All language subtitles for The.Crime.of.the.Century.S01E02.1080p.HEVC.x265-MeGusta[eztv.re]

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.