's definitely something we saw in all of this.
They're clever.
One of the things you point out in your book, and I think it's good too, is, A couple of very famous deaths.
You know, sometimes I don't want to say these people were used, you know, by a higher power to sort of underscore the dangers of drugs to us, but you point out in the book, Philip Seymour Hoffman's death.
I mean, this incredibly promising actor who was just stunning when he died.
Prince died.
I mean, both of them swept up in this same crisis that we're talking about.
And sometimes seeing somebody that famous and talented, seeing their life cut short, can really be, I don't know, a It gets your attention and it focuses you in a way that can be productive.
Yes, it's a wake up call.
And as I think somebody in the book said, nobody wants to tell Prince that he has an opioid problem, right?
So, back to this idea that wealth and power can protect you from this, nobody's protected from this.
That's why we all need to pay attention and become advocates for our own medical treatments.
Yep.
So then it morphs from Oxy to the heroin scene.
And you write in your book about how this is like the suburban heroin scene, the young teenage girl heroin scene would shock people.
Can you talk about that a bit?
Because it's hard to believe that young cheerleaders are doing heroin, but they are.
Yeah.
And of course, not all of them, but you and I growing up in the 70s and 80s, when kids would experiment with alcohol or weed, You know, maybe some mushrooms or something.
I don't know.
But you talk about kids that grew up in the 90s and the aughts, they had pills at their disposal because Purdue had massively talked doctors into massively over prescribing these drugs.
So a kid could just experiment, like the way a kid in years your would have done with alcohol or marijuana.
But only now they're using a much more dangerous drug.
And so, I mean, actually, I was just at a premiere event here in Roanoke with the first person I ever knew who this had happened to.
And he was a young man named Spencer Mompower.
And when I first met him, he was from a wealthy family.
His mom was a civic leader, had a chain of jewelry stores, and he was about to go to federal prison for five and a half years for having sold heroin to his former private school classmate.
Who died.
And I spent the summer hanging out with him trying to learn about this nascent cell of heroin users in the wealthy white suburbs of Roanoke.
And he said, Dude, I'm the one that told you what the word dope sick meant.
And I was like, You're absolutely right.
I didn't know what it meant then.
But I remember him describing how if he said, If your dope man wasn't coming until, you know, for three more days and you only had this little, this much left, you would parse it out so that you would still have a little bit at the end because the, The driving fear of all of it was this fear of withdrawal and this fear of dope sickness.
Of course, this, like any addiction, is more likely to affect you if you have a parent who is an addict.
Your book points out that I think you have a 50 to 60%, you're 50 to 60% more likely to become addicted if you have a parent who is an addict.
So, you know, there is, of course, as with any addiction, an extra special red warning label to people who have that in their family.
But there is a treatment, and we talked about how, you know, the, The version of AA doesn't work so well for the opioid addicts, but there is a treatment called Suboxone that does help.
Now, it too is considered a controlled substance, right?
Like an opiate.
It's an opiate.
So it will show up in your blood if you want to do a job that tests your blood before they hire you.
It will show up and it will show up as Suboxone, and then they'll know that you're on that drug, which helps you get off of another opiate.
So you've got sort of an opioid in your blood, which is helping you get off of probably a more serious opioid.
And boom, Bob's your uncle.
I mean, these jobs aren't going to hire you.
That's a real problem, but that drug seems to be very much part of the solution to this crisis.
Absolutely.
It's protective.
And Megan, it has buprenorphine in it, which is the opioid that kind of gloms onto the opioid receptor, but it also has naloxone in it, which is the generic name for Narcan, so that if somebody does go out and use it, it's not going to work for them.
And so it is protective in that way.
And you see in our show, The way the Michael Keaton character is stigmatized for being on it.
And he said, it's what's keeping me clean.
I've never felt clearer than I have in my life.
You see Betsy go to the AA meeting and be told that she's considering going on it.
But somebody says to her, you know, that's just treating a drug with another drug.
And this happened over and over to the young people that I was following for my book.
And it is a real problem.
Especially among law enforcement people who have seen it diverted and sold.
But I would argue, and many experts argue, that the reason it is so widely diverted is because it largely isn't available to the people who need it.
So there is this big market demand for it.
Only one in five people with opioid use disorder has access to it.
So that's something we know it works.
We know it's dangerous to go off of.
Harder opioids without being on it.
So we really need to make it available at a scale to match the crisis.
How long can one stay on it?
So everyone's different.
And some people think it's okay.
You might have to be on it for the rest of your life.
Dr. Van Z, the doctor who's portrayed in the show, he told me years ago he said he's got patients weaned down very, very slowly, and they might just be on a teeny little bit every day.
But he's afraid because he's seen people, you know, even when they're on a small amount, when they go off, some have relapsed.
And so he's very, very cautious about it.
He only does it when a person voluntarily wants.
Voluntarily wants to taper off, but it's something to be done with all caution.
But he, I mean, he does have some amazing success stories, as do all MAT doctors.
I mean, the thing about law enforcement is they only see the bad side of it, the people breaking the law side of it.
They don't see the people who are getting jobs back, getting their kids back.
Well, and I think employers need to see that drug and maybe have a different reaction instead of seeing, like, oh, drug addict and they've got an opioid in them now.
It's no, someone who, Has actively taken steps to change their life.
And you can find out for how long they've been clean and been on it because you're not taking opioids in addition to Suboxone if you're taking Suboxone.
But to me, it's just so frustrating because you see, Beth, it's like these companies, they get you addicted.
They get you addicted to their drug.
Your life spirals.
So many of these people wind up committing crimes, whether it's shoplifting or something with cars, what have you, because they're desperate, selling drugs, buying drugs.
And now they have a criminal record.
Then they get on Suboxone, which is the way out for a lot of them.
Then they can't get a job because they've got that in their blood, which is a tell.
So now you can, you know, your employers are looking at somebody who's got a criminal past, who's got this drug, which is a tell, who probably doesn't present all that well physically because they've been an addict for all this time.
And it's an impossible spiral to pull yourself out of.
You need so much support, so much love, so much understanding from your family, from society, from employers, from law enforcement, from the judicial system.
And from we didn't even touch the story of expanded Medicaid.
And I, You know, your book is really smart on that.
I love people to read your arguments for Medicaid expansion.
It's just number one tool for reducing overdose deaths in various states, but we still have 12 states that haven't expanded it, right?
Yep.
Yep.
Because they think it's, again, I think they think it may be tough love, but it may just be cruel and a way of stopping people from getting out of a really tough situation.
Right.
And as this opioid litigation money, as it starts to funnel down, is so important.
That states and communities get together people who really understand the science and aren't just spouting off this tough love crap, which isn't working and is starting to meet people where they are.
We know that people who visit needle exchanges, I know that sounds counterintuitive.
Why are you going to give a drug user a clean needle?
Well, because they're going to use regardless until they get real help.
So, why don't we make sure they use safely?
And that's going to cut down on the spread of hepatitis C and HIV, which is skyrocketing in some communities.
Yeah, no, they're also five times more likely to enter treatment when they go to a needle exchange.
Oh, and on top of that, you've said it's cheaper to pay for the needle than it is to pay for the disease, the treatment of the disease they're going to get from dirty needles.
Politics Dividing Our Communities 00:07:46
So it's like society's in.
We're in this whether we want to be or not.
And the only question now is what is the smart way of dealing with it?
Beth Macy is one of the people who has been calling attention to it for a long time.
Thoughtful diagnoses and possible solutions.
I'm grateful for you, Beth.
Thank you.
Thank you so much.
Thank you, Megan.
Really appreciate it.
All the best.
Coming up, my message to you all just ahead of Christmas.
Before we go, I wanted to say a few words about connection.
We all need it, whether through partners.
Children, friends, colleagues, pets.
And I think for most of our history, we have needed to feel connected to our fellow Americans too, to the very idea of America itself.
Feels like that's waning these days, doesn't it?
As we become more tribal, more political, more judgmental, less forgiving, it seems like we are dividing into two groups in this country these days those who love America and those who loathe it.
But you gotta stop and wonder every once in a while, is that Real?
Does half of the country actually hate it?
Or is a dour, misguided subsection driving that narrative?
A subsection who most of us see as lost, a little sad, and a group either to be ignored or defeated.
Peggy Noonan had a Wall Street Journal column out after the 9 11 anniversary this year, captioned, America has lost the thread.
I recommend it to you.
She was right after the Met Gala, and they were supposed to be wearing these patriotic outfits, and they didn't get it because Hollywood.
But the column was about how it feels like we no longer live in the America that came together after the 9 11 attacks.
We're so divided now.
We're so mean to one another, unlike back then.
Quote Following the trauma and drama of 9 11, she wrote, we started discovering in some new way our nation's meaning, what it was in history, meant in history, meant to us.
We talked about it.
We saw.
The first thing the firemen did after the towers fell was put up the flag.
Exactly.
I remember those days so vividly, don't you?
When we were quicker to hold doors for one another, to cede the cab to someone else, to let somebody else go in front of us at the grocery aisle.
There was a sense that we were going through something together and that we would get through it together.
These days there's loose talk of secession.
Constant, constant demonization of whole groups of Americans based on The most pernicious of reasons skin color, gender, background, political party, beliefs that differ from our own when it comes to hard work, tenacity, mental toughness, and so on.
But then you put down the TV remote or the newspaper or the smartphone and you step out into the real world where you are still free to hold a door for someone, to smile at a stranger, to cede your place in the grocery aisle.
And when you do, you find kindness.
Abounds.
It's everywhere, blue and red America.
That's who we are.
If you live in a predominantly red or blue city, state, town, maybe you don't get to spend a lot of time with people who disagree with you.
That is an advantage I have had living the past 20 years in New York City and now in Connecticut as a center right person.
I am surrounded by Democrats, tons of them everywhere, virtually all of them, who I absolutely happen to love.
Even my mom.
I don't necessarily agree with most of their politics, but I socialize with them.
I cry with them.
I celebrate the babies with them and I mourn them when they pass, like my sweet neighbor, Stu, this month.
You don't think about politics in those moments.
You don't think about who somebody votes for.
These folks want what most people want they want safe neighborhoods, good schools, an end to the pandemic, grace for themselves or for their kids if they screw up, a healthy environment, a good job.
Good health care, the ability to save a little, maybe take a vacation here or there.
They are not running around trying to cancel people, defund the police, enter trans girls and girls' sports irrespective of the unfair advantages, force kink on young kids, segregate classes, or divide children by skin color.
That is a woke problem.
It's not necessarily a Democrat problem.
And it's important to understand the difference there.
I speak here of little D Dems, not the party itself.
Big D Dems have proven they are beholden to the loudest, cruelest, most insane voices in their party.
They actually did push in city after city to defund the cops and put criminals back on the street.
They actually do favor X rated books in schools and radical trans and race messaging that is unhinged.
I do not have a friend, and again, most of my closest pals are lifelong Democrats, who favors that nonsense.
So, I am thinking about the non woke left this holiday season and how we can all come together, back together on the things we share, the things we all love.
How they and you and I can find a way to save this country, to defeat the angriest lot among us, the ones who hate America, who don't want to be here, who don't see this country as the shining city on the hill.
Elections, yes, that is one important way, keep them out of power.
It is also important to speak out against their madness when we can, right?
When we see it, if we can.
I realize it requires a lot in certain professions in particular, but in whatever way you can find it, it is important to speak out.
But also remember not to do what they do and dismiss half the country because they wear a different jersey.
What if huge swaths of these Democrats were on the side of America and due process and the First Amendment?
They are.
Would you want to chase them into the arms of your opponent by calling them names and treating them rudely and always assuming the worst about them?
That's what you fall into in right wing media, right?
The left is horrible.
Well, it's not all the left.
It's not.
Don't divide the army.
You don't have to.
A recent survey done by Real Clear Politics investigations showed that 85% of Americans say they are patriotic, believe themselves to be patriotic.
Nine out of 10 voters.
Believe the US continues to do a lot of good in the world.
And 90% of voters reject the notion that America does more harm than good globally.
This holiday season, think about that 85% of our patriotic countrymen and how we can find our way back to one another.
Maybe for a stint, we can just be extra kind.
Hold the doors, allow the merges, give the wave, make small talk at the store, right?
When they're checking you out, scanning your items, smile.
Say something stupid.
Kind.
Take a shot, right?
And for those of you who remember 912, like I do, right?
911 and 912, those two days together, the devastation and the beginning of the rest.
Think about that feeling you got when, in the midst of our darkest hour in lower Manhattan, the firefighters still in harm's way made sure that our flag went back up.
Extra Kindness During Holidays 00:00:21
And America, all of us cheered.
Merry Christmas, happy holidays, happy new year.
Thanks for listening to The Megyn Kelly Show.
No BS, no agenda, and no fear.
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