AMERICAN PAIN by John Temple Page A

States.”

    Despite the competition, Purdue continued to be the face of the opioid gold rush because it had introduced the first blockbuster narcotic. In response to the bad press, Purdue eventually did make a number of concessions. The company put additional warnings about addiction in its information about OxyContin. It stopped making the much-sought-after 160-milligram mega-pill. It began reporting physicians it believed might be diverting drugs.
    Hundreds of lawsuits were filed against Purdue, mostly personal-injury claims from small-town plaintiffs claiming they’d been hurt by the drug, and the drugmaker was committed to winning them all. No trials, few settlements. Purdue hired big-gun corporate defense law firms in Atlanta and New York and spent $3 million a month in legal bills. The company beat back almost every lawsuit, including a number of class-action cases.
    When Purdue finally lost a big one in 2007, it was a criminal case, not civil. The charge was led by a US attorney named John Brownlee, whose district in Roanoke, Virginia, had been devastated by pharmaceutical painkillers. Brownlee had prosecuted street dealers and doctors and finally decided to investigate the top of the narcotics chain. The company pleaded guilty to federal criminal charges that it had lied about the drug’s risk of addiction. Three top executives paid $34.5 million in fines and the company paid $600 million, one of the largest such fines ever paid by a pharmaceutical company.
    Golbom and a group of activists traveled to Virginia for the sentencing, and Golbom spoke at a rally outside the courthouse. Golbom let loose. A photographer snapped a picture of him mid-cry, his face contorted in anger, chopping a hand through the air. The anger was real, but his outbursts on the radio and at the rally were not quite genuine. His natural state was quieter, more analytical. But he was experimenting, willing to do anything to strike a chord.

    Golbom didn’t want to do away with opioids. Morphine was a godsend for someone with pancreatic cancer, someone hospitalized for trauma. But over the long run, he increasingly believed, few people seemed to get better on the stuff. He didn’t even want new laws; he just wanted people to better understand what they were taking.
    And to Golbom, the federal government’s approach to the opioid crisis was contradictory.
    On one hand, there was plenty of concern and action. The feds had gone after Purdue, and the Centers for Disease Control and Prevention had published report after report on painkiller deaths. Lawmakers held hearings and railed about oxycodone crime and addiction in their districts. The DEA stepped up its investigations of doctors whose patients had died after receiving huge prescriptions.
    On the other hand, the government was ultimately responsible for the flood of narcotics. The FDA signed off on one new opioid formulation after another—patches, lollipops, and pills, pills, pills. Many observers questioned why the FDA was so compliant with the pain industry. What escaped most people’s attention was that the pharmaceutical companies had an even more dependable ally in, ironically, the Drug Enforcement Administration.
    One of the DEA’s most important and least recognized duties is to decide how much of each controlled substance can be manufactured. If the DEA decides that the amount of oxycodone being made exceeds the “medical, scientific, research, and industrial needs of the United States,” it can reduce the drug’s production, simply cut it down by denying pharmaceutical companies’ annual requests to manufacture more of the drugs.
    Instead, year after year, the DEA had signed off on hikes in the manufacturing quotas of all popular prescription narcotics. Golbom dug up the numbers. And they were stunning.
    In 1993, three years before OxyContin came out, the DEA allowed pharmaceutical companies to manufacture 3,520 kilograms of oxycodone.
    In 2007, the DEA signed off on the