The Daily Beast Podcast - Trump Came This Close to Making the Opioid Crisis More Hellish

Episode Date: May 16, 2021

Trump is no longer president, but Biden still has two health crises on his hands: COVID and opioids. Documentarian Alex Gibney, whose latest film Crime of the Century explores the opioid crisis and how (and who) is still killing Americans with them, shares the messed up reality to Jesse Cannon and Molly Jong-Fast on this bonus episode of The New Abnormal, including how Trump almost made it worse. Plus, he explains how doctors are complicit, too, and the reason big pharma is still getting away with using human beings as opioid guinea pigs. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hello and welcome to another bonus episode of the new abnormal. Today, I'm really excited because we have one of my favorite directors on. He's directed zero days, totally under control. Enron, the smartest guys in the room, taxi the dark side, going clear on Scientology, just so many amazing documentaries. But today we're going to talk about his new one, Crime of the Century, on the Sacklers as well as the opioid crisis. And this conversation is awesome.

and I'm so happy to welcome Alex Gibney. Welcome back to the new abnormal Alex Gibney. I don't understand how you make so many movies. I don't really understand it either. But my wife will tell you that there was a time when I didn't make any movies. Really? Yeah, making up for lost time. Yeah, there were a long series.

It was when my kids were little, too, so there was even more reason for me to do it. Yeah, I know. So this is the third movie you've been here in like six months discussing. Talk to us about, I mean, we both watched the movie. We were both, I think. We didn't watch it together, but we were both pretty horrified. How did you get to this subject? You know, it was interesting.

I was having a meeting, actually, with the investigative team at the Washington Post. We were talking about ideas, and they were talking about their long investigation into this crisis. and they described the three stages of the crisis, prescription opioids, heroin, and fentanyl in a way that I really hadn't properly understood before. And that really piqued my interest because I had looked at the opioid crisis as a kind of natural disaster, sort of like a hurricane or a flood, you know, something that just happens. But seeing it within the context of a big series of crimes, that really caught my interest. And I dug in. And that was about three years ago to show you it wasn't like we just cranked this out. Yeah, you can tell.

Was there a person in the dock where you were like, holy moly, this person puts it all together? Well, there are a number of people who put it all together. But my holy moly moment was in one of the side characters. When we interviewed that guy, Gary Blin, who was kind of a too rat for Purdue, when you get to that level of malfeasance and you see it up close and personal. Or the other person where my jaw drop was Alex. Berlachoff, the salesperson for instance. Oh, yeah. Oh, man. What a personality.

He's a character out of Glenn Gary, Glenn Ross. And very honestly about how these scams, indeed crimes, were committed. And he was in the middle of it. So, you know, there were a number of jaw dropper moments for me in this, in the making of this film. The scene I found most disturbing was the scene where they talk about the people who trust the most were doctors. And it's so depressing because obviously we're in the stage where we're like, trust scientists, trust doctors, and then you see them being really untrustworthy.

It just sucked the life out of me. It was terrible because, I mean, that was actually very much of a business model for both for Purdue and also for insis and a number of other companies. The idea is to take the most trusted figure in people's lives and to flip that person to corrupt them by paying them lots of money. And then the next thing you know, you have a business model where doctors that people allegedly trust are either over prescribing opioids or are part of a pill mill, which is actually manufacturing a system for diverting opioids into the illicit market. Those videos of the parties, I don't know why they really upset me. Well, you can see that they don't have anything to do with health care. I mean, we were able to. able to get one of these videos at a Purdue sales conference. I think it was back in 1997. And they're singing those rock and roll songs about selling Oxycontin. You got to sell.

Oxycontin, sell. And they're all dancing. Isn't it awesome that we're selling more opioids than Viagra? Then to see the rap video, for instance, where the rap is literally a description of crime after crime after crime. And by the way, they produced that rap video too. years after the first subpoenas were issued for a federal investigation into the company. So it shows you just how much they felt above the law because our regulatory framework was clearly so infeble. And Chris Dodd, that shocked me. It is surprising. Liberal Democratic senator from Connecticut, but Connecticut is where Purdue Farmer's headquarters is. Yeah. And so, you know, he's taking Purdue's position and had discussed talking points with Purdue a few days prior to this hearing

where this very poignant character, Art Van Z, a country doctor in the western corner of Virginia, he's just trying desperately to get people to pay attention to the fact that opioids is ravaging, opioids are ravaging his community. And he wants the government to do something about it. and the response is kind of like, well, you know, in that part of the country, there are addicts. That's just the things are. You shouldn't have been poor. I mean, that stuff really struck me. Have you kept in touch with that doctor?

Yes, we did a couple of press things, and he's, you know, very much part of that. I mean, I didn't interview him that very long ago. You know, he's still very much a member of the community. He's still, you know, he's grown up with so many of the people in that community where he's treated them as little kids and now he's treating them as adults. I mean, he's, you know, he's a central part of that community. So you show this Congressman Tom Marino, who is one of the more egregious legislators to advance laws to make opioid use explode. And he was appointed by Trump when Trump was appointing every wolf to the hen house.

It may have been that I was so emotionally overwhelmed. But did he do anything in the Trump administration that really made this explode? And has it been rolled back or has anything happened with that? So ultimately, he was nominated by Trump to be the drug czar, but ultimately didn't take that position for a number of reasons. One, there was a huge amount of pushback. And two, he ended up, I believe he was diagnosed with cancer, if I'm not mistaken. So we ended up stepping down. But I just indicated that Trump's first, his go-to guy happened to be the guy who did more than anybody to eviscerate the DEA's ability to go after these companies that were flooding America with opioids.

Of course. I mean, have you seen any good progress? I mean, look, there is good progress. And in some cases, there has been a kind of overcorrection. I mean, I would say that, you know, the severity of advisories on opioid prescription has sometimes gone too far. Well, that's good. Sorry. No, no.

It's good in a way. I mean, it needs to be more textured, I think, because, you know, in some cases, opioid medication is valuable. You know, in the few days after an operation, oxycodone or morphine is great, you know, for end-of-life cancer pain. For sure. Yeah. You know, something like onsen is great. But the con here was convincing people that there was no danger, that no dose was too high, that you couldn't get addicted, that it was good for everything. Right.

And that you can't, and you shouldn't take pain medicine. I mean, right, as a regular thing, unless you're dying. I mean, there you go. Well, you just have to be very cautious and careful. and aware of the dangers. You know, there may be some cases where it's indicated because nothing else works. But by the way, you know, one of the long term, not for everybody, but for some people, one of the long term downsides of taking opioids over a long period of time is that it actually

makes you more sensitive to pain. So it actually increases the severity of your symptoms. It can in addition to creating a kind of, you know, physical dependence. I'm always struck by that, like, you know, with cigarettes, as a child of the 80s, like we were told exactly what's going to happen to us if we spoke. But with opioids, like, when Rush Limbaugh

apparently loses his hearing from taking too many of them, on to like, you know, I've had a friend die from opioids every year except one in the last 22 years. Prince died from fentanyl. Yeah, yeah. I mean, but they just don't tell you explicitly, like what's going to happen to you

if you get addicted to this, like the way we've done with some things. The education seems so, poor. Well, you know what's shocking in a way is that how could we not have known better? Because that was one of the purposes in the in the film in the opening credit sequence of going through the history of opioids and in going back to King Tut. In the 19th century, opium was the world's most traded commodity because it balanced world trade with China. And why? Because, you know, it was enormously addictive. And the Chinese government tried to put

push back. And when they did try to push back, the British invaded in order to keep those opioid profits flowing. So it shouldn't have been a mystery that opioids were addictive. And the idea that these companies were able to kind of redefine the issue, both by redefining pain, and then by saying, oh, well, in this new, you know, time release formula, Oxycontin, you know, it's no longer addictive and can't be abused, both of which Purdue knew to be false. Right. Who do you think the villain here is? Unfortunately, it's a little bit like, you know, murder on the Orient Express, where you learn that there are a lot of villains. You know, the key villains, of course, are these big companies that are making lots of money from opioids and are willfully blind to the damage

that they're doing. Obviously, you know, there are bad doctors who contribute to this. There are pharmacies who look the other ways. There's distributors who are some of our biggest companies. their villains. And honestly, I think Congress has just done a terrible job, not to mention our whole system of the revolving door, which continues to contribute to this. But if I would say, who's the worst villain here? You know, I'd say it's our health care system because it's so full of bad incentives that are so much more based on supply and demand than they are the Hippocratic Oath. So, you know, that I think is a bigger takeaway from me. You know, this would only be possible within the context of a health care system that is not treating the totality of the patient and is just

infused by all sorts of market principles that are allowed to run amok. It struck me that advertising pharmaceuticals is part of the real problem in America. I mean, it is. They don't let you advertise pharmaceuticals in other places. Well, but I'm not sure how much, in other words, I don't recall seeing any big billboards for OxyContin that are directed to patients. What they did do was they advertised them or they pushed them hard to doctors. And they had a whole campaign.

And then they had this corrupting campaign of making doctors speakers to advance the, you know, to preach the auspile of the opioid. And then they would pay them to be speakers. And then, lo and bold, they started prescribing more opioids. And by the time you get to incis, they actually have a return on investment chart. So that if they're, if they're paying a doctor $10,000, They expect that doctor to write at least double. They've got to write $20,000 worth of opiator.

They cut off their speaker payments. Has there been anything to curtail that? Like that seemed like one of, I mean, I've known that's going on forever now since I, you know, 20 years I've seen it. But is that coming to an end? Is there any way to stop that? You know, obviously when it gets to the point of being so bold and so brash as in the case of insis, you can prosecute that. That's just fraud.

And it's the definition of a bribe. But the bigger problem is is curtailing the practice of basically paying for medical advice or opinions that you want. And how do you curtail that practice? That is a bigger, more systemic problem that I think, you know, Congress would need to address. Jesus Christ. I mean, it's so disturbing. For you, what isn't in the documentary? Like, what was just you couldn't put in there for any number of reasons?

Is there anything in there that we should know about that's not in there? I'm sure. There's a lot. I mean, one of the things that was staggering to me, and this was a problem in the editing room, when we got our hands on this prosecution memo, which is basically a brief, 120-page brief by prosecutors, federal prosecutors, who wanted to indict for felonies, the key executives at Purdue Pharma, you know, there's a tremendous amount. of detail in there. And we did roll down some of that detail and included a lot more in the

film and ultimately had to trim it back. So there are a lot of other examples here that are not good examples. And, you know, I think if you go into some of these communities and you ask people, you know, do you know anybody who's died of opioid overdose? And, you know, these folks all have friends, family, and they can tell these heart-rending stories. I mean, like that, like that story of that young girl Sarah Fiselle in part two. Yeah, it's heart-ranching. So one of the things, you know, people are as like, oh, I want to see bipartisan legislation. You show some in this where Marshall Blackburn is pushing through this legislation to loosen

opium laws and Obama signs it. That was passed by unanimous consent. Yeah. I was jaw dropped and I kind of even expect things like that. Do you think now that we have this hyper-partisan world where every congressman could seize on things like this to make a tax? Do we think that that would not happen now? Do we think that's at least something we're safe from? Look, I don't know. I think it's going to, I mean, here's where it's going to take a kind of popular revolt to turn this on its head, because obviously one of the

things the doc does is to show the power of money, people like Big Pharma, you know, because if you want a lot of campaign contributions and you want them fast, how about, you know, tapping your pals at Big Pharma? And then they'll write the legislation, which you will then endorse. may or may not read and those laws will get passed. But I think in the wake of both COVID and the opioid crisis where so many people are dead, you know, you'd think we'd be able to say, you know, you either give us a good health care system or you're out. And that's our bedrock issue. So explain to us why you're not doing that work. That would be what I would say. We did see some good pushback against Big Pharma with this IP from the Biden administration.

So I hope we may get there. Yeah, that seemed like a pretty big deal. I'm curious, since the Sacklers have clearly evaded any punishment, we don't see this discouraging any of future people from doing just as egregious things, do we? No, we don't. In the dock, it actually happens twice, and we debated a lot about this in the cutting room. You know, it seemed like a double beat where Purdue gets its hand slapped, but doesn't have to endure any real punishment in 2006

because of a deal cut mysteriously, and nobody knows exactly who cut that deal at the Department of Justice. But Rudy Giuliani was a part of it. And then it happens again in 2020 with this deal cut again at the Department of Justice where fines are paid, but key facts are buried. I mean, something that Patrick Keefe says

at the end of the film is super important. You know, he says a lot of the family of the victims. You know, they care about the money, and of course the money is important, but at the end of the day, what they want is the truth. And the one thing that the companies have been great at is burying the truth. You know, Purdue's in bankruptcy now, but we had initiated a lawsuit to allow us access to some more of those crazy videos that you've seen out of the West Virginia lawsuit. And Purdue has just spent in this moment, in this hour, $200,000 of money that they don't really have to fight us on that. That's how important it is to continue to hide the truth.

Do you think there'll ever be any accountability? What would that look like? I mean, look, I think people, some people have to go to jail. I think that's part of what has to happen. And also the other thing that has to happen, and I think in a broader sense, sometimes this gets into systemic issues that you have to deal with. The whole process of settlements and settling lawsuits, it does make sense. You get it. You know, people, you, you, you, you, you get to a point and you know, you don't want to roll the dice with a jury. But the problem with settlements is that they bury the truth. And that, in a way, is avoiding accountability. And that's why these things happen over and over and over again, because nobody can go back and see,

oh, my God, did you see the record of what these people did over and over and over again out in the field, you know, using human beings as human guinea pigs for opioids? Right. Oh, it's grim. It's grim, but you know what? I think that it's only by excavating the problem that we begin to see a solution. Because in a way, the worst thing would be to see it as just a crisis that happens, because then there is no solution. At least with a crime, there is the potential of punishment. And there's also, you know, trying to put in place measures that prevent the crimes from happening again. And that was one of the formulations of trying to call this the crime. of the century to say we don't want these crimes to happen again. So how about we crack down on

enforcement? And then how about we also, you know, rebuild the system so that it can't happen again? I mean, if you keep leaving your door unlocked over and over again and your TV set keeps getting stolen, you'd think, well, geez, maybe I should lock the door this time. Yeah. The thing that I thought was interesting, I know we have to be done in a minute because Jesse's texting me, was the way the family laundered the crime in philanthropy? Do I think that that's a problem? No, I know that's a problem, but I was glad that you covered that because it's a really common practice too.

Huge, hugely common. And of course, that's, you know, that's what the mob used to do, right? They would take all that money from prostitution and dealing drugs, and then they would go legit in Las Vegas. Or another thing you can do is, yeah, you launder the money by having foundations, so our big foundations are the Rockefeller Foundation, the Fort Foundation. You know, that's an age-old practice. But I think in this case, what was so interesting, and Patrick Keefe did a lot of great digging on that one. And, you know, I highly recommend his book, Empire Pain. The whole idea was their name,

the Sackler name, was on all these museum walls. But nobody knew where the money came from. Literally the only name I've ever seen as abundant as theirs around New York is the Cokes. Right. Yeah. Another great one. Yeah. What are you doing next? I'm doing something for the 20th anniversary of 9-11.

All right. Well, we'll have to have you back. Thank you so much for joining us, Alex. Thanks, Molly. Thanks, Jesse. Really good to talk to you. You as well. On that note, we'll wrap this episode of the new abnormal from The Daily Beast.

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