Opinion

Audio Astra: The never-ending, slithering specter of opioids

January 14, 2022 3:33 am
The Kansas Department of Health and Environment says Kansas experienced a 54% surge in drug overdose fatalities in the first six months of 2021 compared to that period in 2020. KDHE attributed about 45% of those deaths to ingestion of fentanyl, which is often added to other drugs such as cocaine and heroin. (Getty Images)

The Kansas Department of Health and Environment says Kansas experienced a 54% surge in drug overdose fatalities in the first six months of 2021 compared to that period in 2020. KDHE attributed about 45% of those deaths to ingestion of fentanyl, which is often added to other drugs such as cocaine and heroin. (Getty Images)

Audio Astra reviews recent audio reporting on Kansas news, including podcasts and radio stories. Eric Thomas directs the Kansas Scholastic Press Association and teaches visual journalism and photojournalism at the University of Kansas.

“Empire of Pain”

Patrick Radden Keefe, April 13, 2021

Purdue’s $4.5 Billion Opioid Settlement Got Thrown Out. Now What? 

The Journal, Dec. 22, 2021

The image is something from Gothic fiction: a black snake curling past your chair as you sit in the dark. As you wait for the snake to pass, you realize that the shadow on the ground is getting larger and somehow becoming, impossibly, a darker shade of black. As you wait for it to slither out the other door, the snake instead coils around your chair. You look to the door, hoping to see the tail. But there is no end. The serpent, to your peril, keeps getting larger.

“Empire of Pain,” by Patrick Radden Keefe

After listening to “Empire of Pain,” an audiobook released last year by the New Yorker writer Patrick Radden Keefe, the opioid crisis seems like exactly this: an ever-growing, never-ending serpentine crisis. The evil zookeeper who slid the snake into the room was the Sackler family, the insufferable and monstrous clan that led Purdue Pharma and other companies.

Keefe’s reporting shoves the Sacklers reluctantly onto center stage to squirm as the audience hears the recitation of the self-serving company emails, secret internal research and the accusations from former Purdue executives. Keefe’s reporting extends back to the first generation of pharmaceutical marketing fabulists so we can identify when the snake entered the room.

Arthur Sackler, the late founder of the family’s medical advertising empire, stars at the outset of the audiobook, a striving son of New York. Using the imprimatur of a medical degree, Arthur seeds companies that slalom past FDA regulators, stare down Congressional investigations and provide the Sackler family tree with untold wealth. We watch in horror as one of these seedling companies, Purdue Pharma, unleashes “innovations” in pain care that undo the lives of millions of Americans. The crisis widens so uncontrollably that at one point, 2.3 million people in Ohio have an opioid prescription — about one in five.

The book’s portrait of opioids reaches further back, past the Sackler family’s humble American beginnings, to “thousands of years ago, at the dawn of human history.” “Some figured out that if you slice into the head of a poppy, it will ooze a milky paste, and this substance has medicinal properties.” Keefe continues, “if the plant seemed to possess magical properties, it was also understood, even in the ancient world, that it carried certain dangers.” Listening to the Sackler’s recent and willful denial of these dangers, risks that we understood millennia ago, makes Keefe’s writing maddening and vital.

Keefe delicately calculates how culpable one single family should be. His nuanced conclusion, built on research that fills 16 hours of audio, is that the Sackler family is not alone in feeding this current and mighty opioid surge. Other companies, the DEA and FDA contributed. But the Sacklers deserve more blame than anyone else, Keefe writes, for a crisis still growing throughout America.

In Kansas, the crisis is expanding, but also changing shape. People with opioid use disorder are at an increasing risk of dying from taking fentanyl, a bogglingly potent synthetic opioid. Celia Llopis-Jepsen of the Kansas New Service reported Monday on “the growing practice of spiking other drugs with fentanyl — to heighten the addiction and keep buyers coming back for more — is fueling a sharp increase in fatal overdoses across Kansas and the U.S.”

Last fall in Shawnee, 16-year-old Cooper Davis died after taking a pill laced with fentanyl. Cooper’s mom, Libby, told Fox 4 News, “We tried to convince him that he would not always know what he was being given, that there was just too many unknowns out there and what he was doing was dangerous.”

Cooper’s death, courageously described publicly by his family, is one of the few opioid deaths acknowledged publicly. The CDC’s tally suggests that more than 500 Kansans died from drug overdoses in Kansas last year; opioid overdoses are obviously common in that statistic.

Here is the challenge in writing or discussing the opioid epidemic. By tracing the increased use of fentanyl, we divert focus from the Sacklers. By referencing the DEA’s advice on how to recognize counterfeit pills, we forget about the Sacklers. Reporting on the epidemic can not constantly trace back to the damage, from the start, by the Sacklers.

In listening to “Empire of Pain,” I watched the remaining time in the audiobook slowly disappear, worried about justice for the billionaires. While rooting for a settlement that would gut their family fortunes, I was sure that the Sacklers’ expensive lawyers, lobbyists and bankruptcies gambits would rescue them.

– Eric Thomas

Keefe’s work cements this link with every chapter. In listening to “Empire of Pain,” I watched the remaining time in the audiobook slowly disappear, worried about justice for the billionaires. While rooting for a settlement that would gut their family fortunes, I was sure that the Sacklers’ expensive lawyers, lobbyists and bankruptcies gambits would rescue them. 

Last month, however, a federal judge in New York overturned the settlement between Purdue Pharma and the tangle of municipalities, hospitals, pharmacies and individuals who were suing. The “Journal” podcast, from the Wall Street Journal, recruited Jonathan Randles, a reporter specializing in bankruptcy cases, to put the recent ruling in context.

“I’ve covered bankruptcies since 2015,” Randles said. “I can’t think of another situation where an approved bankruptcy settlement like this, an approved reorganization plan, gets overturned on appeal.”

The original settlement, which Keefe impugns in his book, would have largely shielded the Sacklers. This kind of protection might seem a fair trade for a $4.5 billion payout from the family. “The Journal” explains, however, that the Sacklers raided $10 billion from the company, essentially on the eve of the bankruptcy litigation, to enrich themselves.

Ryan Hampton, a man who traces a nightmare of opioid dependence back to a single oxycontin prescription, explains on the podcast how the overturned settlement could represent greater penalties for the Sacklers, but also a risk for plaintiffs like him.

“It gave me a sense of hope that someday the Sacklers may see their day in court, but it gave me a tremendous amount of worry, because with Judge McMahon’s decision, means this plan needs to be reworked,” Hampton said.

Those reworkings might wickedly leave victims with even less than the original settlement.

In his book, Keefe cites the observation by Martin Booth, in his book “Opium: A History,” that when it comes to products derived from the opium poppy, history repeats itself. That is to say, when we finally get the snake out of our house, it will likely return in another form. 

Guiding that snake will be another menacing shepherd, the haunting resurrection of the Sackler family, looking to profit from a fresh generation of hellish addiction.

What did we miss? Email [email protected] to let us know of a Kansas-based audio program that would be interesting to Audio Astra readers.

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Eric Thomas
Eric Thomas

Eric Thomas directs the Kansas Scholastic Press Association, a nonprofit that supports student journalism throughout the state. He also teaches visual journalism and photojournalism at the William Allen White School of Journalism and Mass Communication at the University of Kansas in Lawrence. He lives in Leawood with his wife and two children.

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