American Overdose

A comprehensive portrait of a uniquely American epidemic -- devastating in its findings and damning in its conclusions The opioid epidemic has been described as "one of the greatest mistakes of modern medicine." But calling it a mistake is a generous rewriting of the history of greed, corruption, and indifference that pushed the US into consuming more than 80 percent of the world's opioid painkillers. Journeying through lives and communities wrecked by the epidemic, Chris McGreal reveals not only how Big Pharma hooked Americans on powerfully addictive drugs, but the corrupting of medicine and public institutions that let the opioid makers get away with it. The starting point for McGreal's deeply reported investigation is the miners promised that opioid painkillers would restore their wrecked bodies, but who became targets of "drug dealers in white coats." A few heroic physicians warned of impending disaster. But American Overdose exposes the powerful forces they were up against, including the pharmaceutical industry's coopting of the Food and Drug Administration and Congress in the drive to push painkillers -- resulting in the resurgence of heroin cartels in the American heartland. McGreal tells the story, in terms both broad and intimate, of people hit by a catastrophe they never saw coming. Years in the making, its ruinous consequences will stretch years into the future.

*LONGLISTED FOR THE ORWELL PRIZE FOR POLITICAL WRITING 2019* 'A riveting and urgent reckoning of colossal corruption.' - Philip Gourevitch One hundred and fifty Americans are killed each day by the opioid epidemic, described by a former head of the Food and Drug Administration as 'one of the greatest mistakes of modern medicine'. But as Chris McGreal reveals in American Overdose, it was an avoidable tragedy driven by bad science, corporate greed and a corrupted medical system. In a narrative brimming with the guilty, the victims and the unlikely heroes, Chris McGreal travels from West Virginia 'pill mills' to the corridors of Washington DC as he unravels the story of Big Pharma's hijacking of American healthcare and politics to push mass prescribing of 'heroin in a pill'. He meets the police and FBI agents who struggled to get prosecutors to go after doctors they called 'drug dealers in white coats'; the families devastated by painkillers they thought would heal, not kill; and the physicians and scientists who took on the drug companies behind the epidemic. The result is an immensely powerful account of the terrible human cost of the crisis, and a stark warning of the consequences of a healthcare system run as a business, not a service.

The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.

Using the examples of Vioxx, Celebrex, cholesterol-lowering statin drugs, and anti-depressants, Overdo$ed America shows that at the heart of the current crisis in American medicine lies the commercialization of medical knowledge itself. Drawing on his background in statistics, epidemiology, and health policy, John Abramson, M.D., an award-winning family doctor on the clinical faculty at Harvard Medical School, reveals the ways in which the drug companies have misrepresented statistical evidence, misled doctors, and compromised our health. The good news is that the best scientific evidence shows that reclaiming responsibility for your own health is often far more effective than taking the latest blockbuster drug. You -- and your doctor -- will be stunned by this unflinching exposé of American medicine.

A “deeply reported, deeply moving” (Patrick Radden Keefe) account of everyday heroes fighting on the front lines of the overdose crisis, from the New York Times bestselling author of Dopesick (inspiration for the Peabody Award-winning Hulu limited series) and Factory Man. Nearly a decade into the second wave of America's overdose crisis, pharmaceutical companies have yet to answer for the harms they created. As pending court battles against opioid makers, distributors, and retailers drag on, addiction rates have soared to record-breaking levels during the COVID pandemic, illustrating the critical need for leadership, urgency, and change. Meanwhile, there is scant consensus between law enforcement and medical leaders, nor an understanding of how to truly scale the programs that are out there, working at the ragged edge of capacity and actually saving lives. Distilling this massive, unprecedented national health crisis down to its character-driven emotional core as only she can, Beth Macy takes us into the country’s hardest hit places to witness the devastating personal costs that one-third of America's families are now being forced to shoulder. Here we meet the ordinary people fighting for the least of us with the fewest resources, from harm reductionists risking arrest to bring lifesaving care to the homeless and addicted to the activists and bereaved families pushing to hold Purdue and the Sackler family accountable. These heroes come from all walks of life; what they have in common is an up-close and personal understanding of addiction that refuses to stigmatize—and therefore abandon—people who use drugs, as big pharma execs and many politicians are all too ready to do. Like the treatment innovators she profiles, Beth Macy meets the opioid crisis where it is—not where we think it should be or wish it was. Bearing witness with clear eyes, intrepid curiosity, and unfailing empathy, she brings us the crucial next installment in the story of the defining disaster of our era, one that touches every single one of us, whether directly or indirectly. A complex story of public health, big pharma, dark money, politics, race, and class that is by turns harrowing and heartening, infuriating and inspiring, Raising Lazarus is a must-read for all Americans.

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

An exploration of drug addiction in the United States.

A shocking inside account of reckless capitalism and injustice in the Purdue Pharma bankruptcy case. In September 2019, Purdue Pharma—the maker of OxyContin and a company controlled by the infamous billionaire Sackler family—filed for bankruptcy to protect itself from 2,600 lawsuits for its role in fueling the U.S. overdose crisis. Author and activist Ryan Hampton served as co-chair of the official creditors committee that acted as a watchdog during the process, one of only four victims appointed among representatives of big insurance companies, hospitals, and pharmacies. He entered the case believing that exposing the Sacklers and mobilizing against Purdue would be enough to right the scales of justice. But he soon learned that behind closed doors, justice had plenty of other competition—and it came with a hefty price tag. Unsettled is the inside story of Purdue’s excruciating Chapter 11 bankruptcy proceedings, the company’s eventual restructuring, and the Sackler family’s evasion of any true accountability. It’s also the untold story of how a group of determined ordinary people tried to see justice done against the odds—and in the face of brutal opposition from powerful institutions and even government representatives. Although America was envisioned as an equitable place, where the vulnerable are protected from the greed of the powerful, the corporate-bankruptcy process betrays those values. In its heart of hearts, this system is built to shield the ultra-wealthy, exploit loopholes for political power, promote gross wealth inequality, and allow companies such as Purdue Pharma to run amok. The real story of the Purdue bankruptcy wasn’t that the billion-dollar corporation was a villain, a serial federal offender. No matter what the media said, Purdue didn’t do this alone. They were aided and abetted by the very systems and institutions that were supposed to protect Americans. Even on-your-side elected officials worked against Purdue’s victims—maintaining the status quo at all costs. Americans deserve to know exactly who is responsible for failing to protect people over profits—and what a human life is worth to corporations, billionaires, and lawmakers. Unsettled is what happened behind closed doors—the story of a sick, broken system that destroyed millions of lives and let the Sacklers off almost scot-free.