AMERICAN CARTEL

A meticulous examination of how unscrupulous drug manufacturers, aided by thousands of pharmacies and doctors, produced and concealed a public health crisis.

Higham and Horwitz, who published groundbreaking exposés of the drug industry for the Washington Post, document how American opioid manufacturers, especially Purdue Pharma, recklessly distributed billions of pain pills across the country, generating an unprecedented drug epidemic. Their account of widespread corruption does, indeed, “open a horrifying panorama on corporate greed and political cowardice” while also showing “the efforts of community activists, DEA agents, and a coalition of lawyers to stop the human carnage.” In brisk, often harrowing chapters, the authors present riveting descriptions of government investigations into the crisis, struggles to thwart those investigations by targeted corporations and their allies, and the (ongoing) courtroom proceedings that have revealed an astoundingly expansive web of negligence, greed, and callousness. Along the way, Higham and Horwitz lay bare a series of alarming facts about the institutions that fostered the epidemic, including how several opioid manufacturers exerted extraordinary influence over members of Congress, their attempts to launch public relations campaigns that undermined faith in science, and the pronounced indifference of some of their executives to the catastrophe they helped create. A particularly gripping thread of the narrative follows the heroic efforts of whistleblower Joseph T. Rannazzisi, a retired and ostracized member of the DEA who called out both the amorality of the drug industry and the inefficacy of his former employer. Also striking are the descriptions of certain loosely regulated Florida clinics, which attracted enormous and sometimes unruly crowds of clients from across the country. The authors could have offered a little more attention to the voices of epidemic victims—for that, see Beth Macy’s potent duo, Dopesick and Raising Lazarus—but they effectively acknowledge the suffering that hundreds of thousands have endured, creating an unforgettable portrait of unthinkable corporate greed and malfeasance.

A stunning depiction of corruption in the drug industry and those who confronted it.