186 - The Opioid Crisis with Patrick Radden Keefe

A major pharmaceutical distributor mentioned as an intermediary in the drug supply chain, familiar to the host Peter Attia from his previous life.

A major pharmaceutical distributor mentioned as an intermediary in the drug supply chain.

Another pharmaceutical company whose executives faced and received jail time for their role in the opioid crisis, in contrast to Purdue Pharma executives.

A company notorious for corporate fraud, mentioned as part of a trend of reduced criminal charges and jail time for corporate executives in the last 10-15 years.

The small patent medicine company that Arthur Sackler purchased in 1952 and largely handed over to his brothers, before it became Purdue Pharma.

The pharmaceutical company owned by the Sackler family, responsible for developing and aggressively marketing OxyContin, which played a significant role in the opioid crisis.

The pharmaceutical company that developed Librium and Valium, for which Arthur Sackler designed successful advertising campaigns.

An insurance company that filed a fascinating claim in Purdue's bankruptcy, citing an internal study showing hundreds of thousands of their plan members diagnosed with opioid use disorder after being prescribed Purdue opioids.

A company notorious for corporate fraud, mentioned as part of a trend of reduced criminal charges and jail time for corporate executives in the last 10-15 years.

A messaging app where a chat log among Mortimer Sackler's heirs revealed a 'lockstep feeling of persecution' and lack of introspection regarding the opioid crisis.

The family that owned Purdue Pharma, known for their philanthropy but also for making a vast fortune from OxyContin amid its controversial legacy in the opioid crisis.

One of the three Sackler brothers who, along with Raymond, ran Purdue Frederick after Arthur's acquisition.

Leader of the Sinaloa Cartel, who was not a household name when Patrick Radden Keefe first wrote about him in 2012.

An investigative journalist and author who wrote the book 'Empire of Pain' about the Sackler family and Purdue Pharma's role in the opioid crisis.

Hired by Purdue and the Sacklers as a 'hatchet man' to navigate legal challenges, particularly in pressuring the Justice Department to reduce charges against Purdue executives.

A second-generation Sackler, whose heirs' WhatsApp log revealed their collective feeling of persecution.

Married to Mortimer Sackler, Jr., and a board member of Purdue Pharma; she expressed concern over her children attending Manhattan elite private schools due to the family's stigma.

The eldest of the three Sackler brothers, instrumental in developing pharmaceutical advertising and marketing strategies, and an early stakeholder in Purdue Frederick.

A retail pharmacy chain, representing the retail arm in the drug distribution chain.

One of the three Sackler brothers who, along with Mortimer, ran Purdue Frederick after Arthur's acquisition.

The FDA medical examiner who was a key figure in the controversial approval process of OxyContin, later joining Purdue Pharma.

Chief Medical Officer of Purdue Pharma, who gave sworn testimony to Congress in 2000 denying early knowledge of OxyContin's abuse problem, later contradicted by internal emails.

US Senator, mentioned as one of the political figures who received donations from the opioid industry and whose actions were influenced by lobbying.

Former U.S. President who signed HR 4709, a bill that weakened DEA's enforcement capabilities against opioid distribution, although its impact on his awareness is unclear.

Former U.S. President, whose presidency paralleled Patrick Radden Keefe's writing, used as an analogy for how billionaires can become deluded and out of touch due to their advisors.

Involved in the George W. Bush Justice Department, he was one of the individuals who overruled federal prosecutors seeking felony charges against Purdue executives.

A second-generation Sackler and medical doctor involved in Purdue Pharma, who reportedly suggested using oxycodone for a new drug that became OxyContin.

A Purdue sales representative in Virginia and West Virginia, who in 1999 learned from a doctor about a young relative's death from an OxyContin overdose.

Involved in the George W. Bush Justice Department, she was one of the individuals who overruled federal prosecutors seeking felony charges against Purdue executives.

A former DEA official initially seen as a credible voice against drug distribution, who later became a powerful lobbyist for the pharmaceutical industry, including Cardinal Health.

A former US Attorney for the Southern District of New York and former head of the SEC, who represented Purdue and the Sacklers for years, raising questions about the 'revolving door' between government and industry.

Former US Senator, mentioned as one of the political figures who received donations from the opioid industry and whose actions were influenced by lobbying.

Former US Senator, mentioned as one of the political figures who received donations from the opioid industry and whose actions were influenced by lobbying.

A second-generation Sackler and cousin of Cathy, intimately involved with OxyContin's development and marketing, who strongly believed in its 'no ceiling effect' for dosage.

Former US Representative, mentioned as one of the political figures who received donations from the opioid industry and whose actions were influenced by lobbying.

A pain expert at Stanford who treated Peter Attia's back pain effectively after his opioid addiction, utilizing injections, Neurontin, and NSAIDs.

The bankruptcy judge in White Plains, New York, chosen by the Sackler family, who approved temporary litigation freezes against the family and is expected to grant permanent immunity through 'non-consensual third-party releases'.

A street in Greenwich Village, New York City, where the humble Purdue Frederick Factory was originally based.

An example of a state whose Attorney General would be unable to proceed with a state-based claim against the Sacklers if the federal bankruptcy judge grants permanent immunity.

The location of the bankruptcy court where Purdue Pharma filed for bankruptcy, and where Judge Robert Drain presides.

The location of a small federal prosecutor's office where investigators pursued Purdue Pharma, leading to the 2007 guilty plea.

The governmental agency responsible for approving drugs for safety and efficacy, as well as regulating marketing claims.

Hosted by Peter Attia, this is the podcast where the interview with Patrick Radden Keefe about the opioid crisis takes place.

A Mexican drug cartel that Patrick Radden Keefe investigated, noting their diversification into different drugs, including heroin, which led him to investigate the opioid crisis.

A publication for which Patrick Radden Keefe wrote a cover story in 2012 about the Sinaloa drug cartel.

A vast state mental hospital in Queens, New York, where the Sackler brothers witnessed inhumane conditions and considered chemical solutions for mental afflictions.

A magazine where Patrick Radden Keefe worked full-time, and for which he covered Mexican drug cartels.

The governmental agency responsible for drug enforcement, mentioned as a regulator in the drug supply chain.

Reference to a case study approach that Patrick Radden Keefe used to analyze the Sinaloa Cartel as a transnational commodities enterprise.

A large high school in Brooklyn where Arthur Sackler first honed his skills in advertising as the advertising manager for student publications.

Investigated Curtis Wright in 2002-2003, and later involved in the federal case against Purdue.

An organization that introduced 'pain' as the fifth vital sign and received funding from the Sackler family and Purdue, highlighting industry influence on medical standards.

The hospital in inner city Baltimore where Peter Attia did his residency, and encountered many patients with IV drug-use related infections, providing early insights into the heroin crisis.

His Justice Department overruled federal prosecutors in Virginia, preventing felony charges against Purdue executives in 2007.

A major tranquilizer for psychotic patients, described as a game-changer that emptied asylums and showed the Sackler brothers a glimpse of their envisioned future in chemical solutions.

A powerful synthetic opioid, a significant contributor to opioid overdose deaths, particularly in the later stages of the crisis, often coming from China or Mexico.

A strong NSAID that 'basically saved' Peter Attia by breaking the cycle of pain, allowing him to avoid narcotics post-surgery.

A minor tranquilizer developed by Roche, whose marketing and advertising strategy was designed by Arthur Sackler, becoming the biggest selling drug in pharmaceutical history.

A combination pill containing oxycodone, where oxycodone was seen by physicians as more benign due to its smaller dosage when cut with acetaminophen.

An antidepressant suggested by Peter Attia's girlfriend to help him manage opioid withdrawal symptoms during his cold turkey cessation attempt.

A long-acting sodium channel blocker, like Novocaine, which studies showed could prevent incisional pain if injected before surgery, reducing the need for postoperative narcotics.

Purdue's ground-breaking cancer pain drug, a continuous-release form of morphine, which served as the precursor and inspiration for OxyContin.

An opioid, mentioned in comparison to oxycodone; its continuous-release form was considered a potential 'aha moment' for Purdue after MS Contin.

A combination pill containing oxycodone, where oxycodone was seen by physicians as more benign due to its smaller dosage when cut with aspirin.

A non-addictive, benign drug used by Peter Attia to deal with neuropathic pain during his recovery from back injury and addiction, though it has sedating effects.

The product of Insys, implicated in explicit bribery schemes, which led to jail time for its CEO, in stark contrast to the Purdue case.

The active ingredient in Percocet and Percodan, chosen for OxyContin due to its perceived benign nature and weaker stigma compared to morphine, despite being stronger.

A non-opioid pain reliever, used to cut oxycodone in Percocet.

A prescription painkiller developed by Purdue Pharma, central to the opioid crisis, and designed with a continuous-release system.

An antibiotic that was a 'huge game changer' in World War II, marking an exciting time for pharmaceutical companies to develop new branded drugs.

A laxative sold by Purdue Frederick, successful as an over-the-counter cash crop product, ironically addressing a common side effect of opioid use.

An antiseptic solution licensed and sold by Purdue Frederick, which had battlefield applications during the Vietnam War.

Another minor tranquilizer developed by Roche, also marketed by Arthur Sackler, which surpassed Librium as the biggest selling drug.

An illicit opioid drug, whose surge in supply from Mexico after 2010 was linked to the rise of prescription opioid addiction, and which remains a major cause of overdose deaths now.

A potent opioid, the active ingredient in MS Contin, associated with treating severe cancer pain and having a strong stigma.

A short-acting sodium channel blocker, similar to Novocaine, mentioned in comparison to Marcaine.

A magazine that published a piece about the AMA's involvement with the Sacklers and Purdue, and the concept of 'pain' as the fifth vital sign.

Referenced with a scene analogy to explain how lobbyists and influential figures can exert 'soft corruption' by sending the 'right messenger' to their targets.

A bill that deceptively appeared to fight the opioid crisis but effectively weakened the DEA's ability to halt suspicious opioid shipments, signed by President Obama.