In the Midst of America’s War on Drugs, No One Could Get Arrested for ‘The Crime of the Century’

Tony Sokol

Alex Gibney’s “The Crime of the Century” aims to make audiences think about legalized drug pushing, and viewers will need something to dull the pain. Or better still, to soften their lives when there’s no pain there. Let’s face it, for many Americans, “the opioid crisis” means they can’t get any, and this two-part, four-hour HBO documentary says that’s the way it was always supposed to be. The documentary points out how the epidemic has claimed half a million lives. But this is what was prescribed. Three out of 4 doctors, regulatory agencies and politicians agreed with the diagnosis. They saw it on TV.

OxyContin was the heroin of the late ‘90s, and you didn’t have to be connected to get entangled in the drug. Right wing pundit Rush Limbaugh could barely get through a broadcast without some “purple peelers.” But drugs and radio go back even further than Dr. Johnny Fever at “WKRP in Cincinnati.”  When Purdue Pharma started peddling OxyContin in 1996, they crashed a hungry market. The heroin high became a middle class normal, and when statistics start piling up in the middle class, there’s a crisis. The documentary series casts hillbilly heroin as the major gateway drug.

Purdue Pharma pushed OxyContin as safe because it came with a time-released sealant. Developed as control-released oxycodone, the active part of the drug took more time to get into the bloodstream. But the coating didn’t seal off the addictive effects. This was no epiphany in the world of the pharmaceutical industry promotion, where the name of the game is to keep your customers coming back for more. Dr. Arthur Sackler, whose family owns Purdue Pharma, was the first chemist to use the magic of advertising to sell drugs. He was the guy who brought us Valium. The Rolling Stones made a hit out of it when Mick sang “Mother’s Little Helper.” 

Gibney does his homework. He offers a history of the Sackler family, from Brooklyn immigrants flipping a small drug company into a medical marketing company. They were pioneers in televised medicine shows, and the same three-quarters of the doctors who endorsed their products, didn’t have home or office addresses. We also get a succinct history of heroin use and abuse which goes all the way back to ancient Egypt, when King Tut became fascinated with the botany of poppies. The documentary also speeds through the drug wars the British East India Company instigated against China, which created the first drug czars to battle the addictive encroachment. From the mafia through Mexican cartels, we learn how the drug became legal, illegal, and ultimately legal enough to market. 

We also learn that Curtis Wright who works at Purdue is the same FDA team medical review officer Curtis Wright who let the pharmaceutical company word the approval papers for OxyContin. The papers were very detailed about the drug’s efficacy for pain, but loosely interpret words like “addictive” or “prone to abuse.” Even Dr. Richard Sackler, the individual who profited the most from the drug’s success, admits in archival testimony that just because a drug takes away pain doesn’t mean it’s a good drug. But even as the drug company zealot testifies, he lays out his spiel: There’s nothing better for pain than opioids.

Sustained release Oxycontin was initially prescribed as end-of-life treatment. With the new approval, not only could late-stage cancer or surgical recovery patients get OxyContin, but anyone in any kind of pain. And what is pain, after all, besides suffering, soreness, throbbing, and aching. “Pain is whatever the person experiencing the pain says it is,” promised the ads. It became the Big Mac of narcotics. It was more than a pain medicine, it was a quality-of-life vitamin supplement, and it was legal, if you knew where to get it.

The most popular dealers were called pill mills, but masqueraded as pain clinics in Florida, where doctors made the drug available on demand. According to the interview with Patrick Radden Keefe, author of “Empire of Pain: The Secret History of the Sackler Dynasty,” there was plenty of demand. Dr. Lynn Webster, who distributed the drug through his Lifetree Clinic, talks about high-paying speaking engagements. The documentary painfully examines the recidivism of a patient of his, who quit and got addicted to the drug over and over.

The company knew pills could be crushed, and snorted or injected. And they knew hillbilly heroin was selling on the street for $40 a pill. We hear Purdue’s chief medical officer, Paul Goldenheim, testify how the company addressed the problem of OxyContin addiction in the heartland. But the documentary also includes the part where the company was inspired to double the dosage from 80 to 160 milligram pills after hearing the street value. Richard Sackler, in his deposition in Kentucky Vs. Purdue Pharma in 2015, suggests changing the definition of addiction. An addictive drug should reward, he concedes, but that’s not enough. His drug reps pushed through West Virginia, Kentucky, and other poor states. When the states hit back with addiction accusations, the companies came up with the term “pseudo addiction.” This is when “a patient is looking like a drug addict because they are pursuing pain relief.” It is the first indication to increase the dosage.

The problem with drugs is you constantly need more of them to achieve an appreciable euphoria. To top the high of Oxycodone, the second half of the documentary series centers on fentanyl, a synthetic opiate which is 100 times as powerful as morphine and 50 times stronger than heroin. While the first drug was “heroin in a pill,” this one comes in spray form. The documentary features Insys Therapeutics founder John Kapoor, while we are educated on the natural progression of hyper-engineered corporate drug pushers who get addicted to the treatment of pain.  

No one more than former VP of Sales at Insys, Alec Burlakoff, who finds it to be a lucrative career with more perks than Percocet. For him, it is all about passion. “Not deceit, not lies, it’s not about not having a conscience,” he says. He walks into doctor’s offices just wanting to know “Is this game over yet?” until the doctors ask “What’s in it for me?” He’s called a used car salesman on steroids, but he’s completely honest. Former Insys regional sales manager Sunrise Lee, who was recruited from a gentleman’s club, practically grinds her message through to doctors who can’t resist the sway of the spray.

“The Crime of the Century” states its case clearly and directly, building on the work reporters Scott Higham and Sari Horwitz did for “The Washington Post.” Interviews with DEA attorney Jonathan Novak, and Assistant Attorneys for Massachusetts David Lazarus, Nathaniel Yeager and Fred Wyshak, range from frustration to downright anger. The strongest stories come from the people caught up in the crisis, as the reported deaths rise to the media saturation level of the crack plague. The journalism is exhaustive. Big Pharma created the crisis.

“The business of criminal cartels and pharmaceutical companies are connected,” Gibney says outright in a voiceover early in “The Crime of the Century.” Big Pharma went out of its way to distance themselves from their drug cartel cousins. They hired former prosecutors like Mary Jo White as lobbyists. Rudy Giuliani traded on his “America’s Mayor” image to push pills for Purdue. But while America spent billions on the war against drugs, Americans spent billions on their personal battlefronts.

When the feds finally busted Purdue, they were fined $600 million. Former DEA agent Joe Rannazzisi, who was pushed out of his job by Congress members who were in drug company pockets, says it was a speeding ticket. The Sackler family made billions a year, but evaded prosecution. Congress pushed through a bill which revoked protections on consumers. The message of “The Crime of the Century” is clear, and three-fold. The nation is addicted to pharmaceuticals. Big Pharma is addicted to drug money. The recidivism rate for both is high.

“The Crime of the Century” part one premieres May 10 and and part two May 11 at 9 p.m. ET on HBO.