Original subtitles

When we talk about drugs like oxycodone,

you're talking about drugs that are

essentially heroin pills.

I was pretty convinced that we had a major problem

on our hands.

This is the first time I've ever seen this.

Purdue didn't have any evidence that the drug was safe,

so the company obtained the help of a medical officer

in FDA to claim that OxyContin was not prone to abuse.

If you're Richard Sackler, if you're Purdue,

that means your army of sales reps can go out and say

that the FDA approved this.

They knew that OxyContin was being abused.

When you're in that much pain and you're addicted

at such a high dose, you're a trapped rat.

Purdue ends up getting pursued by the authorities.

The Justice Department effectively agreed to bury

critical information.

Purdue made about nine billion dollars

marketing OxyContin.

They paid 600 million to the government.

You are basically telling pharmaceutical companies

you have a green light to do this.

They paid the speeding ticket.

Drug overdose deaths across the U.S.

have more than tripled since 1990.

40 people die every day

from prescription painkiller overdoses.

The trajectory has simply been upward.

It's America's silent epidemic.

A plague in our country.

- Good afternoon. - How are you?

We have with us today Joe Rannazzisi.

He is retired from the DEA.

The opioid crisis started with prescriptions.

Prescriptions and patient care...

This idea that we weren't adequately treating pain.

Drugs like OxyContin come on to the market

and thought provokers and medical experts

began to preach the gospel of the opioid.

We started using the pain scale.

"Pain is the fifth vital sign."

They developed new medical terms like "pseudoaddiction."

Craziness.

Your body builds a tolerance, you need more drug.

As you need more drug, you need stronger drug.

As you get stronger drug, it's more expensive.

And instead of buying $150 worth of pills a day,

you're buying $20 or $30 of heroin bags a day.

The problem encroaching on Colorado.

Taking a toll on the Magnolia State.

More and more lives in Farmburg County...

- Woodland Hills... - West Palm Beach...

- Springfield area... - Denver...

Right now we have this wide-ranging

amount of fentanyl and fentanyl by-products,

and it's killing a lot of people.

The synthetic opioid

is the deadliest drug in the United States.

Five people OD'd on the same day in January.

We lost three people last weekend.

We didn't just wake up one day and say,

"Everybody just switch over to fentanyl."

It was a progression, and it was a natural progression.

Here in Cook County, it's three deaths per day.

Mississippi's seen close to 200 overdose deaths.

Opioid deaths are up 20%

since the start of the pandemic.

And overdose death is underreported.

We know that for sure.

So we really don't know how many people died.

Hundreds of cities, counties,

and states across the country

have launched a wide-ranging lawsuit

targeting the pharmaceutical industry.

To stop the behaviors.

To hold these folks accountable.

Enough is enough.

We've got people dying on our streets.

We started seeing massive amounts of death.

Our prescriptions by 2012 were over 250 million.

The question is, why?

Are we the only people in the world

that know how to treat pain?

No.

We consume that much

because our policies

are basically created by the manufacturers.

So we've reached out to all the companies.

We have all the responses,

which we have woven into the story.

Yeah.

Half the company's declined to comment

because of the ongoing litigation,

and then the other half, you know,

issued fairly lengthy statements.

Purdue, Johnson & Johnson, all commented.

What's their, you know, main defense right now?

Yeah, FDA-approved drugs,

that they weren't doing anything illegal.

Each point they pushed back on.

Okay.

You know, one of the remaining questions is,

are there gonna be any criminal charges against anybody?

And whether they're coordinated by the Department of Justice

or if they're individual investigations

by U.S. Attorneys Offices.

We're not quite sure,

but there's something happening.

Narrator: The investigative team at the "Post"

began to follow leads to a very big story.

Some of America's largest pharmaceutical companies

were not only profiting from the opioid crisis,

they may have been manufacturing it.

The origin of the opioid story

began with the role of Purdue Pharma

and the family who controlled it... the Sacklers.

We have had many run-ins with the Sacklers recently.

Their main point of contention

is that they did not ignite

the opioid crisis singlehandedly.

Whether you believe that or don't believe that,

there is voluminous evidence that the crisis began

when OxyContin hit the streets.

Purdue led the charge, Sackler came up with the idea,

and everybody else followed.

Other drug companies moved into that market

that Purdue had created.

They moved into that huge opioid

multibillion-dollar market.

So other manufacturers began

making generic versions

of OxyContin...

Oxycodone, hydrocodone,

drug distributors started sending

massive amounts of these drugs downstream

because there were corrupt doctors all over the country.

It became like the Wild West.

This was a new drug cartel that was being established

in the United States.

But instead of coming in from a foreign country,

there were drug dealers who were wearing suits

and lab coats.

I think that's it.

- Go and do. - All right.

Narrator: To penetrate the network

of corporate drug dealers,

the investigative unit at the "Post" needed help

from an inside source,

someone with firsthand knowledge

of the way the deals worked

and how they turned into crimes.

On a tip,

they contacted a retired DEA agent, Joe Rannazzisi.

Eventually got him on the phone.

He was very animated, and he was very upset.

He had a lot of great information

and, essentially, we just kept on talking,

and I figured, "Okay."

"If he's not crazy and he's not making this up,

this is a really good story."

I'd like to thank you for the opportunity to appear today

to discuss prescription drug diversion

and the critical role the DEA plays...

Narrator: Before he left the DEA,

Rannazzisi repeatedly tried to warn Congress

about prescription drug abuse.

The abuse of pharmaceuticals continues to be

a significant problem in the United States,

and it's based on pharmaceutical diversion

from the supply chain.

He was in charge of the Diversion Control Division

at the DEA.

They make sure that pharmaceuticals

that are controlled substances like opioids

are not diverted to the black market,

that they stay within the supply chain,

from the manufacturer

to the drug distributors, which are the middlemen,

to the pharmacies on the retail level.

Individuals and organizations have created schemes

within the health care delivery system that appear legitimate

but are nothing more than illegal operations

to facilitate the illegal distribution

of pharmaceuticals.

Pharmaceutical diversion...

I've dealt with a lot of whistleblowers

throughout my career, and, you know,

some of them are a little crazy,

some of them are a little paranoid and conspiratorial,

but I really wanted to meet Joe to vet him more.

So I went out

to a little Greek restaurant in Northern Virginia.

I interviewed him for about two hours.

Look, I made a lot of my decisions over the years

at the Athena Pallas.

I could sit there and just think

and not have to worry about DEA and headquarters

and the phone ringing.

So, when I had important decisions to make,

I would go and find a table,

sometimes with somebody else, sometimes by myself,

and sit there and just try and work things out.

Scott Higham starts asking me questions,

and I'm telling him a story

about congressional and industry influence

and, you know, money going in

and the Justice Department folding and all this stuff.

And I don't know if Scott believed me or not,

but, you know,

Scott's from Long Island, and I'm from Long Island.

We kind of talked the same talk, you know?

We come from the same place.

We're on the South Shore of Long Island.

I always wanted to be a police officer

in narcotics, specifically.

I've been around law enforcement my whole life,

as a kid growing up in a law enforcement family,

and so I got cops.

I covered them as a reporter

at "The Baltimore Sun" and in Miami.

I studied pharmacy

at Butler University in Indianapolis.

I figured that being a pharmacist

is the quickest way to learn about the drugs.

Once I got my pharmacy degree,

I started applying to be a law enforcement officer.

And then I was subsequently hired by DEA.

Log on to the Internet,

type in the keyword "medications,"

and you'll get hundreds of results,

many of them promising drug delivery...

Right after 2000, 2001,

what we started seeing was Internet pharmacies.

A patient would get on the Internet, and he would say,

"Hydrocodone without a prescription."

And you'd get a million hits that would pop up.

And so you'd find one and go to that website,

and it would take you to a patient survey form,

and you would say, "I've got back pain."

The problem is, is no one ever saw the patient.

As long as they had any kind of credit card,

they were fine.

You had a doctor on the East Coast,

the patient or the drug seeker was on the West Coast,

the pharmacy was in the Midwest.

It was just a trafficking organization

that was hiding behind the veil of the Internet.

Without objection,

the bill was read a third time and passed.

As soon as Congress shut down the Internet sites

by passing the Ryan Haight Act,

almost overnight, we started seeing these clinics pop up,

and our people in Florida saying, "Yeah, all of a sudden,

we have all these clinics all over the place."

I'm going down to Florida.

Florida is a very corrupt state.

It's a place

where a lot of people who want to get involved in rackets go

to make fast money.

So the Mob is down there. Drug dealers are down there.

There's a lot of money laundering,

poor regulations.

There's a patchwork of law enforcement.

The regulations over the practice of medicine

and pharmacy in Florida were a lot more lax

than other states.

It provided fertile ground for these clinics to open up.

Right around 2010 in Broward County,

they went from a very small amount of pain clinics

to 142, I think, in a period of a couple years,

two or three years.

Palm Beach County has more pill mills than McDonald's.

The sense was that

we were always just trying to tread water.

We needed more resources.

We needed more field investigations,

and we needed more lawyers.

When I started,

all of our focus had been on these pill mills.

There's one hallway is the doctor's.

And you go in,

and they often literally had a laminated menu,

and they would say, "It's a cash-only business.

You give me the cash for what it is you're looking for."

And then you take that prescription,

you go down to the other end of the hallway,

and it's a dispensary.

And it's all owned by the same person,

so they're running the doctor's,

and they're running the pharmacy.

They were basically fronts for drug dealers,

for really corrupt doctors

who were selling prescriptions for cash,

trading prescriptions for sex.

They actually basically just give 'em out.

People would hop in their car,

they'd get onto Interstate 75.

It's a highway that runs up the spine of America

from Florida up through Appalachia

all the way through Ohio.

It was a very busy, very lucrative pathway

for narcotics in America.

It became known as the Oxy Highway.

I'm Doug Smith with Fox 13.

Can I talk with you about the clinic,

what's going on inside the clinic?

When I pass by here,

the frickin' line is around the corner.

Patients would be lined up in the morning,

waiting to get into these pill mills

so they could get a cursory examination,

if any examination.

We were in there less than ten minutes with a doctor,

walked out with a prescription for Vicodin.

Mm-hmm.

Is that the way it works inside?

If you have proper, uh,

documentation and everything, we take care of you.

- We had no medical records. - We had no X-rays.

Yeah. Who would that doctor be?

I'm not quite sure.

But if you give me a call, I'll be checking into it.

So a bad doctor who's running a clinic

writes a script not for a legitimate medical purpose.

Okay, you can't stop that guy from writing that prescription,

but a pharmacist could,

because if a pharmacist gets that prescription

and it shows red flags,

that pharmacist has a requirement

to resolve those red flags

before he dispenses the medication.

Now, what are these red flags?

Patient traveling 200 miles to a pharmacy.

You could be the greatest pharmacist in the galaxy.

No one's driving 200 miles for you to fill their prescription.

There's a reason for that.

We had to take action, and we had to do it very quickly.

We just started moving massive amounts of resources

down into Florida.

They got task force officers.

They got every diversion investigator in the state,

and they ran undercover operations all over the place.

- There was one case. - It was a female undercover.

Doctor said, "So how you feeling today?"

"Oh, I'm fine."

"So what are you here for? You here for your Oxycodone?"

"Yes.

Could I have some alprazolam, too?"

And he says yes, and he wrote the prescription.

He goes, "Would you like some methadone also?"

And she goes, "Sure."

That was the extent of the visit.

And you look at that, and you go,

"My God, this is not medi... This is a crack house."

Hi.

First of all, turn that off, man.

I don't want to be recorded, okay?

- Let's talk about that. - Are you a doctor?

- Excuse me? - Are you a doctor?

- Don't... - It don't matter who I am.

In a minute, I'm gonna snatch this camera from this, dude.

- You don't even know, man. - Okay, sir.

Follow 'em wherever they're going.

There was one store in particular

that was known by drug users as the go-to CVS.

A DEA investigator said to the pharmacist,

"What's going on here?

"Don't you see that all these people

"are coming with out-of-state licenses and out-of-state tags

"and they're lining up at your door at 8:00 in the morning?

Don't you think that's suspicious?"

And this pharmacist told the DEA, "Well, you know, look.

At 2:00, we cut off our sales."

And the investigator said,

"Why do you cut off your sales at 2:00?"

And she said, "Well, we want to save medication

for our real pain patients."

- Open the door! - On the ground, on the ground!

- Go, go, go! - Get on the ground!

Narrator: In 2011, there was a crackdown by the DEA.

Operation Pill Nation

involved more than 500 law enforcement officers,

resulting in seizures of 70 vehicles,

$19 million in cash, and 105 arrests.

Doctor, do you feel like you were contributing

to addicts' addictions?

Was it worth it?

Narrator: But the real problem wasn't on the street.

It was in the executive suites of pharmaceutical companies,

which had become addicted to the profits

opioids could deliver.

Please help me welcome John Kapoor.

Narrator: John Kapoor

was a veteran pharmaceutical investor

who saw a business opportunity in pain relief.

He started a company called Insys

to market a drug called Subsys.

It was a fast-acting spray device for fentanyl,

a synthetic opioid 100 times stronger than morphine.

I know there are all kinds of definitions

for entrepreneurs.

The one that I think we all recognize most

is that entrepreneurs are risk takers.

narrator: The FDA limited the use of Subsys

to a very narrow market...

Cancer patients suffering so-called breakthrough pain.

To expand the market,

Kapoor was determined to find a way around the FDA's rules.

You, as an entrepreneur, have to have a dream.

And then you work with passion

to make that dream come true.

Narrator: That passion to make a dream come true

is what would lead Kapoor and Insys into the world of crime.

Every U.S. Attorney's Office

in every district in the United States

has someone who's supposed to specialize in health care.

Boston has always taken a lead role in that.

They've taken on some very high-profile

criminal investigators involving Pfizer

and GSK and several others.

And because our office has a reputation

for being successful with these types of cases,

we get a lot of whistleblower lawsuits filed in Boston.

And so, in 2013,

I got a whistleblower complaint sent to me.

It laid out some of the things that were happening

at Insys Therapeutics.

Subsys was launched in March of 2012,

and it goes into this very tight market.

And for the next three months, from March to early June 2012,

Kapoor is devastated,

and he calls it the worst effing launch

in the history of the pharmaceutical industry, right?

So he starts firing people.

Fires the VP of sales,

and he's trying to find a way to be profitable.

Narrator: Kapoor hatched a plan to exploit a loophole.

While the FDA limited the drug to patients with cancer pain,

doctors were allowed to use their own judgment

about whether to expand the market,

so Kapoor leaned on his sales reps

to court doctors to write more scripts for Subsys

and to increase the doses.

Through emails and phone recordings,

prosecutors discovered a sales campaign

to lead doctors into raising the demand for fentanyl

by expanding the very definition of pain.

I assign two criminal prosecutors,

and they began working on the case in late 2013...

Fred Wyshak, who is sort of a legend in Boston.

He prosecuted Whitey Bulger. He's prosecuted the Mob.

In all these types of cases, you need insiders.

It's very difficult

to penetrate a criminal organization

to the top of that organization

without insiders.

Alec Burlakoff.

You must've identified him early on

- in your investigation. - Absolutely.

Alec Burlakoff was a primary target of the investigation.

And so what in your mind makes a good salesman?

One word... passion.

It's not deceit. It's not lies.

It's not not having a conscience.

It's passion.

When I was hired,

there was a meeting that took place

where all the managers were there,

and, basically, everybody was yelled and ridiculed

and screamed at for the lack of sales.

They were abysmal, basically. They're nonexistent.

It's all on the rep

to ensure that this drug starts getting prescribed.

And none of it's doable...

Unless you break the rules.

But to tell the truth... This job was made for me.

I mean, I was raised in a family

where you don't cry

you don't lose, you don't take off work,

you don't miss school, you are not sick, you know,

and you get the job done.

I grew up in a lower-class, middle-class neighborhood

way out on Long Island...

A small town called King's Park.

There was a lot going on in my house.

Wasn't a place to have friends over.

Never knew what kind of yelling and screaming

and fighting was gonna take place.

I got a bachelor's in psychology,

a master's in social work.

I said, "You know, I'm gonna go work

for the best school that I can find."

And I did a search, and a private school came up

in Boca Raton.

I did phys ed for two years.

After that, I was a guidance counselor.

It was a very small salary,

but I was hanging out with kids all day,

doing what I love.

The problem with working at this school

was that I put myself around very wealthy people...

All affluent, I mean, beyond affluent.

And I went out to the parking lot one day,

and I went to the parent

who was driving a Bentley convertible,

and he was smoking a cigar, and I said,

"Sir, you know, we have a no-smoking policy here."

"Can you kindly put that out?"

And he took a puff.

He blew it right in my face, in my eyes and said,

"Petty rules from petty people."

It was literally from that moment

that I knew I had to go make some money.

I leveraged some of the relationships

that I had at the school... A lot of doctors there.

One of the doctors basically said to me,

"Well, I'm a big prescriber of a product

that Eli Lilly promotes," at the time,

"And I can get you an interview."

And I jumped all over it, finished the school year,

and was on my way into pharmaceuticals.

Narrator: Working for Eli Lilly,

Burlakoff's first pharmaceutical was Prozac.

He was named rookie of the year

for his big batting average with doctors,

but he was soon fired for handing out free samples

to hundreds of people, including one 16-year-old.

He hooked up next with Johnson & Johnson

and then applied for a sales job

for a company named Cephalon.

And I never heard of Cephalon.

It's not like Johnson & Johnson or Eli Lilly.

So that was my first taste of small biotech.

And what does "small biotech" mean?

It means a lot.

The payouts, the bonus plan is "uncapped."

It's a very attractive word to a salesperson... "uncapped."

- There's no ceiling... - The more you sell...

The more you sell, the more you get compensated, period.

By the time I walked out of the interview,

I called my wife and said, "I'm going to a new company."

narrator: The product was Actiq.

It was a lollipop made of fentanyl,

whose potency carried an enormous risk of overdose.

For end-of-life cancer pain, Actiq made sense,

but that was a very small market.

To pump up sales,

Burlakoff had to convince doctors to prescribe it

for much more, from back aches to ankle sprains.

How to do that?

Through bribes packaged as speaker's programs.

If you have pain that lasts all day

narrator: Burlakoff would pay doctors to promote the drug.

In exchange, doctors would prescribe more and more.

It was a program that appealed to the founder of Insys,

John Kapoor.

At the interview,

once I got into the nuances of the program

and what it took to be successful,

he just banged his fist on the table and said,

"That's our next VP of sales," and walked out the door.

I don't think there's any way to understand

what happened at a company like Insys

without referring to Purdue Pharma.

They were the pioneers.

They went out and had a mission

to change the mind of the medical establishment

about how dangerous these drugs were

and to persuade physicians not to worry too much

about the addictiveness of strong opioids.

Insys used Purdue's playbook.

You have a very strong, powerful product,

and you incentivize your sales reps

with the understanding

that they're going to be compensated based on volume,

and they go out with an incentive to sell.

For many of you out there,

you have not had the opportunity

to experience the excitement

or, more importantly, the achievement

of being on this stage.

So John Kapoor hires Burlakoff,

and he makes him the head of the Southeast district...

Florida, Alabama.

With Kapoor's permission,

he hires his buddy from college,

this guy called Joe Rowan, as a sales rep.

Rowan has a very close relationship

with a doctor in Mobile, Alabama, named Xiulu Ruan,

and Ruan's known to be running a pill mill operation.

So they start to bribe Ruan in August of 2012.

And immediately there's a massive turnaround

in the success of the drug in the Southeast.

A pharmaceutical company has a right

to try to educate people, right?

So they do what's called

non-research payments to doctors.

They give you money, and in exchange,

you go and you talk about the drug to colleagues.

By itself, it's not illegal.

What happens with Insys is that

they start paying exorbitantly huge number

of speaker programs,

and they use the speaker program

basically as a way to cover

for the bribes that they're paying.

Kapoor, ultimately,

he invested between $3 million and $4 million a year

on the speaker program at its height.

They were bribing people at that level nationwide.

So it was basically,

"Here's some money. Write some scripts."

Yes.

It was actually... Well, you say "basically."

That word makes me nervous,

because if I said "basically" to Dr. John Kapoor,

he'd say, "Basically, you're fired."

There is no "basically" here.

It's very clear, concise. It's very direct.

As an entrepreneur,

don't get arrogant, even if you're successful.

You should believe in yourself,

and one important thing is stay humble.

- We are so professional! - Oh, are you videotaping this?

Turn that shit off!

What, what...

The best region at Insys!

The key to increasing sales of Subsys

was to build a relationship with a doctor.

When you go into the office

and they meet you for the first time,

it's a test.

They're gonna look you in the eye, and they're gonna say,

"Hey, Alec, how you doing? So you have Subsys?

What's that indicated for?"

And you have some reps say,

"Oh, it's indicated for... breakthrough pain,"

or they say, "It's indicated for breakthrough pain

in cancer patients."

Something like that.

My play is I look 'em dead, directly in the eye,

and I laugh, and I go, "Doc",

"you know exactly what this drug's indicated for.

"It's indicated for breakthrough pain

"in cancer patients 18 or older that are opioid tolerant

"on 24-hour, around-the-clock medications.

"Why do you ask me that question?

"You know I can't talk to you

"about anything outside of that indication.

"However, you also know you are the doctor

"and you can do whatever you damn well please.

So is this game over yet? Are we done?"

And they go, "Hey, how can I help you?

What can I sign for? What's your sample?"

Blah, blah, blah. Or, "You have 30 seconds."

I love when they say I have 30 seconds.

"I have 30 seconds what?

"To sell you a schedule II opioid?

"'Cause I'll probably do it, and the sad part is

"you'll probably have no idea how to manage the side effects,

"the drug interactions, the precautions, the warnings,

"the respiratory depression,

"and everything else that's gonna come along with it.

"So let's both do each other a favor.

"You name the restaurant. You name the time.

"You name the date.

"I don't care where it is. I don't care what it costs.

"I will be there.

"You stay as long as you want or as short as you want,

"but I can't sell this drug to you in 30 seconds.

It's irresponsible."

Now, back then, did I really care about being responsible?

No.

So, look, Alec Burlakoff's a lot to take.

I mean, he is a car salesman on steroids.

But there's an honesty to what he's saying that is...

A frankness to what he's saying that's unique.

Cut me off if I'm rambling, 'cause I know I am,

but there's four categories.

There's blue, yellow, green, red.

- Blue is analytical. - Hmm!

That means if you don't have a scientific, double-blind,

placebo-controlled study with a lot of patients

that proves your data is right, you're not getting a sale.

What does that mean to me?

It means I don't call on analytical doctors

'cause I don't have any studies like that.

Then you have your yellow. That's your amiable doctor.

They want to be friends with everybody.

They want everybody to love them...

You're the best!

Which means if you're selling a drug

and there's five other competitors,

they just go on a rotation.

"This one gets Subsys. This one gets Lazanda.

This one gets Abstral." And then we go back around.

Guess what.

They're out because they're just sharing the wealth.

So now you got your green,

which is kind of like your earthy type of doctor.

Renewable.

Like, God forbid you do a lunch and not recycle.

You'll never go back there again.

But then you got your reds.

Reds are your businessmen.

They own their practice. They run their practice.

- They manage their books.

They see a crazy number of patients.

It's all about efficiency.

In fact, when you as the rep walk in there,

they run to you with a pen to sign,

and they're running away at the same time

because they don't have time to talk with you

because they're treating patients, making money.

And if he's a red and he's a businessman,

I got to show him the WIFM.

What is the WIFM?

That's all they're thinking...

"What's in it for me?"

"Buddy, will you stop talking about the freakin' drug?

"Will you stop talking about saving the patient?

"Will you stop talking about the science,

"and will you please tell me what's in it for me?

Because you're wasting my time."

Those are the reds.

Those are the doctors you want to find,

and those are the doctors you want to move in,

live, eat, and breathe with.

It was a seven-day, 24-hour-a-day job.

They call me at 3:00 in the morning,

they want to go out, I go.

They want me to go to temple on Saturday, I go.

They want me to go to church on Sunday, I go.

You go through the step-by-step process.

Okay, did I take him to dinner? Check.

Did I take him to a hockey game? Check.

Did I take him to a nightclub? Check.

I mean, this is uncapped bonuses.

This is your opportunity.

You wanted to put the money in the doctor's pocket.

Didn't care about anything else.

Just wanted that bonus.

They start the bribe scheme in the summer of 2012.

By the beginning of 2013,

as the company is launching its first IPO,

they can now go and say that the drug is profitable.

And so right away,

investors look at it and said, "Something's going on here."

And they started investing.

By the end of the year,

Insys was the most popular pharmaceutical drug

to invest in.

It was the most popular IPO on Wall Street.

The CEO, Mike Babich, was being interviewed on MSNBC.

By the end of 2014, the market cap was in the billions.

2015, Subsys was one

of the top five most profitable opioid products

in the United States.

That product that we launched three years ago today,

this year will do close to $300 million.

You can make a lot of money

getting doctors to prescribe a medication

to people who don't need it,

who they're not just gonna lose a couple thousand dollars.

They're gonna lose their life.

So one whole piece of the case

is we're gonna bribe doctors

to write as many scripts as we possibly can,

but then they very quickly realized

written scripts without payment doesn't help anybody.

- The drug's expensive. - Very expensive.

So there's different dosages of the medication.

For the highest dosage, 1,600 micrograms,

at times, I believe it was going

for more than $15,000 a month.

And insurance companies,

Medicare in particular, have rules.

And in this case, Subsys, you know,

has to be prescribed for the treatment

of breakthrough cancer pain in cancer patients.

If you're an insurer and you're trying to figure out

whether or not you're willing to pay for a drug,

one of the things you're gonna look at is,

are they prescribing it for what the label says it's for?

Right?

"The label says it's for cancer patients.

"This patient doesn't have cancer.

Why are we paying for this?" Right?

And so they started misleading them.

What they set up is this Insys reimbursement center,

the IRC, and what they would do

is they would work with doctor's offices

to get prescriptions for Subsys approved.

People would go, they would clock in,

and they would put the headset on and get assigned files,

and they would just call and lie.

The insurance company would say,

"Are you calling from Dr. Smith's office?"

"Oh, yes. I'm right here in sunny Florida."

But really, they blocked their outgoing caller ID.

They were in Arizona in a cubicle the whole time.

So a patient goes to see a doctor,

the doctor prescribes Subsys,

somehow the office at the IRC needs to know enough

about the patient to be able to call

on the patient's behalf and lie.

So the sales reps had to convince the doctors

to agree to give them access

to patients' personal information

and various pieces of information

about their diagnoses.

Let's say a doctor just wrote Subsys for back pain

or for neck pain.

What Insys did was say...

One of the tactics that they figured out worked

was talk really fast...

Give them a lot of information at once,

sound like you know what you're talking about.

And they would spin these stories

that just weren't true.

They had a list.

If you're calling Humana,

these are the lies you need to say.

If you're calling Blue Cross Blue Shield,

say this.

And then insurance companies, they used the algorithm.

So, if the answer triggered the right way,

it would lead them down a decision tree

to approve or not approve.

And Insys knew this and took advantage of this.

Yes, um...

So you'll hear these callers anticipate

not only the next question, but the next three questions.

So if Insys knows the algorithm,

they've, like, broken the code.

- They've broken the code. - They cracked the code.

And they could call all day, every day

and get these approved.

Okay, the medication's been approved until one year...

It's approved. It's approved.

The request is approved through March 13.

So you can go ahead and call it in to the pharmacy.

This was something driven from John Kapoor,

driven at the top... what the success rate was on the IRC,

how they were doing.

The lies, the deceit.

There's nothing they wouldn't say to get the drug approved.

And Dr. Kapoor's philosophy was very simple.

"The doctor prescribes it. He puts pen to pad.

"That patient will get the drug.

Do you understand me?"

John Kapoor insisted

that their approvals be something like 90% to 100%,

which according to the testimony was way beyond

any kind of industry goal or standard.

I've been through this before.

I'm looking at this, and I'm going, "Okay.

Clearly, we're breaking the law."

That medication's intended for the use and management

of breakthrough pain in cancer patients.

Dr. Volking is treating the breakthrough pain

as 338.29.

The opioid crisis today is just that.

It's a crisis. We all have to work together.

Because our prescriptions by 2012 were over 250 million.

250 million in the United States.

Everybody who's registered

to handle a controlled substance

has a requirement under the law

to maintain effective controls against diversion.

Manufacturers... "Well, we just make the drugs.

We don't prescribe 'em."

Distributors... "Well, we're just logistic companies.

We don't prescribe or dispense."

Pharmacies... "We just take valid prescriptions"

"written by doctors

and dispense the medications as ordered."

Doctors... "We're just treating our patients."

And then it goes to the patients.

By the way, those are the guys that are dying.

And everybody's pointing the fingers at each other,

but all downstream towards the doctors.

I don't want you to think

that I have a problem with doctors.

In fact, most of the doctors, the vast majority of doctors

are doing exactly what they're supposed to do.

But there are bad doctors

that were doing really bad things

with controlled substances.

I can't stop them.

But the pharmacists can,

because the pharmacists don't have to fill the prescriptions.

But if the pharmacist continues

to fill the prescriptions,

the Controlled Substances Act supplies a check

at the distributor-to-pharmacy level.

When the manufacturer makes the pill,

they're not allowed to sell it directly to a pharmacy,

so they sell it to one of these three companies

almost exclusively...

McKesson, Cardinal Health, and AmerisourceBergen.

And those three companies own

something along the lines of 90% of the opioid market.

When I first started doing this investigation,

I had never heard of these companies.

I had never heard of McKesson.

They are not only

the largest drug distribution company in America,

they are the fifth-largest company in the United States.

These companies keep very low profiles.

They don't want to be in the press,

and they do a very good job

of just staying off the radar screen.

- Hello? Can I help you? - How you doing?

- What are you shooting? - The trucks coming in and out.

- What are you shooting for? - It's for a documentary.

- Nope. Cannot do that. - Nope, not here.

The distributors, the big three...

When an order comes in,

they have an obligation to have a system in place

that identifies whether the order is suspicious.

If the order is suspicious,

they need to stop the shipment.

So, if you see a pharmacy

that's been ordering 5,000 tablets for the last two years

and now they're ordering 40,000, then 60,000,

then 100,000, that's suspicious.

You... there's no way you could say it's not suspicious.

But what we saw was

distributors not filing suspicious orders

and then continuing to ship.

narrator: When distributors recklessly filled hundreds

of suspicious orders,

the DEA had the ability to shut them down

with a powerful weapon...

An ISO, or Immediate Suspension Order.

Nobody used that weapon more effectively

than a DEA lawyer named Linden Barber.

DEA's regulation calls on distributors

to detect and report suspicious orders to DEA.

Those are, according to the regulations,

orders of unusual size, unusual frequency,

or those that

narrator: One of the top lawyers

at the DEA's Drug Diversion Division,

Linden Barber worked closely with Joe Rannazzisi

in preventing companies from profiting

from opioid abuse.

He was doing a lot of work with us,

trying to get the industry in compliance.

Linden would be the first to get angry

about how many people died.

He had that drive, that push to file all these cases,

to cowboy it.

Narrator: Late in 2007,

Barber, Rannazzisi, and the DEA

set their sights on Cardinal Health.

They shut down a key distribution center

with an ISO

for failing to report hundreds of blatantly suspicious orders

of narcotics.

A $130 billion company,

Cardinal settled the case by paying a $34 million fine.

In the final deal,

Cardinal did not admit wrongdoing,

and damaging evidence of public harm was suppressed.

I didn't want to settle these cases.

I wanted to go in front of a court.

I wanted to present all the evidence.

I wanted to be transparent.

A $34 million fine does nothing.

That's a traffic ticket.

$34 million for Cardinal is nothing.

It didn't take very long

before they basically were turning around

and doing the same thing.

Cardinal was distributing millions of pills

to two CVS pharmacies in Sanford, Florida,

right on the edge of a highway.

So people would cruise in, get their drugs,

and be out in, like, no time at all.

Narrator: As part of the CVS case,

the DEA started investigating Cardinal once more.

Angered by a second Rannazzisi-led investigation,

Cardinal started an influence campaign,

using former Department of Justice officials

to lobby their old colleagues.

You know, the revolving door and the swamp

is alive and well in Washington.

Jamie Gorelick was the Deputy Attorney General

during the Clinton administration,

so she was the second-highest-ranking

law enforcement official in the United States.

After she left,

she joined one of the biggest law firms in town here.

She is a exceedingly powerful woman,

and Cardinal Health had retained her.

She reached out to the then-Deputy Attorney General,

James Cole, and asked him

if they could take a look at this case...

You know, "Did they really have to come after them that hard?"

"They're trying to do the right thing.

Is there a way that we can talk about this?"

And that got back to Joe,

that Jamie Gorelick had been involved.

Look, as much as I understand

that Jamie Gorelick is a fine attorney,

I don't think she knows the Controlled Substances Act

better than me.

narrator: In a series of calls and letters,

Gorelick pressed Cole to prevent the DEA from acting.

"Immediate suspension," wrote Gorelick,

"is a drastic and punitive enforcement tool.

"We would appreciate the opportunity

"to discuss this urgent matter with you

prior to any action by DEA."

Cole responded

by demanding an immediate briefing by Rannazzisi.

I said, "Before we start",

"no one's ever wanted a briefing

"on why we're doing certain things.

What makes this case so special?"

And the response was, "'Cause I'm the Deputy Attorney General

of the United States, and I want to know."

And that really didn't answer the question.

And it just got very adversarial.

But once we presented the facts, they couldn't...

I mean, the facts were the facts.

These companies were an imminent danger

to public health.

Around that time, we're reaching, like,

170,000 people who had died from drug overdoses.

That is just a phenomenal number.

Doing CPR!

During this time period, I'm out on the road.

I'm talking to parents who've lost kids.

I'm talking to wives who've lost husbands.

I'm talking to people who've lost loved ones,

and they're all saying the same thing...

Why is this happening?

And my response is, "We're doing everything we can."

And then to sit there and go through an inquisition

about why I'm doing a certain thing,

to a company... To at least one company

that was already charged with the same violation

several years ago, it kind of pissed me off.

And that's when I came back, and I call my team.

I said, "You know, this is war. We're at war now."

"You go out and serve those ISOs,

and we'll just see where it goes."

I was proud of the work they did.

Those guys busted their butts for, you know, months,

getting these cases together.

We were absolutely amped up.

If you want to do some real good,

if that's really what you want to do,

if you want to go out and you want to fight bad guys,

you're doing this kind of thing,

and you're thinking, "This is great."

So, in February of 2012,

we issued the Immediate Suspension Orders.

Narrator: A federal judge ruled in favor of the DEA.

The ISO went into effect,

shutting down the flow of drugs.

Ultimately, Cardinal agreed to stop shipping opioids

from one warehouse for two years

and paid a $44 million fine,

but the tactics of the DEA enraged Cardinal

and other big pharma companies.

When the companies didn't like

that they were being held accountable,

they said, "Enough is enough."

And instead of complying,

they just decided to change the statute.

Thank you, Madam Speaker.

I rise in strong support of HR 471,

the Ensuring Patient Access

and Effective Drug Enforcement Act,

bringing greater clarity and transparency

to the requirements for safe and secure distribution

of these medicines.

Pharmaceutical companies have infinite gobs of money

to throw at politicians to change the laws,

and that is disgusting.

That's horrible.

That's not the way the law should work.

They should be changing their behaviors, not the rules.

Tell me about Rachel's.

What kind of place was Rachel's?

You know, high-end dance club

with five-star steak restaurant.

One day Alec comes in to the club.

It was slow, and I just saw this guy sitting by the stage.

And I do what I normally do...

Is I sit down and I talk to people.

You know?

That's how I kind of feel them out,

see what kind of people they are,

and if they appreciate more of a conversation, you know...

Then I'm good, right?

Um, but, uh, we talked a bit,

and he told me that he was VP of sales

in pharmaceuticals.

He didn't take any dances till later on that night,

but he had offered to do a private dance with me.

And then he left, and I didn't...

I really didn't think he would come back,

but he came back and said, "Yep, let's do this.

We'll do the private dance."

And that's how it got started.

I get a call from him a couple weeks later,

and he tells me that he thinks

he has a regional sales manager's position for me.

And it seemed like it was the perfect job, honestly.

Just do what I do now, and it wasn't anything different.

The first time I interviewed her,

I told her, "This is the industry."

And she says, "This is what I do every day."

Dancing is how you get a clientele base

that would come in and see just you.

I can shoot the shit with men, you know?

You have to be able to read people by their body language,

what they talk about.

You have to be able to listen

so that you can find out how you relate.

As far as psychology, quite frankly,

her prior employment is all about psychology.

I mean, you got to meet a customer, right?

Are you gonna spend an hour, two hours, three hours

wasting your time when he's not gonna give you a dollar?

Or are you going to know in five minutes

that this isn't your guy,

get up and start circling the place

and find your next opportunity?

What's a whale doctor?

We used that in strip clubs, too.

So what's a whale in a strip club?

A whale is the guy with the money

and that likes to spend it.

When I worked at Insys, the whales were the guys

who were prescribing this medication,

this class of medication for a long time.

Those were the whales.

They know what they're doing,

and if you can get that business,

then you're good.

Base salary for the regional sales manager was $80,000

before bonuses.

They called it Mid-Atlantic,

but it was Michigan, Wisconsin, Indiana,

Illinois, Ohio, Maryland, and Washington, DC.

My sales team, we started off as the worst in the nation,

and we ended up the top region in the nation

shortly after I started.

She's probably the best salesperson I've ever met.

And the best salespeople I hired

were the people who understood,

what is the most important thing to you?

Being number one in the country on that list

or making the most money?

I typically go with the person who says being number one

'cause I know they're sick

like me.

Got to be number one.

When I met Alec, I don't know, he seemed crazy,

but I thought he was brilliant.

After starting with the company

and communicating with him daily

and listening to him on the conference calls and...

That's when I really got to know him.

We became, you know, good friends

and developed a relationship,

even though I knew that he was married.

Which, I mean, we all say love can be blind, right?

You know, I saw this man who worked really hard,

did things for people, gave people opportunities,

like myself.

I was born in Hawaii, Honolulu.

Born into a very abusive household.

My parents got divorced

shortly after my brother was born.

And then shortly after that, my father actually took us.

We were on the, you know, run.

We were milk-carton children for a few years.

We lived all over the place...

Boston, San Francisco,

different parts of California, Chicago, Puerto Rico.

Sometimes two weeks to two months.

I never had a childhood.

I raised my sister and my brother

at a very young age.

You know, I'm ironing at five years old and cooking.

Eventually the law caught up with him.

They found my mother. We moved to Michigan.

I ended up getting emancipated when I was 16.

You have to prove

that you can take care of yourself financially,

which I did, working three jobs,

going to school, a superior honor roll student.

Finished school, got married, and had a son

and started going to college.

And once I turned 18, I started dancing, too.

When you don't have anything and you don't have any support,

you've got to grind your way and, you know,

treat it like a business, and that's what I did.

You know, I pushed myself through school.

Initially, it was pre-med and then natural healing.

And I was board certified for medical massage therapy.

Everybody used to call me Superwoman...

Or Supermom.

And I could do it all.

In 2012,

I went down to Florida with the kids

to try to make some money.

And it was that summer when I met Alec.

I listened to him.

He said that I needed a four-year degree.

He knew I didn't have a four-year degree.

And so he helped me out with my résumé.

Just said that I had to, you know,

put that I had this bachelor's degree.

I trusted him.

Part of what Alec Burlakoff did

is he pulled in three people who he knew he could trust

to implement Kapoor's strategy.

That is not easy to do.

It's not easy to hire people

who are gonna manage other people

to engage in criminal activity.

- You know, they targeted... - They targeted us,

people who were...

I call us the naive dreamers,

um.

Where we still believed in the dream and worked really hard.

Sunrise Lee, you know, there's this sort of narrative

that wants to portray her

as this person that worked at a club,

and that's true, but she was a much more

sophisticated criminal than that.

She's so successful, she's promoted.

She at one point was responsible

for a third of the country

in terms of all the sales reps and the sales managers.

And she has a conversation with the district manager,

and she said, "Listen",

"you got to make sure that you stay on top of these guys

"because they will stop writing

"unless you're there every day talking to them.

"You got to hold them accountable

for what they agreed to do."

Which, of course, is the definition of a bribe.

Kapoor wanted doctors to have twice the amount

of net revenue generated by their prescriptions

as they were given an honorarium in bribes.

You got to tell the doctor, "Look, we are not Pfizer.

"We track every penny. I'm held accountable.

"If we come to an agreement that you're gonna speak

"and we're gonna pay you honorarium to speak,

"you must clearly understand that you will be expected

"to write double of what we paid you

"back in prescriptions.

"And if it's not there,

"we're gonna reduce your programs quickly,

"and then we're just gonna basically...

You're gonna disappear off the map."

Right?

The whole thig is disgusting.

- Kapoor, he had, like, a... - A spreadsheet.

Excel spreadsheet.

In pharmaceuticals, it's a "no-no."

It's a forbidden. You don't do it.

For obvious reasons, right?

You start connecting the dots, and things don't look so good.

It was the smoking gun.

They could look at a list of prescribers,

and they could say, "Here's what we've paid this person,

and here's their scripts."

And they could do the simple math to see,

"Are we making money or not?"

That was a devastating piece of evidence

because it showed the true intent.

There was a doctor in Illinois named Paul Madison.

He was associated with a doctor

called in the media "Dr. Million Pills."

He had a practice with him.

There's one email describing Madison's office

as a "shady pill mill."

And what do they do?

Sunrise Lee, she goes in, and she flirts with him,

and she is seen giving him a lap dance.

- Never happened, okay? - It just... it never happened.

It's not even allowed to happen at a dance club.

You would get booted out.

They sign him up as a speaker,

and they start bribing him.

And that happened all around the United States.

And another doctor they worked with

was Gavin Awerbuch in Michigan,

who ultimately became the number-one prescriber

of substances in the United States at one point,

was paid for three different speaker programs a week.

A doctor suddenly isn't a doctor anymore at all.

They're working for Insys Therapeutics.

They're working for themselves.

They're working for money,

and the patient has no knowledge of it.

It is truly frightening.

This is a Gallup poll.

America's ratings of honesty

and ethical standards in professions.

Does anybody know what the number-one profession is

in honesty and integrity?

Anyone, yell it out.

- Nursing. - Who said that?

Who said nursing? You did.

Think about that.

Nurses, medical doctors, and pharmacists

are one, two, and three.

You trust them. Everybody trusts them.

Why? Because you go there to get better.

You go there to get better.

Okay, that's important

because people trust their medical professionals,

so they'll do what they're told to do.

Okay? What's the bottom five?

- Bingo!

Members of Congress are last.

But this... ahead of 'em are stockbrokers,

advertising practitioners, telemarketers,

and car salespeople.

The bottom five.

More can and must be done to treat this growing epidemic,

and that is why we have all worked together

on HR 4709, the Ensuring Patient Access

and Effective Drug Enforcement Act of 2014.

What is The Ensuring Patient Access

and Effective Drug Enforcement Act?

- Sounds great, doesn't it?

I mean, what could be wrong with that?

You know, you get...

Patients get access to their medications,

and there's effective law enforcement.

So why would anybody be opposed to that?

This is one of these kind of non sequiturs.

It's like one of the most bizarre names for a bill

that does everything the opposite.

Narrator: Instead of passing a law to protect patients,

members of Congress worked hard to pass a bill

that would undercut the DEA's power to stop companies

from recklessly flooding the country with narcotics.

To understand why,

it helps to look at how Cardinal had retained

a former DEA official who was perfectly positioned

to persuade Congress to do the wrong thing.

The chair recognizes Mr. Barber.

Five minutes for an opening statement.

Good morning, Mr. Chairman.

For the last 3 1/2 years as the director

of the DEA compliance and litigation practice

at Quarels & Brady,

I have dealt with registrants on a daily basis,

but prior to that, I was the Associate Chief Counsel at DEA.

I worked at the agency for 12 years...

Linden Barber left the DEA

and formed his own practice

within a law firm here in town,

representing the very same companies

that he used to go after.

So around and around and around it goes.

He brought with him the knowledge

of where the DEA enforcement regime is weakest,

and he started to advise his clients to that effect.

If you have a DEA compliance issue

or you're facing a government investigation,

I'd be happy to hear from you.

According to email traffic that we received,

there was an email between a couple of people

at the Department of Justice,

and one person said Linden Barber wrote this bill.

Narrator: The bill completely changed the conditions

under which the DEA could issue a suspension order.

It redefined the term "imminent danger"

as a "substantial likelihood of an immediate threat."

In law, language is everything.

So it would be impossible for the DEA to show

that a drug distributor based in Ohio or Connecticut

or Upstate New York

posed an immediate threat of deaths

by sending drugs downstream to a community

in West Virginia.

It's just impossible.

You could show before it was imminent,

but you can't show now that it's immediate.

So, if they passed the legislation,

there would be no more immediate shutdown

of narcotics distribution.

It could happen after a hearing,

but it couldn't happen

like that.

The Ensuring Patient Access

and Effective Drug Enforcement Act

provides much-needed clarity in the Controlled Substances Act.

And DEA's authority to issue immediate suspensions

will be protected from judicial curtailment

because there will be a clear legal standard.

So, when Linden left

and then all these people that I loved

and loved working with, you know, begin leaving,

and they're leaving to go work

for who they claimed were the bad guys.

And they take that same righteous anger that they had

working for DEA,

and now they're using that righteous anger

on the other side.

I don't know how you do that.

You know, if you go and work for the drug company,

that's you.

I mean, that... if you want to...

I never criticize a man for how he's making his money.

As a former counsel who appeared in federal courts,

assisted U.S. Attorney's office

in defending the suspension power of the agency,

having a clear legal standard is always best.

There are federal statutes

that were passed around the same time as the CSA

that contained a definition of imminent danger...

I had a conversation with a key staff member

of the Energy & Commerce Committee,

who said, "We actually had somebody come up here"

"and testify who used to work for the DEA.

"He was, like, a top lawyer for the DEA

"who said that the law needed to be clarified,

and it was really important."

And I said, "Who was that lawyer?"

And the staffer said, "It was Linden Barber."

And I said, "Do you know who Linden Barber is?

Do you know who he works for?"

He's like, "No. Who does he work for?"

I said, "He represents all of these companies."

It was kind of a stunning moment.

You don't really want to see

how the sausage is made on Capitol Hill.

Our bill seeks to facilitate greater collaboration

between industry stakeholders and regulators

in our nation's effort to combat prescription drug abuse.

Distributors and pharmacists are finding

that he unnecessary adversarial regulatory environment

created by the DEA is putting effective enforcement outcomes

in jeopardy.

The company's lobbyists

basically came up with a strategy...

"How can we stop the DEA from picking on us

and bothering us and hurting us?"

They zeroed in on this congressman, Tom Marino,

and also Marsha Blackburn from Tennessee.

You know, it's interesting,

'cause Tom Marino and Marsha Blackburn's districts

were both really hard hit by opioids.

To every family member

who has lost a loved one to an overdose...

The drug industry got them on board

to champion their cause.

McKesson, Cardinal Health, AmerisourceBergen,

Purdue Pharma, CVS, all these companies

were lobbying heavily in support of this bill.

And most were paying Tom Marino, Marsha Blackburn,

Orrin Hatch, and a host of other members of Congress

a lot of money to get this bill passed.

They're getting campaign money,

and industry lobbyists are writing the questions

for them to ask the DEA officials.

The chair recognizes Ms. Blackburn for five minutes.

Thank you so much.

Mr. Rannazzisi... Am I saying your name correctly?

- Yes, ma'am. - I'm close enough, huh?

- Perfect. - Okay.

You know, we all are concerned about patients

that are in pain that need medication.

Numerous seniors in my district are complaining.

They call my office on a regular basis

'cause they can't get their pain medications.

It's critical that patients

who desperately need these medicines have access

without undue delay.

I mean, what are we doing to make sure

that these folks are heard from

and that the drugs are available?

We do not want patients to go without their medication,

true pain patients that need their medication.

We don't want that.

But there is no...

Tell me what you're doing about it.

Sometimes it seems that

all the DEA cares about is the number of enforcement actions

and not real solutions to stop the abuse.

- That's not correct. - Provide us some data.

If you would go on our website and look at the cases

that are posted on our website, both on the case...

It would've been great

had you been prepared to provide that for us.

Articulate what the efforts are that the DEA is engaged in.

Besides the on-site investigations that we do,

the cyclical investigations to determine compliance

and to assist them in complying

you know, besides the fact

that they call in and request assistance...

- Okay, well let me move on... - Questions?

Then if it's laborious.

I think you were ticking off... it's not laborious.

You asked me to tick off what I do.

And 16,651 people in 2010 died

of opiate overdose, okay?

Opiate-associated overdose. This is not a game.

We're not playing a game.

Nobody is saying it is a game, sir.

Well, yeah, kind of you did,

because you're questioning why we're doing this.

And all you had to do is go back and look at the cases

that we did in '11, '12, '13,

all these different cases.

Go through the documents,

and you could see what they were doing.

But for some reason, Representative Blackburn

decided that she didn't want the supply chain touched.

And I guess it's kind of a Monday attitude sort of day.

So let me move on, okay?

I thought maybe you were doing a little bit to help.

Then Representative Blackburn and Tom Marino

were investigating me for attempting

to intimidate Congress.

Joe Rannazzisi, a senior DEA official,

has publicly accused we sponsors of the bill

of "supporting criminals."

This offends me immensely.

What happened was we had a telephone call,

and we started arguing.

And I said, "If you pass this bill,

"it's going to stop us from doing our jobs,

"our ability to stop the hemorrhaging.

"And with all these people dying, well, you know,

"if this bill passes, that blood's on your hands.

It's not on mine."

They filed a complaint

with the Office of the Inspector General.

Ultimately, that was the end of my career.

It was a management change.

A new guy came in,

replaced me with a guy who had no pharmaceutical experience,

and in 2015, after I retired, they replaced my whole staff.

Now, this is important 'cause this is the perfect storm

for bad policy and legislation...

Regulatory pressure on powerful industry,

money, lobbying, and Congress.

And that's exactly what happened.

Without objection,

the bill was read a third time and passed.

They all passed it without even a vote.

It was just unanimous consent,

which just means that it will pass,

but if one member of Congress stands up

and says, "I'm against this,"

the bill stops dead in its tracks,

and they have to vote on it.

Not one member of Congress stood up and said,

"I object to this bill."

This is bipartisan.

The Democrats and the Republicans

saw the importance in this and got together.

People don't like to hear this, but

nobody really realized what the language change meant.

I don't think that they read it.

I think the vast majority of bills that get passed

on Capitol Hill...

Legislators do not read those bills.

And they had no excuse for this one,

because it was, like, three pages.

And the key paragraph is on the first page.

They were just asleep at the switch,

and they gutted the DEA's ability

to go after these companies.

People were dying by the tens of thousands,

and their own representatives

are basically selling 'em down the river.

It's one of the most outrageous things I've ever seen

in the 35 years I've been doing this.

Was there any controversy or any pause by President Obama

when the law went to his desk for signature?

None.

It just sailed right through his office.

And it's... to this day, it's, like, the big mystery.

I mean, nobody would talk to us.

The head of the DEA wouldn't talk to us.

The head of the Office of Management and Budget,

which signs off on every piece of legislation,

wouldn't talk to us.

The top lawyer for the White House

wouldn't talk to us.

The president wouldn't talk to us.

It's incredibly unusual.

Mr. President-elect

narrator: The incoming Trump administration pledged

to do better than Obama, but when it came time

for Trump to announce his drug czar,

he named Tom Marino, the man who spearheaded

the law to protect the opioid companies.

Following the passage of the Marino bill,

opioid prescriptions soared in some parts of the country.

Yet in many states, there were also countercurrents

that swirled in unpredictable ways.

As far back as 2012,

a building resistance to opioids was colliding

with a growing dependence on them.

You have millions of people

who start using these drugs

and become dependent.

And then

a series of things happen

that are good things that should've happened earlier.

States start tightening up regulations,

pill mills shut down,

doctors get a little more careful

about writing prescriptions.

These changes are good to one way of thinking,

in the sense that they make it harder

to buy and abuse pharmaceutical opioids.

But what that does is it drives all these people

who are already addicted on to the black market.

Narrator: The illegal trafficking of narcotics

increased due to growing demand.

International drug cartels catered to those

who had become addicted to prescription pills.

As their need for narcotics increased

and doctors were more reluctant

to prescribe rising doses,

users turned to heroin

and a synthetic opioid 50 times more powerful...

Fentanyl.

Fentanyl has been around,

you know, decades and decades

and still today has an extremely important use

medically within the medical community.

For the illicit side,

when OxyContin and these things kind of came into the market

in the 1990s and then people becoming physically addicted

to it unknowingly,

if we look at enforcement

against the pharmaceutical industry that took place

and against doctors and how things are being prescribed,

the people who utilized those drugs,

they now were kind of cut off in their supply.

And cartels and the illicit side of the markets

went to fill the void.

This is the busiest port of entry in the United States.

So we're talking about thousands and thousands

and thousands of people that come through every day.

The San Ysidro port,

the first time fentanyl was really intercepted here

in bulk quantity was in 2014.

And since then,

it has just kind of grown out exponentially.

It's just part of almost daily intercept loads here.

I can tell you that there is Chinese-produced fentanyl

that has entered the United States through the port,

but there is also illicitly made fentanyl

from other locations that have come through the port.

narrator: Since 2015,

fentanyl overdoses have been rising dramatically.

Rates have soared by 2,000% in San Diego,

where a federal task force

is seeking to prosecute dealers

for the deaths of their buyers.

One case involved a 24-year-old college student

named Sarah Fuzzell.

Her parents called her their angel on Earth.

After getting hooked on prescription painkillers,

she battled addiction for five years

until the pandemic shut down her support network.

After dropping out of school,

she died of a fentanyl overdose.

The father of the girl who had passed away

had been reaching out, and he said that

when he received her property back,

her cell phone, when it turned on

and was powered up,

that the person that they believe

had sold the drugs to their daughter

was still communicating through the phone.

They gave us the phone so we could utilize it

for investigative value.

You almost have to manufacture the energy

to even want to reach out

to, like, law enforcement... You guys...

Because, you know,

the ultimate goal of wishing Sarah wasn't dead,

that's not a possibility to change that.

So, you know, there's probably some families

that just kind of quietly go away

just because there's so much hurt.

But we're wide open to doing anything that we can do

- that will help. - Yeah.

So let me just give you kind of a quick rundown...

Okay.

Of kind of what took place.

We spent well over 40-straight man-hours...

Between about 15 to 30 people at one time

getting this to go down.

Basically what we're doing

is we're targeting a suspected fentanyl distributor

who we believe is responsible

for a recent overdose drug death.

And, essentially, what we're doing

is we're trying to lure the distributor out

to this particular parking lot,

and then we're gonna place that person under arrest.

- So... - Oh, sweet.

Yeah, Wasser to all code five units.

Try to set something up for tomorrow.

I think we've been pushy enough for the day,

and I think it's just best

that we back off for the moment, break.

We had a hard time.

We set up for it.

We spent the entire day waiting,

and we never were able to make that contact.

Okay.

We really appreciate

what you and your task force and all are doing, you know?

It's making a difference.

Every day

it is a continuous game of cat and mouse,

where, you know, the impact of the death

is one piece of this entire puzzle.

You have people who are nefariously producing it,

people who are buying, procuring chemicals,

moving that stuff around the world,

looking for people to perfect a new recipe

or way to market it in a faster way.

narrator: To figure out the puzzle of the opioid crisis,

you have to look for ill-fitting pieces

all over the country.

In Lubbock, Texas,

the DEA opened an investigation

into a possible drug cartel operation

when the medical examiner reported a sudden rise

in deaths from fentanyl overdoses.

But something surprised the agents.

The likely kingpin turned out

not to be a professional criminal.

Instead,

all evidence seemed to lead to a local computer repair man

named Caleb Lanier.

I guess there's a couple times in my life

where I could've walked away, but it's so hard.

When the doctors start prescribing these drugs,

get you addicted to them,

it numbs you, and it's dangerous

because somebody that's depressed and has anxiety

and now doesn't feel the fears and doesn't...

They're going to do things like I did.

They are.

I grew up in a little town called Clovis, New Mexico.

It's on the border of Texas and New Mexico.

About 40,000 people at the time.

Pretty normal family.

My parents did everything they could

to help me the best they could.

Three sisters that are all older than me,

so definitely got picked on a little bit from them,

but I knew they all loved me

and I had support, so, you know,

it wasn't a matter of me not having loved ones around me

or growing up in a rough neighborhood

or anything like that that led to the path that I'm at now.

Now, I got ran over by a pickup truck in 2001.

Ran across my right leg, across my chest,

and up off my left shoulder.

Needless to say, from that point on,

I've dealt with pain my entire life...

Physical pain, emotional pain as well.

It's hard to even talk about it.

I started taking very heavy opiates.

I was being prescribed

40 milligrams of OxyContin with 2 milligrams Xanax

from day one,

and that's huge amounts of opiates and Xanax together,

which is not supposed to be prescribed to begin with.

I became addicted pretty quickly.

He would go to a doctor in Portales, New Mexico.

I went with him a couple of times.

He would say, "Oh, I researched this medication,

and I'd like to try it."

And she said, "Okay, Caleb."

The first time, I didn't think anything of it.

And then after a couple of times

and him switching up medications

and her not even looking into it,

just prescribing him whatever he wanted,

I said, "Wow, I don't think

that she should be prescribing you whatever you want."

And he said, "Oh, no, she's my family doctor.

She trusts me. She knows I do the research."

And that was probably my first inkling

that, you know, something was wrong.

Pain has an issue

of causing people to become depressed.

I mean, it's just... It's part of it, you know?

When you deal with it every day...

I explain it like a roller coaster,

and you're on that roller coaster,

and you're getting nauseous, and you're about to vomit,

and every time the roller coaster comes around,

you're looking at the guy that has that stop switch.

And you're like, "Stop this thing. I want off."

But there's no stopping. It's the rest of your life.

It wears on you.

You look at the things that you used to be able to do,

the things you want to do with your family,

the things you want to do with your friends,

and you can't do them.

I got where I was using so much

that I would go through my entire prescription

within the first four days of the month.

You're so tired of this roller coaster,

you'd rather just put a needle in your arm

and make the pain go away.

I started using heroin at that point.

Heroin worked for a short period of time,

but it was too expensive.

I had also been on fentanyl,

and that led to me finding it on the Internet.

The first thing that we saw...

There was a shipment of fentanyl

that was destined to Lubbock, Texas,

that was seized by Customs and Border Protection

in November of 2015.

We started talking to Lubbock Police Department,

the sheriff's office, narcotics units,

and we discovered that they were also seeing an uptick

in fentanyl.

They were buying it in street-level sales.

And then we had several people that walked into our door

that were fentanyl users that had gone to drug rehab.

We took the intelligence from those individuals,

and we started extensive surveillance on Caleb Lanier.

And we discovered that, yes,

this is the person that's using the dark web,

reaching out to labs in China directly.

- Hello, everyone.

We are the vendor of research chemical products.

Include 2-FDCK, etizolam...

He had a wood shed behind his house

that he used as a modified chemistry lab.

He was experimenting extensively

with different variants of fentanyl...

Furanyl fentanyl, acrylofentanyl.

And he was tweaking them

and he was using them on himself

to try to figure out which provided the best high,

which lasted the longest,

and he figured out a way that he could maximize his profits

while he was also treating himself.

I thought I was a good father.

I thought I was a good husband,

but it look back at it sober and realize it's insane.

Most heroin addicts might shoot up

two, three times a day.

I was shooting 20 times a day.

There was times I was so high, right,

that I would fall asleep while I'm counting $100 bills.

I would have to get my children

to help me count the money.

Lanier, he was a victim of the opioid epidemic,

but then he starting selling, distributing,

and he realized the profitability in it.

He could import 200 grams of fentanyl from China

for around $3,500,

and he was making over $300,000 in profit.

He started developing ways to launder his money.

He had a new business

that had a lot of cash deposits that weren't normal.

He started recruiting other people

to sell fentanyl in the street,

to gather money to take back to Lanier.

He became the leader of a drug-trafficking organization.

The fentanyl that they were bringing in the community

attracted a whole new branch of people

that normally wouldn't even be associated with opioids.

We had people from all walks of life

overdosing on fentanyl,

and we knew that if we didn't get

a handle on it really quick,

it was gonna be a bigger and bigger problem.

When you look at this problem,

it can look, from a distance,

forbiddingly complex, but, actually,

there's a mechanism that should be pretty easy to understand.

So what Purdue would say today...

What a lot of these pharmaceutical companies

say today is...

"Don't blame us for the opioid crisis.

"These people today, they're dying from heroin.

They're dying from fentanyl."

As though the roots of this thing,

it was some foreign invasion,

when the truth is that the pharmaceutical companies

got very good at getting people on to opioids

but not at getting them off.

Titration, it's actually the responsible thing to do,

but not in this regard.

But, typically, what you're supposed to do is start low,

and titrate slow.

You're supposed to titrate up to the appropriate level.

Now, this is something

that happens in medicine all the time,

and it's totally normal, right?

Start the low dose, play it conservative.

It's simply about balancing the side effects with efficacy.

But at Insys, was the higher, the better.

It was called the effective dose campaign.

It was a campaign that was created by Dr. John Kapoor.

What Kapoor said unequivocally

and what is in black and white in emails

is they knew that if you got

to a 400-microgram dose or higher,

they would stay on the drug longer,

and so they'd make more money.

In the context of this video,

it's like titrate means, like, goose up the dosage,

and then we're gonna make more money.

- Is that the idea?

Yes.

They spent a lot of time and energy

trying to convince sales reps to do this,

and some of the more absurd aspects of the case

with this bottle,

of a 1,600-microgram dose of Subsys

dancing around to a rap

written over a popular A$AP Rocky song,

trying to convince the sales force,

"Go tell your doctor titration's not a problem."

That video was the worst possible move

we could've ever made.

We asked the sales force to put together a short video,

and then we would provide the award to the best video.

All right, dude!

- Dude, we killed it last year. - We demolished it last year.

Reps are gonna be gunning for us.

Absolutely.

So these two really sharp, good-looking guys,

you know, who look like models, supermodels...

Obviously, they went all-out.

And they're phenomenal salespeople, by the way.

When that video first came through email,

I'm watching this video, and I'm engaged.

I was enthusiastic

and actually was a little bit emotional.

I said, "I can't believe the effort they put in.

I'm touched."

The person in the costume

dancing and singing and rapping, that's not me.

People who know me, they know I can't dance.

They know I can't rap.

"Yeah, I'm a 5'8" Jewish guy.

I mean, it's just not happening.

Months later, they go,

"You got to put this costume on,

"and we're gonna reveal it at the end

that you're the guy in the costume."

Whoo!

Nine takes later, an hour and a half later,

this frickin' thing is done.

Just in terms of shedding light

on the corporate culture, right?

John Kapoor is in the room

while this video is being played.

This is two years after they've received a subpoena

from the government looking into their practices.

As all this was happening,

you took a pretty confident approach,

in terms of... you gave a speech

at, like, a rep conference or something like that,

and one of the things you said up at the top was,

- "Oh, any spies here?" - Mm-hmm.

You referred to the investigation.

Mm-hmm.

You must've had an idea

that there was something worth investigating.

But why were you so confident that nothing was gonna happen?

- I wasn't confident. - I was scared as heck.

I talked to my dad every night,

and I'm like, "How do I get out of this freakin' place?"

He's like, "Just leave."

And I'm like, "But they did this,

"and they did that, and they have this,

"and they told me to do this, and no matter what I do,

"I'm gonna be in trouble,

and they promised me all this money,"

and all these stupid things.

I mean, from the moment I woke up in the morning,

my heart would be just pounding through my chest, you know?

And the whole drive to the office,

just pounding, pounding, pounding.

This is in Chandler, Arizona.

We moved, like, two or three times.

This was the final office that I was a part of.

You know, my kids were in a new school.

We're in a new place.

My wife's trying to get adjusted.

I forced 'em to make this move.

And the numbers come in while I'm driving to work,

always.

Literally, you're just holding your phone.

Boom. There it shows up.

213, 330, whatever.

"Alec, what plan of action do you have in place?

"Alec, do you have a flight booked?

"Where are you staying?

"Why is your flight not booked? Are you a moron?

"I don't understand.

The guy's down 18% from last week."

"Dr. Kapoor, can I speak?"

"No!

"Alec, you're VP of sales. Where are the prescriptions?

"They're not there?

"Pack your bags, grab your kids,

grab your wife, catch a bus home."

People were getting fired left and right.

I don't know if it's different for anybody else,

but for me,

because I entered in knowing, if I don't produce,

that I'm dispensable at any point regardless

because I'm the one that didn't have the degree.

But the culture, definitely

it wasn't an equal culture.

I heard about other relationships with girls

and executives,

and once they had expired...

Then you're dispensable, right?

A lot of pressure.

A lot of pressure.

"Do this or this."

The relationship with Alec didn't help.

It was very volatile.

What's very weird is Alec was saying things like,

"I'm out of time. I'm out of time."

And I was pressuring him to tell me what is going on,

and he pulled out a gun out of his glovebox,

and he was like, "You see? I'm carrying this gun."

He's like, "You don't know. I'm carrying this.

I got to protect myself."

He had obviously been treated poorly

by the company.

I think that he became aware

that he was gonna be the scapegoat in the case,

that the other defendants were going to blame Burlakoff.

The company told me nothing, ever.

I asked a million times,

"What happened with this doctor?"

"Why did this doctor get arrested? What..."

"I heard a patient passed away. What..."

"Ne... Alex, stay in your lane. What's your lane? Sales."

I think a lot of people who have been in legal situations

would understand what I'm talking about.

It's just no way to live,

wondering when the other shoe is gonna drop.

He reached out again.

We were actually able to

get him telling us a location.

We're gonna try to bounce him from 6th over to 4th,

kind of that roundabout over by Horton Plaza.

What's the last you've told him?

- I said I'm coming. - Oh, okay.

So we wound up in downtown San Diego.

We set him in on a vehicle.

10-4 the ID.

So, basically, he's saying he spent his money on this,

that he needs her to be there before 1:30.

He last relayed his location at 12:48 at 6th and Broadway

and says that he has no car.

All right, updated... He's saying he's on his way.

I asked him where he was, and that was his response.

Also said, "Just let me know where you parked

so I can come find you."

And then, "Oh, on my way."

- It's torture.

Just wait. The wait's always torture.

You think you'd get used to it, but it's just...

All right, James, start moving in.

- Now. - Now.

- Lights.

- San Diego Police! - Let me see your hands!

- Get on the ground! - Do it now!

- Drop to the ground right now! - Don't move!

Put your hands behind your back!

- Do not move! - Don't move.

Say about 5:30 in the morning,

I was sleeping on the couch, and I woke up,

and went and said good morning to my wife.

And I heard 'em hit the door.

Saying, "DEA."

They looked like they were fixing to kill somebody.

And I panicked and put my hands in the air,

and I watch as they come in with HAZMAT suits.

Everyone was very, very stressed,

and it wasn't the people, it was fentanyl.

It's 50 times more potent than what you would see

in normal heroin coming in from Mexico.

We had no idea how spread it would be throughout the house,

what efforts we would have to take to clean it up

and dismantle their labs.

We just had no idea.

During the search warrant,

we found several analogues of fentanyl

that DEA had never seen in the U.S. before.

I had about 300 grams of pure acrylic fentanyl.

Sells for about $300 a gram,

so a lot of money's worth.

When we hit 'em,

they were kind of at the peak of their organization.

They were probably selling

$25,000 to $30,000 a week in fentanyl.

I don't know how he managed to do that.

I never even saw a package get delivered here.

He never left the couch,

and we didn't have people coming and going either.

So whatever he was doing, he was really quiet about it.

I'd never expected the raid.

When I saw those officers piling up on my porch

through my bedroom window,

I thought it was, like, a home invasion.

I was trying to call 911 from my phone.

I didn't know that they were police officers.

I can still to this day

hear my wife and my children screaming.

Looking back at 'em,

and I said, "Please move me so they can't see me."

Fear? I didn't have that.

It was shame, but it wasn't fear.

If anything, I was relieved. Just take me to jail.

I was either gonna die from withdrawals,

or I was getting off of drugs,

and I didn't care which one it was.

You have the right to remain silent.

You can refuse to answer questions at any time.

Anything you say...

We found fentanyl on him.

We went back to the hotel room that they stayed in,

and we were able to find more drugs there.

He's an addict himself, so he fuels his use by sales.

Wow.

And, you know, at the end of the day,

everybody's a victim in this thing.

You know, other than the people that manufacture it

and, you know, make the big money from it.

You know, once you get past that,

once you get into the people that use,

whether they're dealers or customers

or whatever they might be,

everybody becomes a victim.

So I don't know if it's worse to die and finally be at peace

and not have to fight these urges every day.

I don't know if that's the worst

or if it's these people that live

that every day now have to be tortured

with this need to go out and find this stuff.

You know, it's just wrong.

I just don't understand how the pharmaceutical companies

get away with this stuff.

You did a great job staying in touch.

- We appreciate you. - You're welcome.

Have a good evening.

You too. Bye-bye.

I'd been working on the case

over the course of several years.

And suddenly, Alec Burlakoff left me a message,

and the message says, "I fired my lawyer,

and I want to come in, and I want to talk to you."

This is highly unusual. This has never happened, right?

You know, white-collar folks are always well-represented,

and the last think you want to do is go in and talk

to the federal government without a lawyer.

I decided to fly from Arizona to Boston,

and I met with Mr. Yeager,

and there were a couple other people in the room.

And I basically proceeded to speak with them

for about four, five hours

and basically lied to them.

What I did was, is I told a lot of truths.

I just left myself out of it.

You can say it was based on a true story,

just left the names out, you know?

And we just let him talk, you know?

We had evidence against him.

We knew that we were gonna prosecute him at some point.

We had, very early on, texts and emails

telling people to go bribe doctors,

that he personally was asking doctors to write prescriptions

in exchange for money paid by Insys.

So, when the conversation was over, I told him

I thought he just spent the last four hours lying to us,

it was nice meeting him, and he'd be hearing from us.

- I mean, I just felt... - My whole world,

I knew it was basically crashing in,

and it was gonna happen really slowly,

and it was gonna be very painful.

You know, several months later

he was charged and indicted.

narrator: In October 2017, Burlakoff, Kapoor,

Sunrise Lee, and four others

were charged with leading a nationwide conspiracy

to profit by using fraud and bribes

to cause the illegal distribution of fentanyl.

In addition to bribing doctors, the charges included

defrauding insurance providers.

- Thank you, sir.

- Any comment? - No.

Narrator: The evidence against Alec Burlakoff

was so overwhelming,

his attorney asked him

to consider cooperating with the prosecution

in exchange for a deal.

I looked at him, tears started to come to my eyes,

and I said, "Yes, I will do it. I will plead guilty."

Because there is no way under any circumstance

that I would ever sit on the same side

or at the same table as John Kapoor, ever.

We all chose him to be our mentor,

and he was supposed to take us to the promised land

if we followed him loyally.

And look where he took us.

narrator: From the bench, the presiding judge

called the crimes of Insys "an offense of greed"

for bribing doctors to prescribe an addictive drug

without regard for the best interests of their patients

and sentenced Alec Burlakoff to 26 months in prison.

Sunrise Lee wasn't able

to make a deal with prosecutors,

likely because she couldn't offer them an inside look

at decisions made in the executive suite.

She was sentenced to a year in prison.

They painted this picture of me

you know, as a dancer, being uneducated,

and...

And just the stereotype of it all.

It stole a lot from me.

Everything that I've worked hard my entire life for.

It's the first time ever in my life

where I haven't been able to persevere.

narrator: John Kapoor was sentenced to 5 1/2 years.

In the courtroom, he had listened without expression

to the mother of a woman who had overdosed on Subsys.

"The actions of John Kapoor and his conspirators,"

she said, "had been a sentence of hell for our family."

All the decisions that these people are making at Insys

and, for that matter,

every other opioid company in the United States,

are made in the context of what is very clearly an epidemic.

You know, in 2012,

the first year of this criminal conspiracy for Insys,

I think there were something like 230 million, 240 million

prescriptions for opioids in the United States.

That's more than one prescription

for every adult American.

When we were doing our reporting,

"The Washington Post" sued to get this confidential.

Drug Enforcement Administration database

that tracked all these prescription pills,

from the manufacturer to the distributor to the pharmacy.

It was a virtual road map,

a blueprint that would show us, give us so many insights

into understanding the opioid epidemic.

Never in my wildest dreams did I imagine

we were talking about the kinds of numbers that came out.

We got nine years of data

and between 2006 and 2014,

100 billion pills had been sent out

to communities all across this country.

Narrator: The opioid companies knew every pharmacy

in every small town where every pill was going.

From Maine to Mexico,

they could track the very abuse they were manufacturing.

The database ranked cities by pills per person.

In some places, close to one a day

for every man, woman, and child.

Did the companies really think

that all those pills were for back pain?

This is something that affects everybody.

It doesn't matter your color,

your nationality, your gender,

whether you're economically privileged,

or poor.

It doesn't matter.

As long as the opioid sales go up,

and opioid deaths will go up

and opioid treatment admissions are gonna go up.

That's where we are now.

And that's where we continue to be.

Okay, that said

narrator: After Rannazzisi was forced out of the DEA,

he took his message on the road

to those who would listen

and he began to be a witness for towns and counties

trying to take action against the big drug companies.

One by one, they started suing the opioid manufacturers

and distributors for the damage done.

With more than 2,500 lawsuits from all over the country,

a judge in Ohio convened

a multi-district litigation center

to consolidate the claims in one courtroom.

Late in 2019, reporters converged in Cleveland,

because in the first big case,

two counties in Ohio were resisting a legal settlement

with three major drug distributors

for their role in fueling the opioid crisis.

It seemed that there might finally be a trial,

where the public would see evidence

of the corporate negligence that had cost so many lives.

Then at the last minute,

the companies took out their checkbooks

and paid to keep the evidence hidden.

A settlement has been reached for our two counties

with the...

The three big defendants.

The settlement does not bring things to an end.

It is, though,

a very good development for the people of our counties.

What was the sticking point last night?

Why did it take till midnight, 1:00 a.m.?

Money.

They wanted to pay less. I wanted them to play more.

Is there an admission of wrongdoing on behalf...

No, but, you know, common sense tells me

when they paid over $323 million

to these two counties,

one might say that's a pretty good admission.

Narrator: In cases like these,

lawyers like to represent that money paid

is some kind of justice, and in a sense, it is.

After all, the cost of addiction is high,

and the price of treatment centers and first responders

should be borne by the companies responsible.

But what of the lives lost?

How do you put a value on them?

During the COVID pandemic,

opioid addiction and overdoses increased.

It was not surprising, then, that in the fall of 2020,

the families of those who had died

were stirred by rumors that the federal government

might bring new criminal charges against the Sacklers,

the family that had profited so much

during the opioid crisis and the company

that had started it all, Purdue Pharma.

This morning,

the Department of Justice is announcing a resolution

which will redress past wrongs

and will also provide extraordinary new resources

for the treatment and care of those affected by opioids...

Narrator: Late in 2020, the Trump administration rushed

to make an announcement for the presidential election.

Pleading guilty to three felony counts

narrator: The Sackler family would pay a $225 million fine.

Purdue Pharma would plead guilty to kickbacks and fraud

and promised to pay fines totaling more than $8 billion.

That number immediately gets repeated in headlines

all across the country.

The news goes out on the wires.

You think, "My God. $8 billion. That's massive."

But Purdue is in bankruptcy

and only has about a billion dollars,

which a whole bunch of creditors

are already fighting over.

That money is never going to get paid by the company

or anybody else.

It's a number, in some ways, I think,

that's been kind of designed to make headlines.

narrator: Behind the headlines was an intricate plot.

In 2019, Purdue had declared Chapter 11 bankruptcy,

which allowed it to continue to operate

while paying fines to those seeking damages.

That led to a cruel irony.

The only way the company could pay damages

was to increase its sales of drugs, including OxyContin.

To pay for the damage done by opioids,

Purdue Pharma would sell more opioids.

- Shame on Purdue! - All: Shame on Purdue!

Dead from greed!

Narrator: While the company was charged with crimes,

none of Purdue's executives or owners were indicted,

and the Sacklers

refused to take any personal responsibility.

Sacklers lie! All: People die!

Sacklers lie! All: People die!

Narrator: That raised questions.

Starting in 2008,

just after Purdue pled guilty to a previous felony,

the Sacklers started taking more than $10 billion

out of the company

in complicated overseas transactions

and vaulted vast sums in their accounts.

Of the $10 billion, roughly half went to taxes,

so that money, we do not have.

It was paid in taxes.

The family and the board acted legally and ethically.

So I think that's not the right way to look at this.

The resolution here is very significant.

It involves, for the company, three felony guilty pleas.

For both the company and the shareholders,

it involves very sizable amounts of money.

If you talk to people

whose lives have been touched by this,

a lot of them will say, "It's not about the money.

"You could never generate enough money

"to make up for the human cost.

That can never happen."

What does matter to a lot of these people is truth.

And, finally, I'm gonna leave you with this.

We've talked about truths, talked about fiction,

and now we're gonna talk about reality.

Turn that up?

- I need an ambulance. - My son's not breathing.

What's the address? 10731?

31, yes. Hurry.

- He's blue? - He's... white.

How old is he?

Oh, God, he's dead!

Ma'am, I need you to calm down. How old is he?

- Oh, he's dead! - Ma'am?

Ma'am, I need you to calm down.

How old is he?

- Can you pick up on that?

- Stop, please.

- How old is he?

I know I could've fought my case more,

but I was done fighting.

I've been sentenced to 135 months in federal prison

for conspiracy to possess furanyl fentanyl

and fentanyl with intent to distribute.

I am currently in Federal Correction Institute

at Big Springs, Texas.

It's a low-security prison.

It could be worse.

I could be dead.

You know what I mean?

I'm close to home,

so my wife can come visit me.

I get to visit my kids every weekend.

This saved my life.

It gives me an opportunity for a second act.

I screwed up the first one.

I can't ever take it back,

but I get an act two

where maybe I can build upon the past

and use my past experiences

to make a better life

for my wife and my kids

and possibly other people

that would go down

the same stupid road I went down.

So yeah, I mean

act two.