The Crime of the Century (2021) s01e02 Episode Script

1
When we talk about drugs
like oxycodone,
you're talking about
drugs that are
essentially heroin pills.
I was pretty convinced
that we had a major problem
on our hands.
♪
This is the first time
I've ever seen this.
Purdue didn't have any evidence
that the drug was safe,
so the company obtained
the help of a medical officer
in FDA to claim that OxyContin
was not prone to abuse.
If you're Richard Sackler,
if you're Purdue,
that means your army of
sales reps can go out and say
that the FDA approved this.
They knew that OxyContin was
being abused.
When you're in that much pain
and you're addicted
at such a high dose,
you're a trapped rat.
Purdue ends up getting
pursued by the authorities.
The Justice Department
effectively agreed to bury
critical information.
Purdue made about
nine billion dollars
marketing OxyContin.
They paid 600 million
to the government.
You are basically telling
pharmaceutical companies
you have a green light
to do this.
They paid the speeding ticket.
♪
Drug overdose deaths
across the U.S.
have more than tripled
since 1990.
40 people die every day
from prescription painkiller
overdoses.
The trajectory has simply
been upward.
It's America's
silent epidemic.
A plague in our country.
♪
♪
- Good afternoon.
- How are you?
♪
We have with us today
Joe Rannazzisi.
He is retired from the DEA.
The opioid crisis started
with prescriptions.
Prescriptions
and patient care--
This idea that we weren't
adequately treating pain.
Drugs like OxyContin come on
to the market
and thought provokers
and medical experts
began to preach the gospel
of the opioid.
♪
We started using
the pain scale.
"Pain is the fifth vital sign."
They developed new medical
terms like "pseudoaddiction."
Craziness.
Your body builds a tolerance,
you need more drug.
As you need more drug,
you need stronger drug.
As you get stronger drug,
it's more expensive.
And instead of buying
$150 worth of pills a day,
you're buying $20 or $30
of heroin bags a day.
The problem encroaching
on Colorado.
Taking a toll
on the Magnolia State.
More and more lives
in Farmburg County--
- Woodland Hills--
- West Palm Beach--
- Springfield area--
- Denver--
Right now
we have this wide-ranging
amount of fentanyl
and fentanyl byproducts,
and it's killing
a lot of people.
♪
The synthetic opioid
is the deadliest drug
in the United States.
Five people OD'd
on the same day in January.
We lost three people
last weekend.
We didn't just wake up
one day and say,
"Everybody just switch over
to fentanyl."
It was a progression, and
it was a natural progression.
Here in Cook County,
it's three deaths per day.
Mississippi's seen close
to 200 overdose deaths.
Opioid deaths are up 20%
since the start
of the pandemic.
And overdose death
is underreported.
We know that for sure.
So we really don't know
how many people died.
Hundreds of cities,
counties,
and states across the country
have launched
a wide-ranging lawsuit
targeting
the pharmaceutical industry.
To stop the behaviors.
To hold these folks
accountable.
Enough is enough.
We've got people dying
on our streets.
We started seeing
massive amounts of death.
Our prescriptions by 2012
were over 250 million.
The question is, why?
Are we the only people
in the world
that know how to treat pain?
♪
No.
We consume that much
because our policies
are basically created
by the manufacturers.
♪
So we've reached out
to all the companies.
We have all the responses,
which we have woven
into the story.
Yeah.
Half the company's declined
to comment
because
of the ongoing litigation,
and then the other half,
you know,
issued fairly
lengthy statements.
Purdue, Johnson & Johnson,
all commented.
What's their, you know,
main defense right now?
Yeah, FDA-approved drugs,
that they weren't doing
anything illegal.
Each point
they pushed back on.
Okay.
You know, one
of the remaining questions is,
are there gonna be any criminal
charges against anybody?
And whether they're coordinated
by the Department of Justice
or if they're individual
investigations
by U.S. Attorneys Offices.
We're not quite sure,
but there's something
happening.
Narrator: The investigative
team at the "Post"
began to follow leads
to a very big story.
Some of America's largest
pharmaceutical companies
were not only profiting
from the opioid crisis,
they may have been
manufacturing it.
The origin of the opioid story
began with the role
of Purdue Pharma
and the family who
controlled it--the Sacklers.
♪
We have had many run-ins
with the Sacklers recently.
Their main point of contention
is that they did not ignite
the opioid crisis
singlehandedly.
Whether you believe that
or don't believe that,
there is voluminous evidence
that the crisis began
when OxyContin hit
the streets.
Purdue led the charge,
Sackler came up with the idea,
and everybody else followed.
Other drug companies moved
into that market
that Purdue had created.
They moved
into that huge opioid
multibillion-dollar market.
So other manufacturers began
making generic versions
of OxyContin--
Oxycodone, hydrocodone,
drug distributors
started sending
massive amounts
of these drugs downstream
because there were corrupt
doctors all over the country.
It became like the Wild West.
This was a new drug cartel
that was being established
in the United States.
But instead of coming in
from a foreign country,
there were drug dealers
who were wearing suits
and lab coats.
I think that's it.
- Go and do.
- All right.
Narrator: To penetrate
the network
of corporate drug dealers,
the investigative unit
at the "Post" needed help
from an inside source,
someone
with firsthand knowledge
of the way the deals worked
and how they turned
into crimes.
On a tip,
they contacted a retired
DEA agent, Joe Rannazzisi.
Eventually got him
on the phone.
He was very animated,
and he was very upset.
He had a lot
of great information
and, essentially,
we just kept on talking,
and I figured, "Okay.
"If he's not crazy
and he's not making this up,
this is a really good story."
I'd like to thank you for
the opportunity to appear today
to discuss
prescription drug diversion
and the critical role
the DEA plays--
Narrator: Before he left
the DEA,
Rannazzisi repeatedly tried
to warn Congress
about prescription drug abuse.
The abuse of pharmaceuticals
continues to be
a significant problem
in the United States,
and it's based
on pharmaceutical diversion
from the supply chain.
He was in charge of
the Diversion Control Division
at the DEA.
They make sure
that pharmaceuticals
that are controlled substances
like opioids
are not diverted
to the black market,
that they stay
within the supply chain,
from the manufacturer
to the drug distributors,
which are the middlemen,
to the pharmacies
on the retail level.
Individuals and organizations
have created schemes
within the health care delivery
system that appear legitimate
but are nothing more than
illegal operations
to facilitate
the illegal distribution
of pharmaceuticals.
Pharmaceutical diversion
I've dealt with a lot
of whistleblowers
throughout my career,
and, you know,
some of them are
a little crazy,
some of them are a little
paranoid and conspiratorial,
but I really wanted
to meet Joe to vet him more.
So I went out
to a little Greek restaurant
in Northern Virginia.
I interviewed him
for about two hours.
♪
Look, I made a lot
of my decisions over the years
at the Athena Pallas.
I could sit there
and just think
and not have to worry about DEA
and headquarters
and the phone ringing.
So, when I had
important decisions to make,
I would go and find a table,
sometimes with somebody else,
sometimes by myself,
and sit there and just try
and work things out.
Scott Higham starts
asking me questions,
and I'm telling him a story
about congressional
and industry influence
and, you know,
money going in
and the Justice Department
folding and all this stuff.
And I don't know
if Scott believed me or not,
but, you know,
Scott's from Long Island,
and I'm from Long Island.
We kind of talked
the same talk, you know?
We come from the same place.
We're on the South Shore
of Long Island.
I always wanted to be
a police officer
in narcotics, specifically.
I've been around
law enforcement my whole life,
as a kid growing up
in a law enforcement family,
and so I got cops.
I covered them as a reporter
at "The Baltimore Sun"
and in Miami.
I studied pharmacy
at Butler University
in Indianapolis.
I figured that being
a pharmacist
is the quickest way
to learn about the drugs.
Once I got my pharmacy degree,
I started applying to be
a law enforcement officer.
And then I was subsequently
hired by DEA.
Log on to the Internet,
type in the keyword
"medications,"
and you'll get hundreds
of results,
many of them promising
drug delivery--
Right after 2000, 2001,
what we started seeing
was Internet pharmacies.
A patient would get on the
Internet, and he would say,
"Hydrocodone
without a prescription."
And you'd get a million hits
that would pop up.
And so you'd find one
and go to that website,
and it would take you
to a patient survey form,
and you would say,
"I've got back pain."
The problem is,
is no one ever saw the patient.
As long as they had any kind
of credit card,
they were fine.
You had a doctor
on the East Coast,
the patient or the drug seeker
was on the West Coast,
the pharmacy was
in the Midwest.
It was just
a trafficking organization
that was hiding behind
the veil of the Internet.
♪
Without objection,
the bill was read a third time
and passed.
As soon as Congress
shut down the Internet sites
by passing
the Ryan Haight Act,
almost overnight, we started
seeing these clinics pop up,
and our people in Florida
saying, "Yeah, all of a sudden,
we have all these clinics
all over the place."
I'm going down to Florida.
Florida is
a very corrupt state.
It's a place
where a lot of people who want
to get involved in rackets go
to make fast money.
♪
So the Mob is down there.
Drug dealers are down there.
There's a lot
of money laundering,
poor regulations.
There's a patchwork
of law enforcement.
The regulations over
the practice of medicine
and pharmacy in Florida were
a lot more lax
than other states.
It provided fertile ground
for these clinics to open up.
♪
Right around 2010
in Broward County,
they went from a very small
amount of pain clinics
to 142, I think, in a period
of a couple years,
two or three years.
Palm Beach County has more
pill mills than McDonald's.
The sense was that
we were always just trying
to tread water.
We needed more resources.
We needed more
field investigations,
and we needed more lawyers.
When I started,
all of our focus had been
on these pill mills.
There's one hallway
is the doctor's.
And you go in,
and they often literally had
a laminated menu,
and they would say,
"It's a cash-only business.
You give me the cash for what
it is you're looking for."
And then you take
that prescription,
you go down to the other end
of the hallway,
and it's a dispensary.
And it's all owned
by the same person,
so they're running
the doctor's,
and they're running
the pharmacy.
They were basically fronts
for drug dealers,
for really corrupt doctors
who were selling prescriptions
for cash,
trading prescriptions for sex.
They actually basically just
give 'em out.
OxyContin, Xanax bars ♪
Percocets and Lortab ♪
Valiums, morphine patches,
ecstasy ♪
And it's all up for grabs ♪
What you want?
What you need? ♪
Hit me up ♪
People would hop
in their car,
they'd get onto Interstate 75.
It's a highway that runs up
the spine of America
from Florida
up through Appalachia
all the way through Ohio.
Hit me up, I got you ♪
It was a very busy,
very lucrative pathway
for narcotics in America.
It became known
as the Oxy Highway.
♪
I'm Doug Smith with Fox 13.
Can I talk with you
about the clinic,
what's going on inside
the clinic?
Some people melt 'em down
in a needle ♪
And shoot 'em up ♪
When I pass by here,
the frickin' line
is around the corner.
Patients would be lined up
in the morning,
waiting to get
into these pill mills
so they could get
a cursory examination,
if any examination.
We were in there less than
ten minutes with a doctor,
walked out with a prescription
for Vicodin.
Mm-hmm.
Is that the way it works
inside?
If you have proper, uh,
documentation and everything,
we take care of you.
- We had no medical records.
- We had no X-rays.
Yeah.
Who would that doctor be?
I'm not quite sure.
But if you give me a call,
I'll be checking into it.
See, I'm a pill popper ♪
So I'ma keep poppin' 'em ♪
So a bad doctor
who's running a clinic
writes a script not for
a legitimate medical purpose.
Okay, you can't stop that guy
from writing that prescription,
but a pharmacist could,
because if a pharmacist gets
that prescription
and it shows red flags,
that pharmacist has
a requirement
to resolve those red flags
before he dispenses
the medication.
Now, what are these red flags?
Patient traveling 200 miles
to a pharmacy.
You could be the greatest
pharmacist in the galaxy.
No one's driving 200 miles for
you to fill their prescription.
There's a reason for that.
We had to take action, and we
had to do it very quickly.
We just started moving
massive amounts of resources
down into Florida.
They got
task force officers.
They got every diversion
investigator in the state,
and they ran undercover
operations all over the place.
- There was one case.
- It was a female undercover.
Doctor said,
"So how you feeling today?"
"Oh, I'm fine."
"So what are you here for?
You here for your Oxycodone?"
"Yes.
Could I have
some alprazolam, too?"
And he says yes, and he wrote
the prescription.
He goes, "Would you like
some methadone also?"
And she goes, "Sure."
That was the extent
of the visit.
And you look at that,
and you go,
"My God, this is not medi--
This is a crack house."
Hi.
First of all,
turn that off, man.
I don't want to be recorded,
okay?
- Let's talk about that.
- Are you a doctor?
- Excuse me?
- Are you a doctor?
- Don't--
- It don't matter who I am.
In a minute, I'm gonna snatch
this camera from this, dude.
- You don't even know, man.
- Okay, sir.
Follow 'em
wherever they're going.
♪
There was one store
in particular
that was known by drug users
as the go-to CVS.
A DEA investigator said
to the pharmacist,
"What's going on here?
"Don't you see
that all these people
"are coming with out-of-state
licenses and out-of-state tags
"and they're lining up at your
door at 8:00 in the morning?
Don't you think
that's suspicious?"
And this pharmacist told the
DEA, "Well, you know, look.
At 2:00, we cut off our sales."
And the investigator said,
"Why do you cut off your sales
at 2:00?"
And she said, "Well, we want
to save medication
for our real pain patients."
- Open the door!
- On the ground, on the ground!
- Go, go, go!
- Get on the ground!
Narrator: In 2011, there was
a crackdown by the DEA.
Operation Pill Nation
involved more than
500 law enforcement officers,
resulting in seizures
of 70 vehicles,
$19 million in cash,
and 105 arrests.
Doctor, do you feel like
you were contributing
to addicts' addictions?
Was it worth it?
Narrator: But the real problem
wasn't on the street.
It was in the executive suites
of pharmaceutical companies,
which had become addicted
to the profits
opioids could deliver.
Please help me welcome
John Kapoor.
Narrator: John Kapoor
was a veteran
pharmaceutical investor
who saw a business opportunity
in pain relief.
He started a company
called Insys
to market a drug
called Subsys.
It was a fast-acting
spray device for fentanyl,
a synthetic opioid 100 times
stronger than morphine.
I know there are all kinds
of definitions
for entrepreneurs.
The one that I think
we all recognize most
is that entrepreneurs
are risk takers.
♪
narrator: The FDA limited
the use of Subsys
to a very narrow market--
Cancer patients suffering
so-called breakthrough pain.
To expand the market,
Kapoor was determined to find
a way around the FDA's rules.
You, as an entrepreneur,
have to have a dream.
And then you work with passion
to make that dream come true.
Narrator: That passion
to make a dream come true
is what would lead Kapoor and
Insys into the world of crime.
♪
Every U.S. Attorney's Office
in every district
in the United States
has someone who's supposed
to specialize in health care.
Boston has always taken
a lead role in that.
They've taken on
some very high-profile
criminal investigators
involving Pfizer
and GSK and several others.
And because our office
has a reputation
for being successful
with these types of cases,
we get a lot of whistleblower
lawsuits filed in Boston.
And so, in 2013,
I got a whistleblower
complaint sent to me.
It laid out some of the things
that were happening
at Insys Therapeutics.
♪
Subsys was launched
in March of 2012,
and it goes
into this very tight market.
And for the next three months,
from March to early June 2012,
Kapoor is devastated,
and he calls it
the worst effing launch
in the history of the
pharmaceutical industry, right?
So he starts firing people.
Fires the VP of sales,
and he's trying to find a way
to be profitable.
Narrator: Kapoor hatched
a plan to exploit a loophole.
While the FDA limited the drug
to patients with cancer pain,
doctors were allowed
to use their own judgment
about whether to expand
the market,
so Kapoor leaned
on his sales reps
to court doctors to write
more scripts for Subsys
and to increase the doses.
Through emails
and phone recordings,
prosecutors discovered
a sales campaign
to lead doctors into raising
the demand for fentanyl
by expanding the very
definition of pain.
♪
♪
I assign
two criminal prosecutors,
and they began working
on the case in late 2013--
Fred Wyshak, who is
sort of a legend in Boston.
He prosecuted Whitey Bulger.
He's prosecuted the Mob.
In all these types of cases,
you need insiders.
It's very difficult
to penetrate
a criminal organization
to the top
of that organization
without insiders.
Alec Burlakoff.
You must've identified him
early on
- in your investigation.
- Absolutely.
Alec Burlakoff was a primary
target of the investigation.
♪
And so what in your mind
makes a good salesman?
One word--passion.
It's not deceit.
It's not lies.
It's not
not having a conscience.
It's passion.
♪
When I was hired,
there was a meeting
that took place
where all the managers
were there,
and, basically, everybody
was yelled and ridiculed
and screamed at
for the lack of sales.
They were abysmal, basically.
They're nonexistent.
It's all on the rep
to ensure that this drug
starts getting prescribed.
And none of it's doable
Unless you break the rules.
But to tell the truth--
This job was made for me.
I mean, I was raised
in a family
where you don't cry
you don't lose,
you don't take off work,
you don't miss school,
you are not sick, you know,
and you get the job done.
♪
I grew up in a lower-class,
middle-class neighborhood
way out on Long Island--
A small town called
King's Park.
I don't need you
to worry for me ♪
'Cause I'm all right ♪
There was a lot going on
in my house.
Wasn't a place
to have friends over.
I don't want you to tell
me it's time to come home ♪
Never knew what kind
of yelling and screaming
and fighting was
gonna take place.
I don't care what you say
anymore ♪
This is my life ♪
I got a bachelor's
in psychology,
a master's in social work.
Go ahead
with your own life ♪
Leave me alone ♪
I said, "You know,
I'm gonna go work
for the best school
that I can find."
And I did a search,
and a private school came up
in Boca Raton.
I never said I was
a victim ♪
I did phys ed for two years.
After that,
I was a guidance counselor.
It was a very small salary,
but I was hanging out
with kids all day,
doing what I love.
Don't get me wrong ♪
The problem with working
at this school
was that I put myself around
very wealthy people--
All affluent,
I mean, beyond affluent.
And I went out
to the parking lot one day,
and I went to the parent
who was driving
a Bentley convertible,
and he was smoking a cigar,
and I said,
"Sir, you know, we have
a no-smoking policy here."
Can you kindly put that out?"
And he took a puff.
He blew it right in my face,
in my eyes and said,
"Petty rules
from petty people."
It was literally
from that moment
that I knew I had
to go make some money.
I leveraged some
of the relationships
that I had at the school--
A lot of doctors there.
One of the doctors basically
said to me,
"Well, I'm a big prescriber
of a product
that Eli Lilly promotes,"
at the time,
"And I can get you
an interview."
And I jumped all over it,
finished the school year,
and was on my way
into pharmaceuticals.
Narrator: Working for
Eli Lilly,
Burlakoff's first
pharmaceutical was Prozac.
He was named rookie
of the year
for his big batting average
with doctors,
but he was soon fired
for handing out free samples
to hundreds of people,
including one 16-year-old.
He hooked up next
with Johnson & Johnson
and then applied
for a sales job
for a company named Cephalon.
And I never heard
of Cephalon.
It's not like Johnson & Johnson
or Eli Lilly.
So that was my first taste
of small biotech.
And what does
"small biotech" mean?
It means a lot.
The payouts, the bonus plan
is "uncapped."
It's a very attractive word
to a salesperson-- "uncapped."
- There's no ceiling--
- The more you sell
The more you sell, the more
you get compensated, period.
By the time I walked out
of the interview,
I called my wife and said,
"I'm going to a new company."
♪
narrator: The product
was Actiq.
It was a lollipop
made of fentanyl,
whose potency carried
an enormous risk of overdose.
For end-of-life cancer pain,
Actiq made sense,
but that was
a very small market.
To pump up sales,
Burlakoff had to convince
doctors to prescribe it
for much more, from back aches
to ankle sprains.
How to do that?
Through bribes packaged
as speaker's programs.
If you have pain that
lasts all day
narrator: Burlakoff would pay
doctors to promote the drug.
In exchange, doctors would
prescribe more and more.
It was a program that appealed
to the founder of Insys,
John Kapoor.
At the interview,
once I got into the nuances
of the program
and what it took
to be successful,
he just banged his fist
on the table and said,
"That's our next VP of sales,"
and walked out the door.
♪
I don't think there's
any way to understand
what happened at a company
like Insys
without referring
to Purdue Pharma.
They were the pioneers.
They went out
and had a mission
to change the mind
of the medical establishment
about how dangerous
these drugs were
and to persuade physicians
not to worry too much
about the addictiveness
of strong opioids.
Insys used Purdue's playbook.
You have a very strong,
powerful product,
and you incentivize
your sales reps
with the understanding
that they're going to be
compensated based on volume,
and they go out
with an incentive to sell.
For many of you out there,
you have not had
the opportunity
to experience the excitement
or, more importantly,
the achievement
of being on this stage.
♪
So John Kapoor hires
Burlakoff,
and he makes him the head
of the Southeast district--
Florida, Alabama.
With Kapoor's permission,
he hires his buddy
from college,
this guy called Joe Rowan,
as a sales rep.
Rowan has
a very close relationship
with a doctor in Mobile,
Alabama, named Xiulu Ruan,
and Ruan's known to be running
a pill mill operation.
So they start to bribe Ruan
in August of 2012.
And immediately
there's a massive turnaround
in the success of the drug
in the Southeast.
A pharmaceutical company
has a right
to try
to educate people, right?
So they do what's called
non-research payments
to doctors.
They give you money,
and in exchange,
you go and you talk
about the drug to colleagues.
By itself, it's not illegal.
What happens with Insys is that
they start paying exorbitantly
huge number
of speaker programs,
and they use
the speaker program
basically as a way to cover
for the bribes
that they're paying.
Kapoor, ultimately,
he invested between $3 million
and $4 million a year
on the speaker program
at its height.
They were bribing people
at that level nationwide.
So it was basically,
"Here's some money.
Write some scripts."
Yes.
It was actually--
Well, you say "basically."
That word makes me nervous,
because if I said "basically"
to Dr. John Kapoor,
he'd say,
"Basically, you're fired."
There is no "basically" here.
It's very clear, concise.
It's very direct.
As an entrepreneur,
don't get arrogant,
even if you're successful.
You should believe in yourself,
and one important thing
is stay humble.
- We are so professional!
- Oh, are you videotaping this?
Turn that shit off!
What, what--
The best region at Insys!
Rack City, bitch,
Rack, Rack City, bitch ♪
Rack City, bitch,
Rack, Rack City, bitch ♪
Rack City, bitch,
Rack, Rack City, bitch ♪
Ten, ten, ten, twenties
and them fifties, bitch ♪
Rack City, bitch,
Rack, Rack City, bitch ♪
Rack City, bitch,
Rack, Rack City, bitch ♪
Rack City, bitch,
Rack, Rack City, bitch ♪
Ten, ten, ten, twenties
and them fifties, bitch ♪
I'm a motherfucking star ♪
The key to increasing sales
of Subsys
was to build a relationship
with a doctor.
When you go into the office
and they meet you
for the first time,
it's a test.
They're gonna look you in the
eye, and they're gonna say,
"Hey, Alec, how you doing?
So you have Subsys?
What's that indicated for?"
And you have some reps say,
"Oh, it's indicated for
breakthrough pain,"
or they say, "It's indicated
for breakthrough pain
in cancer patients."
Something like that.
My play is I look 'em dead,
directly in the eye,
and I laugh, and I go, "Doc,
"you know exactly what
this drug's indicated for.
"It's indicated
for breakthrough pain
"in cancer patients 18 or older
that are opioid tolerant
"on 24-hour,
around-the-clock medications.
"Why do you ask me
that question?
"You know I can't talk to you
"about anything outside
of that indication.
"However, you also know
you are the doctor
"and you can do whatever
you damn well please.
So is this game over yet?
Are we done?"
And they go,
"Hey, how can I help you?
What can I sign for?
What's your sample?"
Blah, blah, blah.
Or, "You have 30 seconds."
I love when they say
I have 30 seconds.
"I have 30 seconds what?
"To sell you
a schedule II opioid?
"'Cause I'll probably do it,
and the sad part is
"you'll probably have no idea
how to manage the side effects,
"the drug interactions,
the precautions, the warnings,
"the respiratory depression,
"and everything else that's
gonna come along with it.
"So let's both do each other
a favor.
"You name the restaurant.
You name the time.
"You name the date.
"I don't care where it is.
I don't care what it costs.
"I will be there.
"You stay as long as you want
or as short as you want,
"but I can't sell this drug
to you in 30 seconds.
It's irresponsible."
Now, back then, did I really
care about being responsible?
No.
So, look,
Alec Burlakoff's a lot to take.
I mean, he is a car salesman
on steroids.
But there's an honesty
to what he's saying that is--
A frankness to what he's saying
that's unique.
Cut me off if I'm rambling,
'cause I know I am,
but there's four categories.
There's blue, yellow,
green, red.
- Blue is analytical.
- Hmm!
That means if you don't have
a scientific, double-blind,
placebo-controlled study
with a lot of patients
that proves your data is right,
you're not getting a sale.
What does that mean to me?
It means I don't call
on analytical doctors
'cause I don't have any studies
like that.
Then you have your yellow.
That's your amiable doctor.
They want to be friends
with everybody.
They want everybody
to love them
You're the best!
Which means
if you're selling a drug
and there's five other
competitors,
they just go on a rotation.
"This one gets Subsys.
This one gets Lazanda.
This one gets Abstral."
And then we go back around.
Guess what.
They're out because they're
just sharing the wealth.
So now you got your green,
which is kind of like
your earthy type of doctor.
Renewable.
Like, God forbid
you do a lunch and not recycle.
You'll never go
back there again.
But then you got your reds.
Reds are your businessmen.
They own their practice.
They run their practice.
They manage their books.
They see a crazy number
of patients.
It's all about efficiency.
In fact, when you as the rep
walk in there,
they run to you with a pen
to sign,
and they're running away
at the same time
because they don't have time
to talk with you
because they're treating
patients, making money.
And if he's a red
and he's a businessman,
I got to show him the WIFM.
What is the WIFM?
That's all they're thinking--
"What's in it for me?"
"Buddy, will you stop talking
about the freakin' drug?
"Will you stop talking
about saving the patient?
"Will you stop talking
about the science,
"and will you please tell me
what's in it for me?
Because you're wasting
my time."
Those are the reds.
Those are the doctors
you want to find,
and those are the doctors
you want to move in,
live, eat, and breathe with.
It was a seven-day,
24-hour-a-day job.
They call me
at 3:00 in the morning,
they want to go out, I go.
They want me to go to temple
on Saturday, I go.
They want me to go to church
on Sunday, I go.
You go through
the step-by-step process.
Okay, did I take him
to dinner? Check.
Did I take him
to a hockey game? Check.
Did I take him to a nightclub?
Check.
Shake up the dice ♪
Throw down your ice ♪
Bet it all, playa,
fuck the price ♪
Money ain't a thing,
throw it out like rice ♪
Been around the world
cop the same thing twice ♪
Rub on my tits,
squeeze on my ass ♪
Give me some, unh! ♪
Step on the gas ♪
Pop the cork and roll up
the hash ♪
You know what we about,
sex, drugs, and cash ♪
I mean,
this is uncapped bonuses.
This is your opportunity.
You wanted to put the money
in the doctor's pocket.
Didn't care
about anything else.
Just wanted that bonus.
♪
East Coast, West Coast,
worldwide ♪
They start the bribe scheme
in the summer of 2012.
By the beginning of 2013,
as the company is launching
its first IPO,
they can now go and say
that the drug is profitable.
And so right away,
investors look at it and said,
"Something's going on here."
and they started investing.
By the end of the year,
Insys was the most popular
pharmaceutical drug
to invest in.
It was the most popular IPO
on Wall Street.
Mafioso,
that's how this thing go ♪
The CEO, Mike Babich, was
being interviewed on MSNBC.
By the end of 2014, the market
cap was in the billions.
2015, Subsys was one
of the top five most
profitable opioid products
in the United States.
That product that we launched
three years ago today,
this year will do close
to $300 million.
You can make a lot of money
getting doctors to prescribe
a medication
to people who don't need it,
who they're not just gonna lose
a couple thousand dollars.
They're gonna lose their life.
♪
So one whole piece
of the case
is we're gonna bribe doctors
to write as many scripts
as we possibly can,
but then they very quickly
realized
written scripts without payment
doesn't help anybody.
- The drug's expensive.
- Very expensive.
So there's different dosages
of the medication.
For the highest dosage,
1,600 micrograms,
at times,
I believe it was going
for more than $15,000 a month.
And insurance companies,
Medicare in particular,
have rules.
And in this case, Subsys,
you know,
has to be prescribed
for the treatment
of breakthrough cancer pain
in cancer patients.
If you're an insurer and
you're trying to figure out
whether or not you're willing
to pay for a drug,
one of the things
you're gonna look at is,
are they prescribing it for
what the label says it's for?
Right?
"The label says
it's for cancer patients.
"This patient
doesn't have cancer.
Why are we paying for this?"
Right?
And so they started
misleading them.
What they set up is this
Insys reimbursement center,
the IRC,
and what they would do
is they would work
with doctor's offices
to get prescriptions
for Subsys approved.
People would go,
they would clock in,
and they would put the headset
on and get assigned files,
and they would just call
and lie.
The insurance company
would say,
"Are you calling
from Dr. Smith's office?"
"Oh, yes. I'm right here
in sunny Florida."
But really, they blocked
their outgoing caller ID.
They were in Arizona
in a cubicle the whole time.
So a patient goes
to see a doctor,
the doctor prescribes Subsys,
somehow the office at the IRC
needs to know enough
about the patient
to be able to call
on the patient's behalf
and lie.
So the sales reps had
to convince the doctors
to agree to give them access
to patients'
personal information
and various pieces
of information
about their diagnoses.
Let's say a doctor just
wrote Subsys for back pain
or for neck pain.
What Insys did was say
One of the tactics
that they figured out worked
was talk really fast
Give them a lot
of information at once,
sound like you know
what you're talking about.
And they would spin
these stories
that just weren't true.
They had a list.
If you're calling Humana,
these are the lies you need
to say.
If you're calling
Blue Cross Blue Shield,
say this.
And then insurance companies,
they used the algorithm.
So, if the answer triggered
the right way,
it would lead them down
a decision tree
to approve or not approve.
And Insys knew this
and took advantage of this.
Yes, um
So you'll hear
these callers anticipate
not only the next question,
but the next three questions.
So if Insys knows
the algorithm,
they've, like, broken the code.
- They've broken the code.
- They cracked the code.
And they could call all day,
every day
and get these approved.
Okay, the medication's been
approved until one year
- It's approved.
- It's approved.
The request is approved
through March 13.
So you can go ahead and
call it in to the pharmacy.
This was something driven
from John Kapoor,
driven at the top--what the
success rate was on the IRC,
how they were doing.
The lies, the deceit.
There's nothing they wouldn't
say to get the drug approved.
And Dr. Kapoor's philosophy
was very simple.
"The doctor prescribes it.
He puts pen to pad.
"That patient will get
the drug.
Do you understand me?"
John Kapoor insisted
that their approvals be
something like 90% to 100%,
which according
to the testimony was way beyond
any kind of industry goal
or standard.
I've been
through this before.
I'm looking at this,
and I'm going, "Okay.
Clearly,
we're breaking the law."
That medication's intended
for the use and management
of breakthrough pain
in cancer patients.
Dr. Volking is treating
the breakthrough pain
as 338.29.
♪
The opioid crisis today
is just that.
It's a crisis.
We all have to work together.
Because our prescriptions
by 2012 were over 250 million.
250 million
in the United States.
Everybody who's registered
to handle
a controlled substance
has a requirement under the law
to maintain effective controls
against diversion.
Manufacturers--
"Well, we just make the drugs.
We don't prescribe 'em."
Distributors--"Well, we're just
logistic companies.
We don't prescribe
or dispense."
Pharmacies--"We just take
valid prescriptions
"written by doctors
and dispense the medications
as ordered."
Doctors--"We're just treating
our patients."
And then it goes
to the patients.
By the way, those are the guys
that are dying.
And everybody's pointing
the fingers at each other,
but all downstream
towards the doctors.
I don't want you to think
that I have a problem
with doctors.
In fact, most of the doctors,
the vast majority of doctors
are doing exactly
what they're supposed to do.
But there are bad doctors
that were doing
really bad things
with controlled substances.
I can't stop them.
But the pharmacists can,
because the pharmacists don't
have to fill the prescriptions
But if the pharmacist
continues
to fill the prescriptions,
the Controlled Substances Act
supplies a check
at the
distributor-to-pharmacy level.
♪
When the manufacturer makes
the pill,
they're not allowed to sell it
directly to a pharmacy,
so they sell it
to one of these three companies
almost exclusively--
McKesson, Cardinal Health,
and AmerisourceBergen.
And those three companies own
something along the lines
of 90% of the opioid market.
When I first started doing
this investigation,
I had never heard
of these companies.
I had never heard of McKesson.
They are not only
the largest drug distribution
company in America,
they are the fifth-largest
company in the United States.
These companies keep
very low profiles.
They don't want to be
in the press,
and they do a very good job
of just staying off
the radar screen.
♪
- Hello? Can I help you?
- How you doing?
- What are you shooting?
- The trucks coming in and out.
- What are you shooting for?
- It's for a documentary.
- Nope. Cannot do that.
- Nope, not here.
The distributors,
the big three--
When an order comes in,
they have an obligation
to have a system in place
that identifies whether
the order is suspicious.
If the order is suspicious,
they need to stop
the shipment.
So, if you see a pharmacy
that's been ordering 5,000
tablets for the last two years
and now they're ordering
40,000, then 60,000,
then 100,000,
that's suspicious.
You--there's no way you
could say it's not suspicious.
But what we saw was
distributors not filing
suspicious orders
and then continuing to ship.
♪
narrator: When distributors
recklessly filled hundreds
of suspicious orders,
the DEA had the ability
to shut them down
with a powerful weapon--
An ISO,
or Immediate Suspension Order.
Nobody used that weapon
more effectively
than a DEA lawyer
named Linden Barber.
DEA's regulation calls
on distributors
to detect and report
suspicious orders to DEA.
Those are,
according to the regulations,
orders of unusual size,
unusual frequency,
or those that
narrator: One of
the top lawyers
at the DEA's
Drug Diversion Division,
Linden Barber worked closely
with Joe Rannazzisi
in preventing companies
from profiting
from opioid abuse.
He was doing a lot of work
with us,
trying to get
the industry in compliance.
Linden would be the first
to get angry
about how many people died.
He had that drive, that push
to file all these cases,
to cowboy it.
Narrator: Late in 2007,
Barber, Rannazzisi,
and the DEA
set their sights
on Cardinal Health.
They shut down
a key distribution center
with an ISO
for failing to report hundreds
of blatantly suspicious orders
of narcotics.
A $130 billion company,
Cardinal settled the case
by paying a $34 million fine.
In the final deal,
Cardinal did not admit
wrongdoing,
and damaging evidence
of public harm was suppressed.
I didn't want to settle
these cases.
I wanted to go in front
of a court.
I wanted to present
all the evidence.
I wanted to be transparent.
A $34 million fine
does nothing.
That's a traffic ticket.
$34 million for Cardinal
is nothing.
It didn't take very long
before they basically
were turning around
and doing the same thing.
Cardinal was distributing
millions of pills
to two CVS pharmacies
in Sanford, Florida,
right on the edge
of a highway.
So people would cruise in,
get their drugs,
and be out
in, like, no time at all.
Narrator: As part of
the CVS case,
the DEA started investigating
Cardinal once more.
Angered by a second
Rannazzisi-led investigation,
Cardinal started
an influence campaign,
using former Department
of Justice officials
to lobby their old colleagues.
You know, the revolving door
and the swamp
is alive and well
in Washington.
Jamie Gorelick was
the Deputy Attorney General
during
the Clinton administration,
so she was
the second-highest-ranking
law enforcement official
in the United States.
After she left,
she joined one of the biggest
law firms in town here.
She is
a exceedingly powerful woman,
and Cardinal Health
had retained her.
She reached out to the
then-Deputy Attorney General,
James Cole, and asked him
if they could take a look
at this case--
You know, "Did they really have
to come after them that hard?
"They're trying to do
the right thing.
Is there a way
that we can talk about this?"
And that got back to Joe,
that Jamie Gorelick had
been involved.
Look,
as much as I understand
that Jamie Gorelick
is a fine attorney,
I don't think she knows
the Controlled Substances Act
better than me.
♪
narrator: In a series
of calls and letters,
Gorelick pressed Cole to
prevent the DEA from acting.
"Immediate suspension,"
wrote Gorelick,
"is a drastic and punitive
enforcement tool.
"We would appreciate
the opportunity
"to discuss this urgent matter
with you
prior to any action by DEA."
Cole responded
by demanding an immediate
briefing by Rannazzisi.
I said, "Before we start,
"no one's ever wanted
a briefing
"on why we're doing
certain things.
What makes this case
so special?"
And the response was, "'Cause
I'm the Deputy Attorney General
of the United States,
and I want to know."
And that really didn't answer
the question.
And it just got
very adversarial.
But once we presented
the facts, they couldn't--
I mean,
the facts were the facts.
These companies were
an imminent danger
to public health.
♪
Around that time,
we're reaching, like,
170,000 people who had died
from drug overdoses.
That is just
a phenomenal number.
Doing CPR!
During this time period,
I'm out on the road.
I'm talking to parents
who've lost kids.
I'm talking to wives
who've lost husbands.
I'm talking to people
who've lost loved ones,
and they're all saying
the same thing--
Why is this happening?
And my response is, "We're
doing everything we can."
And then to sit there
and go through an inquisition
about why I'm doing
a certain thing,
to a company--
To at least one company
that was already charged
with the same violation
several years ago,
it kind of pissed me off.
And that's when I came back,
and I call my team.
I said, "You know, this is war.
We're at war now.
"You go out
and serve those ISOs,
and we'll just see
where it goes."
I was proud of the work
they did.
Those guys busted their butts
for, you know, months,
getting these cases together.
♪
We were absolutely amped up.
If you want to do
some real good,
if that's really
what you want to do,
if you want to go out
and you want to fight bad guys,
you're doing this
kind of thing,
and you're thinking,
"This is great."
So, in February of 2012,
we issued the
Immediate Suspension Orders.
Narrator: A federal judge
ruled in favor of the DEA.
The ISO went into effect,
shutting down the flow
of drugs.
Ultimately, Cardinal agreed
to stop shipping opioids
from one warehouse
for two years
and paid a $44 million fine,
but the tactics of the DEA
enraged Cardinal
and other big pharma
companies.
When the companies
didn't like
that they were being held
accountable,
they said, "Enough is enough."
And instead of complying,
they just decided
to change the statute.
Thank you, Madam Speaker.
I rise in strong support
of HR 471,
the Ensuring Patient Access
and Effective Drug
Enforcement Act,
bringing greater clarity
and transparency
to the requirements for safe
and secure distribution
of these medicines.
Pharmaceutical companies have
infinite gobs of money
to throw at politicians
to change the laws,
and that is disgusting.
That's horrible.
That's not the way
the law should work.
They should be changing their
behaviors, not the rules.
♪
Tell me about Rachel's.
What kind of place
was Rachel's?
You know,
high-end dance club
with five-star steak
restaurant.
One day
Alec comes in to the club.
It was slow, and I just saw
this guy sitting by the stage.
And I do what I normally do--
Is I sit down
and I talk to people.
You know?
That's how I kind of
feel them out,
see what kind of people
they are,
and if they appreciate more
of a conversation, you know
Then I'm good, right?
Um, but, uh, we talked a bit,
and he told me
that he was VP of sales
in pharmaceuticals.
He didn't take any dances
till later on that night,
but he had offered to do
a private dance with me.
And then he left,
and I didn't--
I really didn't think
he would come back,
but he came back and said,
"Yep, let's do this.
We'll do the private dance."
And that's how it got started.
I get a call from him
a couple weeks later,
and he tells me that he thinks
he has a regional sales
manager's position for me.
And it seemed like it was
the perfect job, honestly.
Just do what I do now, and it
wasn't anything different.
The first time
I interviewed her,
I told her,
"This is the industry."
And she says,
"This is what I do every day."
Dancing is how you get
a clientele base
that would come in
and see just you.
I can shoot the shit with men,
you know?
You have to be able to read
people by their body language,
what they talk about.
You have to be able to listen
so that you can find out
how you relate.
As far as psychology,
quite frankly,
her prior employment
is all about psychology.
I mean, you got to meet
a customer, right?
Are you gonna spend an hour,
two hours, three hours
wasting your time when he's not
gonna give you a dollar?
Or are you going to know
in five minutes
that this isn't your guy,
get up and start circling
the place
and find
your next opportunity?
What's a whale doctor?
We used that
in strip clubs, too.
So what's a whale
in a strip club?
A whale is the guy
with the money
and that likes to spend it.
When I worked at Insys,
the whales were the guys
who were prescribing
this medication,
this class of medication
for a long time.
Those were the whales.
They know what they're doing,
and if you can get
that business,
then you're good.
♪
Base salary for the regional
sales manager was $80,000
before bonuses.
They called it Mid-Atlantic,
but it was Michigan,
Wisconsin, Indiana,
Illinois, Ohio, Maryland,
and Washington, DC.
♪
My sales team, we started off
as the worst in the nation,
and we ended up the top region
in the nation
shortly after I started.
She's probably the best
salesperson I've ever met.
And the best salespeople
I hired
were the people
who understood,
what is the most important
thing to you?
Being number one in the country
on that list
or making the most money?
I typically go with the person
who says being number one
'cause I know they're sick
like me.
Got to be number one.
When I met Alec,
I don't know, he seemed crazy,
but I thought
he was brilliant.
After starting with the company
and communicating
with him daily
and listening to him
on the conference calls and--
That's when I really got
to know him.
We became, you know,
good friends
and developed a relationship,
even though I knew
that he was married.
Which, I mean, we all say
love can be blind, right?
♪
You know, I saw this man
who worked really hard,
did things for people,
gave people opportunities,
like myself.
♪
I was born in Hawaii,
Honolulu.
Born into a very abusive
household.
My parents got divorced
shortly after my brother
was born.
And then shortly after that,
my father actually took us.
We were on the, you know, run.
We were milk-carton children
for a few years.
We lived all over the place--
Boston, San Francisco,
different parts of California,
Chicago, Puerto Rico.
Sometimes two weeks
to two months.
I never had a childhood.
I raised my sister
and my brother
at a very young age.
You know, I'm ironing
at five years old and cooking.
♪
Eventually
the law caught up with him.
They found my mother.
We moved to Michigan.
I ended up getting
emancipated when I was 16.
You have to prove
that you can take care
of yourself financially,
which I did,
working three jobs,
going to school,
a superior honor roll student.
Finished school, got married,
and had a son
and started going to college.
And once I turned 18,
I started dancing, too.
When you don't have anything
and you don't have any support,
you've got to grind your way
and, you know,
treat it like a business,
and that's what I did.
You know, I pushed myself
through school.
Initially, it was pre-med
and then natural healing.
And I was board certified
for medical massage therapy.
♪
Everybody used to call me
Superwoman
Or Supermom.
And I could do it all.
In 2012,
I went down
to Florida with the kids
to try to make some money.
And it was that summer
when I met Alec.
♪
I listened to him.
He said that I needed
a four-year degree.
He knew I didn't have
a four-year degree.
And so he helped me out
with my résumé.
Just said
that I had to, you know,
put that I had
this bachelor's degree.
I trusted him.
Part of what
Alec Burlakoff did
is he pulled in three people
who he knew he could trust
to implement
Kapoor's strategy.
That is not easy to do.
It's not easy to hire people
who are gonna manage
other people
to engage in criminal activity.
- You know, they targeted--
- They targeted us,
people who were--
I call us the naive dreamers,
um
where we still believed in the
dream and worked really hard.
Sunrise Lee, you know,
there's this sort of narrative
that wants to portray her
as this person
that worked at a club,
and that's true,
but she was a much more
sophisticated criminal
than that.
She's so successful,
she's promoted.
She at one point was
responsible
for a third of the country
in terms of all the sales reps
and the sales managers.
And she has a conversation
with the district manager,
and she said, "Listen,
"you got to make sure that you
stay on top of these guys
"because they will stop writing
"unless you're there every day
talking to them.
"You got to hold them
accountable
for what they agreed to do."
which, of course,
is the definition of a bribe.
♪
Kapoor wanted doctors
to have twice the amount
of net revenue generated
by their prescriptions
as they were given
an honorarium in bribes.
You got to tell the doctor,
"Look, we are not Pfizer.
"We track every penny.
I'm held accountable.
"If we come to an agreement
that you're gonna speak
"and we're gonna pay you
honorarium to speak,
"you must clearly understand
that you will be expected
"to write double
of what we paid you
"back in prescriptions.
"And if it's not there,
"we're gonna reduce
your programs quickly,
"and then we're just gonna
basically--
You're gonna disappear
off the map."
Right?
The whole thig is disgusting.
- Kapoor, he had, like, a--
- A spreadsheet.
Excel spreadsheet.
In pharmaceuticals,
it's a "no-no."
It's a forbidden.
You don't do it.
For obvious reasons, right?
You start connecting the dots,
and things don't look so good.
It was the smoking gun.
They could look
at a list of prescribers,
and they could say, "Here's
what we've paid this person,
and here's their scripts."
And they could do
the simple math to see,
"Are we making money or not?"
That was a devastating piece
of evidence
because it showed
the true intent.
♪
There was a doctor in
Illinois named Paul Madison.
He was associated
with a doctor
called in the media
"Dr. Million Pills."
He had a practice with him.
There's one email describing
Madison's office
as a "shady pill mill."
And what do they do?
Sunrise Lee, she goes in,
and she flirts with him,
and she is seen giving him
a lap dance.
- Never happened, okay?
- It just--it never happened.
It's not even allowed to happen
at a dance club.
You would get booted out.
They sign him up
as a speaker,
and they start bribing him.
And that happened
all around the United States.
And another doctor
they worked with
was Gavin Awerbuch
in Michigan,
who ultimately became
the number-one prescriber
of substances in the
United States at one point,
was paid for three different
speaker programs a week.
A doctor suddenly isn't
a doctor anymore at all.
They're working
for Insys Therapeutics.
They're working
for themselves.
They're working for money,
and the patient has
no knowledge of it.
It is truly frightening.
♪
This is a Gallup poll.
America's ratings of honesty
and ethical standards
in professions.
Does anybody know what
the number-one profession is
in honesty and integrity?
Anyone, yell it out.
- Nursing.
- Who said that?
Who said nursing?
You did.
Think about that.
Nurses, medical doctors,
and pharmacists
are one, two, and three.
You trust them.
Everybody trusts them.
Why? Because you go there
to get better.
You go there to get better.
Okay, that's important
because people trust
their medical professionals,
so they'll do
what they're told to do.
Okay?
What's the bottom five?
Bingo!
Members of Congress are last.
But this--ahead of 'em
are stockbrokers,
advertising practitioners,
telemarketers,
and car salespeople.
The bottom five.
♪
More can and must be done to
treat this growing epidemic,
and that is why
we have all worked together
on HR 4709,
the Ensuring Patient Access
and Effective Drug Enforcement
Act of 2014.
What is
The Ensuring Patient Access
and Effective Drug
Enforcement Act?
Sounds great, doesn't it?
I mean, what could be wrong
with that?
You know, you get--
Patients get access
to their medications,
and there's
effective law enforcement.
So why would anybody be opposed
to that?
This is one of these
kind of non sequiturs.
It's like one of the most
bizarre names for a bill
that does everything
the opposite.
Narrator: Instead of passing
a law to protect patients,
members of Congress
worked hard to pass a bill
that would undercut the
DEA's power to stop companies
from recklessly flooding
the country with narcotics.
To understand why,
it helps to look
at how Cardinal had retained
a former DEA official
who was perfectly positioned
to persuade Congress
to do the wrong thing.
The chair recognizes
Mr. Barber.
Five minutes
for an opening statement.
Good morning, Mr. Chairman.
For the last 3 1/2 years
as the director
of the DEA compliance
and litigation practice
at Quarels & Brady,
I have dealt with registrants
on a daily basis,
but prior to that, I was the
Associate Chief Counsel at DEA.
I worked at the agency
for 12 years--
Linden Barber left the DEA
and formed his own practice
within a law firm
here in town,
representing
the very same companies
that he used to go after.
So around and around
and around it goes.
He brought with him
the knowledge
of where the DEA enforcement
regime is weakest,
and he started to advise
his clients to that effect.
If you have
a DEA compliance issue
or you're facing
a government investigation,
I'd be happy to hear from you.
According to email traffic
that we received,
there was an email
between a couple of people
at the Department of Justice,
and one person said
Linden Barber wrote this bill.
Narrator: The bill completely
changed the conditions
under which the DEA could
issue a suspension order.
It redefined the term
"imminent danger"
as a "substantial likelihood
of an immediate threat."
♪
In law,
language is everything.
So it would be impossible
for the DEA to show
that a drug distributor
based in Ohio or Connecticut
or Upstate New York
posed an immediate threat
of deaths
by sending drugs downstream
to a community
in West Virginia.
It's just impossible.
You could show before
it was imminent,
but you can't show now
that it's immediate.
So, if they passed
the legislation,
there would be
no more immediate shutdown
of narcotics distribution.
It could happen
after a hearing,
but it couldn't happen
like that.
The Ensuring Patient Access
and Effective Drug
Enforcement Act
provides much-needed clarity in
the Controlled Substances Act.
And DEA's authority
to issue immediate suspensions
will be protected
from judicial curtailment
because there will be
a clear legal standard.
So, when Linden left
and then all these people
that I loved
and loved working with,
you know, begin leaving,
and they're leaving to go work
for who they claimed were
the bad guys.
And they take that same
righteous anger that they had
working for DEA,
and now they're using
that righteous anger
on the other side.
I don't know how you do that.
You know, if you go and work
for the drug company,
that's you.
I mean, that--
If you want to--
I never criticize a man
for how he's making his money.
As a former counsel who
appeared in federal courts,
assisted
U.S. Attorney's office
in defending the suspension
power of the agency,
having a clear legal standard
is always best.
There are federal statutes
that were passed around
the same time as the CSA
that contained a definition
of imminent danger
I had a conversation
with a key staff member
of the Energy
& Commerce Committee,
who said, "We actually had
somebody come up here
"and testify
who used to work for the DEA.
"He was, like, a top lawyer
for the DEA
"who said that the law
needed to be clarified,
and it was really important."
And I said,
"Who was that lawyer?"
And the staffer said,
"It was Linden Barber."
And I said, "Do you know
who Linden Barber is?
Do you know who he works for?"
He's like, "No.
Who does he work for?"
I said, "He represents all
of these companies."
It was kind of
a stunning moment.
You don't really want to see
how the sausage is made
on Capitol Hill.
♪
Our bill seeks to facilitate
greater collaboration
between industry stakeholders
and regulators
in our nation's effort to
combat prescription drug abuse.
Distributors and pharmacists
are finding
that he unnecessary adversarial
regulatory environment
created by the DEA is putting
effective enforcement outcomes
in jeopardy.
The company's lobbyists
basically came up
with a strategy--
"How can we stop the DEA
from picking on us
and bothering us
and hurting us?"
They zeroed in on
this congressman, Tom Marino,
and also Marsha Blackburn
from Tennessee.
You know, it's interesting,
'cause Tom Marino and
Marsha Blackburn's districts
were both really hard hit
by opioids.
To every family member
who has lost a loved one
to an overdose--
The drug industry got them
on board
to champion their cause.
McKesson, Cardinal Health,
AmerisourceBergen,
Purdue Pharma, CVS,
all these companies
were lobbying heavily
in support of this bill.
And most were paying
Tom Marino, Marsha Blackburn,
Orrin Hatch, and a host
of other members of Congress
a lot of money
to get this bill passed.
They're getting
campaign money,
and industry lobbyists
are writing the questions
for them to ask
the DEA officials.
♪
The chair recognizes
Ms. Blackburn for five minutes.
Thank you so much.
Mr. Rannazzisi--Am I saying
your name correctly?
- Yes, ma'am.
- I'm close enough, huh?
- Perfect.
- Okay.
You know, we all
are concerned about patients
that are in pain
that need medication.
Numerous seniors
in my district are complaining.
They call my office
on a regular basis
'cause they can't get
their pain medications.
It's critical that patients
who desperately need
these medicines have access
without undue delay.
I mean, what are we doing
to make sure
that these folks are heard from
and that the drugs are
available?
We do not want patients
to go without their medication,
true pain patients
that need their medication.
We don't want that.
But there is no--
Tell me what you're doing
about it.
Sometimes it seems that
all the DEA cares about is the
number of enforcement actions
and not real solutions
to stop the abuse.
- That's not correct.
- Provide us some data.
If you would go on our
website and look at the cases
that are posted on our website,
both on the case--
It would've been great
had you been prepared
to provide that for us.
Articulate what the efforts
are that the DEA is engaged in.
Besides the on-site
investigations that we do,
the cyclical investigations
to determine compliance
and to assist them
in complying
you know, besides the fact
that they call in
and request assistance--
- Okay, well let me move on
- Questions?
Then if it's laborious.
I think you were ticking
off--it's not laborious.
You asked me to tick off
what I do.
And 16,651 people in 2010 died
of opiate overdose, okay?
Opiate-associated overdose.
This is not a game.
We're not playing a game.
Nobody is saying
it is a game, sir.
Well, yeah, kind of you did,
because you're questioning
why we're doing this.
And all you had to do is go
back and look at the cases
that we did in '11, '12, '13,
all these different cases.
Go through the documents,
and you could see
what they were doing.
But for some reason,
Representative Blackburn
decided that she didn't want
the supply chain touched.
And I guess it's kind of
a Monday attitude sort of day.
So let me move on, okay?
I thought maybe you were doing
a little bit to help.
♪
Then Representative
Blackburn and Tom Marino
were investigating me
for attempting
to intimidate Congress.
Joe Rannazzisi,
a senior DEA official,
has publicly accused
we sponsors of the bill
of "supporting criminals."
This offends me immensely.
♪
What happened was
we had a telephone call,
and we started arguing.
And I said,
"If you pass this bill,
"it's going to stop us
from doing our jobs,
"our ability to stop
the hemorrhaging.
"And with all these people
dying, well, you know,
"if this bill passes,
that blood's on your hands.
It's not on mine."
♪
They filed a complaint
with the Office
of the Inspector General.
Ultimately, that was the end
of my career.
It was a management change.
A new guy came in,
replaced me with a guy who had
no pharmaceutical experience,
and in 2015, after I retired,
they replaced my whole staff.
Now, this is important 'cause
this is the perfect storm
for bad policy
and legislation--
Regulatory pressure
on powerful industry,
money, lobbying, and Congress.
And that's exactly
what happened.
Without objection,
the bill was read a third time
and passed.
They all passed it
without even a vote.
It was just unanimous consent,
which just means
that it will pass,
but if one member of Congress
stands up
and says, "I'm against this,"
the bill stops dead
in its tracks,
and they have to vote on it.
Not one member of Congress
stood up and said,
"I object to this bill."
This is bipartisan.
The Democrats
and the Republicans
saw the importance in this
and got together.
People don't like
to hear this, but
nobody really realized what
the language change meant.
I don't think
that they read it.
I think the vast majority
of bills that get passed
on Capitol Hill--
Legislators
do not read those bills.
And they had no excuse
for this one,
because it was, like,
three pages.
And the key paragraph
is on the first page.
They were just asleep
at the switch,
and they gutted
the DEA's ability
to go after these companies.
People were dying
by the tens of thousands,
and their own representatives
are basically selling 'em down
the river.
It's one of the most outrageous
things I've ever seen
in the 35 years
I've been doing this.
Was there any controversy
or any pause by President Obama
when the law went to his desk
for signature?
None.
It just sailed
right through his office.
And it's--to this day,
it's, like, the big mystery.
I mean,
nobody would talk to us.
The head of the DEA
wouldn't talk to us.
The head of the Office
of Management and Budget,
which signs off on every piece
of legislation,
wouldn't talk to us.
The top lawyer
for the White House
wouldn't talk to us.
The president wouldn't talk
to us.
It's incredibly unusual.
Mr. President-elect
narrator: The incoming Trump
administration pledged
to do better than Obama,
but when it came time
for Trump to announce
his drug czar,
he named Tom Marino,
the man who spearheaded
the law to protect
the opioid companies.
Following the passage
of the Marino bill,
opioid prescriptions soared
in some parts of the country.
Yet in many states, there were
also countercurrents
that swirled
in unpredictable ways.
As far back as 2012,
a building resistance
to opioids was colliding
with a growing dependence
on them.
You have millions of people
who start using these drugs
and become dependent.
And then
a series of things happen
that are good things that
should've happened earlier.
States start tightening up
regulations,
pill mills shut down,
doctors get
a little more careful
about writing prescriptions.
These changes are good
to one way of thinking,
in the sense that
they make it harder
to buy and abuse
pharmaceutical opioids.
But what that does
is it drives all these people
who are already addicted
on to the black market.
Narrator: The illegal
trafficking of narcotics
increased
due to growing demand.
International drug cartels
catered to those
who had become addicted
to prescription pills.
As their need
for narcotics increased
and doctors were
more reluctant
to prescribe rising doses,
users turned to heroin
and a synthetic opioid
50 times more powerful--
Fentanyl.
♪
Fentanyl has been around,
you know, decades and decades
and still today has
an extremely important use
medically within
the medical community.
For the illicit side,
when OxyContin and these things
kind of came into the market
in the 1990s and then people
becoming physically addicted
to it unknowingly,
if we look at enforcement
against the pharmaceutical
industry that took place
and against doctors and how
things are being prescribed,
the people who utilized
those drugs,
they now were kind of cut off
in their supply.
And cartels and the
illicit side of the markets
went to fill the void.
♪
This is the busiest port
of entry in the United States.
So we're talking about
thousands and thousands
and thousands of people
that come through every day.
The San Ysidro port,
the first time fentanyl
was really intercepted here
in bulk quantity was in 2014.
And since then,
it has just kind of grown out
exponentially.
It's just part of almost daily
intercept loads here.
I can tell you that there
is Chinese-produced fentanyl
that has entered the
United States through the port,
but there is also
illicitly made fentanyl
from other locations that
have come through the port.
♪
narrator: Since 2015,
fentanyl overdoses
have been rising dramatically.
Rates have soared by 2,000%
in San Diego,
where a federal task force
is seeking
to prosecute dealers
for the deaths
of their buyers.
♪
One case involved
a 24-year-old college student
named Sarah Fuzzell.
Her parents called her
their angel on Earth.
After getting hooked
on prescription painkillers,
she battled addiction
for five years
until the pandemic shut down
her support network.
After dropping out of school,
she died
of a fentanyl overdose.
♪
The father of the girl
who had passed away
had been reaching out,
and he said that
when he received
her property back,
her cell phone,
when it turned on
and was powered up,
that the person
that they believe
had sold the drugs
to their daughter
was still communicating
through the phone.
♪
They gave us the phone
so we could utilize it
for investigative value.
You almost have
to manufacture the energy
to even want to reach out
to, like, law enforcement--
You guys--
Because, you know,
the ultimate goal of wishing
Sarah wasn't dead,
that's not a possibility
to change that.
So, you know, there's probably
some families
that just
kind of quietly go away
just because
there's so much hurt.
But we're wide open to doing
anything that we can do
- that will help.
- Yeah.
So let me just give you
kind of a quick rundown
Okay.
Of kind of what took place.
♪
We spent well over
40-straight man-hours
♪
Between about 15 to 30 people
at one time
getting this to go down.
♪
Basically what we're doing
is we're targeting a suspected
fentanyl distributor
who we believe is responsible
for a recent overdose
drug death.
And, essentially,
what we're doing
is we're trying to lure
the distributor out
to this particular
parking lot,
and then we're gonna place
that person under arrest.
♪
- So
- Oh, sweet.
♪
♪
Yeah, Wasser
to all code five units.
Try to set something up
for tomorrow.
I think we've been pushy enough
for the day,
and I think it's just best
that we back off
for the moment, break.
We had a hard time.
We set up for it.
We spent the entire day
waiting,
and we never were able
to make that contact.
Okay.
We really appreciate
what you and your task force
and all are doing, you know?
It's making a difference.
♪
Every day
it is a continuous game
of cat and mouse,
where, you know,
the impact of the death
is one piece
of this entire puzzle.
You have people who are
nefariously producing it,
people who are buying,
procuring chemicals,
moving that stuff
around the world,
looking for people
to perfect a new recipe
or way to market
it in a faster way.
♪
narrator: To figure out the
puzzle of the opioid crisis,
you have to look
for ill-fitting pieces
all over the country.
In Lubbock, Texas,
the DEA opened
an investigation
into a possible
drug cartel operation
when the medical examiner
reported a sudden rise
in deaths
from fentanyl overdoses.
But something surprised
the agents.
The likely kingpin turned out
not to be
a professional criminal.
Instead,
all evidence seemed to lead
to a local computer repair man
named Caleb Lanier.
♪
♪
I guess there's
a couple times in my life
where I could've walked away,
but it's so hard.
When the doctors start
prescribing these drugs,
get you addicted to them,
it numbs you,
and it's dangerous
because somebody that's
depressed and has anxiety
and now doesn't feel the fears
and doesn't--
They're going to do things
like I did.
They are.
♪
I grew up in a little town
called Clovis, New Mexico.
It's on the border of Texas
and New Mexico.
About 40,000 people
at the time.
Pretty normal family.
My parents did everything
they could
to help me the best
they could.
Three sisters
that are all older than me,
so definitely got picked on
a little bit from them,
but I knew they all loved me
and I had support,
so, you know,
it wasn't a matter of me not
having loved ones around me
or growing up
in a rough neighborhood
or anything like that that led
to the path that I'm at now.
♪
Now, I got ran over
by a pickup truck in 2001.
Ran across my right leg,
across my chest,
and up off my left shoulder.
Needless to say,
from that point on,
I've dealt with pain
my entire life--
Physical pain,
emotional pain as well.
It's hard to even talk
about it.
I started taking
very heavy opiates.
I was being prescribed
40 milligrams of OxyContin
with 2 milligrams Xanax
from day one,
and that's huge amounts
of opiates and Xanax together,
which is not supposed to be
prescribed to begin with.
I became addicted
pretty quickly.
♪
He would go to a doctor
in Portales, New Mexico.
I went with him
a couple of times.
He would say, "Oh,
I researched this medication,
and I'd like to try it."
And she said, "Okay, Caleb."
The first time,
I didn't think anything of it.
And then after
a couple of times
and him switching up
medications
and her not even looking
into it,
just prescribing him
whatever he wanted,
I said, "Wow, I don't think
that she should be prescribing
you whatever you want."
And he said, "Oh, no,
she's my family doctor.
She trusts me.
She knows I do the research."
And that was probably
my first inkling
that, you know,
something was wrong.
♪
Pain has an issue
of causing people
to become depressed.
I mean, it's just--
It's part of it, you know?
When you deal with it
every day--
I explain it like
a roller coaster,
and you're
on that roller coaster,
and you're getting nauseous,
and you're about to vomit,
and every time the
roller coaster comes around,
you're looking at the guy
that has that stop switch.
And you're like,
"Stop this thing. I want off."
But there's no stopping.
It's the rest of your life.
It wears on you.
You look at the things that
you used to be able to do,
the things you want to do
with your family,
the things you want to do
with your friends,
and you can't do them.
I got where I was using
so much
that I would go through
my entire prescription
within the first four days
of the month.
You're so tired
of this roller coaster,
you'd rather just put
a needle in your arm
and make the pain go away.
I started using heroin
at that point.
Heroin worked
for a short period of time,
but it was too expensive.
I had also been on fentanyl,
and that led to me finding it
on the Internet.
The first thing
that we saw--
There was a shipment
of fentanyl
that was destined
to Lubbock, Texas,
that was seized by
Customs and Border Protection
in November of 2015.
We started talking
to Lubbock Police Department,
the sheriff's office,
narcotics units,
and we discovered that
they were also seeing an uptick
in fentanyl.
They were buying it
in street-level sales.
And then we had several people
that walked into our door
that were fentanyl users
that had gone to drug rehab.
We took the intelligence
from those individuals,
and we started extensive
surveillance on Caleb Lanier.
And we discovered that, yes,
this is the person
that's using the dark web,
reaching out to labs
in China directly.
Hello, everyone.
We are the vendor
of research chemical products.
Include 2-FDCK, etizolam
♪
He had a wood shed
behind his house
that he used
as a modified chemistry lab.
He was experimenting
extensively
with different variants
of fentanyl--
Furanyl fentanyl,
acrylofentanyl.
And he was tweaking them
and he was using them
on himself
to try to figure out
which provided the best high,
which lasted the longest,
and he figured out a way that
he could maximize his profits
while he was also
treating himself.
I thought I was
a good father.
I thought I was
a good husband,
but it look back at it sober
and realize it's insane.
Most heroin addicts
might shoot up
two, three times a day.
I was shooting 20 times a day.
There was times
I was so high, right,
that I would fall asleep while
I'm counting $100 bills.
I would have
to get my children
to help me count the money.
♪
Lanier, he was a victim
of the opioid epidemic,
but then he starting selling,
distributing,
and he realized
the profitability in it.
He could import 200 grams
of fentanyl from China
for around $3,500,
and he was making
over $300,000 in profit.
He started developing ways
to launder his money.
He had a new business
that had a lot of cash
deposits that weren't normal.
He started recruiting
other people
to sell fentanyl
in the street,
to gather money
to take back to Lanier.
He became the leader of a
drug-trafficking organization.
The fentanyl that they were
bringing in the community
attracted a whole
new branch of people
that normally wouldn't even
be associated with opioids.
We had people
from all walks of life
overdosing on fentanyl,
and we knew
that if we didn't get
a handle on it really quick,
it was gonna be a bigger
and bigger problem.
♪
When you look
at this problem,
it can look, from a distance,
forbiddingly complex,
but, actually,
there's a mechanism that should
be pretty easy to understand.
So what Purdue
would say today--
What a lot of these
pharmaceutical companies
say today is
"Don't blame us
for the opioid crisis.
"These people today,
they're dying from heroin.
They're dying from fentanyl."
As though the roots
of this thing,
it was some foreign invasion,
when the truth is that
the pharmaceutical companies
got very good at
getting people on to opioids
but not at getting them off.
I love titration, yeah,
that's not a problem ♪
And I got new patients,
and I got a lot of 'em ♪
Titration, it's actually
the responsible thing to do,
but not in this regard.
But, typically, what you're
supposed to do is start low
and titrate slow.
You're supposed to titrate up
to the appropriate level.
Now, this is something
that happens in medicine
all the time,
and it's totally normal, right?
Start the low dose,
play it conservative.
It's simply about balancing
the side effects with efficacy.
But at Insys,
was the higher, the better.
It was called
the effective dose campaign.
It was a campaign that was
created by Dr. John Kapoor.
What Kapoor said
unequivocally
and what is in black and white
in emails
is they knew that if you got
to a 400-microgram dose
or higher,
they would stay
on the drug longer,
and so they'd make more money.
I love titration, yeah,
that's not a problem ♪
And I got new patients
and I got a lot of 'em ♪
In the context
of this video,
it's like titrate means, like,
goose up the dosage,
and then we're gonna make
more money.
Is that the idea?
Yes.
They spent a lot of time
and energy
trying to convince sales reps
to do this,
and some of the more absurd
aspects of the case
with this bottle,
of a 1,600-microgram dose
of Subsys
dancing around to a rap
written over a popular
A$AP Rocky song,
trying to convince
the sales force,
"Go tell your doctor
titration's not a problem."
I love titration ♪
Yeah, it's not a problem ♪
That video
was the worst possible move
we could've ever made.
We asked the sales force
to put together a short video,
and then we would provide
the award to the best video.
All right, dude!
- Dude, we killed it last year.
- We demolished it last year.
Reps are gonna be gunning
for us.
Absolutely.
So these two really sharp,
good-looking guys,
you know, who look like
models, supermodels
Obviously, they went all-out.
And they're phenomenal
salespeople, by the way.
When that video first came
through email,
I'm watching this video,
and I'm engaged.
I was enthusiastic
and actually was
a little bit emotional.
I said, "I can't believe
the effort they put in.
I'm touched."
Okay, I got it,
and just ♪
Yes, Lord ♪
The person in the costume
dancing and singing
and rapping, that's not me.
People who know me,
they know I can't dance.
They know I can't rap.
Yeah, I'm a 5'8" Jewish guy.
I mean,
it's just not happening.
Months later, they go,
"You got to put
this costume on,
"and we're gonna reveal it
at the end
that you're the guy
in the costume."
Whoo!
Nine takes later,
an hour and a half later,
this frickin' thing is done.
I love titration,
yeah, that's not a problem ♪
Just in terms
of shedding light
on the corporate culture,
right?
John Kapoor is in the room
while this video
is being played.
This is two years after
they've received a subpoena
from the government
looking into their practices.
As all this was happening,
you took
a pretty confident approach,
in terms of--
You gave a speech
at, like, a rep conference
or something like that,
and one of the things you said
up at the top was,
- "Oh, any spies here?"
- Mm-hmm.
You referred
to the investigation.
Mm-hmm.
You must've had an idea
that there was something worth
investigating.
But why were you so confident
that nothing was gonna happen?
- I wasn't confident.
- I was scared as heck.
I talked to my dad every night,
and I'm like, "How do I get out
of this freakin' place?"
He's like, "Just leave."
And I'm like,
"But they did this,
"and they did that,
and they have this,
"and they told me to do this,
and no matter what I do,
"I'm gonna be in trouble,
and they promised me
all this money,"
and all these stupid things.
I mean, from the moment
I woke up in the morning,
my heart would be just pounding
through my chest, you know?
And the whole drive
to the office,
just pounding, pounding,
pounding.
This is in Chandler, Arizona.
We moved, like,
two or three times.
This was the final office
that I was a part of.
You know, my kids were
in a new school.
We're in a new place.
My wife's trying
to get adjusted.
I forced 'em
to make this move.
And the numbers come in
while I'm driving to work,
always.
Literally, you're just holding
your phone.
Boom.
There it shows up.
213, 330, whatever.
"Alec, what plan of action
do you have in place?
"Alec, do you have
a flight booked?
"Where are you staying?
"Why is your flight not booked?
Are you a moron?
"I don't understand.
The guy's down 18%
from last week."
"Dr. Kapoor, can I speak?"
"No!
"Alec, you're VP of sales.
Where are the prescriptions?
"They're not there?
"Pack your bags,
grab your kids,
grab your wife,
catch a bus home."
People were getting fired
left and right.
I don't know if it's different
for anybody else,
but for me,
because I entered in knowing,
if I don't produce,
that I'm dispensable
at any point regardless
because I'm the one
that didn't have the degree.
But the culture, definitely
it wasn't an equal culture.
I heard about other
relationships with girls
and executives,
and once they had expired
then you're dispensable,
right?
A lot of pressure.
A lot of pressure.
"Do this or this."
The relationship with Alec
didn't help.
It was very volatile.
What's very weird is Alec
was saying things like,
"I'm out of time.
I'm out of time."
And I was pressuring him
to tell me what is going on,
and he pulled out a gun
out of his glovebox,
and he was like, "You see?
I'm carrying this gun."
He's like, "You don't know.
I'm carrying this.
I got to protect myself."
He had obviously been
treated poorly
by the company.
I think that he became aware
that he was gonna be
the scapegoat in the case,
that the other defendants
were going to blame Burlakoff.
The company
told me nothing, ever.
I asked a million times,
"What happened
with this doctor?
"Why did this doctor
get arrested? What--
"I heard a patient passed away.
What--"
"Ne--Alex, stay in your lane.
What's your lane? Sales."
I think a lot of people who
have been in legal situations
would understand
what I'm talking about.
It's just no way to live,
wondering when the other shoe
is gonna drop.
♪
He reached out again.
We were actually able to
get him telling us a location.
We're gonna try to bounce him
from 6th over to 4th,
kind of that roundabout
over by Horton Plaza.
What's the last
you've told him?
- I said I'm coming.
- Oh, okay.
So we wound up
in downtown San Diego.
We set him in on a vehicle.
10-4 the ID.
So, basically, he's saying
he spent his money on this,
that he needs her to be there
before 1:30.
♪
He last relayed his location
at 12:48 at 6th and Broadway
and says that he has no car.
All right, updated--
He's saying he's on his way.
I asked him where he was,
and that was his response.
♪
Also said, "Just let me know
where you parked
so I can come find you."
And then, "Oh, on my way."
It's torture.
Just wait.
The wait's always torture.
You think you'd get used to it,
but it's just--
All right, James,
start moving in.
- Now.
- Now.
Lights.
♪
- San Diego Police!
- Let me see your hands!
- Get on the ground!
- Do it now!
- Drop to the ground right now!
- Don't move!
Put your hands
behind your back!
- Do not move!
- Don't move.
Say about 5:30
in the morning,
I was sleeping on the couch,
and I woke up,
and went and said good morning
to my wife.
And I heard 'em hit the door.
Saying, "DEA."
They looked like they were
fixing to kill somebody.
And I panicked
and put my hands in the air,
and I watch as they come in
with HAZMAT suits.
♪
Everyone was
very, very stressed,
and it wasn't the people,
it was fentanyl.
It's 50 times more potent
than what you would see
in normal heroin
coming in from Mexico.
We had no idea how spread it
would be throughout the house,
what efforts we would have
to take to clean it up
and dismantle their labs.
We just had no idea.
During the search warrant,
we found several analogues
of fentanyl
that DEA had never seen
in the U.S. before.
I had about 300 grams
of pure acrylic fentanyl.
Sells for about $300 a gram,
so a lot of money's worth.
When we hit 'em,
they were kind of at the peak
of their organization.
They were probably selling
$25,000 to $30,000 a week
in fentanyl.
I don't know how he managed
to do that.
I never even saw a package
get delivered here.
He never left the couch,
and we didn't have people
coming and going either.
So whatever he was doing,
he was really quiet about it.
I'd never expected the raid.
When I saw those officers
piling up on my porch
through my bedroom window,
I thought it was, like,
a home invasion.
I was trying to call 911
from my phone.
I didn't know that they were
police officers.
I can still to this day
hear my wife and my children
screaming.
Looking back at 'em,
and I said, "Please move me
so they can't see me."
Fear?
I didn't have that.
It was shame,
but it wasn't fear.
If anything, I was relieved.
Just take me to jail.
I was either gonna die
from withdrawals,
or I was getting off of drugs,
and I didn't care
which one it was.
You have the right
to remain silent.
You can refuse to answer
questions at any time.
Anything you say
♪
We found fentanyl on him.
We went back to the hotel room
that they stayed in,
and we were able to find
more drugs there.
He's an addict himself,
so he fuels his use by sales.
Wow.
And, you know,
at the end of the day,
everybody's a victim
in this thing.
You know, other than
the people that manufacture it
and, you know,
make the big money from it.
You know,
once you get past that,
once you get
into the people that use,
whether they're dealers
or customers
or whatever they might be,
everybody becomes a victim.
So I don't know if it's worse
to die and finally be at peace
and not have to fight
these urges every day.
I don't know
if that's the worst
or if it's these people
that live
that every day now
have to be tortured
with this need to go out
and find this stuff.
You know, it's just wrong.
I just don't understand how
the pharmaceutical companies
get away with this stuff.
♪
You did a great job
staying in touch.
- We appreciate you.
- You're welcome.
Have a good evening.
- You too.
- Bye-bye.
♪
I'd been working on the case
over the course
of several years.
And suddenly, Alec Burlakoff
left me a message,
and the message says,
"I fired my lawyer,
and I want to come in,
and I want to talk to you."
This is highly unusual.
This has never happened, right?
You know, white-collar folks
are always well-represented,
and the last think you want
to do is go in and talk
to the federal government
without a lawyer.
I decided to fly
from Arizona to Boston,
and I met with Mr. Yeager,
and there were a couple
other people in the room.
And I basically proceeded
to speak with them
for about four, five hours
and basically lied to them.
What I did was, is I told
a lot of truths.
I just left myself out of it.
You can say it was based
on a true story,
just left the names out,
you know?
And we just let him talk,
you know?
We had evidence against him.
We knew that we were gonna
prosecute him at some point.
We had, very early on,
texts and emails
telling people
to go bribe doctors,
that he personally was asking
doctors to write prescriptions
in exchange for money
paid by Insys.
So, when the conversation
was over, I told him
I thought he just spent the
last four hours lying to us,
it was nice meeting him,
and he'd be hearing from us.
- I mean, I just felt--
- My whole world,
I knew it was basically
crashing in,
and it was gonna happen
really slowly,
and it was gonna be
very painful.
You know,
several months later
he was charged and indicted.
♪
narrator: In October 2017,
Burlakoff, Kapoor,
Sunrise Lee, and four others
were charged with leading
a nationwide conspiracy
to profit
by using fraud and bribes
to cause the illegal
distribution of fentanyl.
In addition to bribing
doctors, the charges included
defrauding
insurance providers.
Thank you, sir.
♪
- Any comment?
- No.
Narrator: The evidence
against Alec Burlakoff
was so overwhelming,
his attorney asked him
to consider cooperating
with the prosecution
in exchange for a deal.
♪
I looked at him, tears
started to come to my eyes,
and I said, "Yes, I will do it.
I will plead guilty."
Because there is no way
under any circumstance
that I would ever sit
on the same side
or at the same table
as John Kapoor, ever.
We all chose him
to be our mentor,
and he was supposed to take us
to the promised land
if we followed him loyally.
And look where he took us.
♪
narrator: From the bench,
the presiding judge
called the crimes of Insys
"an offense of greed"
for bribing doctors
to prescribe an addictive drug
without regard for the best
interests of their patients
and sentenced Alec Burlakoff
to 26 months in prison.
Sunrise Lee wasn't able
to make a deal
with prosecutors,
likely because she couldn't
offer them an inside look
at decisions made
in the executive suite.
She was sentenced to a year
in prison.
They painted this picture
of me
you know, as a dancer,
being uneducated,
and
and just the stereotype
of it all.
It stole a lot from me.
Everything that I've worked
hard my entire life for.
It's
the first time ever in my life
where I haven't been able
to persevere.
♪
♪
narrator: John Kapoor was
sentenced to 5 1/2 years.
In the courtroom, he had
listened without expression
to the mother of a woman
who had overdosed on Subsys.
"The actions of John Kapoor
and his conspirators,"
she said, "had been a sentence
of hell for our family."
♪
All the decisions that these
people are making at Insys
and, for that matter,
every other opioid company
in the United States,
are made in the context of what
is very clearly an epidemic.
You know, in 2012,
the first year of this
criminal conspiracy for Insys,
I think there were something
like 230 million, 240 million
prescriptions for opioids
in the United States.
That's more
than one prescription
for every adult American.
♪
When we were doing
our reporting,
"The Washington Post" sued
to get this confidential
Drug Enforcement
Administration database
that tracked
all these prescription pills,
from the manufacturer to the
distributor to the pharmacy.
It was a virtual road map,
a blueprint that would show us,
give us so many insights
into understanding
the opioid epidemic.
Never in my wildest dreams
did I imagine
we were talking about the kinds
of numbers that came out.
♪
We got nine years of data
and between 2006 and 2014,
100 billion pills
had been sent out
to communities
all across this country.
Narrator: The opioid companies
knew every pharmacy
in every small town
where every pill was going.
From Maine to Mexico,
they could track the very
abuse they were manufacturing.
The database ranked cities
by pills per person.
In some places,
close to one a day
for every man, woman,
and child.
Did the companies really think
that all those pills were
for back pain?
♪
This is something
that affects everybody.
It doesn't matter your color,
your nationality, your gender,
whether you're
economically privileged
or poor.
It doesn't matter.
As long as the opioid sales
go up,
and opioid deaths will go up
and opioid treatment admissions
are gonna go up.
That's where we are now.
And that's
where we continue to be.
Okay, that said
narrator: After Rannazzisi
was forced out of the DEA,
he took his message
on the road
to those who would listen
and he began to be a witness
for towns and counties
trying to take action against
the big drug companies.
One by one, they started
suing the opioid manufacturers
and distributors
for the damage done.
♪
With more than 2,500 lawsuits
from all over the country,
a judge in Ohio convened
a multi-district
litigation center
to consolidate the claims
in one courtroom.
Late in 2019, reporters
converged in Cleveland,
because in the first big case,
two counties in Ohio were
resisting a legal settlement
with three major
drug distributors
for their role
in fueling the opioid crisis.
♪
It seemed that there might
finally be a trial,
where the public
would see evidence
of the corporate negligence
that had cost so many lives.
Then at the last minute,
the companies took out
their checkbooks
and paid to keep
the evidence hidden.
A settlement has been reached
for our two counties
with the--
The three big defendants.
The settlement does not bring
things to an end.
It is, though,
a very good development
for the people of our counties.
What was the sticking point
last night?
Why did it take till midnight,
1:00 a.m.?
Money.
They wanted to pay less.
I wanted them to play more.
Is there an admission
of wrongdoing on behalf--
No, but, you know,
common sense tells me
when they paid
over $323 million
to these two counties,
one might say
that's a pretty good admission.
Narrator: In cases like these,
lawyers like to represent
that money paid
is some kind of justice,
and in a sense, it is.
After all,
the cost of addiction is high,
and the price of treatment
centers and first responders
should be borne
by the companies responsible.
But what of the lives lost?
How do you put a value
on them?
♪
During the COVID pandemic,
opioid addiction
and overdoses increased.
It was not surprising, then,
that in the fall of 2020,
the families
of those who had died
were stirred by rumors
that the federal government
might bring new criminal
charges against the Sacklers,
the family
that had profited so much
during the opioid crisis
and the company
that had started it all,
Purdue Pharma.
♪
This morning,
the Department of Justice
is announcing a resolution
which will redress past wrongs
and will also provide
extraordinary new resources
for the treatment and care
of those affected by opioids--
Narrator: Late in 2020, the
Trump administration rushed
to make an announcement
for the presidential election.
Pleading guilty
to three felony counts
narrator: The Sackler family
would pay a $225 million fine.
Purdue Pharma would plead
guilty to kickbacks and fraud
and promised to pay fines
totaling more than $8 billion.
That number immediately gets
repeated in headlines
all across the country.
The news goes out on the wires.
You think, "My God.
$8 billion. That's massive."
But Purdue is in bankruptcy
and only has
about a billion dollars,
which a whole bunch
of creditors
are already fighting over.
That money is never going
to get paid by the company
or anybody else.
It's a number,
in some ways, I think,
that's been kind of designed
to make headlines.
♪
narrator: Behind the headlines
was an intricate plot.
In 2019, Purdue had declared
Chapter 11 bankruptcy,
which allowed it
to continue to operate
while paying fines
to those seeking damages.
That led to a cruel irony.
The only way the company
could pay damages
was to increase its sales
of drugs, including OxyContin.
To pay for the damage done
by opioids,
Purdue Pharma would sell
more opioids.
♪
- Shame on Purdue!
- All: Shame on Purdue!
Dead from greed!
Narrator: While the company
was charged with crimes,
none of Purdue's executives
or owners were indicted,
and the Sacklers
refused to take any personal
responsibility.
- Sacklers lie!
- All: People die!
- Sacklers lie!
- All: People die!
Narrator: That raised
questions.
Starting in 2008,
just after Purdue pled guilty
to a previous felony,
the Sacklers started taking
more than $10 billion
out of the company
in complicated overseas
transactions
and vaulted vast sums
in their accounts.
Of the $10 billion,
roughly half went to taxes,
so that money, we do not have.
It was paid in taxes.
The family and the board acted
legally and ethically.
So I think that's not
the right way to look at this.
The resolution here
is very significant.
It involves, for the company,
three felony guilty pleas.
For both the company
and the shareholders,
it involves very sizable
amounts of money.
♪
If you talk to people
whose lives have been touched
by this,
a lot of them will say,
"It's not about the money.
"You could never generate
enough money
"to make up
for the human cost.
That can never happen."
What does matter to a lot
of these people is truth.
♪
And, finally, I'm gonna
leave you with this.
We've talked about truths,
talked about fiction,
and now we're gonna talk
about reality.
Turn that up?
- I need an ambulance.
- My son's not breathing.
- What's the address?
- 10731?
- 31, yes.
- Hurry.
- He's blue?
- He's white.
How old is he?
Oh, God, he's dead!
Ma'am, I need you
to calm down. How old is he?
- Oh, he's dead!
- Ma'am?
Ma'am, I need you
to calm down.
How old is he?
Can you pick up on that?
Stop, please.
How old is he?
I know I could've
fought my case more,
but I was done fighting.
I've been sentenced to 135
months in federal prison
for conspiracy to possess
furanyl fentanyl
and fentanyl with intent
to distribute.
I am currently in
Federal Correction Institute
at Big Springs, Texas.
It's a low-security prison.
It could be worse.
I could be dead.
You know what I mean?
I'm close to home,
so my wife
can come visit me.
I get to visit my kids
every weekend.
This saved my life.
It gives me an opportunity
for a second act.
I screwed up
the first one.
I can't ever
take it back,
but I get
an act two
where maybe I can
build upon the past
and use my
past experiences
to make
a better life
for my wife
and my kids
and possibly
other people
that would
go down
the same stupid
road I went down.
So yeah,
I mean
act two.