Patrick Radden Keefe on the Sacklers' Responsibility for the Opioid Crisis

Psychoactive listeners. Uh. Today's guest has written a book that is creating quite a bush. The book is called Empire of Pain, and it looks at the role of one company, Produe Pharma, and one family who owned that company, the Sacklers, in terms of the role that they played in creating what we now widely regard as a massive opioid epidemic in America, where almost a half a million people have

died over the last twenty years from opioid related overdoses. Now, Patrick has been a top investigative journalist a writer for a long time. He's been writing for The New Yorker magazine for the last fifteen years before this book, he did three other books. One was on global eavesdropping, one was on the Chinatown Underground, one was about a murder in Northern Ireland. And he uses these stories and families oftentimes to kind of reflect on broader issues that are

going on. So, Patrick, you and I if we crossed paths a few years ago, not in person, but by phone when you were writing a story about Washington State's efforts to implement the merril On, a legalization initiative that I've been involved in in twelve and then I saw you had also written these wonderful stories about the capture and the pursuit of El Chappo al Chapoozman and notorious Mexican drug trafficker. So I think one thing you and I share in common is this fascination with drugs and

drug markets. And just tell me about where you came to this fascination front. Yeah, you know, it probably started with the with the Mexican side of things. I wrote a big piece of cover story for the New York Times magazine in about Chappo Goosman and the Cineloa cartel. And it's funny to think back, but I had to explain to the editors of the New York Times magazine who Choppo Goosman was and why it was worth writing

about him. You know, he has become more of a household name and a and a meme, but at the time it was not all that well known. And what was interesting to me was that there was a tendency to talk about the illegal drug trade and the Mexican drug syndicates as these criminal organizations, but not to think of them as businesses. And I was really chiefly interested

in them as businesses. So that first piece was I joked, it was like a Harvard Business School case study of a Mexican drug cartel, and that was how I got into it. So I've always been interested in these issues, but maybe particularly these questions about listit and illicit markets

and the convergences between them. You know that the work I did on Mexican drug cartels, I was most interested in these cartels as multinational commodities enterprises doing billions of dollars in business to cater to a predominantly North American market. And then in Washington State, I was interested in the idea that you can legalize pot with the stroke of a pen. But the reality is that there has been an underground, a very vibrant underground pot economy for decades.

So what happens, you know, what are the implications for not just sort of taxes and regulation, but marketing for growers, for consumers. And then, in a weird way, I kind of I worked my way all the way through to the purely listit f d a regulated universe of produe pharma, which for reasons I'm sure we'll talk about, you know, I think the fact that in this case it's a family of billionaire philanthropists who aren't going to go to jail does nothing in my mind to diminish the um

the negative consequences of the kind of business there. M I'll tell you this. So I'm gonna be perfectly frank with you. In reading your book, right, there's this part of me that always is reading through the eye of the devil's advocate, and there's a part of me saying, you know, what are you missing here? What seems unfair? You know, this blaming so much of the opioid crisis

on one family and one company. You know, I've seen that over forty years, have been so often with Colombia Mexican drug factors being blamed for cocaine or this or that or that or this, and so what I want to do really is two things, because on the one hand, I think you make an incredibly powerful case that produe pharma and the sacklers really deserve a huge measure of blame and responsibility for what in fact has happened in

this country over the last twenty years. On the other hand, your book was really interesting me because I know some of the characters in your book. I mean some of them. I've crossed paths with some of them. I even was friendly with or worked with a bit. I've been sympathetic to the concerns around opia, phobia and the pain community. Uh.

You know. On the other hand, you know, I also got approached by a law firm a couple of years ago that was suing all these pharmaceutical companies, and you know, did a day's worth of consulting for them as well. And I've had my own experiences with pain and my own views about where pain management and other things can go wrong. So let me first start off by talking

about the family. I think you said, you know, there are ways in which people say, my god, it sounds just like that HBO series Succession, except here you have the founding members, you know, the older generation born a hundred years ago, Arthur and Raymond and Mortimer, and then the successive and the ones they're after. Tell me why you decided to focus on the family, Well, for a

number of reasons. I mean, you know, the first thing I would say on the issue of blame, as I make pretty clear in the book, you have an opioid crisis that's lasted for a quarter of a century, half a million people dead. Who knows which statistics you should believe, but by some estimates to plus million people now struggling with addiction to opioids of one sort or another. You don't get there through the actions of one family alone, or you know, anyone bad actor or any set of

bad actors. Right, It's incredibly complex, and I think it takes a village. You know, there's all kinds of systemic failure. There's all kinds of bad pharmaceutical companies, bad doctors, bad regulators, and on and on. I do think that the Sacklers in their company play a special role as a kind of They were one of the first movers in this situation. In which I think that there's a great deal of

blame to go around. I was interested in the origin story of this crisis, in how it started, and I think they play a really major role in those early days. And the Sacklers, you know, we can talk about this, I'm sure we will. The Sacklers say in their defense today, listen that the opioid crisis today is a heroin and fentanel crisis, and we don't you know, we're not in that business. This is illegal drugs being purchased on the street. That's not what we did. So don't blame us for

those deaths. But again, the crisis is interesting, right because it, as these things do, it starts small and then it morphs and it evolves. As for why I focused on the family itself, I found the family fascinating. I think families are fascinating generally as a subject. It became important to me not to write a book that would be a straightforward book about the opioid crisis, in part because there are a handful of those books out there, some of them quite good. I was more interested in a

kind of multigenerational family saga. If it were the case that that you had different generations doing different things. I might be less interested, but you get this continuity where the original three Sackler brothers are in the farm of business and I think have a kind of outsized impact, particularly Arthur Sackler, the oldest brother, on the way in which drugs are marketed and sold in this country. Arthur Sackler, who I devote the first third of the book too.

He dies before the introduction of OxyContin, but I think there's a lot in his life that we can learn from in terms of what I would argue is the hijacking of medicine by commerce. I think he was very instrumental in creating some of the systems that have done that that were then used to great effect with OxyContin

and many other drugs. Yeah. Well, I mean it's interesting as I'm reading it, because you're making a link between Arthur Sackler, who's kind of, you know, even though he's the eldest sibling of the three brothers, but he's also kind of a patriarchal figure with the others. He is the guiding genius, the dynamo, the one making the major investments often times and bringing his brothers along. He's regarded as the godfather of medical advertising. He basically it's just

almost magically vertically integrated. I mean he's got advertising, he's got his medical newspapers, he's got the companies collecting the data, then they buy the pharmaceutical companies. He's got all of these things while at the same time being this extraordinary philanthropist. But as you say, he dies um before and his family is not involved with Perdue Pharma when OxyContin comes along.

The other character you focus on is Richard Sackler, who is the head of Perdue Pharma and is thet the nephew of Arthur, and who really drives this thing forward. And I think with Arthur you described a sort of mix of idealism and greed. With Richard, is the balance different. Um No, actually no, I don't think so. I think, uh, Richard is in some ways a less He's a less attractive character because he doesn't have his uncle's charm. Arthur Sackler was somebody who was a kind of a polymath.

He was involved in all kinds of different areas, had a great charisma. Richard doesn't have any of that. So, just to back up for a second, I mean my last book, which is about The Troubles in Northern Ireland is just steeped in moral ambiguity, and there's not a lot of moral ambiguity in this book. I mean, it's pretty clear I think to most people reading the book, um where I come down. I think these people did some bad things. Having said that, I'm not interested in

caricaturi ish condemnations of people. I just don't. I don't really particularly want to spend my time as a journalist doing that. I don't know that as a reader I would want to read, you know, some kind of a screed about the evil of the Sacklers in which they're all kind of tapping their fingertips together and planning their global domination. I think greed was a big part of the cocktail with Richard, but I think idealism was as well.

You know, opioids are are complicated and fascinating, and people have known for thousands of years that drugs derived from the opium poppy have tremendous therapeutic benefit. But they've also known that that was twinned with certain dangers, among them addiction.

And part of what's so interesting to me about the story of Boxing Content and Richard Sackler in particular is that there's a kind of hubris but also in idealism in their idea that they're like, that was the problem for thousands of years, but we've hacked it, and we figured out how to uncouple the therapeutic upsides from the downsides. And as a consequence, these drugs that had historically been you know, doctors have been a little bit more cautious

about prescribing them. They should be prescribed, you know, left and right, potentially to tens of millions of Americans. I don't think it was just greed that drove that, you know, I think it was optimism. And where the story gets really interesting for me morally is that what happens when the world starts to tell you, you know, that you

were wrong. And so where I would be as an ethical matter most unforgiving of of Richard is is actually not in the first instance, where you put the drug out there and you make kind of fantastical claims for it. But it's more what happens and you start hearing that actually people are getting addicted to it in significant numbers,

and in many cass dying. I mean, OxyContin hits the market in a roughly seven or so what was so special about it and what was the kind of broad strokes about the way this thing emerges for better and for worse. So OxyContin was a powerful opioid pain killer. It's released in ninety six, and it was pure oxycodone, which is a very strong opioid, but with a special coating which allowed it to disperse into your blood stream

slowly over the course of a number of hours. And so what this meant is that you could have quite big doses of oxycodon. Traditionally you would have seen oxycodone and drugs like percadan or percocet, but there it's cut with a set of menifa or aspirin, which meant that there was a limit to how much you could take. And so here you could get big sixty eight milligram pills of pure oxycodone with that coating. The drugs released in nineties six, and you start to see problems almost

right away. But you eventually have a situation in which more and more people are abusing OxyContin by crushing the pills, and you can thereby kind of override that slow release mechanism and get the full dose sol at once. But people are also in a doctor's care just finding that they're becoming addicted to the drugs. So more and more people start becoming addicted, abusing the drug, overdosing, eventually dying, and slowly this kind of controversy builds around OxyContin and

Produce Pharma. During this period, the company keeps doubling down. They never really hesitate in their big marketing push, and eventually there's a federal guilty plea in two thousand and seven when the company pleads guilty to miss branding the drug, to criminal charges of miss branding the drug, essentially having made claims about it's safety that turned out to be fraudulent.

And it's interesting because that's sort of this interesting moment in the story where people look back and they think, Okay, well, you know, certainly what the company always said was we had a few bad apples prior to two thousand and seven, we had the guilty plea, and then we really cleaned up our act and beefed up our compliance department and

got religion. In two thousand and ten, they reformulate the drug, making it harder to crush the pills, and you fast forward to there's a second guilty plea, So it turns out that you know, during that period when they supposedly were on the straight and narrow, in fact, they had been going right back to the old ways of kind of zealously over promoting the drug. And so you had a second guilty plead to federal criminal charges in late covering a period of time that dated back ten years.

So really this is a kind of a criminal enterprise, this organization. You've got the guilty plea in two thousand and seven, another one and in between that reformulation in two thousand and ten. Mm hmmm, well, you know, let me I'll share with you sort of some of my history and coming to this isshoe um. And first of all, was you know I had it must have been twenty years ago. I actually had dinner with Richard Sackler and his attorney, Howard, you know, who ends up having complete

guilty to something or other. And I was introduced by Kathy Foley, who was the head of pain Management and slow Cattering. And the reason I knew Kathy was that when I started my organization, it was initially part of George Soros's foundation back in ninety four, and the other

project that he helped get started simultaneous with mine. We were really the first two US projects of soros Is, you know, initial philanthropic Empire was a project on death and dying with dignity, and he appointed Kathy to be the head of that project while she was still head of pain management Sloan Cattering, the leading cancer and you know hospital in New York. And so I'm kind of

educating her about drug policy and we're talking. I'm more focused on addiction, the pain issues kind of peripheral, you know. And at one point she introduced me to Richard around two thousand, two thousand one, and the hopes that maybe he would become supporter of my organization once it had spun out of Sources Foundation. But what was interesting was I had been mostly focused on addiction and the ways in which opio phobia, the irrational fear of opioids, sometimes

got in the way of effective addiction treatment. Right. I was aware that, for example, in trying, you know, method on maintenance was the gold standard of treating drug addiction, National Academy of Science, in Student medicine, World Health Organization, you know, you name it, you know, all said this

is the way to do it. But the barriers, the stigmatization against method on, the notion that you were just substituting one addictive opioid for another in the black community, the notion that this was the chemical bracelet of the white overlords on the black community, the notion that method on should only be used to get you off of heroin, but that it should not be a long term maintenance drug. You know, meeting people who would say, hey, don't blame

me for methan on being my daily medication. Um, I'm no more a method on addict than diabetic is an insulin addict. This is my daily medication. I don't get high, and I'm probably gonna take it for the rest of my life. So when I come into this pain field, which I never fully do, but on the edges of it, I'm very conscious of the ways in which, you know, opioids can be highly dependent, causing and addictive, but that

they have a very important role to play. And now we even see, you know, now there's this huge push to get all the people addicted to drugs onto method on abourd Breneurphane. So when I look at the pain field, I see, on the one hand, the sense in which there's a really legitimate concern that Perdue Pharma and that

Richard Sackler are tapping into. But what I find so persuasive about your book is the incredibly over marketing, aggressive marketing, duplicity, dishonesty, line manipulation of regulators, and all this sort of stuff which led them to promote an incredibly valuable breakthrough medication, oxy content right, which which huge numbers of pain patients were feeling. You know, this was the greatest thing that

ever happened to them. But the company and the Sackler's promoted in a way which is grossly disproportionate to its appropriate need in the community. So anyway, your reactions to my whole riff there, Um, it's hard, right because the you know, you use the phrase the phobia, the irrational uh, you know, irrational fear, fear of opioids. It's you know, with half a million people dead, it's hard for me

to say it. It's entirely irrational, right. I think that these are powerful medications which I think have important therapyic uses. I'm not, by any stretch of the imagination of prohibitionists really when it comes to any drugs. You know, there are some people, including some doctors who think we really shouldn't use strong opioids at all for chronic pain and

what have you. And that's not to me, like, I don't even need to get there in this book, because those are debates that people are having, and and for me, it's a question of marketing, fraudulent marketing, excessive marketing, and careless over prescribing. And I don't think at this point you would find anyone, including frankly, people like Patty Foley, who would dispute the notion that part of the reason

we got here was because of over prescribing. The Sacklers still maintained that at coontin is not iatrogenically, it's just it's just not addictive or you know, addictive only one

percent of the time. I think most people have retired that as a conjecture, that particular statistic for me, the you know, there's a whole bunch of pieces to this, but part of it is that if you have a therapy that is powerful, that has tremendous therapeutic upsides but also potential downsides, it should be prescribed carefully and marketed carefully, and that a situation in which you have an army of sales reps going out with a bunch of literature

that in retrospect turns out to be dodgy, telling physicians ends who are not paying specialists that there are no side effects to this drug. You know, that's a dangerous situation. And I've interviewed plenty of docs who were on the receiving end of this, and I think there's a whole bunch of problems here, right one of the doctors should ideally not be receiving their education in an in a new course of therapy purely from the pharmaceutical company that

is selling the course of therapy. You know, if you're a doctor, probably should do a little more due diligence than that. The pharma companies and you know, pretty as hardly alone here, I think, had a very strong incentive to educate physicians about how to get people on these drugs. And what I've heard again and again and again, as I'm sure you have, is that there was a kind of education and how to get people on these drugs, but no education and how or when to get them off.

You know, maybe people should be on them for years, maybe they shouldn't, do you taper, how do you go about that? And well, the story you hear again and again in this case, I've heard it from families and people who've who have experienced this firsthand is that you know, you go when you get a procedure done and the doc writes you a prescription for whatever thirty days of an opioid, and you find that your use of it

is becoming problematic. You start getting nervous because you know either it's wearing off and you want to take the bills more frequently, or you're finding that you're experiencing withdrawal. You go back to the emergency medicine doc who prescribed it to you, and the doctor says, well, whoa, whoa, I'm not an addiction specialist. My job is to get

you on here, not to get you off. And I think a lot of people end up in a kind of perilous situation in which the nature of medicine as it is practiced in the United States is such that if you offer up a solution that seems like a quick, reliable solution with minimal downsides, that will get somebody off your schedule so you can then see the next patient.

A lot of doctors, I think we're very ready to do that, and you end up with a huge community of people who are kind of orphaned by the system because you know, the drugs are having side effects for them, and they don't there's no infrastructure for how to help them with that, how to help them figure that out.

There's a whole other thing which we can talk about, which is, you know, the big community of pain patients now who feel as though the pendulum has swung too far in the other direction, that opiophobia is back, that their physicians don't want to continue prescribing these medicines that they feel they rely on in order to live their lives. I get a lot of notes from these people, almost

invariably they haven't read my book. I mean, there's a great deal of nuance in the book, and if you're reading it carefully, I think it'd be difficult to to say otherwise. But from a distance, it's look, you're bashing the sacklers. They sold a life saving medicine. You know,

you're you're contributing to the stigma. And of course, I think if you look closely, part of the reason that a lot of these people are stigmatized is precisely because of the kind of behavior that you saw it at Purdue, you know, I mean, you're right, it is a complex story.

You don't. On the one hand, right, you know, the people who specialize in pain management, they knew that opioids were it could be dependent causing, right that if you do, if people are on it for any length of time, they have to go through some withdrawal if they're going to get off of it. That's just sort of part of the course, right, And the people are experts in this stuff knew that you have to manage that. You

manage getting on, you manage getting off. And in a way, you know, they were frustrated because they are They're seeing other doctors and patients and nurses who saying I don't want to take opioids, people who are terminally ill on their death beds, that I don't want to die an addict. You know, evidence that people are dying prematurely because they have this you know, you know, fear of morphine or

this fear of being addicted. They're not making a distinction between what it means to be dependent on drugs and being addicted to them. But then what you describe is basically perdue pharma. It's not just trying to address the issue that they were dealing with the pain docs. What you describe is them deliberately going not after the pain management docs, but going after gps who I know they're

asked from their elbow about this stuff. What you describe is them targeting the biggest prescribers, not people who are specialized pain management experts, but people are just shipping the stuff out right. What you describe is them lying to people about the potential addictiveness of these substances. I mean, I think that's where you nail these guys about just

playing a grossly irresponsible role. That whereas on the one hand, and providing a kind of miracle medication for people who really do benefit from a long acting pain medication like oxy content, they are so grossly over promoting it to people who shouldn't be on it that that's where a big chunk of this blame wise. Yeah, no question. Look, this is a company that has pled guilty to felony charges twice uh in two thousand and seven, and and I would argue, um, and I think I make the case.

I opened a pretty compelling way in the book that in both instances they actually got off They got off pretty easy, particularly compared to the kinds of penalties that we visit in this country on poor people of color who are involved in the retail drug business on the street. I'll put it to this way, when you talk about marketing to the wrong docs. You know, I wanted this book to be a compelling read for non specialists. I

you know, I hope it holds water with specialists as well. Um. You know, I think there's there's some rigor to it, but you make choices right, And I had to remind myself, you know, you're not writing an indictment here where you want to take every single piece of evidence and put it in. What this meant is that I had to pick my examples and I had to be pretty judicious about it. If you just take a fact pattern, Okay, So the fact pattern is there is a clinic, a

pain clinic that is obviously a pill mill. You have a super unethical doctor who is just fire hosing pills at the local community. And you know, eventually, in the fullness of time, this doctor will lose their license and end up going to jail. But before that happens, there is a period of time where Perdue is aware of what's happening because they have this early warning system, which is their own raps who go out and call them these doctors and write reports and they come back and

they tell them about it. You know, it was a real struggle for me to think, Okay, I can only tell so many of those stories. There were so many to pick. It was like a vast buffet of that fact pattern where I'm thinking, geez, do I do the one of Massachusetts? What about the one in California? Or oh, but there's this interesting one over here. It happened again and again and again and again and again. So I'll

tell you what. To me was one of the most astonishing data points that I discovered, And it's it's like just in the weeds enough that I think most people don't necessarily appreciate how crazy it is, how wild it is, but you will. So in two and ten, produce reformulates oxycontum The whole notion with OxyContin is that you had this seal which slowly regulates the dispersal of the drug into your bloodstream in theory over the course of twelve hours.

So there's a lot of evidence that actually doesn't last that long for a lot of patients people quickly figured out that if you break the seal by chewing it or crushing it, you can override that slow release mechanism, and then you can smort the pill. Even if you just swallow it, or if you shoot it up, you know, you get an immediate huge dose of oxy coda. So in two thousand and ten, the company reformulates the drug.

There's pretty good evidence, which I lay out in the book, that the timing here is significant because the patent was about to run out on the original version, um and so they're gonna make this reformulated version. But this is the interesting statistic. Two thousands intend they roll out this new pill, overnight, nationwide sales of eighty milligram oxy content pills drop. So you have to think about this, Right, on the one hand, good for Purdue reformulating the pills

people were abusing those the original version. On the other hand, how could that not be sobering to realize that of their market for their biggest dose of this drug was basically coming from the black market, right. It was people who were abusing the drug. It's non medical prescriptions, it's pill mills. And this is where it gets really interesting me is that you have all these pill mills. The company knows that they're pill mills. They actually kept a

list internally of these bad docstion. What they said is that they said, oor, our sales reps wouldn't call on them. That's what we would do, is we tell our sales report don't call on those on those pill mills. Of course, I interviewed sales reps who are like you didn't have to call on like they were pretty reliable prescribers. You didn't need to go and visit them in order to make that happen. What they don't do is report those

pill mills to the authorities. And and the reason is pretty obvious, right if of your profits on your most profitable pill are coming from the black market, you have a pretty strong incentive not to shut these operations down. And so I think that's part of the reason that you see the black market persists the way it does is with again the mingling of the listit and illicit Yeah.

I mean, Patrick, I'm almost thinking, you know, you think about that article you did in New York or where you and I talked some years ago about how Washington Stay was transitioning from an illicit market to a legal market. And here part of your story is about the transition from a legal market into an illegal market. Absolutely right there, it's Perdue Farma changing the nature of oxy content so that you can't crush it and snort it or inject

it anymore. It becomes a little gummy bear that you can't do much with, or whether it's just doctors now beginning to realize you're being pressured to prescribe less, which you see is a shift happening. And so one of the interesting things about that moment is that Perdue all of a sudden, as you say, loses twenty percent of its sales because that's the of the market that was

looking to crush it and use it entirely illegally. Yet at the same time that also results in a growth, if not an explosion of the market first and heroin and then ultimately fentanyl, and it actually leads to an increase in the number of over those fatalities right after this happens. And so from a policy perspective, it's almost like, Dan, if you do, Dan, if you don't, I mean, I was reading your thing there. I'm going God with the world have been better off if Perdue FARMA had never

gotten permission to do this non crushable version. I mean, I don't look, I don't know. It's hard to say. The The counter factual that I'm more I'm more comfortable with is had they reformulated earlier. I do think it would have made a much bigger difference, you know. In fairness to them, they say, it just takes a long time to develop these drugs. It also took several years for them to get approval from the f d A. So you know, I mean the time, the timing with

the patent does seem worth ruminating. Well, I mean I have to say, you know, oftentimes you say on these investigations like interms, you follow the money, follow the money, follow the money. It's always with the cops and investigators always say, and for you, the subtext to follow the money has followed the paddic right. I mean you talk about they start off with MS content and then they

go to oxycontent and then reformulated oxycontent. I mean, just explain a little bit about the timing of that and how that looks from your perspective. Yeah, just that. I mean, I I think that this will sound probably a bit naive, but to me. There was this interesting thing where any time there was a mystery about timing, you know, why did it take so long for them to reformulate, or

why did this happen at that time? Or there was this kind of st range thing that I talked about at the end of the book where the company wanted to get a pediatric indication for OxyContin, but then they said, but we don't actually want to sell it. We're just doing because the FDA forced us too. But then it

turns out the FDA didn't really force them to. It was more that they were incentivized too, because if they got the pediatric indication they would get six months of extra patent exclusivity, which at the time, you know, it was a billion dollars. So it was just one of those interesting things where often if I had a question, the more I dug, the more documents I got, it was very often the case that the answer was, oh,

it has to do with the patent. At a company like Perdue, where they really only ever had one huge blockbuster product, and the whole history of the company, nothing ever came close to OxyContin, I interviewed many, many people who worked at the company who said that the whole business model was protect the patent, extend the patent. I had somebody who worked to the company, a senior person who worked to the company, who said to me, at times it almost felt like it wasn't a farm a

company at all. It was a small, elite patent law firm, like an intial actual property law firm that happened to have a little marketing wing on the side. So, um, when you talk about the counter factual and you wonder what if I think the thing for me is there were these really crucial moments early on where the company was lying about the drug. They were lying about what

they knew and when they knew it. And I think if there had been a real reckoning in two thousand and one, two to two thousand three, if you'd seen an earlier reformulation, the population of people who had, you know, taken that on ramp to opioids was just smaller at that point, and so it could have been that the

reformulation would have made more of a difference. But by the time you get to two thousand and ten, you just have a huge population of folks who are struggling with these drugs and using them in a in a non medical way, and at that point, if you if you cut those people off from a source of supply that they've counted on, and it's honestly, it's the same thing.

So you can think about the re formulation. But it was also true that by two thousand and ten, a lot of the pill mills are getting shut down, a lot of docs are getting more careful about prescribing and not too I think, push people into the block market. We'll be talking more after we hear this ad. There are two broader context to what's going on here, and there's one which I think you probably could have given more attention to, and the other one which I think

you lay out in spectacular and telling detail. And on the first one, you know, there's a context back in the nineties that basically, whether we're talking about addiction treatment or pain management, both those issues are essentially not being taught in medical schools, and most physicians know remarkably little about that, much less how to manage opioids, whether putting people on or putting people off to those things. What's also happening is that the vast majority of what are

called overdoses are in fact fatal drug combinations. In fact, very few people die simply from taking too much heroin or too much oxy content. The almost all of those overdoses involved people combining it with valley and with benzodiazepines with alcohol. And it's only when fentinyl comes along, which is fifty times more potent than heroin or oxy or whatever, that you see people dropping dead simply from using it. One opioid all by itself. Um, the lock zone the

antidote for an overdose. I mean, my organization started working on trying to get that more out there really beginning in two thousand, but it's not until about two thousand ten or eleven or even the White House, the Drugs Ares Office says, oh, we better start getting behind the

lock zone. So there's this massive misinformation miseducation under education that's going out in the community, which provides a context and where when you have a company over promoting this drug and over marketing and all the insidious ways that they did is just going into a says, right to magnify this. On the other hand, what you do a magnificent job within the book is describing the revolving door of government and industry right the swamp the people who go to work from f d A or d e

A or Justice Department. All the next thing you know, they're working for Purdue Farma. The members of Congress, the the ways in which Purdue farm is able to get what it wants by paying and legally bribing people, maybe even illegally, we don't know, but I mean, you know this sort of really insidious way. And in a culture

where white collar criminality almost never results in incarceration. So the black and brown people are going to prison, you know, by the millions, for selling drugs no more dangerous than these on the black market, but the white collar folks are basically walking away scott free. I don't know if you want to just tell some of the most things that both shocked you when you were looking at that side of things. Oh, I mean, let me say one

thing about mixing first and fentinyl. You know the general now, who knows what's in it? I mean, in fact, you buy heroin on the street, who knows what's end? And maybe cut with fanel you don't even know it. And

you talk to drug users. People are aware, they're aware of the risks, but they also a lot of the time just end up in a situation in which they don't have a safer, reliable source of supply, but they needed when they started, they were taking a pill and you know, not necessarily could have been aficon, could have been you know, any number of things, right, but something that felt like it had the impermater of the f d A. It felt like a kind of a creature

of a regulated system. It's funny because this is a you know, this was one of the things I was interested in the in the pot story with Washington State too, right, is these questions of like, to what extent does regulation mean quality control, you know, in the government kind of getting in and evaluating the product in a way that you would normally associate with kind of an FDA regulated industry.

I just it's interesting to me that you I think you end up with a lot of people who had a certain level of inhibition when they started, and the on ramp was a pharmaceutical product which they could kind of live with as an experiment because it seemed safe.

And I think in many instances, these are people who wouldn't be mixing on the front end, who wouldn't be just you know, taking what they could buy from the guy who's the connection that you have in the moment, but you get into the grip of these things and your judgment can falter, right. I mean, like from the outside, as somebody who who is not addicted or dependent, it's sometimes hard for me to understand, given what we know

about fentinel, specifically the risks that some people take. But I think the thing to remember is that they you know, generally speaking, and that's not the first thing people take. It takes a while to get there on the on the revolving door. Man, I don't know where to start. I mean, I you know, everywhere I looked um and again it's not just perdue, but there is so much money here. You know, oxycontinent has generated thirty five billion

dollars in revenue. Since When you have that much money, I just think that it affects everything, and that the corruption very seldom looks like the kind of standard corruption that we think about when we talk about corruption and the kind of corruption that gets prosecuted. You know, there's a story I tell in the book about Curtis Wright, who was the medical examiner at the FDA in charge of approving oxycontent but also approving the specific marketing language

that could be used in the package insert peroxycontent. It proves the drug in record time. He signs off on this crazy marketing claim that nobody will own it. Now, you know, there's this line that goes in the original package insert that says that the time release coding is believed to reduce the abuse liability of the drug. That is, like Visa the other opioids that were on the market at that time, priceless marketing claim, no basis in I mean is believed. Like what does that even mean? Who

believes it? Nobody has been able to figure out how did that line in and they're just the very idea that a line like that makes it into the package insert. Twenty five years later, nobody can say who wrote it and how it got in there and how it got approved. So Curtis right leaves the FDA and a year later goes to work at Purdue Farma for three times as government salary, and that I continually find shocking. The stacklers often defend themselves by saying, you know, we the FDA

signed off on the stuff we were doing. And I'm like, well, if you if you hire the guy right after he leaves, yeah, I mean, Patrick, you know, I was watching Last couple of Nights, this documentary by Alex Gidney in which you feature prominently the crime of the Century, and he describes it even more atrocious episode involving the Chief Council of d E a working for the Office of Diversion Control,

who goes to work for the pharmacial companies. And then you describe people in the Justice Department and U. S. Attorney has been prossing these cases and flip to the other side, right, I mean, the revolving door is just and and you're talking also, I mean you're a wide range of personalities who go to work for Produe Farm because on the one hand is one of America's greatest scumbags, Rudy Giuliani, but at a point in his life when

he's actually fairly credible, after he's just become a America's mayor. On the other hand, you have Mary Joe White, who was the very distinguished former U. S. Attorney in New York, the former head of the Securities Exchange Commission. You know, everybody answers her phone call and she's out there as

you know, mis credibility on this sort of thing. But you know, there's also an element where you're describing as a sort of systemic stink pot of kind of the facto corruption, buddyism, chrony capitalism, all this sort of stuff. And then there's the quirkiness of personalities. I was wondering about the specific personality of Richard Sackler, right, I mean,

he is the driving force. You point out that he kind of learns these lessons from his uncle Arthur in terms of marketing, but you also described this thing about his you know, best friend in his freshman year of college who describes him as sort of lacking in empathy, right, And even when you see the things that you know, you have these emails where he's saying these absolutely atrocious

things about people who are addicted to drugs. You know, you see the videotape of this testament and there's something just off about it. And now obviously he was a family enterprise, but he is the driver. And I wonder how much you had that feeling like what a different human being, maybe done some things differently at the start or maybe not, you know, circle the wagons in the

same way. I mean, what do you think about that? So? Yeah, I mean a few things to go back to, what I said earlier about how I have no interest in caricatures at the human complication and the individual human complication and the way it plays out inside a family. All of that to me was rich and interesting and worth capturing. And I do think that personality drives events a lot of the time in history, and and so it's important

to understand that. I'm also glad you mentioned the college roommate, because if you remember, the college roommate didn't just say that he lacked empathy. He also said that Richard had an infectious enthusiasm. When he had an idea, he would just plunge headlong after that idea, and he could lead

others along in pursuit of that idea. And to me, that's part of what explained Bines how all this happened, as well, that in his own weird way, he was a leader, you know, he had a vision for what this drug could be, and he didn't really want to let it go. I think that in some ways, if if Purdue Farmer had been a public company, the story would have played out much differently. I think you could very well have gotten up to two thousand and seven

with the guilty plea in two thousand and seven. But I think things would have changed after two thousand and seven and a public company. I think all of the folks who were associated with the bad stuff that happened in the past would have been purged, and instead they

were kept on. And you know, there was this weird I interviewed multiple people who said, who came into the company after two thousand and seven, he said, was this weird thing We're on the one hand, they're saying, oh, there was this guilty plea and now we do things differently. And on the other hand, there's this ongoing veneration for all the people who did all the stuff that got us to the guilty plea. And so there were just

mixed messages about the culture. And I think this is a family business, and it was a business kind of created in the image of the family. The one thing I would say is I wouldn't put too much of it on Richard because there's a bunch of family means who were involved from multiple generations. And as a reporter, when I started work on this book, I had this operating theory, which is I thought I kind of did the family tree. I looked at all the different people

and I said, there's got to be some apostate. There's got to be some Sackler who grew up with it. They grew up with the money. But they actually think that there's something kind of rotten happening. They understand why every state in the country is suing the family business and half the states are suing the family members themselves. And I couldn't find one. And it's remarkable the unanimity with which members of the family, who don't agree on

anything else like this is a worrying family. Often when it comes to the utter blamelessness of the Sacklers, they're pretty much in agreement. And you see these incredible there's a there's a document that I draw in the book this amazing um what's app blog that I got access to, which is like a family what's app of a sort

that you know, anybody might have with their family. And you have a whole bunch of different descendants of Mortimer Sackler texting each other on this what'sapp log In part it looks like because they think that that will be harder to get a discovery. Of course they were wrong about that, which is how I got access to it. But um, there's over a year of these texts back and forth, and nowhere does any single member say, in this private zone of this family, what's up? Hey, jeez?

Maybe the critics have a point, or not even not even something that far, but maybe we should think about our own conduct. Is there something we missed? Those types of questions that that I'm sure you and I and probably others listening, just because you're a normal human being, like you think about your own actions and the decisions you wonder if you did the right thing. I think this is a family that seems largely impervious to that particular.

You make a very persuasive case about that, But let me just press you a bit, right, because it seems to me there's almost like these concentric circles right of maybe guilty responsibility and that on the one hand, Richard is a driving figure. He's basically the CEO, and he's got his brother, and he's got two cousins, and there's some nephews, and there's a bunch of others in involved and there and there are sort of a second circle

who are bear a large share of the responsibility. They're involved in managing and micromanaging the company as well Richard's very much the driver. Then you get to the third circle, which is sort of the third generation, the younger one, and you portrayed one of the characters, a young woman who makes I think an award winning documentary about the need for criminal justice reform, and the question about well

should she be held more responsible? And you know, I'm thinking about like you think about the families, the Fords, the Rockefellers, the big Empires, and eventually the grandchildren's generation

after the founders dead. You know, they may speak out or condemn what their ancestors did, But here you're still talking about a family that at least the two branches, the Raymond and Mortimer who are involved with Produe Pharma, where you know, I wonder why you or I would have done in that similar situation, right, I mean, here you are still going to your family Christmas or Saders

or whatever, and this sort of thing. You know, if they have nothing to do with the family except having benefited from the money and they're out there trying to do good in the world, do they have an obligation to speak out? And then there's the kind of four circle, right, And this is actually about somebody I know Elizabeth Sackler right. And Elizabeth Sackler. I've only met her a few times, but initially it's about twenty years ago. I was doing

some fundraising for Drug Policy Alliance. I was in the early stages of fundraising, and I was at some group of liberal you know, wealthy, wealthy liberals, and in that moment, you know, there's a challenge grant and Liz goes, oh, I'll give twenty five grants, right, So that was great. She makes this contribution and we have dinner thereafter, and I try to bring her in in a bigger way with Drug Policy Alliance, and I'm not all that successful at it, although about ten years ago I get her

to co chair a fundraising event. We do an art auction, and she's at that point chairing the Brooklyn Museum and she's bringing in feminist artists and all this sort of stuff, and she's pretty alienated from the other wing of the family that owns Produe Pharma and they have no for

profit interests in it. She's the daughter of Arthur, who's the kind of godfather of the whole thing, but had no direct involvement in Produe Farm and all this sort of stuff, and she is actually openly condemning Perdue Farma and what they did. I mean, she's putting out the statements one oh no, I mean you look, if you look her up, she says, he's very hostile statements about it. Those statements started just after my New Yorker piece came out.

But that's when the Sackler family becomes I mean, that's you can understand somebody wanted to keep a little profile, but nothing in the peace from Elizabeth expressing even a whisper of disapproval. And and and if you and you should and I won't say what you know, I would never divulge too much. But you have to ask whether that's because I didn't bother trying to see if she

had an opinion on it. Well, look, I can also imagine that you still at this point you say, it's really your article and another one in Esquat, we're gonna come out that time that exposed them in that way. You can see people wanting to lie low. But when she does come out with a pretty strong statement condemning UM and then Nan Golden, the artist who is inspired by your article to really go after the Sackler is

an organized public. You know, demonstrations at the museums against them, and she looks at with Elizabeth Sacklers when she goes, you know, what the hell were there? The whole family's evil, And I wonder, like, what do you think, I mean, would you agree with my analysis of the sort of concentric circles of responsibility. Yeah, the concentered circles is perfect because I would say, you know, circle number one would be Richard and arguably a few of the other board

members who are very intimately involved. Then there's kind of board members who were on the board but maybe less immediately involved, are people like David Sackler, Richard's son, who came in a little bit later, but you know, I think very instrumental. Then there's, uh, the Sacklers, who have you know, stood to benefit made huge fortunes on oxycontent but not on the board, and they do other things

with their life. And then there's the Arthur family. Um yeah, I mean to take the mattel An example first, as the filmmaker, right, yeah, the filmmaker. I think the reasonable people can differ on this, and I mean Josh Sackler, who's David's wife, who's a kind of you know, want to be fashion designer. She's another good example of this too, where there's a guy who's who's involved in um film financing.

We did an interview with the Hollywood Reporter or a while ago, another third generation Sackler, and what he said, he literally said something like, Oh, it has nothing to do with me. You know, the company, the controversy has nothing to do with me. And he has a film financing fund and you know, to my knowledge, no independent

source of income that would would fund that fund. And so to me, the interesting thing is the premise that you could benefit to the tune of tens, maybe even hundreds of millions of dollars from something and say, oh, but it has nothing to do with me. It seems a little hard to you know, it seems a little

hard for me to swallow. One of the great themes I've always been interested in, and it's one of the continuities between this book and the I RA, a book that I wrote as denial, and I think, particularly in families a lot of the time, what that means is that there are questions that don't get asked. So I would hazard that for a lot of the third generation Sacklers, it probably does feel like it doesn't have anything to

do with them. You know, there's money that that appears in a trust for their benefit, and they've never had to worry about that, and they don't ask a lot of questions about where it comes from, and they may not ask too many questions about the business or what it's done. Without getting into too much detail, I can tell you that I know with certainty that there are a number of Sacklers from multiple generations who just kind of don't read the bad press. They didn't read Barry

Meyer's book Painkiller. They didn't read the coverage in the New York Times, didn't read the Big l a time series, didn't read Sam ken Jonas's book Dreamland. They certainly probably wouldn't be reading my book. Um. But so there's a kind of wilful blindness aspect of it right where it's one thing to say I have fully engaged with the details. This is what David Sackler does. In fairness to him, the Third Generations Act. The only third generation one is

on the board. He says, I've engaged with all the details, and I want to have the argument with you. You're wrong, you know, you misunderstand our family. It's another thing to say, Oh, I'm I've just never been all that curious about that side of things. That just take the money and I don't ask any questions. My interests lie in in Hollywood.

That to me seems wrong. I mean, I you know I And it's not to say that the blame is anywhere near what it would be for a Richard Sackler, but I think there is if what you're doing is taking the money, no matter what you're spending the money on, and not really engaging at all with the origins of it. So again, this is different from saying I think mistakes were made of our family businesses played guilty to criminal charges twice. There's a huge epidemic which we share some

portion of the blame for. I'm going to redirect this money that I've inherited in order to remediate that or xpiate that guilt. Nobody's saying that. What they're saying is I'm interested in film. Mass incarceration is my issue. You know Ethan better than most that to talk about mass incarceration and say we're just gonna cabin the war on drugs, We're not gonna talk about the war on drugs. We're just gonna talk about mass incarceration and exclude the war

on drugs as an issue. It's just like the height of intellectual dishonesty. There's no way, Yeah, no, no, I hear your Patrick. I just wonder what you and I would do if we were born into that kind of family and we and we were shamed of it, and we wanted to get on with our lives. We were happy about the money. We want to do good in the world. You know, taking on this means, oh my god, and then I'm gonna go see my family for the next Christmas party or briss or Sader or you name it.

And that's that's why I also think that that Arthur generation, because you know, interesting about Arthur, you know, you tell a story about him and valium and how what he does with valium is almost a model for what then

Richard and Produce Pharma does with oxycontent, right. I think that's what Nan Golden was getting at when she said, Okay, so, yes, Arthur Sackler died before the introduction of oxycontent, But to suggest that his that his hands were clean, when in fact, you know, uh, he was so instrumental in kind of building the world in which oxycontent could end up doing what it did is disingenuous. My sense is that that's what she was in a hyperbolic way. Yeah, yeah, I

think that's right. But I also think about Arthur also fits within a context of mid century and even current day chrony capitalism, that his story maybe not that different from so many other major industry is from banking to oil, to alcohol, tobacco, to consumer goods to you name it, where people figure it out all sorts of of legal and sometimes cause by illegal ways to engage in, you know, forms of vertical integration and their businesses and in which

they live these kind of double lives and moral double lives. And it doesn't justify it. I mean, as somebody else who had to spend twenty years of my life, seventy years my raising money from wealthy people from across the political spectrum to try to end the war on drugs, you know, you realize that people are complex, They come

from all sorts of different places. Much better the people who want to put their wealth, even if it was ill gotten by their ancestors, the ones who want to put it to reducing incarceration, are ending the drug war or promoting good stuff are so much better human beings than the ones who just want to spend it on yachts and mansions and things like that. And that ratio of how much you're willing to put into meaningful philanthropy as opposed to how much you just want to live

lives of luxury. Yeah, I mean, I think again, complicated of issues part of the reason I find them interesting. Believe me, I've spent a lot of time talking to people at museums and universities who are really you know, they're in a real bind about what to do with the Sacklers, and they worry about if they take down the Sackler name, then what kind of precedent does that set, and does it worry other potential future donors and so forth.

I think the issue for me is can you stand by it when the truth is out there and known? Or does the sort of happy families we all get along at the family reunion, you know, we will happily accept your money for our foundation or our university. Is that premised on a kind of denial or a sort of a desire to cover up or only whisper about the source of the funds? You know, there have been

some more more so in the UK. There have been some institutions, Oxford University among them, where they've really come out in a kind of full throated way and said, hell, yeah, we love the Sacklers, will take more of their money. They're great, they've been great friends to us. And yes, we know that all this reporting is out there, and yes, you know that a lot of people seem to be pretty convinced that this is a family with a you know,

a pretty poisonous legacy, but we stand by them. And I actually think there's an argument that an institution could make that you know, people have certainly made it to me in philanthropy that you can take the dirtiest money in the world and give it to me and let me spend it on something good, and that's better than the alternative, which is these people not giving their money away,

which I think is what you were saying. That's a powerful, not insurmountable, but a powerful argument to make with the one asterisk that I think you have to first acknowledge that the money is dirty. If the way in which you sort of square the circle is to say dirty. Yes, there's been some reporting, but who can trust the New York Times? You know, really it's a he said, chief said situation. There's two sides to every story. Um, once you start going down that road in order to justify

taking the money, you've kind of lost me. And I think that a lot of people, for a long time did just that, even tough. I read about Toughts in the book Toughs of the first university to take the Sackler name down, and they got a lot of good press for you know, the student party was really happy

because the students had demanded it. But you know, five years ago, when Sam kenona Is published Dreamland, it was supposed to get assigned as reading for I think incoming students, and the administration quietly scuttled that because they said that that that's just they don't want to create any awkwardness for our donors. So you're not it's not that you're denying the book or you're saying, oh, the book is garbage. What you're saying is the book is out there, it

almost hits too hard. We don't want to create any awkwardness for our donors. Yeah, well, you know, so let me take it back to one other issue of the intersection of money here, and you know, you describe this, I think, with some nuance in the book, which is that a mutuality of interest emerges. At some point. You have the people like the Cathy Foley's leading the pain management community, and then a bigger community of people who are living with pain, for whom being having it managed

by opioids. The other way is they're doing so successfully and other people are angry at not having their pain right, and there's essentially little to no funding to support those efforts. And then along comes Richard Sackler, who sees this opportunity here. Right. He has a drug MS content and oxy content, and he makes common interests with these folks, and so they say, oh my god, now we have a wealthy family and pharmaceutical company that's willing to get behind our efforts to

educate physicians and to change these policies. And he sees somebody whose interests are advancing his own, and in a way, it's a dance, right, And to some extent, the pain management community gets taken for a ride when it turns out that the Sacklers and Produce Pharma want to market this drug in a way that is not at all what they intended. And at the same time there is this need for more education on this stuff and more

to do the right find find the balance right. And in America, we tend to swing between these polls, you know, either it's all opiophobia or it's opioids are fine if ex oxy content. And now we're swinging back the other way. Let's take a break here and go to an egg.

You had towards the end of the book the story about when uh Perdue Pharma is obliged to make a big settlement in Oklahoma, right, I mean bigger than in most other states that they don't want to be a model for others, and the money is all going to go to drug treatment and all this sort of stuff.

And my thought was, what a goddamn waste, because from everything I know about Oklahoma, there is almost nothing really innovative going on about drug treatment in Oklahoma, you know, and that their approach to drugs is an abstinence only, backward,

anti scientific approach. And I'm thinking, if only that money could be spent on, for example, instead of focusing just on addiction treatment, maybe focusing on the proper management of pain in our society, maybe teaching GPS, maybe getting that out so it's not just Center of Disease Control CDC guidelines, but actually educating people because my fear here is that with all the backlash first against the big pharma, in which your book plays a key role and is a

very important and necessary thing to happen, and not just against Purdue Pharma, but the Johnson and Johnson's and then Malon Cross and the endos and all the other ones. Right, but meanwhile, here's fentonel. You know, here's heroin. There's no way to have a supply side solution to the fentinel problem, right the drug is just too hard to really prevent from being made available. The question is is how does

one most effectively point these resources? And my fear is the way that all these settlements are happening right now, it's gonna land up doing relatively little to address the problem that we got ourselves into in the first place. I think this is one of the big fears with tobacco. You know a lot of a lot of this money ended up just in the general funds for the States, so you know, your other helping repay highways um and

totally disconnected from what's going on. You know. The tricky thing with the Sacklers in particular and Purdue, is that there's so much skepticism about money that went into education

on pain management. I think appropriate skepticism that anything that even resembled that cosmetically, even if it was much smarter and you know, devoid of commercial interests, I think would probably raise hackles um but I but I listen to you know, what's so sad about this situation is that you have a public health crisis that's cost trillions of dollars, and because of the country we live in, it's going

to get resolved with money. You know, that's money on the way in, money on the way out, and there's no sum of money that's going to be satisfying a because you know, in the case of the Sacklers or any of these companies, you know they're walking away having made much more. If you put it against the money that they made through the fraudulent activity, it's you know,

deppennies on the dollar. But also because when you think about the costs, right and the human toll at the end of the day, the opioid business, as much as it's had this catastrophic impact, it's not like the tobacco industry there's less money just in total to work with, so you're not going to see settlements on the scale that you have with tobacco. And then finally, there are real questions about how that money is gonna get spent.

And you know, I think those should be a big concern for people, and I think that you know, if you've read my book, there are a few places where you get these headlines where that mean meant. The easiest example to talk about would be just a few months ago in late and the Trump administration, they announced an eight billion dollar fine with criminal sanctions against Purdue Farma, an eight billion dollar settlement. And of course people see that and they think, wow, good for DJ. They really

stuck it to Purdue. And you have to know the story to know that PREDU doesn't have eight billion dollars, and the sacklers who do have eight billion dollars they weren't gonna be kicking in. So it's just like a fake number that gets repeated again and again in headlines.

And to me, at my most cynical, I worry that this is the way it's gonna work, right, is that you get authorities who want to kind of squeeze just enough as much as they can in the way of money out, and then they want to put out press releases to look like they've done their job in the

press us. Frankly, it's complicit because it repeats these phony numbers and the public says, oh, look at them, sort of sticking to the And so I do think that watching that money carefully is important because I think, you know, questions about how it's spent. Once the Daniue mall has appeared to play out, you know, once all of the companies, all the settlements, all the deals are done, that's when people need to really get vigilant about where do those

dollars go? Yeah, yeah, Well, Patrick, I tell you I got to the end of your book and my blood is boiling when you read about Purdue Farmer taking what forty billion dollars of revenue and then the Sacklers taking out over ten billion dollars and putting it into offshore accounts so that they can make the company go bankrupt

and thereby avoid any responsibility. And the way they gain the system and reach to members of Congress and the Justice Department, and that last little bit about the bankruptcy court up in Westchester, which is where you live, where I grew up, and there's a way in which Purdue Farmer can pick the judge they want who's known to be sympathetic to, you know, bankruptcy arguments that are gonna favor. Then the utter a corruption of the thing is just

absolutely infuriating. Anyway, I have to say your book is fantastic. It is a fantastic page turner. I mean, I read it over the past week. I've loved it, and I'm sure that people who are much more removed from this issue than you are going to love it as well. I hope you keep writing on this drugs. Do you have plans for other drug writing this one? We'll see. I'll probably do something very different next, but but I

never stay away for long. But listen, it's great to see you here, and thank you very much for this book, Thank you for taking the time, Thanks for having me. Psychoactive is a production of I Heart Radio and Protozoa Pictures. It's hosted by me Ethan Naedelman. It's produced by Katcha Kumkova and Ben Kibrick. The executive producers are Dylan Golden, Ari Handel, Elizabeth Geesus, and Darren Aronovski for Protozoa Pictures, Alice Williams and Matt Frederick for I Heart Radio, and

me Ethan Nadelman. Our music is by Ari Blusian and especial thanks to Avi Brio, Sep Bianca, Grimshaw and Robert Beatty. If you'd like to share your own stories, comments, or ideas, please leave us a message at eight three three seven seven nine four sixty. That's one eight three three psycho zero. You can also email us as psychoactive at protozoa dot com or find me on Twitter at Ethan Natalman. And if you couldn't keep track of all this, find the information in the show notes