The Pharmacist (2020) s01e03 Episode Script
A Mission from God
[traffic hums.]
[ambient instrumentals.]
[Dan.]
Man, damn, I don't I don't believe this.
I'm losing it.
[chuckling.]
I'm losing it big time, okay? Maybe I dreamed this up, you know? Uh, you know, so I'm I'm not trusting myself at this point in time.
[Dan.]
It's Thursday.
This is important because, uh I'm gonna blow up, because my mind went into paranoia.
I really do believe I crossed the edge.
When I start discussing that I have a purpose, I do rise up to a certain level.
It's when I go beyond that level that I start not functioning totally perfectly.
So help me, God, to think at a good level.
But not go into the paranoia level because I'm losing it.
How couldn't everybody see what was going on? That's what we couldn't understand.
I mean, you know, some people had labeled Danny as crazy, but he went to the FBI, the DEA, you know, local law enforcement, all this, and nothing was happening, so who's crazy here? [Dan.]
I was constantly thinking the DEA and FBI was either incompetent or in cahoots with this doctor.
[truck hums past.]
[Iris.]
One of the reasons the investigation took so long was because we had to go from pharmacy to pharmacy to find the prescriptions written by Dr.
Cleggett.
[Patricia.]
There was no prescription monitoring program.
So you'd have to hunt and peck all around the city and the suburbs to find where all of these patients were going to fill these prescriptions.
[Iris.]
You can spend an entire day, uh, or two, at a pharmacy, picking prescriptions that Dr.
Cleggett wrote.
We found that Dr.
Cleggett prescribed 180,000 OxyContin pills within one year.
And that was only ten pharmacies.
We suddenly realized that it's very likely she was writing millions of pills.
We were experiencing an overdose rate that was just out of control.
[Iris.]
During that time, I saw young people dead from overdose.
Really troubling to me.
I have a son myself.
And I would not wish that on anybody.
[sirens wail.]
[Jack.]
When it spiked, it spiked.
It wasn't like it was a gradual sort of thing.
It just seemed like it just started happening right away.
[dramatic instrumentals.]
[Iris.]
Dr.
Cleggett was making St.
Bernard Parish ground zero for overdoses.
[mechanical clicking and whirring.]
[mellow instrumentals.]
[VCR clicks.]
[reporter.]
Just last week, a man walked into the pharmacy and demanded OxyContin.
He even said he had a gun.
Detectives were able to arrest him as he came out the front doors.
[Dan.]
Drugstores were being robbed.
Crazy things were happening.
They were even walking in, in daylight, and doing these types of things.
[M.
.]
I see the different crimes going on and I know it's because of addiction.
These are not bad people.
These are people that are in the most desperate state.
It's like starving to death.
You're going to do whatever you have to do to feed yourself, because you have to survive.
[Dan.]
I felt like this mayhem that was going on all was tied to Dr.
Cleggett.
And I tried to justify my actions with curtailing OxyContin at the drugstore, because I thought, if some of those people didn't come around our store, okay that we might be less likely to get robbed.
But my boss at my drugstore, Mr.
Claude, thought that I was overreacting and making judgments.
Mr.
Claude is concerned about me.
He knows that I've been talking about this doctor and this drug.
This is maybe what gets me in trouble.
I believe he's filling a lot of OxyContin prescriptions for people that he shouldn't be filling them for.
Danny and Mr.
Claude got into, like, a tension over the prescriptions 'cause OxyContin does make the pharmacy a lot of money.
He couldn't see filling all these prescriptions every day and not not do anything about it.
[Dan.]
Mr.
Claude would tell me, you know, "Don't feel complicit.
It's a legal prescription from a doctor.
" It was always about the doctors.
They knew best.
You start running into prescriptions that are very questionable, but it's not up to you to make the decision that this is the wrong thing to do.
I didn't see it that way.
As a pharmacist, I felt like it was my mission to make a difference.
[Dr.
Lutz.]
Pharmacists are in a position to know which physicians are prescribing appropriately and which physicians are prescribing inappropriately.
Dr.
Cleggett surely must have stood out as one who was not prescribing appropriately.
[mellow instrumentals continue.]
I was appointed Director of Health in 1983.
We were involved at that time in some drug abuse programs, because the abuse of prescription opioids became a problem.
There was a tremendous amount of attention given to pain in the late 1990s.
Most doctors in this country don't treat pain.
[man.]
If you're in pain, a lot of 'em accuse you of being a drug addict or or there to get high.
[woman.]
They started treating me as if I was really just coming to them because I wanted pain medication, I was a drug addict, and that's how they started treating me.
[woman 2.]
Don't accept it if they say, "You have to learn to live with the pain.
" Don't take that.
Find another doctor.
These drug companies came in and were much less interested in people establishing diagnoses.
Just doling out the prescriptions for their pain medications.
[spokesman.]
There's no need for anyone to suffer, because there are medications that work effectively on pain.
[Dan.]
I started thinking this was bigger than just this doctor in New Orleans East.
How in the hell did doctors around the country think this was a wonder drug and not addictive? What, what I saw It looked like over-the-counter heroin.
[Dr.
Spanos.]
Sadly, we've known for years in medicine that we in medicine are doing a very poor job of treating pain.
There's no question that our best, strongest pain medicines are the opioids.
But these are the same drugs that have a reputation for causing addiction and other terrible things.
[Dr.
Lembke.]
Prior to 1980, doctors were very reluctant to prescribe opioids because they were afraid their patients would get addicted, and for good reason.
This country had seen at least two prior opioid epidemics.
One that dated back to the Civil War when heroin was sold next to Bayer Aspirin as a pain reliever for infants.
Then we saw another opioid epidemic when our soldiers were coming back from the Vietnam War.
Many of them had gotten addicted to opium while they were in Vietnam.
[propellers whipping.]
Then, in the 1990s, prescribing more opioids became acquainted with being compassionate.
If you were really a compassionate doctor, you would prescribe opioids.
[Dr.
Spanos.]
These drugs which, I repeat, are our best, strongest pain medications, should be used much more than they are for patients in pain.
[Dr.
Spanos.]
Purdue Pharma and other opioid manufacturers very heavily advocated to doctors that opioid prescribing was safe as long as they were treating patients with pain.
That somehow, the prescription pad conferred this sort of magic halo effect and patients couldn't get addicted.
[Dr.
Spanos.]
The rate of addiction amongst pain patients who are treated by doctors is much less than 1%.
They said patients who are demonstrating all of the signs and symptoms of having become addicted to the opioid that the doctor is prescribing are not in fact addicted.
They're pseudo-addicted.
Pseudo-addiction is when a patient is looking like a drug addict, because they're pursuing pain relief.
If your patient looked like they were getting addicted, they weren't really addicted.
They were in pain.
You needed to give them more opioids.
Addiction is an uncontrolled, compulsive use of a drug, despite the fact that it's doing you harm.
Now that's different from physical dependence.
Physical dependence sounds bad, but all it means is that, if you stop using the drug, then you'll get a withdrawal symptom.
But it's clearly got nothing to do with addiction, because it doesn't have a psychological component.
[Dr.
Spanos.]
That's what doctors across the country were taught in the 1990s and early aughts.
[woman.]
From best practices of sales [Dan.]
Purdue Pharma actually trained their sales reps to actually go out and spread that message that we can alleviate these minor aches and pains that people have without any fear of addiction.
And that this drug was virtually non-addictive.
I didn't know shit about shit with pain medication.
I had no idea what the marketplace looked like.
I just knew that people were making money and I wanted to make money.
Who doesn't? Right? [tense instrumentals.]
I started working with Purdue Pharma in 1998.
After I was hired, we had an extensive training period at Purdue's corporate headquarters in Stamford, Connecticut.
Man, it was a lot of rah-rah.
[crowd cheers.]
[crowd applauds.]
The way it was pitched to us is that - the physicians, the medical fraternity, - [machine whirs.]
they need to know about what this medication can do for their patients.
You gotta remember, OxyContin, at this time, did not have a bad name.
Right? And so you could go in and you start talking to a physician that can see the benefits as I was giving it to him.
[clock ticks.]
We told them it's pain relief that will last 12 full hours.
And And the FDA has approved this language in our package insert, which says it has lower addictive properties.
The package insert is the little piece of paper that's folded up and you get it with every prescription in the pharmacy.
So when somebody would talk to me about, "Well, it's more addictive" "N-No.
" "I mean, Doc, you know what it takes to get stuff in this package insert.
" You have to submit everything to the FDA.
The FDA has gotta pore through it.
The FDA is gonna finally kiss it and put their blessing on it and now I have it.
They say, "Not true.
" [slaps lap sharply.]
Why wouldn't you use it? [mellow instrumentals.]
There were so many people in pain that could benefit from this medicine.
Coming out of training, I'm on fire for all this.
Certainly, these doctors will see the benefit of what I'm selling.
[Dr.
Lutz.]
I can remember, oftentime, I'd go out that door to go to lunch and I can remember the guy from Purdue standing right there, saying, "Oh, Dr.
Lutz, Dr.
Lutz, you've got to see this.
This is the pain pill your patients need.
They don't have to wake up during the night with pain.
They take it, it lasts for 12 hours.
OxyContin, long-acting.
" Almost like car salesmen.
[soft electronic music plays.]
[Dan.]
They sent representatives to go out to the doctors and even pharmacists.
We started having salesmen for Purdue Pharma come into our store.
And they were promoting the drug.
[Chris.]
Part of our job responsibility was to go in and call on pharmacists.
Just talking to them about the medication, just in case they get some questions and they knew how to consult patients that might have questions about it.
You know, give 'em some ink pens and notepads and all of that good, happy, crappy shit.
My district ranged all across south Louisiana.
We would go from Lake Charles to New Orleans.
The way that we would figure out who we were gonna target in our territory, who are we gonna try to convert um, from short-acting opioids to long-acting, because those are the That's the low-hanging fruit.
We would get the data in.
We would know who was writing.
And we would get their name and address.
It was always told to us that this was the most uh, comprehensive data that any company in the industry would could provide to their sales representatives.
I was doing good.
My numbers are growing.
I think they look great.
But we would be told every single day, "There's a next tier of rep.
" Like, "Do you want to go next level?" Because the territory rep in New Orleans East was making me look like I'm just a regular Old Joe.
You don't imagine New Orleans East as a destination for health.
But apparently it was for some people.
Because this rep was killing it.
We were told he was making close to $800,000 a year.
As a territory rep, that's It was unheard of.
His territory was gaining more prescriptions than any other territory in the entire United States of America.
As I would go through the data, 'cause it was delivered weekly to us I saw there was one physician in New Orleans East generating this extremely high level of prescriptions.
And, of course, my natural, you know, inclination is to say, "Let's go see this doctor.
" And we can't.
Because the sun is still in the sky.
And so you have to hang around a lot longer after the sun went down.
[scoffs.]
Okay, that's different hours for a doctor.
[cars passing.]
Let's take a look and see what the fuck is going on out there.
You know how somebody smells when they've been smoking cigarettes for three days and they haven't slept or showered? You know that smell? If you pull up in a parking lot and it smells like that [tense instrumentals.]
it really starts to make you think, "Man, something is not right in this equation.
" [pen scratches lightly.]
What I learned is it might be one doctor doing 95% of the prescriptions.
I don't have to be a good salesman to have a good territory.
I gotta have the right doctors.
[cars rushing past.]
I certainly didn't want to be connected to any illicit activities that could be going on.
Right? [stammers.]
I wanted to be free and clear of that.
Then, you know, you'd get a $35,000-$40,000 bonus check in a quarter.
Right? And you say, "Man" You know "Maybe I'll keep doing this for a little while.
Maybe it'll get better.
" [dramatic instrumentals.]
[cars rushing.]
[Dan.]
In our drugstore, we would read the death notices.
We had a list.
We called it the "death list.
" People that we anticipated were gonna die.
[slide clicks.]
And, believe it or not, we started checking off names.
[microfiche projector clicking.]
Everywhere you looked, people would experience how this was affecting us.
[crickets chirp.]
I talked to an EM that told me, "It's a nightmare," and he said "Our hospital emergency room, we can't get heart patients in, we can't get old people in right now.
We're full of overdoses.
" I can remember one incident on the news where a father lost his 17-year-old son by injecting him with OxyContin.
[reporter 1.]
Paul Breaux allegedly injected his son with two doses of OxyContin.
His son was found dead hours later.
He got those pills the same way most people do.
With a doctor's prescription.
Those prescription drugs were prescribed to him by a Dr.
Cleggett.
Jacqueline Cleggett, out of, uh, New Orleans East.
[M.
.]
I had many friends that overdosed.
They would find them, you know, at home in bed.
And they didn't want to die.
They just used.
They'll just start making what's called the death rattle.
When an opioid user takes too much, they begin trying to breathe and they make this noise and their eyes roll in the back of their head.
And I remember one of my girlfriends doing that.
We were slapping her face and throwing water on her to wake her up.
I've seen that happen a few times.
Very scary.
[reporter 2.]
On separate occasions, two women have fatally overdosed on OxyContin in the home of James Price.
Despite living in Mississippi, Price is a patient of Dr.
Cleggett.
- [mellow instrumentals.]
- [car rushes past.]
[Dan.]
It's an interesting situation, what some people think is insanity.
In Mr.
Claude's mind, I'm going overboard.
In my mind, I see kids dying right and left.
Now, in his mind, he thinks I see these kids dying because my son died.
Yes, it has something to do with my son dying, but these kids are dying.
[Chris.]
There was a rumor that there was a pharmacist who had lost his son tragically.
And he was making a lot of noise about Dr.
Cleggett.
And that's not good for business.
It's not good for business in my territory.
It's not good for business anywhere.
[Jack.]
The crime that was being committed was actually in Dan's profession, so the things that maybe he had just done through muscle training before, and that's filling those scripts and not paying a lot of attention to, he could no longer ignore.
He understood.
Particularly when he would hear that someone he filled a script for died of an overdose.
He knew that he was in that chain.
He was filling those scripts.
[tense instrumentals.]
[Dan.]
As a pharmacist, much less an employee, I have a responsibility for the well-being of my patients.
And nobody is inspired enough to take on Dr.
Jacqueline Cleggett.
So, I have to take a temporary leave of absence, because I definitely feel that I'm actually doing the things that a person should do to correct evils and problems.
It is a calling.
[reporter 3.]
Chalmette pharmacist Daniel Schneider says he's taking a leave of absence from his drugstore job to crusade against the illegal use of OxyContin.
[Dan.]
We have to educate them that these things are way more dangerous than they think they are.
[interviewer.]
OxyContin scares you that much? It scares me every bit that much.
In fact, it scares me worse than what my son died of.
[Dan.]
I was pretty much working full time at shutting Dr.
Cleggett down.
Whatever it took.
[Dan.]
It's an interesting situation because the DEA wants me to stay away from Cleggett completely and quit asking questions and quit talking to people.
They even almost threatened me not to go around her.
But I told them, "Well, sometimes, I just happen to pass that way.
" I'm on the way home and it's even almost not out of the way to just pass by Cleggett's office.
Which I fully well intend to do no matter what they've said.
Because a lot of innocent people are getting hurt.
And so, I think, in the overall scheme of things, it's the right thing to do.
[indistinct chatter.]
[Dan.]
Her operation was so incredible.
Why couldn't they shut her down? I didn't get it.
[Billy.]
You would think, "What a toothless agency, that you don't have mechanisms in place to be able to restrict this type of illegal prescribing.
" We do have mechanisms in place.
DEA builds a case, presents its evidence to the United States Attorney and they'll decide to bring a prosecution.
The Dr.
Cleggett case had been presented.
So I spoke with the United States Attorney.
I met great resistance and I couldn't understand it.
I asked them continually, "Why couldn't we go after this?" And they they said, "Well, doctors are a profession in American society that's held in very high esteem.
" They would all revert to, "The doctors are trained medical professionals.
They know what they're supposed to distribute.
You don't.
" [Iris.]
They weren't accustomed to prosecuting doctors.
Doctors were holy.
[Billy.]
We had to prove that the physicians had morphed from being caring physicians to nothing but dope dealers with white lab coats.
[Patricia.]
It wasn't like you were dealing with a crack dealer or somebody selling pills on the street.
But in reality, every day you don't take somebody like this off the street, you have the potential for more people to die.
The US Attorney kept sending DEA back and back and back to get more and more information.
[Patricia.]
There had to be a lot of really egregious things that you could prove or show to make a prosecutable case, you know, because this was new.
In my opinion the US Attorney's office was not moving fast enough.
They don't see people.
They don't see families destroyed by the opioid crisis.
They only read numbers, stats.
We were on the frontline.
We saw what the effects of the opioid crisis are.
[ambient instrumentals.]
[Dr.
Lembke.]
And then 2001 was really the year the media finally started talking about the fact that people were dying from OxyContin.
[mellow instrumentals.]
[Dan.]
Then, like a ton of bricks, Time magazine released this article reporting that St.
Bernard was one of the hotspots in the country for OxyContin abuse, in the entire nation.
[Patricia.]
St.
Bernard Parish, a community of 75,000 people, led the per capita overdose rate in Louisiana and in the southeast region and probably in a great portion of the United States at the time.
[crickets chirping.]
[Dr.
Lutz.]
There was national coverage, including Newsweek and Time magazine.
It was written in the Times-Picayune.
There were television exposés on it.
There is a prescription painkiller in the news today for all the wrong reasons.
OxyContin.
No new prescription drug in the last 20 years has been as widely abused as quickly as OxyContin.
[reporter 1.]
It is now the most heavily prescribed narcotic in the country.
Sales topped a billion dollars.
[reporter 2.]
Six million prescriptions for the legitimately suffering and, for thousands of others, an addictive nightmare.
[static crackles.]
[ambient instrumentals.]
[Chris.]
Around that time I remember calling on a doctor and I hand him one of the sales aids or whatever and, right in front of me, he just dumped it in the trash.
"Bye.
[slaps knee.]
That's what I think of this.
" [Dr.
Lembke.]
When the reports continued to come out Purdue executives testified before Congress about the OxyContin abuse problem.
My name is Paul Goldenheim.
I'm the senior physician at Purdue Pharma.
And, as you noted, its executive vice-president for research and development.
OxyContin is widely recognized as a highly-effective treatment for pain.
When properly used under the supervision of a physician, it is also an extremely safe medication.
Addiction is rare in the pain patient who is properly managed.
[Chris.]
We were told physicians that understood what this medication was, and the benefits of it, would give it to appropriate patients.
The appropriate patient is not the market.
[Paul.]
We've tried to teach doctors how to use these medicines appropriately.
We have never encouraged misuse or diversion.
There's some notion that because it's a pill manufactured by a pharmaceutical company, it's completely safe, even if you crush it and inject it and wash it down with a six-pack and snort some cocaine.
Where the growth Where the amazing growth and all the dollars that went to the company and went to the territory reps It came from physicians that were not doing the right thing.
Plain and simple.
We've never done anything that could remotely be suggested that it was a good idea for a criminal physician to sell a prescription.
The pharmaceutical opioid industry didn't overtly encourage pill mill doctors, but they certainly didn't do anything about them.
We had to make sure that we were always calling on, uh targets of opportunity, right? Management would have access to the data.
They would see the physicians that were high targets.
"Man, we really need to convert this person.
Let's go see them.
" We would call those people "whales," "monsters," "huge.
" And it was almost a bit of a bragging, uh, point.
It was pitched to me that Purdue spends more money compiling this data to give to representatives than any other company in the business.
[dramatic instrumentals.]
[Dan.]
In 2001, finally people started speaking out and yet nothing seemed to happen that reduced the problem.
Dr.
Cleggett was still out there.
I thought that the US Attorney was moving too slow.
So I personally went to her house and asked Dr.
Cleggett to surrender her controlled-substance license voluntarily.
Dr.
Cleggett's house was in disarray.
Of course, she was sleeping, because it was early morning.
Although we did wake her up, she still seemed, um, disoriented.
We suspected that she was using prescription pills herself.
[Robbie.]
I never witnessed her abusing the pills myself.
But there was talk in the waiting room that maybe Dr.
Cleggett had gotten caught up in the same system that her patients were caught up in.
But, you know, it's hearsay.
[Billy.]
Sometimes you can go to a doctor and say, "Doc, I think you're using drugs yourself and I think it's in your best interest to surrender your license right now.
You have the right to apply to have it returned.
once you seek treatment and help for yourself.
" Some of the doctors will say, "You know what? I am having problems," and will surrender their license.
And that happens more than you'd think.
[Iris.]
I knew that it would not be easy for her to give up her license.
And I also know that it's not an easy road to become a doctor.
So I talked to her woman to woman, profession to profession, explained to her the violations that she faced.
She understood.
She understood.
However, upon going towards her living room to get an ink pen and sign the DEA form, I mentioned her kids.
You know - [somber instrumentals.]
- she went down the, uh, row and explained one was going to college, one was 13 and the other one was ten.
And, uh then told me, no, she couldn't.
She had to pay for college.
[Patricia.]
She said, "I'm not signing that.
I'm not gonna do that.
" And she told them to get out, she was never surrendering her license.
They didn't have anything on her and just leave her alone, you know.
And she refused to surrender her DEA number.
[Dan.]
Nothing seemed to happen to reduce the problem.
[sighs.]
I'm at the wits' end right now.
[stammers.]
I really didn't know what to do.
[girl laughs.]
[continued laughing.]
This is the American statue.
- [Dan.]
That's enough.
- 1987.
[Dan.]
So, Danny boy, I love you.
I'm in your room.
[girl laughs.]
I'm looking at the Beatles.
[stammers.]
And, God, please help me and Annie Annie to have more faith in me [stammers.]
and help her support me.
[Dan.]
Will he make it to the other side? [yelling.]
Oh, Lord! Almost! [Dan.]
But, God, most of all, please, I need help in the direction that I take.
We need a break.
[Dan.]
And then I happened to be watching 20/20.
[Barbara Walters.]
Tonight, secret police tapes of young, healthy people lining up at the doctor's office.
[Dan.]
It was a segment about a doctor in Portsmouth, Ohio.
He had been arrested and charged with running a pill mill.
[reporter.]
Authorities say Dr.
Lilly wrote more than 4,000 bogus prescriptions, mostly for pain medications.
[Dan.]
I couldn't believe how similar he was to Cleggett and he had been taken down by one of the local prosecutors there.
[scoffs.]
I think it's an old story.
I think, uh, it's greed, pure and simple.
You could tell he was not examining patients in such an examination room.
[Dan.]
I wanted to find out what they had done, so I called the prosecutor on the case.
- [ringback tone.]
- [receiver clicks.]
[Rick on phone.]
Hello? - [Dan on phone.]
Yeah, Mr.
, uh, Brown? - Just call me Rick.
- [Dan.]
Okay, Rick, how are you? - Fine.
[Dan.]
Yeah, Rick, I'm calling about that case - that reached national prominence.
- [Rick chuckles.]
Yes.
[Dan.]
We have a situation down here.
I'm a pharmacist.
I'm not in law enforcement, although I'm I've been trying to help out law enforcement as much as I can.
- [Rick.]
Okay.
- And we have a doctor that, uh - seems to make your doctor look good.
- [Rick.]
What are the doctor's credentials? [Dan.]
You're not gonna believe this.
She was trained as a pediatrician.
[Rick.]
Well, well, well.
[Dan.]
Let me tell you what else she does.
If you come in and pay an extra $100, you get stat service.
[Rick.]
Okay, well, this guy [stammers.]
Okay, there must be a They must have this in a playbook, because this doctor had two lines.
One for refills, one for new patients.
[Dan.]
Wow.
[Dan.]
This prosecutor, he had seen them do some of the same things she did.
But he had never seen any of them that had a police department actually on their doorstep.
[Rick.]
Holy cow.
You've got a major problem.
[Dan.]
The FBI and the DEA have been involved also and they just seem to be either dragging their feet, they don't give a damn or [stammers.]
I don't understand what their problem is.
I really don't.
[Rick.]
Well, it's bureaucratic crap as near as I can make out.
We have that problem tremendously.
We have [stammers.]
[Dan.]
You even have You even have that problem? [Rick.]
Oh, crap, we have a local federal task force.
[Dan.]
So they tell you they're doing something and they're not? [Rick.]
They are not telling us what they're doing.
[stammers.]
If you can't cooperate with us, we've got a job to do.
[Dan.]
Exactly.
Which is the question I have to ask y'all.
What was the smoking gun? What's the key to getting a doctor like this? [Rick.]
The key is you need the cooperation of your medical board, who can go in at any time and ask to see the doctor's records.
[Dan.]
Well, good.
Look, I appreciate it.
I may be back in touch with you, but I do appreciate the information you've given me.
- And, uh, wish us luck.
- [Rick.]
Any time.
[Dan.]
He says, "I recommend that you go to the medical board and try to process it through the board.
" So, in April 2001, I wrote a letter outlining Dr.
Cleggett's procedures and my concerns.
[dramatic synth instrumentals.]
For approximately 19 years, I served as complaint counsel to the Louisiana Board of Medical Examiners.
One of the primary functions of the medical board is to make sure the physicians that they license are practicing appropriately.
And that means that if a complaint is filed with the board, then it is the board's authority to investigate that complaint for medical malpractice.
So that put me in the role of, uh, a prosecutor.
And my job is to round up the evidence.
We at DEA have to do a lot more than a medical board does in order to shut down a doctor.
The medical board can do something administratively.
With DEA, we have to prove without a doubt that something has occurred criminally.
[Dr.
Lutz.]
All of a sudden [chuckles.]
this big box of these records shows up.
I call it my "Cleggett file.
" If the state board of medical examiners is suspending somebody's license, they need someone to review the records and give an opinion.
Every profession has a few bad apples.
The problem in medicine is that one bad apple can write hundreds and hundreds of prescriptions.
[George.]
I knew that, in order to proceed with a summary suspension, I would need lead pipe material.
I felt that a licensed pharmacist would have instant credibility with the board.
[Dan.]
It's around Christmas time, I believe, and George Papale calls me and says, "Do you want to get involved in this?" I said, "Amen, I sure do.
" [George.]
He was very grateful, uh and invited me to come to his house for a more in-depth discussion about what had gone on.
My goodness, there were boxes and boxes of materials and videos, and he He couldn't move fast enough.
He was trying to talk and show me things.
He said, "Look, you've got a wealth of information, but, you know you really kinda need a smoking gun.
" And I realized I'm out of the loop.
The only way that I can get back in the loop, I had to go to work back at Bradley's.
[dialing.]
[ringback tone.]
[answering machine chirps.]
[Dan over phone.]
Mr.
Claude, you know, I pray that you want me back.
Uh And hopefully we can work it out, come to some resolution as to how to proceed and what maybe I should do and what I shouldn't do.
So we'll discuss this and we'll see how everything goes.
God bless.
[phone line clicks.]
[mellow instrumentals.]
[Dan.]
I talked to Mr.
Claude at my drugstore.
And we have a heart-to-heart talk.
He says, "Danny, I'm not gonna force you to fill Dr.
Cleggett's prescriptions.
But you can't be questioning all the patients about Dr.
Cleggett.
" [car rushes past.]
So, with some agreements not to hassle the patients, I go back to work at Bradley's Pharmacy.
[Dan.]
I've gotta be careful at the store as to what I say.
However, that doesn't mean I have to be completely quiet.
I do believe that, in some sort of way, some proof will come to me to stop Dr.
Cleggett.
[Dan.]
Part of my agreement was that I leave my tape recorder at home.
But I didn't really do that.
- [Dan.]
Rebecca? - [Rebecca.]
Uh-huh.
[Dan.]
How are you doing? You're a little too soon.
I don't know.
They're supposed to last 22 days and it's, like, been 15.
- When did you see Cleggett? - [Rebecca.]
Yesterday.
Doctor probably shouldn't have gave you these this soon.
[Rebecca.]
Yeah, well, I had a real, real bad surgery.
- Did you? - [Rebecca.]
Yeah.
[Dan.]
Even still, what you have to do now If you have to take 'em more often you've got to get her to write that.
I'm pretty much biding my time, you know, tolerating some of this stuff, okay? And all of a sudden a girl, who appears to be about 16 years of age she comes skipping in the store.
She's actually skipping.
And the mother presents a stack of prescriptions.
She says, "My daughter's got sickle cell and she's really in great pain.
" I look at the prescriptions and it's OxyContin, 80 mg.
Eighty milligrams! This kid weighs 100 pounds! Soma, 100.
Valium, 100.
And roxicodone, which is a short-acting opiate.
These prescriptions surely could have killed this girl.
- I delay the lady a little bit.
- [door rattles.]
I make copies of the prescription and I go out and talk to her.
She's trying to talk me into filling the prescriptions.
I'm not gonna fill these prescriptions.
And I give them back, because they don't want to wait.
It's kind of crazy.
But, unfortunately, I didn't bring my recorder that day.
So I've got to do this right.
I've got to be smart.
I've gotta make sure that Dr.
Cleggett admits she wrote these prescriptions.
Because sure as I try to nail her on it, she's going to say they're forgeries.
[dramatic instrumentals.]
[dial tone.]
So, I called Dr.
Cleggett.
[dialing.]
My adrenaline was really pumping.
This was the chance at the smoking gun that we needed to shut her down.
I gave the child's name.
And I said, "Did you write these prescriptions?" "I certainly did.
" I said, "Well, Dr.
Cleggett, this is a definite overdose.
" She says, "Who the fuck made you a doctor?" [sighs.]
Then she hung up.
[sniffles.]
[voice shaking.]
Smoking gun.
[sniffles.]
[car rushes past.]
I called George Papale.
I said, "George let me tell you about this situation.
" [spirited instrumentals.]
[George.]
Dan Schneider talked to the young lady's physician who had treated her for her illness in the hospital and had discharged her on Tylenol.
As opposed to this huge amount of OxyContin and other medications prescribed by Dr.
Cleggett.
[Dan.]
As soon as the medical board received this affidavit they did verify my concerns with a Dr.
Brobson Lutz.
[Dr.
Lutz.]
Eighty milligram OxyContin for her initial visit.
"To take one or two every 12 hours.
" That's a tremendous dose.
You would never start anybody out on a dose like that.
There is no way that Dr.
Cleggett could have really thought that she was practicing good medicine.
When he put that in an affidavit, if there ever was a smoking gun, that was it.
He says, "Dan I think this just might do it.
" [dramatic instrumentals.]
The medical board sent SUVs there with the St.
Bernard Parish police the DEA [indistinct police radio chatter.]
[Iris.]
Dan Schneider was the linchpin.
As crazy and as out of control as this guy was, he got results.
[George.]
The desk was piled high with tens and twenty-dollar bills in big stacks.
There were stacks and stacks of prescriptions that had already been signed by Dr.
Cleggett and were only awaiting somebody to put the date and the patient's name on the prescription.
When they served Dr.
Cleggett with the summary suspension order, she was not happy about it.
She was mad as a hornet.
She said, "DEA, NOPD, task force, whoever you are, you're dead.
" She literally threatened federal agents.
That was pretty unusual, yes.
Pretty unusual.
[George.]
It was very clear to us that she was not gonna let this go without a major defense and attack.
[dramatic instrumentals crescendo.]
[static crackles.]
[indistinct chatter.]
- [crew member.]
Here's your water.
- Uh-huh.
[crew member.]
When you need it.
I'm gonna put Let me just take one little, quick glance at that.
[crew member.]
And then tissues are going be right here, too, okay? Okay.
[dramatic music playing.]
[ambient instrumentals.]
[Dan.]
Man, damn, I don't I don't believe this.
I'm losing it.
[chuckling.]
I'm losing it big time, okay? Maybe I dreamed this up, you know? Uh, you know, so I'm I'm not trusting myself at this point in time.
[Dan.]
It's Thursday.
This is important because, uh I'm gonna blow up, because my mind went into paranoia.
I really do believe I crossed the edge.
When I start discussing that I have a purpose, I do rise up to a certain level.
It's when I go beyond that level that I start not functioning totally perfectly.
So help me, God, to think at a good level.
But not go into the paranoia level because I'm losing it.
How couldn't everybody see what was going on? That's what we couldn't understand.
I mean, you know, some people had labeled Danny as crazy, but he went to the FBI, the DEA, you know, local law enforcement, all this, and nothing was happening, so who's crazy here? [Dan.]
I was constantly thinking the DEA and FBI was either incompetent or in cahoots with this doctor.
[truck hums past.]
[Iris.]
One of the reasons the investigation took so long was because we had to go from pharmacy to pharmacy to find the prescriptions written by Dr.
Cleggett.
[Patricia.]
There was no prescription monitoring program.
So you'd have to hunt and peck all around the city and the suburbs to find where all of these patients were going to fill these prescriptions.
[Iris.]
You can spend an entire day, uh, or two, at a pharmacy, picking prescriptions that Dr.
Cleggett wrote.
We found that Dr.
Cleggett prescribed 180,000 OxyContin pills within one year.
And that was only ten pharmacies.
We suddenly realized that it's very likely she was writing millions of pills.
We were experiencing an overdose rate that was just out of control.
[Iris.]
During that time, I saw young people dead from overdose.
Really troubling to me.
I have a son myself.
And I would not wish that on anybody.
[sirens wail.]
[Jack.]
When it spiked, it spiked.
It wasn't like it was a gradual sort of thing.
It just seemed like it just started happening right away.
[dramatic instrumentals.]
[Iris.]
Dr.
Cleggett was making St.
Bernard Parish ground zero for overdoses.
[mechanical clicking and whirring.]
[mellow instrumentals.]
[VCR clicks.]
[reporter.]
Just last week, a man walked into the pharmacy and demanded OxyContin.
He even said he had a gun.
Detectives were able to arrest him as he came out the front doors.
[Dan.]
Drugstores were being robbed.
Crazy things were happening.
They were even walking in, in daylight, and doing these types of things.
[M.
.]
I see the different crimes going on and I know it's because of addiction.
These are not bad people.
These are people that are in the most desperate state.
It's like starving to death.
You're going to do whatever you have to do to feed yourself, because you have to survive.
[Dan.]
I felt like this mayhem that was going on all was tied to Dr.
Cleggett.
And I tried to justify my actions with curtailing OxyContin at the drugstore, because I thought, if some of those people didn't come around our store, okay that we might be less likely to get robbed.
But my boss at my drugstore, Mr.
Claude, thought that I was overreacting and making judgments.
Mr.
Claude is concerned about me.
He knows that I've been talking about this doctor and this drug.
This is maybe what gets me in trouble.
I believe he's filling a lot of OxyContin prescriptions for people that he shouldn't be filling them for.
Danny and Mr.
Claude got into, like, a tension over the prescriptions 'cause OxyContin does make the pharmacy a lot of money.
He couldn't see filling all these prescriptions every day and not not do anything about it.
[Dan.]
Mr.
Claude would tell me, you know, "Don't feel complicit.
It's a legal prescription from a doctor.
" It was always about the doctors.
They knew best.
You start running into prescriptions that are very questionable, but it's not up to you to make the decision that this is the wrong thing to do.
I didn't see it that way.
As a pharmacist, I felt like it was my mission to make a difference.
[Dr.
Lutz.]
Pharmacists are in a position to know which physicians are prescribing appropriately and which physicians are prescribing inappropriately.
Dr.
Cleggett surely must have stood out as one who was not prescribing appropriately.
[mellow instrumentals continue.]
I was appointed Director of Health in 1983.
We were involved at that time in some drug abuse programs, because the abuse of prescription opioids became a problem.
There was a tremendous amount of attention given to pain in the late 1990s.
Most doctors in this country don't treat pain.
[man.]
If you're in pain, a lot of 'em accuse you of being a drug addict or or there to get high.
[woman.]
They started treating me as if I was really just coming to them because I wanted pain medication, I was a drug addict, and that's how they started treating me.
[woman 2.]
Don't accept it if they say, "You have to learn to live with the pain.
" Don't take that.
Find another doctor.
These drug companies came in and were much less interested in people establishing diagnoses.
Just doling out the prescriptions for their pain medications.
[spokesman.]
There's no need for anyone to suffer, because there are medications that work effectively on pain.
[Dan.]
I started thinking this was bigger than just this doctor in New Orleans East.
How in the hell did doctors around the country think this was a wonder drug and not addictive? What, what I saw It looked like over-the-counter heroin.
[Dr.
Spanos.]
Sadly, we've known for years in medicine that we in medicine are doing a very poor job of treating pain.
There's no question that our best, strongest pain medicines are the opioids.
But these are the same drugs that have a reputation for causing addiction and other terrible things.
[Dr.
Lembke.]
Prior to 1980, doctors were very reluctant to prescribe opioids because they were afraid their patients would get addicted, and for good reason.
This country had seen at least two prior opioid epidemics.
One that dated back to the Civil War when heroin was sold next to Bayer Aspirin as a pain reliever for infants.
Then we saw another opioid epidemic when our soldiers were coming back from the Vietnam War.
Many of them had gotten addicted to opium while they were in Vietnam.
[propellers whipping.]
Then, in the 1990s, prescribing more opioids became acquainted with being compassionate.
If you were really a compassionate doctor, you would prescribe opioids.
[Dr.
Spanos.]
These drugs which, I repeat, are our best, strongest pain medications, should be used much more than they are for patients in pain.
[Dr.
Spanos.]
Purdue Pharma and other opioid manufacturers very heavily advocated to doctors that opioid prescribing was safe as long as they were treating patients with pain.
That somehow, the prescription pad conferred this sort of magic halo effect and patients couldn't get addicted.
[Dr.
Spanos.]
The rate of addiction amongst pain patients who are treated by doctors is much less than 1%.
They said patients who are demonstrating all of the signs and symptoms of having become addicted to the opioid that the doctor is prescribing are not in fact addicted.
They're pseudo-addicted.
Pseudo-addiction is when a patient is looking like a drug addict, because they're pursuing pain relief.
If your patient looked like they were getting addicted, they weren't really addicted.
They were in pain.
You needed to give them more opioids.
Addiction is an uncontrolled, compulsive use of a drug, despite the fact that it's doing you harm.
Now that's different from physical dependence.
Physical dependence sounds bad, but all it means is that, if you stop using the drug, then you'll get a withdrawal symptom.
But it's clearly got nothing to do with addiction, because it doesn't have a psychological component.
[Dr.
Spanos.]
That's what doctors across the country were taught in the 1990s and early aughts.
[woman.]
From best practices of sales [Dan.]
Purdue Pharma actually trained their sales reps to actually go out and spread that message that we can alleviate these minor aches and pains that people have without any fear of addiction.
And that this drug was virtually non-addictive.
I didn't know shit about shit with pain medication.
I had no idea what the marketplace looked like.
I just knew that people were making money and I wanted to make money.
Who doesn't? Right? [tense instrumentals.]
I started working with Purdue Pharma in 1998.
After I was hired, we had an extensive training period at Purdue's corporate headquarters in Stamford, Connecticut.
Man, it was a lot of rah-rah.
[crowd cheers.]
[crowd applauds.]
The way it was pitched to us is that - the physicians, the medical fraternity, - [machine whirs.]
they need to know about what this medication can do for their patients.
You gotta remember, OxyContin, at this time, did not have a bad name.
Right? And so you could go in and you start talking to a physician that can see the benefits as I was giving it to him.
[clock ticks.]
We told them it's pain relief that will last 12 full hours.
And And the FDA has approved this language in our package insert, which says it has lower addictive properties.
The package insert is the little piece of paper that's folded up and you get it with every prescription in the pharmacy.
So when somebody would talk to me about, "Well, it's more addictive" "N-No.
" "I mean, Doc, you know what it takes to get stuff in this package insert.
" You have to submit everything to the FDA.
The FDA has gotta pore through it.
The FDA is gonna finally kiss it and put their blessing on it and now I have it.
They say, "Not true.
" [slaps lap sharply.]
Why wouldn't you use it? [mellow instrumentals.]
There were so many people in pain that could benefit from this medicine.
Coming out of training, I'm on fire for all this.
Certainly, these doctors will see the benefit of what I'm selling.
[Dr.
Lutz.]
I can remember, oftentime, I'd go out that door to go to lunch and I can remember the guy from Purdue standing right there, saying, "Oh, Dr.
Lutz, Dr.
Lutz, you've got to see this.
This is the pain pill your patients need.
They don't have to wake up during the night with pain.
They take it, it lasts for 12 hours.
OxyContin, long-acting.
" Almost like car salesmen.
[soft electronic music plays.]
[Dan.]
They sent representatives to go out to the doctors and even pharmacists.
We started having salesmen for Purdue Pharma come into our store.
And they were promoting the drug.
[Chris.]
Part of our job responsibility was to go in and call on pharmacists.
Just talking to them about the medication, just in case they get some questions and they knew how to consult patients that might have questions about it.
You know, give 'em some ink pens and notepads and all of that good, happy, crappy shit.
My district ranged all across south Louisiana.
We would go from Lake Charles to New Orleans.
The way that we would figure out who we were gonna target in our territory, who are we gonna try to convert um, from short-acting opioids to long-acting, because those are the That's the low-hanging fruit.
We would get the data in.
We would know who was writing.
And we would get their name and address.
It was always told to us that this was the most uh, comprehensive data that any company in the industry would could provide to their sales representatives.
I was doing good.
My numbers are growing.
I think they look great.
But we would be told every single day, "There's a next tier of rep.
" Like, "Do you want to go next level?" Because the territory rep in New Orleans East was making me look like I'm just a regular Old Joe.
You don't imagine New Orleans East as a destination for health.
But apparently it was for some people.
Because this rep was killing it.
We were told he was making close to $800,000 a year.
As a territory rep, that's It was unheard of.
His territory was gaining more prescriptions than any other territory in the entire United States of America.
As I would go through the data, 'cause it was delivered weekly to us I saw there was one physician in New Orleans East generating this extremely high level of prescriptions.
And, of course, my natural, you know, inclination is to say, "Let's go see this doctor.
" And we can't.
Because the sun is still in the sky.
And so you have to hang around a lot longer after the sun went down.
[scoffs.]
Okay, that's different hours for a doctor.
[cars passing.]
Let's take a look and see what the fuck is going on out there.
You know how somebody smells when they've been smoking cigarettes for three days and they haven't slept or showered? You know that smell? If you pull up in a parking lot and it smells like that [tense instrumentals.]
it really starts to make you think, "Man, something is not right in this equation.
" [pen scratches lightly.]
What I learned is it might be one doctor doing 95% of the prescriptions.
I don't have to be a good salesman to have a good territory.
I gotta have the right doctors.
[cars rushing past.]
I certainly didn't want to be connected to any illicit activities that could be going on.
Right? [stammers.]
I wanted to be free and clear of that.
Then, you know, you'd get a $35,000-$40,000 bonus check in a quarter.
Right? And you say, "Man" You know "Maybe I'll keep doing this for a little while.
Maybe it'll get better.
" [dramatic instrumentals.]
[cars rushing.]
[Dan.]
In our drugstore, we would read the death notices.
We had a list.
We called it the "death list.
" People that we anticipated were gonna die.
[slide clicks.]
And, believe it or not, we started checking off names.
[microfiche projector clicking.]
Everywhere you looked, people would experience how this was affecting us.
[crickets chirp.]
I talked to an EM that told me, "It's a nightmare," and he said "Our hospital emergency room, we can't get heart patients in, we can't get old people in right now.
We're full of overdoses.
" I can remember one incident on the news where a father lost his 17-year-old son by injecting him with OxyContin.
[reporter 1.]
Paul Breaux allegedly injected his son with two doses of OxyContin.
His son was found dead hours later.
He got those pills the same way most people do.
With a doctor's prescription.
Those prescription drugs were prescribed to him by a Dr.
Cleggett.
Jacqueline Cleggett, out of, uh, New Orleans East.
[M.
.]
I had many friends that overdosed.
They would find them, you know, at home in bed.
And they didn't want to die.
They just used.
They'll just start making what's called the death rattle.
When an opioid user takes too much, they begin trying to breathe and they make this noise and their eyes roll in the back of their head.
And I remember one of my girlfriends doing that.
We were slapping her face and throwing water on her to wake her up.
I've seen that happen a few times.
Very scary.
[reporter 2.]
On separate occasions, two women have fatally overdosed on OxyContin in the home of James Price.
Despite living in Mississippi, Price is a patient of Dr.
Cleggett.
- [mellow instrumentals.]
- [car rushes past.]
[Dan.]
It's an interesting situation, what some people think is insanity.
In Mr.
Claude's mind, I'm going overboard.
In my mind, I see kids dying right and left.
Now, in his mind, he thinks I see these kids dying because my son died.
Yes, it has something to do with my son dying, but these kids are dying.
[Chris.]
There was a rumor that there was a pharmacist who had lost his son tragically.
And he was making a lot of noise about Dr.
Cleggett.
And that's not good for business.
It's not good for business in my territory.
It's not good for business anywhere.
[Jack.]
The crime that was being committed was actually in Dan's profession, so the things that maybe he had just done through muscle training before, and that's filling those scripts and not paying a lot of attention to, he could no longer ignore.
He understood.
Particularly when he would hear that someone he filled a script for died of an overdose.
He knew that he was in that chain.
He was filling those scripts.
[tense instrumentals.]
[Dan.]
As a pharmacist, much less an employee, I have a responsibility for the well-being of my patients.
And nobody is inspired enough to take on Dr.
Jacqueline Cleggett.
So, I have to take a temporary leave of absence, because I definitely feel that I'm actually doing the things that a person should do to correct evils and problems.
It is a calling.
[reporter 3.]
Chalmette pharmacist Daniel Schneider says he's taking a leave of absence from his drugstore job to crusade against the illegal use of OxyContin.
[Dan.]
We have to educate them that these things are way more dangerous than they think they are.
[interviewer.]
OxyContin scares you that much? It scares me every bit that much.
In fact, it scares me worse than what my son died of.
[Dan.]
I was pretty much working full time at shutting Dr.
Cleggett down.
Whatever it took.
[Dan.]
It's an interesting situation because the DEA wants me to stay away from Cleggett completely and quit asking questions and quit talking to people.
They even almost threatened me not to go around her.
But I told them, "Well, sometimes, I just happen to pass that way.
" I'm on the way home and it's even almost not out of the way to just pass by Cleggett's office.
Which I fully well intend to do no matter what they've said.
Because a lot of innocent people are getting hurt.
And so, I think, in the overall scheme of things, it's the right thing to do.
[indistinct chatter.]
[Dan.]
Her operation was so incredible.
Why couldn't they shut her down? I didn't get it.
[Billy.]
You would think, "What a toothless agency, that you don't have mechanisms in place to be able to restrict this type of illegal prescribing.
" We do have mechanisms in place.
DEA builds a case, presents its evidence to the United States Attorney and they'll decide to bring a prosecution.
The Dr.
Cleggett case had been presented.
So I spoke with the United States Attorney.
I met great resistance and I couldn't understand it.
I asked them continually, "Why couldn't we go after this?" And they they said, "Well, doctors are a profession in American society that's held in very high esteem.
" They would all revert to, "The doctors are trained medical professionals.
They know what they're supposed to distribute.
You don't.
" [Iris.]
They weren't accustomed to prosecuting doctors.
Doctors were holy.
[Billy.]
We had to prove that the physicians had morphed from being caring physicians to nothing but dope dealers with white lab coats.
[Patricia.]
It wasn't like you were dealing with a crack dealer or somebody selling pills on the street.
But in reality, every day you don't take somebody like this off the street, you have the potential for more people to die.
The US Attorney kept sending DEA back and back and back to get more and more information.
[Patricia.]
There had to be a lot of really egregious things that you could prove or show to make a prosecutable case, you know, because this was new.
In my opinion the US Attorney's office was not moving fast enough.
They don't see people.
They don't see families destroyed by the opioid crisis.
They only read numbers, stats.
We were on the frontline.
We saw what the effects of the opioid crisis are.
[ambient instrumentals.]
[Dr.
Lembke.]
And then 2001 was really the year the media finally started talking about the fact that people were dying from OxyContin.
[mellow instrumentals.]
[Dan.]
Then, like a ton of bricks, Time magazine released this article reporting that St.
Bernard was one of the hotspots in the country for OxyContin abuse, in the entire nation.
[Patricia.]
St.
Bernard Parish, a community of 75,000 people, led the per capita overdose rate in Louisiana and in the southeast region and probably in a great portion of the United States at the time.
[crickets chirping.]
[Dr.
Lutz.]
There was national coverage, including Newsweek and Time magazine.
It was written in the Times-Picayune.
There were television exposés on it.
There is a prescription painkiller in the news today for all the wrong reasons.
OxyContin.
No new prescription drug in the last 20 years has been as widely abused as quickly as OxyContin.
[reporter 1.]
It is now the most heavily prescribed narcotic in the country.
Sales topped a billion dollars.
[reporter 2.]
Six million prescriptions for the legitimately suffering and, for thousands of others, an addictive nightmare.
[static crackles.]
[ambient instrumentals.]
[Chris.]
Around that time I remember calling on a doctor and I hand him one of the sales aids or whatever and, right in front of me, he just dumped it in the trash.
"Bye.
[slaps knee.]
That's what I think of this.
" [Dr.
Lembke.]
When the reports continued to come out Purdue executives testified before Congress about the OxyContin abuse problem.
My name is Paul Goldenheim.
I'm the senior physician at Purdue Pharma.
And, as you noted, its executive vice-president for research and development.
OxyContin is widely recognized as a highly-effective treatment for pain.
When properly used under the supervision of a physician, it is also an extremely safe medication.
Addiction is rare in the pain patient who is properly managed.
[Chris.]
We were told physicians that understood what this medication was, and the benefits of it, would give it to appropriate patients.
The appropriate patient is not the market.
[Paul.]
We've tried to teach doctors how to use these medicines appropriately.
We have never encouraged misuse or diversion.
There's some notion that because it's a pill manufactured by a pharmaceutical company, it's completely safe, even if you crush it and inject it and wash it down with a six-pack and snort some cocaine.
Where the growth Where the amazing growth and all the dollars that went to the company and went to the territory reps It came from physicians that were not doing the right thing.
Plain and simple.
We've never done anything that could remotely be suggested that it was a good idea for a criminal physician to sell a prescription.
The pharmaceutical opioid industry didn't overtly encourage pill mill doctors, but they certainly didn't do anything about them.
We had to make sure that we were always calling on, uh targets of opportunity, right? Management would have access to the data.
They would see the physicians that were high targets.
"Man, we really need to convert this person.
Let's go see them.
" We would call those people "whales," "monsters," "huge.
" And it was almost a bit of a bragging, uh, point.
It was pitched to me that Purdue spends more money compiling this data to give to representatives than any other company in the business.
[dramatic instrumentals.]
[Dan.]
In 2001, finally people started speaking out and yet nothing seemed to happen that reduced the problem.
Dr.
Cleggett was still out there.
I thought that the US Attorney was moving too slow.
So I personally went to her house and asked Dr.
Cleggett to surrender her controlled-substance license voluntarily.
Dr.
Cleggett's house was in disarray.
Of course, she was sleeping, because it was early morning.
Although we did wake her up, she still seemed, um, disoriented.
We suspected that she was using prescription pills herself.
[Robbie.]
I never witnessed her abusing the pills myself.
But there was talk in the waiting room that maybe Dr.
Cleggett had gotten caught up in the same system that her patients were caught up in.
But, you know, it's hearsay.
[Billy.]
Sometimes you can go to a doctor and say, "Doc, I think you're using drugs yourself and I think it's in your best interest to surrender your license right now.
You have the right to apply to have it returned.
once you seek treatment and help for yourself.
" Some of the doctors will say, "You know what? I am having problems," and will surrender their license.
And that happens more than you'd think.
[Iris.]
I knew that it would not be easy for her to give up her license.
And I also know that it's not an easy road to become a doctor.
So I talked to her woman to woman, profession to profession, explained to her the violations that she faced.
She understood.
She understood.
However, upon going towards her living room to get an ink pen and sign the DEA form, I mentioned her kids.
You know - [somber instrumentals.]
- she went down the, uh, row and explained one was going to college, one was 13 and the other one was ten.
And, uh then told me, no, she couldn't.
She had to pay for college.
[Patricia.]
She said, "I'm not signing that.
I'm not gonna do that.
" And she told them to get out, she was never surrendering her license.
They didn't have anything on her and just leave her alone, you know.
And she refused to surrender her DEA number.
[Dan.]
Nothing seemed to happen to reduce the problem.
[sighs.]
I'm at the wits' end right now.
[stammers.]
I really didn't know what to do.
[girl laughs.]
[continued laughing.]
This is the American statue.
- [Dan.]
That's enough.
- 1987.
[Dan.]
So, Danny boy, I love you.
I'm in your room.
[girl laughs.]
I'm looking at the Beatles.
[stammers.]
And, God, please help me and Annie Annie to have more faith in me [stammers.]
and help her support me.
[Dan.]
Will he make it to the other side? [yelling.]
Oh, Lord! Almost! [Dan.]
But, God, most of all, please, I need help in the direction that I take.
We need a break.
[Dan.]
And then I happened to be watching 20/20.
[Barbara Walters.]
Tonight, secret police tapes of young, healthy people lining up at the doctor's office.
[Dan.]
It was a segment about a doctor in Portsmouth, Ohio.
He had been arrested and charged with running a pill mill.
[reporter.]
Authorities say Dr.
Lilly wrote more than 4,000 bogus prescriptions, mostly for pain medications.
[Dan.]
I couldn't believe how similar he was to Cleggett and he had been taken down by one of the local prosecutors there.
[scoffs.]
I think it's an old story.
I think, uh, it's greed, pure and simple.
You could tell he was not examining patients in such an examination room.
[Dan.]
I wanted to find out what they had done, so I called the prosecutor on the case.
- [ringback tone.]
- [receiver clicks.]
[Rick on phone.]
Hello? - [Dan on phone.]
Yeah, Mr.
, uh, Brown? - Just call me Rick.
- [Dan.]
Okay, Rick, how are you? - Fine.
[Dan.]
Yeah, Rick, I'm calling about that case - that reached national prominence.
- [Rick chuckles.]
Yes.
[Dan.]
We have a situation down here.
I'm a pharmacist.
I'm not in law enforcement, although I'm I've been trying to help out law enforcement as much as I can.
- [Rick.]
Okay.
- And we have a doctor that, uh - seems to make your doctor look good.
- [Rick.]
What are the doctor's credentials? [Dan.]
You're not gonna believe this.
She was trained as a pediatrician.
[Rick.]
Well, well, well.
[Dan.]
Let me tell you what else she does.
If you come in and pay an extra $100, you get stat service.
[Rick.]
Okay, well, this guy [stammers.]
Okay, there must be a They must have this in a playbook, because this doctor had two lines.
One for refills, one for new patients.
[Dan.]
Wow.
[Dan.]
This prosecutor, he had seen them do some of the same things she did.
But he had never seen any of them that had a police department actually on their doorstep.
[Rick.]
Holy cow.
You've got a major problem.
[Dan.]
The FBI and the DEA have been involved also and they just seem to be either dragging their feet, they don't give a damn or [stammers.]
I don't understand what their problem is.
I really don't.
[Rick.]
Well, it's bureaucratic crap as near as I can make out.
We have that problem tremendously.
We have [stammers.]
[Dan.]
You even have You even have that problem? [Rick.]
Oh, crap, we have a local federal task force.
[Dan.]
So they tell you they're doing something and they're not? [Rick.]
They are not telling us what they're doing.
[stammers.]
If you can't cooperate with us, we've got a job to do.
[Dan.]
Exactly.
Which is the question I have to ask y'all.
What was the smoking gun? What's the key to getting a doctor like this? [Rick.]
The key is you need the cooperation of your medical board, who can go in at any time and ask to see the doctor's records.
[Dan.]
Well, good.
Look, I appreciate it.
I may be back in touch with you, but I do appreciate the information you've given me.
- And, uh, wish us luck.
- [Rick.]
Any time.
[Dan.]
He says, "I recommend that you go to the medical board and try to process it through the board.
" So, in April 2001, I wrote a letter outlining Dr.
Cleggett's procedures and my concerns.
[dramatic synth instrumentals.]
For approximately 19 years, I served as complaint counsel to the Louisiana Board of Medical Examiners.
One of the primary functions of the medical board is to make sure the physicians that they license are practicing appropriately.
And that means that if a complaint is filed with the board, then it is the board's authority to investigate that complaint for medical malpractice.
So that put me in the role of, uh, a prosecutor.
And my job is to round up the evidence.
We at DEA have to do a lot more than a medical board does in order to shut down a doctor.
The medical board can do something administratively.
With DEA, we have to prove without a doubt that something has occurred criminally.
[Dr.
Lutz.]
All of a sudden [chuckles.]
this big box of these records shows up.
I call it my "Cleggett file.
" If the state board of medical examiners is suspending somebody's license, they need someone to review the records and give an opinion.
Every profession has a few bad apples.
The problem in medicine is that one bad apple can write hundreds and hundreds of prescriptions.
[George.]
I knew that, in order to proceed with a summary suspension, I would need lead pipe material.
I felt that a licensed pharmacist would have instant credibility with the board.
[Dan.]
It's around Christmas time, I believe, and George Papale calls me and says, "Do you want to get involved in this?" I said, "Amen, I sure do.
" [George.]
He was very grateful, uh and invited me to come to his house for a more in-depth discussion about what had gone on.
My goodness, there were boxes and boxes of materials and videos, and he He couldn't move fast enough.
He was trying to talk and show me things.
He said, "Look, you've got a wealth of information, but, you know you really kinda need a smoking gun.
" And I realized I'm out of the loop.
The only way that I can get back in the loop, I had to go to work back at Bradley's.
[dialing.]
[ringback tone.]
[answering machine chirps.]
[Dan over phone.]
Mr.
Claude, you know, I pray that you want me back.
Uh And hopefully we can work it out, come to some resolution as to how to proceed and what maybe I should do and what I shouldn't do.
So we'll discuss this and we'll see how everything goes.
God bless.
[phone line clicks.]
[mellow instrumentals.]
[Dan.]
I talked to Mr.
Claude at my drugstore.
And we have a heart-to-heart talk.
He says, "Danny, I'm not gonna force you to fill Dr.
Cleggett's prescriptions.
But you can't be questioning all the patients about Dr.
Cleggett.
" [car rushes past.]
So, with some agreements not to hassle the patients, I go back to work at Bradley's Pharmacy.
[Dan.]
I've gotta be careful at the store as to what I say.
However, that doesn't mean I have to be completely quiet.
I do believe that, in some sort of way, some proof will come to me to stop Dr.
Cleggett.
[Dan.]
Part of my agreement was that I leave my tape recorder at home.
But I didn't really do that.
- [Dan.]
Rebecca? - [Rebecca.]
Uh-huh.
[Dan.]
How are you doing? You're a little too soon.
I don't know.
They're supposed to last 22 days and it's, like, been 15.
- When did you see Cleggett? - [Rebecca.]
Yesterday.
Doctor probably shouldn't have gave you these this soon.
[Rebecca.]
Yeah, well, I had a real, real bad surgery.
- Did you? - [Rebecca.]
Yeah.
[Dan.]
Even still, what you have to do now If you have to take 'em more often you've got to get her to write that.
I'm pretty much biding my time, you know, tolerating some of this stuff, okay? And all of a sudden a girl, who appears to be about 16 years of age she comes skipping in the store.
She's actually skipping.
And the mother presents a stack of prescriptions.
She says, "My daughter's got sickle cell and she's really in great pain.
" I look at the prescriptions and it's OxyContin, 80 mg.
Eighty milligrams! This kid weighs 100 pounds! Soma, 100.
Valium, 100.
And roxicodone, which is a short-acting opiate.
These prescriptions surely could have killed this girl.
- I delay the lady a little bit.
- [door rattles.]
I make copies of the prescription and I go out and talk to her.
She's trying to talk me into filling the prescriptions.
I'm not gonna fill these prescriptions.
And I give them back, because they don't want to wait.
It's kind of crazy.
But, unfortunately, I didn't bring my recorder that day.
So I've got to do this right.
I've got to be smart.
I've gotta make sure that Dr.
Cleggett admits she wrote these prescriptions.
Because sure as I try to nail her on it, she's going to say they're forgeries.
[dramatic instrumentals.]
[dial tone.]
So, I called Dr.
Cleggett.
[dialing.]
My adrenaline was really pumping.
This was the chance at the smoking gun that we needed to shut her down.
I gave the child's name.
And I said, "Did you write these prescriptions?" "I certainly did.
" I said, "Well, Dr.
Cleggett, this is a definite overdose.
" She says, "Who the fuck made you a doctor?" [sighs.]
Then she hung up.
[sniffles.]
[voice shaking.]
Smoking gun.
[sniffles.]
[car rushes past.]
I called George Papale.
I said, "George let me tell you about this situation.
" [spirited instrumentals.]
[George.]
Dan Schneider talked to the young lady's physician who had treated her for her illness in the hospital and had discharged her on Tylenol.
As opposed to this huge amount of OxyContin and other medications prescribed by Dr.
Cleggett.
[Dan.]
As soon as the medical board received this affidavit they did verify my concerns with a Dr.
Brobson Lutz.
[Dr.
Lutz.]
Eighty milligram OxyContin for her initial visit.
"To take one or two every 12 hours.
" That's a tremendous dose.
You would never start anybody out on a dose like that.
There is no way that Dr.
Cleggett could have really thought that she was practicing good medicine.
When he put that in an affidavit, if there ever was a smoking gun, that was it.
He says, "Dan I think this just might do it.
" [dramatic instrumentals.]
The medical board sent SUVs there with the St.
Bernard Parish police the DEA [indistinct police radio chatter.]
[Iris.]
Dan Schneider was the linchpin.
As crazy and as out of control as this guy was, he got results.
[George.]
The desk was piled high with tens and twenty-dollar bills in big stacks.
There were stacks and stacks of prescriptions that had already been signed by Dr.
Cleggett and were only awaiting somebody to put the date and the patient's name on the prescription.
When they served Dr.
Cleggett with the summary suspension order, she was not happy about it.
She was mad as a hornet.
She said, "DEA, NOPD, task force, whoever you are, you're dead.
" She literally threatened federal agents.
That was pretty unusual, yes.
Pretty unusual.
[George.]
It was very clear to us that she was not gonna let this go without a major defense and attack.
[dramatic instrumentals crescendo.]
[static crackles.]
[indistinct chatter.]
- [crew member.]
Here's your water.
- Uh-huh.
[crew member.]
When you need it.
I'm gonna put Let me just take one little, quick glance at that.
[crew member.]
And then tissues are going be right here, too, okay? Okay.
[dramatic music playing.]