American Cartel

Inside the Battle to Bring Down the Opioid Industry

By: Scott Higham, Sari Horwitz

Narrated by: Kiff VandenHeuvel

Length: 11 hrs and 10 mins

Publisher's summary

The definitive investigation and exposé of how some of the nation's largest corporations created and fueled the opioid crisis—from the Pulitzer Prize-winning Washington Post reporters who first uncovered the dimensions of the deluge of pain pills that ravaged the country and the complicity of a near-omnipotent drug cartel.

American Cartel is an unflinching and deeply documented dive into the culpability of the drug companies behind the staggering death toll of the opioid epidemic. It follows a small band of DEA agents led by Joseph Rannazzisi, a tough-talking New Yorker who had spent a storied 30 years bringing down bad guys; along with a band of lawyers, including West Virginia native Paul Farrell Jr., who fought to hold the drug industry to account in the face of the worst man-made drug epidemic in American history. It is the story of underdogs prevailing over corporate greed and political cowardice, persevering in the face of predicted failure, and how they found some semblance of justice for the families of the dead during the most complex civil litigation ever seen.

The investigators and lawyers discovered hundreds of thousands of confidential corporate emails and memos during courtroom combat with legions of white-shoe law firms defending the opioid industry. One breathtaking disclosure after another - from emails that mocked addicts to invoices chronicling the rise of pill mills - showed the indifference of big business to the epidemic’s toll. The narrative approach echoes such work as A Civil Action and The Insider, moving dramatically between corporate boardrooms, courthouses, lobbying firms, DEA field offices, and Capitol Hill while capturing the human toll of the epidemic on America’s streets.

American Cartel is the story of those who were on the front lines of the fight to stop the human carnage. Along the way, they suffer a string of defeats, some of their careers destroyed by the very same government officials who swore to uphold the law before they begin to prevail over some of the most powerful corporate and political influences in the nation.

©2022 Scott Higham and Sari Horwitz (P)2022 Twelve

Critic reviews

“An eye-opening, shocking and deeply documented investigation of the opioid crisis by two great reporters. This is not just about the greed of the pharmaceutical companies. AMERICAN CARTEL exposes the sweeping moral corruption of some senior officials in the Department of Justice, the Drug Enforcement Administration, the Congress, and the practice of medicine and law. The ultimate corruption is the collective failure to see, define and act on the larger public interest to address a true national emergency.” (Bob Woodward, associate editor of The Washington Post and best-selling author of Peril)

"A story of courageous heroes fighting the opioid crisis, AMERICAN CARTEL reads like a thriller. At the same time, it is a vivisection of the political and corporate corruption that allows pharmaceutical firms to profit from despair. AC follows a group of modern-day 'private eyes' as they investigate players much bigger than the Sacklers, including some of America’s biggest companies and most powerful members of Congress. Like a riveting true crime story, AC 'follows the money' through the revolving doors of Washington, into the swamp of lobbyists and white collar drug rings who recklessly peddle narcotics for billions of dollars as hundreds of thousands of Americans die of overdoses." (Alex Gibney, Academy award-winning filmmaker and director of The Crime of the Century)

“Scott Higham and Sari Horwitz are two of the most tenacious investigative reporters in journalism. For years they dug into America’s opioid epidemic, unearthing a pattern of callousness and recklessness within the drug industry. With a fast-paced and absorbing narrative, and dismaying documentary evidence, they recount how powerful interests abetted widespread addiction and abuse - and how a few determined individuals fought for years to finally hold them to account.” (Marty Baron, executive editor (retired), The Washington Post)

fascinating legal perspective on big pharma

great inside perspectives of how lawyers work with and against each other to score big cases and big dollars

big pharma and its distribution network is scary when we have an drug epidemic.

Excellent

Great writing and narration still, very disturbing to hear what the drug companies in this country get away with.

Great listen

Great choice of narrator.
Story make my blood boil.
Failure of holding the wealthy accountable.

Compelling

Could not stop listening to this well crafted and well reported story. It is timely, revealing and insightful. Skewers Congress, big business, the judiciary, attorneys. Explains a lot. Superior.

Not certain why this was written ---

I purchased the hard cover and listened to the narration on Audible, while reading along in the book. If it were not for the excellent narration of Kiff VandenHeuval, I would have dropped reading the book. It can get tedious. That said, VandenHeuval really brings it to life, so I “hung-in-there”.

Synopsis (Lots of “spoilers” here):

Drug companies, large and small (Actavis, Victor Borelli, Cephalon, Endo, Johnson & Johnson, Mallinckrodt, Purdue, Burt Rosen, Teva, and Watson Labs), their distributors (AmerisourceBergen, Cardinal Health, Harvard Drug, H.D. Smith, Masters Pharmaceutical, McKesson, and Sunrise Wholesale) sell massive amounts of OxyContin and oxycodone through retailers (CVS Health, Rite Aid, Walgreens, and Walmart pharmacies). In turn, these myriad pharmacies fill thousands of dubious prescriptions, overwhelmingly written by unscrupulous physicians or “pill mills”. The profits for everyone in the chain, the “cartel”, are enormous. Thousands of Americans die, especially in the Ohio River Valley, West Virginia, and Florida (where distribution laws are particularly lax).

A dedicated DEA agent, Joe Rannazzisi, makes it his personal project (along with a team of DEA agents) to stop the carnage and blatant abuses of the law.

Meanwhile, through their lobbyists and a few well-placed campaign donations, the drug companies (likened to a “cartel”) enlist congressman Tom Marino (R, Pennsylvania) and U.S. Senator, Marsha Blackburn, (R, Tennessee) to draw the Marino-Blackburn Bill (S.483), which --- through some strategically-placed sleight-of-hand and tactical language editing of existing legislation --- manages to emasculate one of the most powerful tools that the DEA has in order to keep the manufacturers and distributors (the “cartel”) in line: Immediate Suspension Orders (ISOs). Without the ISO, Rannazzisi is powerless, the pills keep on shipping, and more Americans die.

Thought to be just routine, Congress pays little attention to the revised language within S.483; it passes without discussion and opposition. Unwittingly, Obama signs it into law.

Rannazzisi is discredited and is forced into early retirement. The years of stress catch up with him and he has a triple bypass shortly after.

Time passes. Thousands more die from overdoses, with little DEA interference. Hundreds of lawsuits are filed. The plaintiffs, which have grown to more than 4,000 --- cities, counties, native American tribes --- form an MDL (Multidistrict litigation, which consolidates complex cases, so they're managed by one court.) The judge desperately wants the parties to settle. They don’t. They go to trial.

The “cartel” hires big gun law firms to defend themselves from prosecution and any liability. Some cities and counties decided to split-off from the MDL, believing they can get better settlements on their own, others do not. Joe Rannazzisi becomes an “expert witness” in many of the cases and gets a second life out of it, so to speak.

The plaintiffs hire a big gun trial lawyer from Texas, Mark Lanier. Some cases are won, some are lost. ($40 billion in settlements, so far). The MDL is still pending and the book ends before we know the outcome of one of the West Virginia cases, which is litigated by an attorney, Paul Farrell, from West Virginia, who has seen the devastation firsthand. The case is held in the court of a Federal Judge, David A. Faber. (Later, the Judge decides in favor of the distributors.)

NOT ONE corporate CEO has been prosecuted. It so often gets down to “How much Justice can you afford?” What’s new in America, eh?

American Cartel almost reads like a movie script --- you know, behind-the-scenes investigations, court drama, and a lot of dialog --- otherwise I can't figure-out why it was written. The authors' entire story has already published in the Washington Post. I just got the feeling the authors had tons of extra material laying around, and decided to plop it into a book. Or, maybe every investigative reporter at the Post is a Woodward or Bernstein wannabe.

I’d certainly recommend this book and I’d argue that Audible is the way to go; the narration is that good.

There was an HBO documentary on the subject:
(I don't have HBO --- I'd really like to see this.)

PS: Just in the past few days some nationwide pharmacies have been held liable.

A Must Read

This well documented and succinct telling of this aspect of the opioid epidemic is a book, along with Empire of Pain and Dopesick that everyone should listen to.

Folks should hang

Amazing that’s this was done. Jail them soonest for justice. Stop the commonality of it

A must listen.

A must listen. The authors clearly did their research and wove the facts into a compelling narrative, telling the tragic story of an epidemic that continues to this day, fueled by greed and corruption. As captivating as it is frustrating.

Sad

It is sad that money is our God in which we trust. it is only a harbinger of what is to come.

Legal drama, tragic reality

Riveting. Even if you know about it from the news you will be fascinated by the multiple factors and characters in this account of the trials to hold the drug companies accountable. Like tobacco and climate change you, follow the money.