Fentanyl, Inc.: How Rogue Chemists Are Creating the Deadliest Wave of the Opioid Epidemic


Ben Westhoff - 2019
    is the first deep-dive investigation of a hazardous and illicit industry that has created a worldwide epidemic, ravaging communities and overwhelming and confounding government agencies that are challenged to combat it. "A whole new crop of chemicals is radically changing the recreational drug landscape," writes Ben Westhoff. "These are known as Novel Psychoactive Substances (NPS) and they include replacements for known drugs like heroin, cocaine, ecstasy, and marijuana. They are synthetic, made in a laboratory, and are much more potent than traditional drugs"--and all-too-often tragically lethal. Drugs like fentanyl, K2, and Spice--and those with arcane acronyms like 25i-NBOMe-- were all originally conceived in legitimate laboratories for proper scientific and medicinal purposes. Their formulas were then hijacked and manufactured by rogue chemists, largely in China, who change their molecular structures to stay ahead of the law, making the drugs' effects impossible to predict. Westhoff has infiltrated this shadowy world, becoming the first journalist to report from inside an illicit Chinese fentanyls lab and providing startling and original reporting on how China's vast chemical industry operates, and how the Chinese government subsidizes it. He tracks down the little-known scientists who invented these drugs and inadvertently killed thousands, as well as a mysterious drug baron who turned the law upside down in his home country of New Zealand. Poignantly, Westhoff chronicles the lives of addicted users and dealers, families of victims, law enforcement officers, and underground drug awareness organizers in the U.S. and Europe. Together they represent the shocking and riveting full anatomy of a calamity we are just beginning to understand. From its depths, as Westhoff relates, are emerging new strategies that may provide essential long-term solutions to the drug crisis that has affected so many.

Bottle of Lies: The Inside Story of the Generic Drug Boom


Katherine Eban - 2019
    Drawing on exclusive accounts from whistleblowers and regulators, as well as thousands of pages of confidential FDA documents, Eban reveals an industry where fraud is rampant, companies routinely falsify data, and executives circumvent almost every principle of safe manufacturing to minimize cost and maximize profit, confident in their ability to fool inspectors. Meanwhile, patients unwittingly consume medicine with unpredictable and dangerous effects.The story of generic drugs is truly global. It connects middle America to China, India, sub-Saharan Africa and Brazil, and represents the ultimate litmus test of globalization: what are the risks of moving drug manufacturing offshore, and are they worth the savings? A decade-long investigation with international sweep, high-stakes brinkmanship and big money at its core, Bottle of Lies reveals how the world’s greatest public-health innovation has become one of its most astonishing swindles.

Dreamland: The True Tale of America's Opiate Epidemic


Sam Quinones - 2015
    Communities where heroin had never been seen before—from Charlotte, NC and Huntington, WVA, to Salt Lake City and Portland, OR—were overrun with it. Local police and residents were stunned. How could heroin, long considered a drug found only in the dense, urban environments along the East Coast, and trafficked into the United States by enormous Colombian drug cartels, be so incredibly ubiquitous in the American heartland? Who was bringing it here, and perhaps more importantly, why were so many townspeople suddenly eager for the comparatively cheap high it offered?With the same dramatic drive of El Narco and Methland, Sam Quinones weaves together two classic tales of American capitalism: The stories of young men in Mexico, independent of the drug cartels, in search of their own American Dream via the fast and enormous profits of trafficking cheap black-tar heroin to America’s rural and suburban addicts; and that of Purdue Pharma in Stamford, Connecticut, determined to corner the market on pain with its new and expensive miracle drug, Oxycontin; extremely addictive in its own right. Quinones illuminates just how these two stories fit together as cause and effect: hooked on costly Oxycontin, American addicts were lured to much cheaper black tar heroin and its powerful and dangerous long-lasting high. Embroiled alongside the suppliers and buyers are DEA agents, local, small-town sheriffs, and the US attorney from eastern Virginia whose case against Purdue Pharma and Oxycontin made him an enemy of the Bush-era Justice Department, ultimately stalling and destroying his career in public service.Dreamland is a scathing and incendiary account of drug culture and addiction spreading to every part of the American landscape.

Empire of Pain: The Secret History of the Sackler Dynasty


Patrick Radden KeefePatrick Radden Keefe - 2021
    The Sackler name adorns the walls of many storied institutions: Harvard, the Metropolitan Museum of Art, Oxford, the Louvre. They are one of the richest families in the world, known for their lavish donations to the arts and sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing OxyContin, a blockbuster painkiller that was a catalyst for the opioid crisis.Empire of Pain is a masterpiece of narrative reporting and writing, exhaustively documented and ferociously compelling.

Dopesick: Dealers, Doctors, and the Drug Company that Addicted America


Beth Macy - 2018
    From distressed small communities in Central Appalachia to wealthy suburbs; from disparate cities to once-idyllic farm towns; it's a heartbreaking trajectory that illustrates how this national crisis has persisted for so long and become so firmly entrenched. Beginning with a single dealer who lands in a small Virginia town and sets about turning high school football stars into heroin overdose statistics, Macy endeavors to answer a grieving mother's question-why her only son died-and comes away with a harrowing story of greed and need. From the introduction of OxyContin in 1996, Macy parses how America embraced a medical culture where overtreatment with painkillers became the norm. In some of the same distressed communities featured in her bestselling book Factory Man, the unemployed use painkillers both to numb the pain of joblessness and pay their bills, while privileged teens trade pills in cul-de-sacs, and even high school standouts fall prey to prostitution, jail, and death.Through unsparing, yet deeply human portraits of the families and first responders struggling to ameliorate this epidemic, each facet of the crisis comes into focus. In these politically fragmented times, Beth Macy shows, astonishingly, that the only thing that unites Americans across geographic and class lines is opioid drug abuse. But in a country unable to provide basic healthcare for all, Macy still finds reason to hope-and signs of the spirit and tenacity necessary in those facing addiction to build a better future for themselves and their families.

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back


Elisabeth Rosenthal - 2017
    In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast?Breaking down this monolithic business into the individual industries--the hospitals, doctors, insurance companies, and drug manufacturers--that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw.The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients


Ben Goldacre - 2012
    We like to imagine that it’s based on evidence and the results of fair tests. In reality, those tests are often profoundly flawed. We like to imagine that doctors are familiar with the research literature surrounding a drug, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by industry. We like to imagine that regulators let only effective drugs onto the market, when in reality they approve hopeless drugs, with data on side effects casually withheld from doctors and patients.All these problems have been protected from public scrutiny because they’re too complex to capture in a sound bite. But Dr. Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct on a global scale affects us. In his own words, “the tricks and distortions documented in these pages are beautiful, intricate, and fascinating in their details.” With Goldacre’s characteristic flair and a forensic attention to detail, Bad Pharma reveals a shockingly broken system and calls for something to be done. This is the pharmaceutical industry as it has never been seen before.

The Premonition: A Pandemic Story


Michael Lewis - 2021
    But the president insisted there was nothing to worry about.Fortunately, we are still a nation of skeptics. Fortunately, there are those among us who study pandemics and are willing to look unflinchingly at worst-case scenarios. Michael Lewis’s taut and brilliant nonfiction thriller pits a band of medical visionaries against the wall of ignorance that was the official response of the Trump administration to the outbreak of COVID-19.The characters you will meet in these pages are as fascinating as they are unexpected. A thirteen-year-old girl’s science project on transmission of an airborne pathogen develops into a very grown-up model of disease control. A local public-health officer uses her worm’s-eye view to see what the CDC misses, and reveals great truths about American society. A secret team of dissenting doctors, nicknamed the Wolverines, has everything necessary to fight the pandemic: brilliant backgrounds, world-class labs, prior experience with the pandemic scares of bird flu and swine flu…everything, that is, except official permission to implement their work.Michael Lewis is not shy about calling these people heroes for their refusal to follow directives that they know to be based on misinformation and bad science. Even the internet, as crucial as it is to their exchange of ideas, poses a risk to them. They never know for sure who else might be listening in.

The Red Market: On the Trail of the World's Organ Brokers, Bone Thieves, Blood Farmers, and Child Traffickers


Scott Carney - 2011
    As gripping as CSI and as eye-opening as Mary Roach’s Stiff, Carney’s The Red Market sheds a blazing new light on the disturbing, billion-dollar business of trading in human body parts, bodies, and child trafficking, raising issues and exposing corruptions almost too bizarre and shocking to imagine.

Pain Killer: A "Wonder" Drug's Trail of Addiction and Death


Barry Meier - 2003
    From the start, the drug's manufacturer aggressively marketed its patented time-release formula as a breakthrough in the effort to reduce prescription drug abuse. It wasn't long, however, before thrill-seeking teenagers shattered that illusion of safety; by simply crushing an "Oxy," they were able to tap into a high so seductive it would come to dominate their lives. Some patients, seeking relief from pain, also found themselves drawn to the drug's dark side. Pain Killer takes readers on a journey of discovery that begins with the true story of Lindsay, a high-school cheerleader in Virginia who gets hooked on Oxys, and expands outward to explore the critical issues of legitimate pain management, prescription drug abuse, and how the misuse of science by the drug industry threatens the public good. With the fast-rising abuse of prescription drugs by young people ringing alarm bells within government, the how and why behind the OxyContin disaster is a gripping read not only for parents, but also for medical professionals, community leaders, business executives, and all those concerned with this crisis. The dangers described in Pain Killer also reverberate far beyond the threat from a single drug at a particular moment in time. The focus of our government's war on drugs has clearly misled many of us into thinking that only illegal drugs smuggled from beyond our borders can be abused. As Meier tells the dramatic story, some of the most deadly substances are produced and sold legally right here at home.THE EXTRAORDINARY AND TRUE STORY OF OXYCONTIN EQUAL PARTS crime thriller, medical detective story, and business exposé, Pain Killer takes a hard-hitting look at how a powerful drug touted as the salvation for millions triggered a national tragedy. At its inception, the legal narcotic OxyContin was seen as a pharmaceutical dream, a "wonder" drug that would herald a sea change in medical care while reaping vast profits for its maker. It did do that; but it also unleashed a public health crisis that cut a swath of despair and crime through unsuspecting small towns, suburbs, and cities across the country. As reports of OxyContin overdoses made front-page and network news, doctors, narcotics agents, regulators, industry executives, and lawmakers raced in, scrambling to slow the damage. Behind it all stood one of America's wealthiest families, and a drug company whose relentless promotion helped fuel the problem Written by award-winning journalist Barry Meier, whose special report in the New York Times triggered national interest in OxyContin, Pain Killer chronicles the rise of the multibillion dollar pain management industry and lays bare its excesses and abuses.

Insane: America's Criminal Treatment of Mental Illness


Alisa Roth - 2018
    Jails in New York, Los Angeles, and Chicago each house more people with mental illnesses than any hospital. As many as half of all people in America's jails and prisons have a psychiatric disorder. One in four fatal police shootings involves a person with such disorders.In this revelatory book, journalist Alisa Roth goes deep inside the criminal justice system to show how and why it has become a warehouse where inmates are denied proper treatment, abused, and punished in ways that make them sicker.Through intimate stories of people in the system and those trying to fix it, Roth reveals the hidden forces behind this crisis and suggests how a fairer and more humane approach might look. Insane is a galvanizing wake-up call for criminal justice reformers and anyone concerned about the plight of our most vulnerable.

Bad Blood: Secrets and Lies in a Silicon Valley Startup


John Carreyrou - 2018
    Backed by investors such as Larry Ellison and Tim Draper, Theranos sold shares in a fundraising round that valued the company at $9 billion, putting Holmes's worth at an estimated $4.7 billion. There was just one problem: The technology didn't work.For years, Holmes had been misleading investors, FDA officials, and her own employees. When Carreyrou, working at The Wall Street Journal, got a tip from a former Theranos employee and started asking questions, both Carreyrou and the Journal were threatened with lawsuits. Undaunted, the newspaper ran the first of dozens of Theranos articles in late 2015. By early 2017, the company's value was zero and Holmes faced potential legal action from the government and her investors. Here is the riveting story of the biggest corporate fraud since Enron, a disturbing cautionary tale set amid the bold promises and gold-rush frenzy of Silicon Valley.

American Overdose: The Opioid Tragedy in Three Acts


Chris McGreal - 2018
    But American Overdose exposes the powerful forces they were up against, including the pharmaceutical industry's coopting of the Food and Drug Administration and Congress in the drive to push painkillers--resulting in the resurgence of heroin cartels in the American heartland. McGreal tells the story, in terms both broad and intimate, of people hit by a catastrophe they never saw coming. Years in the making, its ruinous consequences will stretch years into the future.

American Pain: How a Young Felon and His Ring of Doctors Unleashed America's Deadliest Drug Epidemic


John Temple - 2015
    From a fortress-like former bank building, American Pain's doctors distributed massive quantities of oxycodone to hundreds of customers a day, mostly traffickers and addicts who came by the vanload. Inked muscle-heads ran the clinic's security. Former strippers operated the pharmacy, counting out pills and stashing cash in garbage bags. Under their lab coats, the doctors carried guns and it was all legal sort of. American Pain was the brainchild of Chris George, a 27-year-old convicted drug felon. The son of a South Florida home builder, Chris George grew up in ultra-rich Wellington, where Bill Gates, Springsteen, and Madonna kept houses. Thick-necked from weightlifting, he and his twin brother hung out with mobsters, invested in strip clubs, brawled with cops, and grinned for their mug shots. After the housing market stalled, a local doctor clued in the brothers to the burgeoning underground market for lightly regulated prescription painkillers. In Florida, pain clinics could dispense the meds, and no one tracked the patients. Seizing the opportunity, Chris George teamed up with the doctor, and word got out. Just two years later Chris had raked in $40 million, and 90 percent of the pills his doctors prescribed flowed north to feed the rest of the country's insatiable narcotics addiction. Meanwhile, hundreds more pain clinics in the mold of American Pain had popped up in the Sunshine State, creating a gigantic new drug industry. American Pain chronicles the rise and fall of this game-changing pill mill, and how it helped tip the nation into its current opioid crisis, the deadliest drug epidemic in American history. The narrative swings back and forth between Florida and Kentucky, and is populated by a gaudy and diverse cast of characters. This includes the incongruous band of wealthy bad boys, thugs and esteemed physicians who built American Pain, as well as penniless Kentucky clans who transformed themselves into painkiller trafficking rings. It includes addicts whose lives were devastated by American Pain's drugs, and the federal agents and grieving mothers who labored for years to bring the clinic's crew to justice."

The Panic Virus: A True Story of Medicine, Science, and Fear


Seth Mnookin - 2011
    The media seized hold of the story and, in the process, helped to launch one of the most devastating health scares ever. In the years to come Wakefield would be revealed as a profiteer in league with class-action lawyers, and he would eventually lose his medical license. Meanwhile, one study after another failed to find any link between childhood vaccines and autism. Yet the myth that vaccines somehow cause developmental disorders lives on. Despite the lack of corroborating evidence, it has been popularized by media personalities such as Oprah Winfrey and Jenny McCarthy and legitimized by journalists who claim that they are just being fair to “both sides” of an issue about which there is little debate. Meanwhile, millions of dollars have been diverted from potential breakthroughs in autism research; families have spent their savings on ineffective “miracle cures"; and declining vaccination rates have led to outbreaks of deadly illnesses like Hib, measles, and whooping cough. Most tragic of all is the increasing number of children dying from vaccine-preventable diseases. In The Panic Virus Seth Mnookin draws on interviews with parents, public-health advocates, scientists, and anti-vaccine activists to tackle a fundamental question: How do we decide what the truth is? The fascinating answer helps explain everything from the persistence of conspiracy theories about 9/11 to the appeal of talk-show hosts who demand that President Obama “prove” he was born in America. The Panic Virus is the ultimate cautionary tale for our time.