Have you watched Painkiller, the limited Netflix series about the OxyContin epidemic that kills thousands of Americans each year—more than car crashes? It is an eye-opening piece–even if you already know the story of the Sackler family and the devastation the family released on America. That devastation continues, which is only one reason this series is important.
From listening to people running for president in 2024, you would not know that more than 100 people a day die of opioid overdoses, or that 81,000 people died of opioid overdoses in 2021, more dead Americans than died in the Vietnam war. Have you seen action plans put forward by any of the dozen or so Republican presidential candidates to address the problem? I have not. Not unless you count Donald Trump’s and Ron DeSantis’ proposals to execute drug dealers.
Painkiller tells the story of the Sackler family’s and Purdue Pharma’s greed, as well as how otherwise good people got involved in distributing drugs (in the case of Purdue, aggressive marketing to persuade doctors to prescribe OxyContin).
The series is worth watching, but it does not address the biggest question—what does the government have to do to stop the epidemic? The Sacklers are no longer in the drug business, but the opioid epidemic continues.
Painkiller offers a simplistic rationale for Purdue’s crimes: greed. Sackler family money allowed it to buy regulatory approvals (by effectively bribing a Food and Drug Administration official) and neuter law enforcement with money (a Maine prosecutor who once publicly attacked Purdue was hired as a consultant to the company) and hiring famous lawyers to game the legal system. (Purdue hired Mary Jo White, a former U.S. Attorney in New York, and Rudy Guiliani to represent it.)
After more than a decade in court, the Sacklers were stopped from peddling these drugs. Yet, the Purdue story is still not over. Despite the company settling the criminal charges brought against it, the Sackler family assets remain in the billions. A court recently rejected a settlement with a Bankruptcy Court that would have ended future financial risk for the family. Thus, trials relating to Purdue will continue indefinitely.
Much more important is the reality of at least 100 people a day dying of opioid overdoses, especially those involving Fentanyl, a synthetic 50 times more potent than heroin. Why isn’t more being done?
Experts admit there is no easy solution. Are those who overdose victims or criminals? Should doctors be second-guessed by lawyers on how they prescribe painkillers? Are families to blame? Would “drug education” programs in schools dissuade people from trying illegal drugs—or legal ones they might not need? Would stronger border enforcement stop the flow of opioids into America?
I do not know the answers to these questions. I also do not know why major presidential candidates, including Joe Biden, are not talking more about the issue, or putting forth bold plans to address it. (In February, President Biden called for “a major surge to stop fentanyl production, sale, and trafficking, with more drug detection machines to inspect cargo and stop pills and powder at the border.” Is that enough?)
The drug problem is not getting better. As a nation, are we ready to accept 100 people a day dying of opioid overdoses? I am not.
Here are questions I would like to see the 2024 candidates answer.
On a scale of one to ten (just like the pain charts doctors use), how serious is the drug problem in the U.S.?
What are the causes of the drug problem?
What actions would you take in your first 100 days in the White House (hopefully in the first 100 hours) to begin addressing the problem?
What commitment of new federal resources to address the addiction problem do you support?
How do you propose to reduce access to illegal opioids, as well as to legal opioids by people who do not need them?
Do you think the FDA is doing its job in protecting the public from opioids?
Do you believe executing drug dealers would solve the opioid epidemic? If so, explain.
Are new laws needed to punish doctors who inappropriately prescribe opioids to people at risk of addiction or to people who do not need the drugs to address intolerable pain? How would such an initiative work?
What innovative ideas do you have to address the drug epidemic?
Do you agree that, if you are elected, voters should hold you accountable for your record on the drug epidemic issue?
If anyone running for president happens to read this piece (I like to think that several candidates are Spy readers), please send me your answers. The Spy, I am sure, would like to publish them.
And, Dr. Harris, where are you on this issue? As a doctor and the First District representative in Congress, what should be done to hold doctors who facilitate access to unneeded addictive opioids accountable? Your website tells us, “Physicians, not government bureaucrats, should provide guidance on medical decisions that affect you and your family.” What would you do to stop doctors from inappropriately prescribing opioids?
J.E. Dean is a retired attorney and public affairs consultant writing on politics, government, and other subjects.