#186 - Patrick Radden Keefe: The opioid crisis—origin, guilty parties, and the difficult path forward

Patrick Radden Keefe is an award-winning staff writer at The New Yorker and the bestselling author of Empire of Pain: The Secret History of the Sackler Dynasty. In this episode, Patrick tells the story of the Sackler family and Purdue Pharma - makers of the pain management drug OxyContin, providing the backdrop for the ensuing opioid epidemic and public health crisis. He reveals the implicit and sometimes explicit corruption of all parties involved in the development, approval, and marketing of OxyContin, leading to a cascade of unintended consequences including addiction and death. He explains the unfortunate lack of accountability for the current crisis, as well as what it all means for those with legitimate pain management needs. Finally, he examines the difficult path ahead towards finding a solution.

We discuss:

• Patrick’s investigation into distribution and use of drugs in our society [3:55];
  
• The scale of the opioid crisis [9:15];
  
• The Sackler brothers: family life, career in the pharmaceutical industry, and role in the current crisis [11:45];
  
• Purdue Pharma: origins, early years, and move towards pain management drugs [17:30];
  
• The development of OxyContin: its conception, marketing, and the controversy around the FDA approval process [25:30];
  
• Early reports of OxyContin addiction and unintended consequences and how Purdue Pharma sidestepped responsibility [40:45];
  
• The many paths to addiction and abuse of OxyContin and the ensuing downfall of Purdue Pharma [47:15];
  
• Peter’s personal experience with OxyContin [57:00];
  
• Pain—the “fifth vital sign,” how doctors are trained in pain management, and the influence of money [1:08:00];
  
• Other players that helped facilitate the eventual opioid crisis [1:16:15];
  
• Lack of accountability following the investigation and prosecution of Purdue and the Sackler family [1:23:30];
  
• Legacy of the Sackler family and their disconnect from reality [1:34:45];
  
• Patrick’s views on the regulation and use of pain management drugs [1:42:15];
  
• The difficult path forward [1:44:45]; and
  
• More.