How I Exposed the Biggest Pharma Scandal of Our Lifetime

When I walked into the diner my source was already there, sitting in a booth. It was late summer of 2001 and, earlier that year, I had started writing articles for The New York Times about the growing abuse of a then little-known painkiller, OxyContin. Its maker, Purdue Pharma, was promoting the powerful narcotic to doctors as a “wonder” drug that was far safer from abuse and addiction than other pain pills.

My involvement in the story started simply. An editor asked me to check out a tip that OxyContin, despite its manufacturer’s claims, was finding its way onto the streets of small towns throughout Appalachia. At the time, I knew nothing about prescription narcotics, or “opioids,” addiction, or Purdue’s owners, the wealthy, secretive Sackler family. I had no idea I soon would become an eyewitness to the biggest prescription drug scandal of our lifetime or be the first national reporter to shine a spotlight on it.

One day, I got a call from a Purdue insider who wanted to meet. We agreed to get together at a diner, located about midway between New York and Stamford, Connecticut, where Purdue was based. My source was nervous but dismayed by what Purdue was doing. Then, I was given a lined sheet of notebook paper. It had the word Toppers handwritten on it. 

Purdue used the term, I was told, to identify its top-selling sales reps—the ones paid the biggest bonuses and awarded free vacations. There was a list of ten names, the geographic territories those reps covered, and the dollar amount of OxyContin they had sold in the previous three months. My source then explained a secret Purdue was guarding: every one of those locations contained thriving “pill mills” where doctors prescribed OxyContin for cash, often to people pretending to be patients in pain.

The area serviced by Purdue’s leading “topper” was Myrtle Beach, South Carolina, and when I got back to the Times, I did some research. It turned out that the DEA had just shut down one pill mill there operating as a pain clinic. When I went to Purdue’s headquarters, its three top executives all claimed to me in an interview they didn’t know anything unusual was happening in Myrtle Beach. But thanks to my source, I knew that wasn’t true.

I spent several months doing more reporting and traveled to Myrtle Beach. There, shop owners in the same strip mall as the pain clinic described how hundreds of cars regularly waited in the parking lot for its doors to open. I interviewed patients at the clinic, including some now cut off from medication, and found that five people prescribed OxyContin there had died by overdose. Local pharmacists also told me how they repeatedly warned Purdue officials about what was happening and how those complaints were ignored.

In late 2001, after that trip, I confronted Purdue executives with what I had found and asked them why they hadn’t responded to the situation in Myrtle Beach when their own sales data was flashing red. The company downplayed the chaos and a Purdue spokesman claimed, providing no evidence, that the huge demand for OxyContin in Myrtle Beach was coming from local retirees dealing with arthritis pain. 

The OxyContin story became so big that in 2003, I published a book, Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic, about the unfolding catastrophe we now call the opioid epidemic. Now, twenty years later, it is the basis of a Netflix series that began airing this month. My book documents how Purdue turned OxyContin, a drug valuable for treating severe pain caused by cancer or chronic health issues, into a billion-dollar blockbuster by launching the biggest-ever pharmaceutical marketing campaign for a powerful and potentially addictive narcotic.

It was built on the lie, pushed by Purdue’s sales team, that OxyContin’s special formulation made it safe to use for back pain, dental pain, and other common problems. In fact, a single tablet of OxyContin contained up to sixteen times the amount of oxycodone, a powerful narcotic, than found in traditional painkillers. 

Purdue’s promotional strategies included falsely claiming to well-meaning doctors that scientific studies showed the risk of patient addiction from OxyContin was “less than one percent.” Such studies didn’t exist, but Purdue and its medical allies engaged in an ideological “War on Pain” by cherry-picking data from clinical trials and distorting their findings. The company also used its money to buy influence, by hiring physicians to promote OxyContin, giving money to law enforcement organizations, and making contributions to professional medical groups.

A U.S. attorney in Maine who first sounded the alarm in that state soon went on Purdue’s payroll, as did the FDA official who, at the company’s urging, approved the specious labeling claim that OxyContin’s time-release formula might reduce its potential to be abused. While researching Pain Killer, I discovered the founder of the Sackler dynasty, Dr. Arthur Sackler, developed many of these techniques in the 1950s when he pioneered the prescription drug advertising industry.

I hoped Pain Killer, along with my reporting, would lead to national action from doctors, politicians, and government officials. But for years, the toll of overdose deaths involving prescription opioids continued to mount. Over the past two decades, that figure has exceeded 280,000 Americans. (Most overdose deaths today involve counterfeit fentanyl.)

My work did get plenty of attention from Purdue, which from the beginning dispatched lawyers and paid mouthpieces to attack me. From the start, Times editors had fortunately waved them away. But then Purdue’s executives found a sympathetic ear at the paper: its brand-new “public editor,” Daniel Okrent. 

In 2003, the Times was embroiled in several scandals involving fabricated or inaccurate reporting, and Okrent, a magazine and book writer, was appointed to address newsroom standards. That November, the month after Pain Killer came out, Rush Limbaugh, the late radio personality, disclosed he was addicted to opioids. I was promoting my new book, so I got permission to write an article for the Times about the science of pain treatment and addiction. Purdue’s name appeared only in the eleventh paragraph, and to avoid any conflict of interest, my book was never mentioned.

I correctly anticipated that Purdue executives would attack me. They went to Okrent to complain that I was using the paper to sell my book. In his debut column, Okrent took their side. Apparatchiks at the Times didn’t have the stomach to blow off Okrent, his first time out of the box. After that, I was barred for a time from writing about Purdue, the opioid crisis, and related topics. (Years later, Okrent, whose term as public editor was set for 18 months, told Patrick Radden Keefe for his book, Empire of Pain, that he had often wondered if he “made a mistake.” He described me as being “batshit”—a fair description, since, as I told Keefe, I believed Okrent had been “played for a chump.”) 

I soon learned why Purdue was so desperate to get me off their case. At the same time its executives were complaining to Okrent, federal prosecutors were using my reporting as a road map for a criminal investigation into Purdue. By 2007, my ban was over, and the Justice Department’s inquiry had quietly culminated in charges against Purdue and those executives for misleading doctors and patients about the dangers of OxyContin.

An official with the United States Attorney’s office in Roanoke, Virginia, alerted me about the development before it was publicly announced. The Purdue executives planned to fly on a corporate jet into Abingdon, Virginia, enter their pleas in a courthouse, and fly back to Stamford, Connecticut. Their lawyers asked the U.S. attorney in Roanoke, John Brownlee, not to alert the media. He made one exception: me.

On a May evening in 2007, I had dinner with Brownlee at a Mexican restaurant. He showed me the draft version of a press release his office planned to issue the next day after the executives entered their pleas. In it, he personally thanked me for my work both at the Times and in Pain Killer. I felt vindicated but asked him to delete those sentences.

The Justice Department hailed the case as a victory. It wasn’t. Prosecutors in Virginia wanted to charge the Purdue executives with felonies that carried prison sentences. But Purdue and the men hired the most politically connected lawyers money could buy: Rudolph Giuliani, who needs no introduction; Mary Jo White, who at the time was a former U.S. attorney then in private practice; and Howard Shapiro, the former chief counsel of the FBI. Political appointees in the Bush administration Justice Department caved and forced the Virginia prosecutors to negotiate a deal under which the company’s three men—its president, top lawyer, and former chief medical officer—pleaded guilty to a misdemeanor that held them solely liable for being Purdue Pharma’s “responsible” executives while the company was committing crimes, but did not personally charge them with wrongdoing. 

Almost a decade passed before I wrote another big Times story about Purdue and the Sacklers. Then, around 2017, a source gave me a secret Justice Department prosecution memo that brought me back into the OxyContin saga. It was filled with evidence prosecutors planned to present when seeking felony indictments against the Purdue executives back in 2007, including secret company emails and grand jury testimony. But because the case never went to trial, this explosive memo had been buried.

The evidence gathered by prosecutors pointed to the depth of Purdue’s crimes and deceit. They found that almost immediately after OxyContin’s introduction in 1996, doctors began telling company sales reps that the drug had a high “street value” and that users were crushing tablets and snorting the powder. And by 1999, according to prosecutors, Purdue executives were getting regular reports about pharmacy break-ins and other crimes related to OxyContin, including the arrests of doctors for illegally prescribing it. “I feel like we have a credibility problem with our product,” one company sales rep wrote Purdue executives in 1999. 

The memo also contained emails sent by top Purdue executives to Richard Sackler, who was the company’s president during the boom years of OxyContin sales, and other Sackler family members, about the abuse of the drug and another company opioid. My reporting for the Times was also cited in it.

I wrote a front-page article for the Times about the memo, which became the subject of a Times television documentary. Meanwhile, state attorneys general were bringing a new wave of lawsuits against Purdue and, for the first time, individual members of the Sackler family. 

For decades, the Sacklers had successfully shielded themselves from scrutiny by hiding behind layers of lawyers, lobbyists, and hired mouthpieces. But one by one, their allies, enablers, and supporters would slip away. 

In 2017, a celebrated photographer, Nan Goldin, started a campaign that convinced some museums to strip the family’s name from their walls (the Sacklers were major collectors and art philanthropists). New books appeared about the Sacklers and the opioid epidemic, ones in which I had the curious experience of seeing myself depicted as a character in the story.

Around the time I retired from the Times in 2017, two screenwriters, Micah Fitzerman-Blue and Noah Harpster, approached me about turning my book into a television series. Earlier this month, Painkiller, a six-part dramatic series about the Sacklers and the origins of the opioid epidemic based on my book and the work of The New Yorker’s Patrick Radden Keefe, began streaming on Netflix. (A new paperback edition of Pain Killer is also out.)

On the same day the Netflix show started airing, the Supreme Court made a surprise decision about a long, ongoing bankruptcy proceeding involving Purdue Pharma. The court froze a deal under which the Sacklers would contribute $6 billion to a fund for OxyContin victims, and in return, get lifetime protection against being personally named in further lawsuits. The Biden administration has taken the position that allowing the deal to go forward will create a way for the rich to use the bankruptcy system to buy their way out of liability. The Court will hear the case later this year.

As for Sacklers, they have never been charged with any crimes. Richard Sackler and other family members involved with Purdue Pharma insist they did nothing wrong and knew nothing about the crimes committed by their company. They have cast their $6 billion settlement agreement as an act of generosity. I have long believed, however, that if the Justice Department had the guts in 2007 to put the Purdue executives on trial, then the arc of the opioid epidemic might have bent in the right direction.

In the Netflix show there is some fictionalizing of how things unfolded. For one, Arthur Sackler, the patriarch of the Sackler family, appears as a character, despite the fact he was long dead before the first tablet of OxyContin was sold. In the series, Arthur, the advertising huckster who built the Sackler name and fortune, is a ghost advising his nephew, Richard Sackler, as he oversees another chapter of the family’s history: the transformation of the Sacklers into public pariahs.

Back in 1996, Richard Sackler proclaimed that “the launch of OxyContin will be followed by a blizzard of prescriptions that will bury the competition.” It did that. It also started a blizzard of chaos and despair that has touched millions of lives. 

Barry Meier is the author of Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic. Read Maya Sulkin’s Free Press piece “America’s Love Affair with Adderall” here.

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