Writer Barry Meier is a former New York Times journalist, and author of the book “Pain Killer: A Wonder Drug's Trail of Addiction and Death.” It’s the grim story of OxyContin, the opioid epidemic, the pharmaceutical company Purdue Pharma, and its owners, the Sackler Family. His groundbreaking reporting helped bring the corporate malfeasance that fueled a massive wave of substance misuse to light for the first time.
“The over prescription and the misuse of this drug essentially triggered or planted the seed for the opioid epidemic that we have today. I mean, most of the overdose deaths today involve illegal forms of fentanyl, counterfeit drugs that are made by cartels in Mexico, but 20 years ago, there was a growing number of overdoses starting in the hundreds and going into the thousands – and eventually, into the tens of thousands – that were being caused by prescription narcotics or opioids, as they're sometimes called.”
We sit down with Meier, who discusses the impact of “Pain Killer” – which has been adapted into a Netflix series – after the news.
In 2001, New York Times reporter Barry Meier began reporting a story about an obscure painkiller called OxyContin. Produced by Purdue Pharma under the ownership of the Sackler Family, the opioid was marketed as being safe from possible addiction or misuse. As he found and later published in his groundbreaking 2003 book “Pain Killer: A Wonder Drug's Trail of Addiction and Death,” the drug was in fact wreaking havoc on the streets of America. Meier sat down with WAMC to talk about how his journey with OxyContin, Purdue Pharma, and the Sackler family all began- and how the story has continued in the years since “Pain Killer” – now a drama series on Netflix – was first published.
MEIER: It started out like most stories do, with a tip. You get a call from someone, an editor comes over to you, and in this case, one of my editors had actually gotten a tip from a pharmacy board regulator, who told him that there was a hot new drug on the street, this relatively little-known painkiller at the time called OxyContin. And what made it so unusual was that the sales reps for its producer were going around telling doctors and pharmacists that, essentially, this drug could not be abused, it was safe, you could prescribe it to patients for all kinds of purposes, and you didn't have to worry about them getting addicted or them abusing the drugs or the drug ending up on the street. So, it was basically on the basis of that tip that I started doing reporting and found out very quickly that it was the hottest thing on the street. And that led me to start investigating how it gotten out there and what its manufacturer knew about the problems.
WAMC: From the standpoint of 2023, all of these revelations and these major corners you turned in your reporting are taken for granted, the realization that misuse of the drugs was widespread and that they were incredibly valued on the streets, being sold illicitly. When did you turn that corner into realizing the full extent of what the story meant?
You know, I think it happened pretty quickly in the course of my reporting. I started reporting on OxyContin and its manufacturer Purdue Pharma, this little-known company that was owned by the secretive and wealthy family called the Sacklers in 2001, and fairly soon, I got a tip from a company insider that the largest sales of this drug were taking place in parts of the United States where so called pill mills were operating, which were basically pain clinics, or supposed pain clinics where patients or supposed patients could walk in and pay a doctor $50 to write a prescription for them. And I had the sales data showing that, and it quickly dawned on me that this company knew that this drug was being highly prescribed in areas where it was also being largely abused.
So, what were the impacts of the over prescription of these drugs?
Well, I mean, I think the over prescription and the misuse of this drug essentially triggered or planted the seed for the opioid epidemic that we have today. I mean, most of the overdose deaths today involve illegal forms of fentanyl, counterfeit drugs that are made by cartels in Mexico, but 20 years ago, there was a growing number of overdoses starting in the hundreds and going into the thousands – and eventually, into the tens of thousands – that were being caused by prescription narcotics or opioids, as they're sometimes called. And that's the part that I found fascinating, that we were living in a situation where drugs that were legally produced by the pharmaceutical industry that were prescribed by doctors had become the prevalent drugs of abuse.
So, where were the regulator in all of this as over prescription and misuse of the drug became so prevalent? Who was supposed to be minding the till here and protecting Americans from this exact kind of situation?
Well, this never would have happened absent an insane decision by the FDA to approve a label for OxyContin that allowed the manufacturer to say that it might be less prone to abuse than competing opioids. And that kind of was, not only opened the gate to the massive prescribing of OxyContin, but also to the criminal activity on behalf of Purdue Pharma, where, they didn't go out and say, oh, it may be less prone to abuse- They went out and said it was less prone to abuse and began to manufacture a lot of fake science that fooled doctors into thinking that, you know, we can use this drug for kind of common source of pain, be it back pain or arthritis or the types of uses that doctors had not previously used these powerful drugs for. And unfortunately, regulators, law enforcement officials, and lawmakers are very slow to react.
Over the course of reporting the story, how close did you get to the Sackler family? And did you get any sense of what conversations were like internally within their inner circles about how they perceived their role in contributing so significantly to this public health crisis?
My research into the Sackler family was mainly stuff that I dug up in libraries, archives. There was a fascinating estate battle that went on. But you know, it's- We think of the Sacklers today as the family that essentially made their billions from this single drug OxyContin. But what I sketched out in the book is the history of the Sacklers and the critical role that Arthur Sackler, who was sort of the most prominent family member who essentially created the Sackler fortune- He, back in the 1950s and 60s, created the entire industry of pharmaceutical advertising. There hadn't been these types of ads that we, are now ubiquitous in our lives, that we see on TV, he essentially laid the foundation for that entire industry, as well as creating- I mean, I see it as a seduction of the medical profession and the corruption of the medical profession where he made doctors essentially arms of drugmakers, where doctors would go out and talk at dinners or give lectures to their colleagues to promote drugs. And all of this marketing, all these promotional techniques that were essentially used by Purdue and other companies to promote their drugs were effectively created by Arthur Sackler.
In the years since you've covered the Sacklers and your book was published, what's transpired with a family that takes us up to the modern day?
It's been fascinating, because, I, kind of, in my book, where the bankruptcy proceeding is just starting to get traction, there's a new wave of lawsuits that have, in 2017 and 2018, that are being filed, not only against Purdue Pharma, but against the Sackler family, as individuals, the members of the Sackler family that were involved with the company. So fast forward, there's Purdue faced with this wave of litigation filed for bankruptcy. Not unusual for companies to seek bankruptcy protection, when they're about to be blasted to smithereens by lawsuits. But what takes place is extraordinarily interesting, and that is that the Sackler family, which is also being sued without declaring bankruptcy themselves, have effectively coat tailed on to Perdue’s bankruptcy, and said to the claimants, you know, we will give you, now the figure is $6 billion, if you just leave us alone, if you give us what is effectively an insurance policy, and guarantee us that we can go on with our lives and enjoy our fortune without being sued again. So essentially, the claimants agreed to do that, until this very dramatic turn of events just a few weeks ago on August- I mean, it was very ironic because it was on the same day that “Pain Killer” debuted on Netflix. The Supreme Court said, wait a minute, this may violate the kind of spirit and law of bankruptcy proceedings where wealthy individuals can use this system to seek protection for themselves without going into bankruptcy, so we want to review this whole process. And there will be a hearing I believe where this matter will be argued now before the Supreme Court and it may throw out this entire agreement.
Your reporting raises so many questions about corporate malfeasance, about advertising, about how the medical industry operates, about how pharmacies operate. Can you give us your sense of what the major takeaways are from the story of painkillers and the Sackler family as of late 2023?
Well, there are several. One is, the Sackler family, whose names were once on museums and medical schools – not only here in the United States, but throughout the world – they've become public pariahs. And that's largely as a result of a campaign by the photographer named Nan Goldin to get museums to remove their names. From the regulatory standpoint, I don't think – I certainly hope – that the FDA will ever approve a drug with allowing its manufacturer to make the type of claim that it did for OxyContin. I mean, that was scandalous, and hopefully, there's been some recognition of that. Medically, it's a double-edged sword. There are a lot of doctors who will not prescribe very powerful opioids anymore. They feel like patients could abuse them, patients could get addicted, and that's also created a dilemma for some patients who actually need these drugs and function well because they have these drugs. So, we're kind of- We've long been in this pendulum swing of, how do we use these drugs, to whom do doctors prescribe them, and hopefully, there's going to be a focus going forward on both getting these drugs to what is really a fairly small percentage of patients who need them, and coming up with alternative ways of treating pain, which is a very real problem for lots of people.
When you look back over your reporting on this remarkable story, were there any moments that stood out to you as like, well, this is going to make it into the book on “Barry Meier reflects on his journalistic career?”
Well, I mean, I think there were probably three pivotal moments. The first pivotal moment was when I got that document back in 2001, when it became clear to me that the company was aware that its best sales were happening in areas where the highest levels of abuse was. So that really sort of like turbocharged my investigation. The second big moment was in 2007, when I was called by the US Attorney in Virginia, who said to me, Barry, this company and three of his executives are going to plead guilty to criminal charges. They've asked us not to contact the media, but your reporting was so important to our investigation, we want you to be there. And so, I came down to Virginia and I was the only reporter present in the courtroom when they entered their guilty pleas. And then a decade later, in 2017, when another source gave me the evidence that the same prosecutors wanted to use and weren't allowed to proceed and use in bringing felony indictments against the Purdue executives. Essentially, their whole plan was stopped by political higher-ups in the Justice Department in 2007. That forced them to strike this plea deal. And I saw the scope of the evidence that they had compiled, and I sort of lay it out in in the latest edition of “Pain Killer.” And I think anyone who sees that, anyone who reads that, anyone who appreciates what these prosecutors had found would will be horrified to learn that they were not able to make this information public at the time, because I believe if they had been able to make this information public, I believe if the trial of these executives had gone forward – even if these executives had been found not guilty – but the mere fact that this evidence would have gone out into the public sector would have been created such an awakening at that time that the scope and the direction of the opioid epidemic might very well have been blunted.
I wanted to focus in on your personal experience as a reporter, because it seems like, you have this tip, and as you follow it, you must have had this moment of realization that the story that you were following concerned the suffering of untold thousands happening in real time. What was it like knowing that your reporting possibly could make such a major impact on the world, given the immediacy and the ongoing nature of the story that you'd stumbled upon?
Well, you know, when I wrote “Pain Killer” initially back in 2003, I, like every other reporter, had hope- You hope when you invest your time and your effort into a story you believe is very significant, that it's going to have real percussions in the wider world. And it was something of a disappointment when it didn't. And in part that was due to the fact that when the book came out in 2003, this company had not been indicted for crimes. There were crimes that were obvious in the book, but they hadn't been acted upon by the Justice Department or any other legal authority. And so, they were able to say, well, Barry, he’s sort of like out there, no one's listening to what he's saying. And they had a very powerful PR and lobbying machine. They employed people like Rudy Giuliani, who- This is 15 years before he goes out and has hair dye dripping down his face, claiming election interference, and he's still is, it's only a couple of years after 9/11. He's still America's Mayor, and they hire him for his clout. And he's going like, this seems like a great company, I've used their drugs, they're honorable people, and they launched a pretty significant PR and lobbying campaign to present themselves in the best possible light to blunt the impact of the book, and to also attack me personally.
Well, what does that feel like, to be in the crosshairs of a multi-billion-dollar conglomerate?
Well, it's, you know- I think it comes with the territory. I don't think anyone that goes into journalism- You'd have to be naive to think that if you take on a major entity, be a politician or a corporation, that there's not going to be blowback. But I felt at that time that what I was doing is what- I was being, you know, that was my duty as a reporter, and that was my duty as a journalist. You don't control what happens to your work when it gets out into the world. You never know what's going to happen. And if someone had come to me in 2003 and interviewed me and said, hey, Barry, do you know that 20 years from now, this work that you did will have endured, would be, is going to serve as a foundation for other books for other journalists, it's going to be a jumping off point for many other journalists in the future, and it's going to matter and make a difference? I would have said, yeah, that sounds really interesting, but, you know- Call me in 20 years.
