Did The Sacklers Get Away With It?, by Ralph Nader Radio

Did The Sacklers Get Away With It?, by Ralph Nader Radio

Postby admin » Sun Dec 19, 2021 4:25 am

Did The Sacklers Get Away With It?
by Ralph Nader
RALPH NADER RADIO HOUR EP 404 TRANSCRIPT
December 4, 2021
https://www.ralphnaderradiohour.com/did ... y-with-it/

Steve Skrovan: We're gonna start today's show talking about the opioid crisis. Right now, it's common knowledge that the Sackler family who ran Purdue Pharma, the makers of OxyContin, bears the lion’s share of the blame for fueling an addiction that continues to take thousands of lives, tears families apart, and destroys entire communities. But according to our first guess, Ryan Hampton, the Sacklers had a lot of willing accomplices. He states that they committed “coldblooded corporate genocide, rubberstamped by the FDA [Food and Drug Administration] and cosigned by the free market.” And many of those accomplices were the ones tasked with holding them accountable, which they didn't in any meaningful way. Mr. Hampton was co-chair of the official creditor committee that was supposed to be watchdogging Purdue’s bankruptcy proceedings. This committee of creditors included representatives from insurance companies, hospitals, and pharmacies. And Mr. Hampton was one of only four actual victims on that committee.

In his new book, Unsettled: How the Purdue Pharma Bankruptcy Failed the Victims of the American Overdose Crisis, he pulls back the curtain on how the system of corporate bankruptcy does more to protect the criminals than bring justice to the victims. As always, somewhere in the middle, we'll check in with our tireless corporate crime reporter Russell Mokhiber. But first, let's hear about how Purdue Pharma’s killing spree was aided and abetted by the American injustice system, David?

David Feldman: Ryan Hampton is a national addiction recovery advocate, community organizer, and author. His latest book is Unsettled: How the Purdue Pharma Bankruptcy Failed the Victims of the American Overdose Crisis. Welcome to the Ralph Nader Radio Hour, Ryan Hampton.

Ryan Hampton: Thank you for having me. It's good to be here.

Ralph Nader: Welcome indeed, Ryan. This book covers a lot of ground and I noticed that you're not just focusing on the Purdue Pharmaceutical company or the Sackler family who owned it, but you say that you want people to understand, and I'm quoting you, “that the Sacklers, Purdue and many of the states and government actors were all hiding the truth from the American public. All of them are to blame. They all profited by maintaining the status quo, harming people, whether that was their intention or not.”

But I think when it comes to [the] Sackler family and Purdue, you indicated they really knew what was happening to millions of people with their unbridled promotion of OxyContin in these pharmaceutical tentacles as they headed throughout the country. You say, the story of Purdue Pharma, the billionaire family that owned it, that's the Sackler family, and the carnage they wreaked on unsuspecting Americans is what you're talking about. So, why don't you tell our listeners, some of whom may not be fully aware of the carnage, the number of people who have died, wreckage among millions of families, and to this day, they may not be aware of it. So, I want you just to lay the predicate for your book before we get into some of the details. What was the carnage and how did it inflict itself on so many people?

Ryan Hampton: I think it's important to know that we're in an unprecedented overdose crisis right now that's driven mainly by illicit Fentanyl, but a lot of this started the Pandora's box for the current day overdose crisis had a lot to do with Purdue Pharma, had lot to do with pharmaceutical oxycodone/OxyContin. You know, we think of the Sackler family as the first family, of big pharma, and rightly so for many reasons.

They released OxyContin in the 90s, utilizing tactics that were criminal and false advertising and false marketing. In fact, they pretty much wrote their own new drug approval or NDA with the FDA in the late 90s. They made a statement called the delayed absorption statement, which they knew to be false, that said that when the oxycodone made it through the bloodstream over the course of 12 hours, which their product allowed it to through its coding versus just instant release, that the risk of addiction was less than 1%, which they knew was false.

As I write in the book, Dr. Curtis Wright, who was with the FDA and who was the individual who was responsible for writing their new drug approval in the late 90s, invited representatives from Purdue Pharma to meet him at a hotel in Rockville, Maryland, right near the FDA, to actually write the drug approval for the FDA. Let me repeat that. Purdue Pharma wrote their own drug approval that went on to be approved by the Food and Drug Administration. It would be no surprise to folks that Dr. Curtis Wright just a few years later retired from the FDA and took a job making close to $400,000 a year at Purdue Pharma. These were some of the tactics that the company employed. When OxyContin started showing up in the pockets of coal mine workers in Appalachia or people who were going to pill clinics in South Florida and overdoses started to really ratchet up in the 2000s, and this data was coming back to Purdue and they saw where these prescriptions were coming from. And they saw the correlation between where the hotspots were for the overdoses and where the hotspots were for the pill clinics and where the prescribers were, we could imagine another world where Purdue said, “Hey, there's a problem here. We need to do something. We need to start working with prescribers. We need to start working with the federal government. We need to make sure that these overdose numbers are going down.” But no, Instead of doing that, led by Dr. Richard Sackler and Sackler family members who sat on the board of directors and controlled it, up until recently, they doubled down. They offered incentives to those prescribers, which they called super whales in the means of speaking fees and gifts and international trips. And they wanted to keep that pill pipeline open. That's how I got caught up in it. I wasn't just a victim's representative on the Unsecured Creditors Committee. I almost lost my life to OxyContin multiple times. I was prescribed in a doctor's office, someone that we’re taught to trust, and someone who lived this myself. And we can't forget also that Purdue is now a serial federal offender, right? I mean, they pled guilty in federal court in 2007 to these crimes. Three executives pled guilty. No one ever served any jail time. And recently they pled guilty again in October of 2020 for utilizing the same marketing tactics that they were found guilty for in 2007! So, this has been a story that's been coming along. The Sackler family made billions of dollars off of their blockbuster product OxyContin. I think people oftentimes forget that one of the biggest beneficiaries of OxyContin’s success actually happens to be the federal government in terms of taxes. They’ve taken over $5 billion from the family in taxes. And that's something I write about in the book and was maddening to me, but that's how we got here. We're now in a place where overdose death is more prevalent than car accidents, gun violence. For every eight COVID[-19] deaths here in the United States, we have one reported overdose death. This crisis is getting out of control and the death curve continues to tick up. Yet the Sackler family, as a result of the process that was laid out and prescribed before them by the bankruptcy code, will walk away without a single indictment, ever sitting for a grand jury and paying off $4.5 billion and walking off into the sunset while my friends and people I care about, in my community continue to die.

Ralph Nader: And the Sackler family is still worth over $14 billion and the $4 billion plus they agreed to was spread over 10 years. It seemed like, as your book points out, that big money corrupted everybody that touched it. It corrupted the FDA. It corrupted other government officials at the state level. It corrupted the pharmacies that went along with this and knew that they were overprescribing and huge amounts were pouring into West Virginia rural areas where all those pills were going. It corrupted everybody it touched and it betrayed the public's trust. [When] people hear the words ‘Food and Drug Administration’, they don't know that a large part of its budget is paid by the drug industry with a law that passed in Congress supposedly to save the taxpayer money. And then the FDA turns around, as you say, and lets the Sackler family and its buffer company, Purdue, write the actual approval for this drug, which of course minimized the warnings and wrote it in a public relations way to favor the company. But the immediate question is, did they get away with this in other countries, Ryan? I mean, Canada, Europe, Japan. Did they crack down more than the toady Food and Drug Administration?

Ryan Hampton: So, they did get away with it in other countries although they were exposed pretty heavily in Italy. Mundipharma, the international arm of Purdue, has not faced any type of criminal charges in other countries although they were exposed pretty heavily for a lot of their efforts in Italy. And Canada is actually caught up in the bankruptcy right now as one of the creditors in the United States bankruptcy. So, that's an ongoing kind of live ball discussion with respect to some of the international arms.

It has been very hard to track the wealth of the Sackler family, and I write about it in Unsettled. It has been very hard to track their wealth because they have these things called IACs, which are independent associated companies all over the world where their money is spread. And tracking those dollars was a nightmare. I sat in every deposition, read tens of thousands of pages of discovery, and really, the estimate that you put on how much they're worth is a conservative estimate because it's probably more than that. We just don't know where the money is. But, people have to know money is still corrupting the process today as we have this conversation! The Sackler family - at the end of paying that settlement of 4.5 million after 9 to 10 years just based on their current investments and a standard kind of moderate interest rate - will be able to pay back that $4.5 billion and net possibly $1 billion on top of it. So, at the end of this, they will be richer than they are today and have paid the settlement back. That is insanity. This so-called bankruptcy wasn't a bankruptcy. It was a heist. It was a scam. It was a money grab.

When this is all said and done… we hear all the headlines about the bankruptcy, [but] people don't oftentimes talk about the victims. The government, the Department of Justice, [and] the state attorneys general say they're doing this for the victims. 130,000 victims who have claims in this bankruptcy if the plan is ultimately held up on appeal and confirmed $750 million, an average payout of $5,000 per family. The most a mother or father will receive if their child overdosed and died from this product is $48,000. And in proving that claim and that harm, the barriers are extremely tall.

Ralph Nader: Listeners should know that the most recent modes of evaluating and judging petitions for bankruptcy, what's called Chapter 11 by crooked companies or companies that are terribly mismanaged, has developed a level of immunity unlike ever conceived by corporate lawyers in the past. It's not just what Ryan points out. Not only is it a get out of jail card when the judge approves the bankruptcy conditions, but it allows them to escape civil lawsuits under tort law and it allows them to actually make a profit. Because the Sackler family, according to your book, Ryan, took $10 billion out of the Purdue company starting in 2008 and put it in all kinds of so-called trusts around the world. And they immunized that money from being taken by the lawsuits brought by state attorneys general and private plaintiff lawyers. So, this is beyond the imagination of writers of fiction about corporate fugitives from justice. And Congress is deep into this except for Senator Elizabeth Warren who wants to reform these bankruptcy laws. And listeners should know that individuals can't get away with this with bankruptcy. There now is a double standard. The privileges, immunities, escape from justice under corporate bankruptcy laws are far, far more enabling than any debtor who tries to start a clean slate and declares bankruptcy for a few thousand dollars of debt. This is a double standard. Someday it should be challenged under the equal protection laws of the U.S. Constitution. But as you say, this family, the Sackler family, has its name on a number of philanthropic institutions, including in Washington, D.C. Why aren't people demanding, the way they demand to take [Thomas] Jefferson and [Abraham] Lincoln off names; why aren't people demanding to take the names of the Sacklers off these institutions, especially the big one in Washington?

Ryan Hampton: Well, they are, Ralph. I worked a lot with Nan Goldin and other activists and, we've had actions in front of the Smithsonian. It was one of the first protests that I helped put together in 2018 to demand that the Smithsonian take the Sackler name off their art wing there, right on the Capitol mall.

Ralph Nader: What are they saying?

Ryan Hampton: No comment. No response from them; it is maddening. Some institutions like Tufts [University] and other universities have began to take the Sackler name down. But in the bankruptcy plan, what's also maddening/one of the more upsetting things is that the state attorneys general and activists were calling for banning the Sackler name from philanthropic institutions for a long time. They negotiated a deal with the Sacklers that their name, if the plan is confirmed, cannot be on philanthropic institutions until they've paid their $4.5 billion in total. [Although] once they've paid their settlement, their name can go back up on these institutions! It’s a maddening, small point in the bankruptcy plan. But I want to just address one thing to go back to the $10 billion that the Sacklers had withdrawn. The week after the 2007 consent judgment, there was a memo from an executive at Purdue that was written to Jonathan Sackler, Richard Sackler’s brother, also on the board, one of the executives of the company, about how to diversify the family's money and to protect them. And they recommended certain actions that the family take. In the 8 to 10 years prior to that $10 billion withdrawal, the Sackler family had only withdrawn something like $1 billion from the company. And after the 2007 guilty plea, they knew that the states and that other potential litigants had their sights set on the Sacklers and they quickly started withdrawing dollars out of the company. So, they had been preparing for this bankruptcy for quite some time.

Ralph Nader: Without this bankruptcy shield, there would've been a lot of law enforcement actions. There would've been civil actions that would be more effective. There would've been follow up on criminal cases. And so, before we get to the intricacies of the bankruptcy and Judge [Robert] Drain who presided over it and the plaintiff lawyers and the defense lawyers and the state attorneys general, the reason why I raised the name Sackler on these institutions is because they are now moving to eliminate the last remaining social sanction for their crimes, which is stigma. And it shows you the power that these corporations have. They escaped from regulation. They escaped essentially from criminal prosecution. None of these people are going to jail. They escaped from the state attorneys general. And now they want to escape from stigma/ the sanction, and just come back and start their mode of operating and getting more profits all along. So, let's ask this question--what is the state of Purdue Pharma now? It's supposed to be – it is in bankruptcy, but it's coming out in some sort of public trust for the victims. Is that too much to describe or what?

Ryan Hampton: Yeah. So, it's being restructured as a… it's no longer Purdue Pharma. It's a new company. It's known as NewCo [New Company] as an abbreviation for new company. The board of directors is gonna be appointees of state attorneys general or attorneys general themselves. It's being reformulated into a public-benefit corporation. So, all proceeds and revenue from the company and profit from the company will be going into the NOAT, which is the National Opioid Abatement Trust, to pay the settlement. It will continue to sell OxyContin to drive profits and drive revenue. Without the sale of OxyContin, there is no settlement. I think that's one thing people need to understand is that what people think is a substantial settlement, I think it's nothing. But there's nothing without the Sackler contribution of $4.5 billion and without a reformulated Purdue Pharma as a public-benefit corporation to continue selling OxyContin. But the control of the company will now be the states, which does give me pause, because it now becomes an issue of who regulates the regulators. The government is now essentially in the business of selling opioids, selling OxyContin. OxyContin inherently is not a bad medication. Opioids are not inherently bad. It's how they're marketed. It's how they're put into the market [i.e.,] how the Sacklers weaponized the American medicine cabinet. So, to drive profits, it is concerning that the government controls because who calls the shots then? Who holds them accountable?

Ralph Nader: It's like China. The Chinese government invested into the tobacco industry and they had a conflict of interest between their public health responsibilities and the huge revenues that were coming in because of the sales. But let's go into the circles of irresponsibility here, Ryan. And I beseech you try to be a little brief because we're gonna cover a lot of circles. Congress. Did Congress hold hearings? What did it do and didn't do in your judgment?

Ryan Hampton: I think Congress has had a few hearings on the topic, but they've done nothing. [chuckle] The SACKLER Act was proposed just this past March, to eliminate the releases for the Sacklers yet the government and Congress knew that the Sacklers wanted these releases when they filed for bankruptcy in September of 2019. They were about 18 months late to the game. Bankruptcy reform has been on and off as a hot topic. But no, Congress knows what the problem is. Congress isn't moving. We've seen some performative gestures.

Ralph Nader: Did members return contributions that were made politically to them by the Sackler family?

Ryan Hampton: Yes. We have seen contributions returned from individuals, but they were small contributions--a thousand here, a thousand there, maybe $2,800 once in a while. I think it's notable to know though, that even in the midst of the bankruptcy, in the middle of the process, my committee discovered that the Democratic Attorneys General Association, the Republican Attorneys General Association, the Democratic Governors Association, and the Republican Governors Association were accepting six-figure contributions from Purdue Pharma in the middle of the bankruptcy, in the middle of the process, still taking checks from them!!! Ralph Nader: That's beyond anybody's level of cynicism. That is really gross. So, Congress, in summary, has not passed any corrective legislation. They have not passed reform of the atrocious get out of jail bankruptcy system. Let's go to the Justice Department. What have they done and what do you think they should have done or should do now? Because there's no statute of limitation on crimes like that.

Ryan Hampton: Right. I'm actually headed to Washington, D.C. tomorrow morning on a plane to go stand out in front of the Justice Department with about a hundred advocates from around on the country to call for Attorney General Merrick Garland and Deputy Attorney General Lisa Monaco to use the evidence that they have to prosecute the Sacklers criminally. The Department of Justice settled civilly with the Sackler family in October of 2020. They said at the time that criminal prosecution was still a on the table. My understanding from the backdoor deals and the Department of Justice was in all of the mediation meetings that I was in during the bankruptcy, was that because they've accepted a civil settlement, even though they are saying publicly that they can still charge criminally, they're likely not to charge criminally, because if they do that, the Sacklers will obviously pull back their $4.5 billion contribution of which the federal government is taking a chunk. I recently found out just through a simple search through federal government records that the chief counsel to Attorney General Garland is a former lead attorney at Sidley Austin [LLP], who before she joined the administration and the Department of Justice was a lawyer representing Purdue Pharma!

Ralph Nader: So, there was no grand jury convened for the Sackler family.

Ryan Hampton: Not only was there no grand jury, in 20 years, not one single member of the Sackler family has faced an indictment or sat for a grand jury. They didn't do it in 2007; they didn't do it in 2020, and they're not doing it today. I have friends who are sitting in jail for simple marijuana charges, serving time in jail for marijuana. Yet the Sacklers will never, ever even have to sit for a grand jury, or haven't yet.

Ralph Nader: What a comparison, huh? That's why you should have on some of your signs in front of the Justice Department, call it the ‘Injustice Department’ presiding over the criminal injustice system. Somebody caught with a joint or with a couple ounces of marijuana over the years, goes to jail for 5, 10 years, and these corporate criminals escape. Now, to be fair to the Sackler family, they repeatedly say to the media, “We didn't do anything wrong. We didn't do anything wrong.” Tell us what they did wrong.

Ryan Hampton: [major laughter] They used criminal tactics. Their marketing was wrong. They weaponized, like I said before, the American medicine cabinet with a product they knew could kill people.

Ralph Nader: We're talking with Ryan Hampton, author of the gripping, and I say that as an understatement, the book, Unsettled: How the Purdue Pharma Bankruptcy Failed the Victims of the American Overdose Crisis. Give us an idea what the marketing was. First, the marketing to the pharmacies, the marketing to the doctors, and then the marketing to the public.

Ryan Hampton: Right. It all goes down to their claim of OxyContin is less than 1% addictive. Their claim around, David Haddox, who is an executive at Purdue, pseudo addiction--that people who may feel dependent on the drug, aren’t addicted. They're just pseudo addicted, which means that it's just a side effect of the medication, like what I experienced. I was told/my doctor was told that you had less than 1% chance to become addicted, which makes the products seem way safer, completely safe, actually, when it wasn't. They had the data. They had the science. They knew this was a lie and they sold it to the American public and the FDA helped them do it. They used tactics with Practice Fusion, which was this marketing apparatus that was used in front of doctors that would push OxyContin and Purdue opioids to the top of the list when people were asking for some sort of pain care. And they were incentivizing those doctors to do it. They were essentially paying doctors to prescribe this medication and pass on this lie. You've got to look at the larger problem here too, though, which is allowing highly addictive, problematic narcotics to be marketed like they’re Coca-Cola or marketed like it's McDonald's or marketed like it's some other household product. That's what Purdue did and they used lies to do it. That is criminal because it kills.

Ralph Nader: Did they advertise it on TV?

Ryan Hampton: Yes.

Ralph Nader: Did they advertise it on TV?

Ryan Hampton: Yes. Television, radio, direct mail, promotional products, trips and junkets for doctors, and financial incentives for doctors.

Ralph Nader: And all along people were dying in communities all over the country. You go to any community in the country and you say to someone, “Do you know anybody in the neighborhood who has died because they took this so-called painkiller that actually killed them?” And they say, “Oh, yeah, I know. She was 19 years old and had all the promise in life and she took it.” So, we're talking here big numbers, listeners. What's the official estimate? How many people have died from this Purdue Pharma drug over the last 15 years?

Ryan Hampton: Right. Well, from OxyContin, they're looking at numbers that are probably… their market share was small from prescription opioids, though. Prescription opioids, you're looking at about 400,000 (people), but it's important to know and this was my case. My addiction started with a Purdue product and Purdue had many products. Hydromorphone was another one of theirs and OxyContin. But I then went on from – because once more people started using OxyContin, the prices started to go up, so, it was a supply and demand issue. Many users of OxyContin, people who were misusing it, then moved on to other drugs when they couldn't afford the OxyContin anymore. I moved onto heroin and it almost killed me. So, a lot of the deaths that we see every year, where it's like someone died of a heroin overdose or a fentanyl overdose, or some other drug overdose. For a lot of people in the last 10 years, those addictions started in a doctor's office or with a prescription. And we're going into this whole new third wave of the opioid crisis now where illicit Fentanyl is kind of in everything and so, it's a whole new ballgame. But a lot of us who had issues with other drugs down the line, it started with OxyContin. Because we don't have good data on that, it's hard to actually say this many people died from OxyContin.

Ralph Nader: You're talking about the deadly forces this drug put in motion. Fentanyl is probably the deadliest thing you could pick up on the streets today. And I know you're a major figure in the recovery movement, which we’ll talk about in a moment, but just to continue the circle, tell us about the law firms. Tell us about the plaintiff law firms and the corporate law firms. Name the corporate law firms who love to be anonymous.

Ryan Hampton: (laughter) There were several of them. One of the things that I realized early on when I joined the committee was [that] there were a group of law firms and lawyers that were supposed to be on opposite sides, and they knew each other. It felt like they played golf on the weekends or vacationed with each other's families. And because I was the co-chair of this committee, I had to sign off on a lot of the bills that were going to the estate. And I started seeing bills for $20 million, $30 million, going up $40-50 million paying attorneys.

Ralph Nader: Legal bills.

Ryan Hampton: Legal bills. So, Akin Gump [Akin Gump Strauss Hauer & Feld LLP] was the law firm that represented just my committee, the creditors committee. They've been paid over something like $140 million so far. The plaintiff lawyers, though, in general, when you put them all in one bucket--the plaintiff lawyers, the contingency lawyers that worked for the states, the contingency lawyers that worked for the victims, the NAS [neonatal abstinence syndrome] babies and others, they will--and I know I said in the book a little bit over a billion, but now it's actually eking closer to a billion and a half; over 1,000 lawyers and consultants. In this case, under 1,000 will take home – if this plan is confirmed – over $1.5 billion. $1.5 billion when over 130,000 victims will have to share in $750 million, average payout of $5,000, each family. That is a crime in itself. A coalition of firms that billed themselves as the opioid justice team that purport to represent families impacted by NAS babies don't care. And I write about this in the book. I believe they don't care at all about NAS babies. They threw junk science into this bankruptcy to beef up their claims. They don't care about how much their clients actually get. They care about how much they're gonna get paid. The legal system, the tort system, the way that these kind of vulture lawyers were able to just descend on the carcass of Purdue and start picking it apart just blew my mind. I've never seen anything like it.

Ralph Nader: You say they were close to the corporate lawyers representing Purdue and the Sackler family.

Ryan Hampton: Oh, of course. Oh, yes. Very much. And all of them were, though. Like the lawyers, Pillsbury law firm [Pillsbury Winthrop Shaw Pittman] and Andrew Troop and all these other lawyers that were representing the consenting states and the non-consenting states and the plaintiff lawyers. They were all in cahoots, I believe, with Davis Polk [& Wardwell]. People think of bankruptcy and they think, well, like Purdue is on the stand, like they're the defendant, right? Nothing can be further from the truth. Purdue’s law firm, Davis Polk, self-proclaimed in open court that they were basically the conductor of the process. And that was true. They led the process. If Purdue wasn't willing to do something, it didn't happen. People think of bankruptcy court and bankruptcy process like some sort of trial. It's not an examination of the facts; it's not an examination of the truth. The debtor who you think of as the defendant, run the entire process; they run the show. So, everybody needed to be close to Davis Polk. Everybody needed to be close to Marshall Huebner, who was their chief counsel, who is someone I just absolutely can't stand. He used to make claims that because there were four victims on the UCC [Unsecured Creditors Committee] and there were five corporate creditors, that if there was a five to four vote in the favor of the company, that victims supported it because the votes were secret. That was another setup because the Department of Justice knew that they couldn't see the majority of victims on that Unsecured Creditors Committee because they knew how that would go down.

Ralph Nader: This looks like another book on the lawyers. I hope some law professors listening in can write a book on this part of the story. But the litigation is not quite over because as you know, most of the state attorneys general folded, including the most courageous one in terms of her past cases, Attorney General [Maura] Healy of Massachusetts. But I checked this out, there is an appeal that's going up. And the following attorneys general are standing firm against this atrocious settlement or surrender or capitulation. And they are led by the attorney general of Connecticut, Attorney General [William] Tong, the attorneys general of California, Delaware, D.C., Maryland, Oregon, Rhode Island, Vermont and Washington state. That's the only thing left that might turn this thing around. And the chances are not great, but at least they didn't throw in the towel. So, that's where they are, listeners.

Ryan Hampton: Yeah. I want to say something really quick though about that. It is important to know that if let's say the appeal is thorny, because I wish we would've had this information before they got so far down into the plan. Because if this appeal is successful, there is no mechanism right now that protects that paltry sum, that $750 million for the victim creditors. Essentially, that will be the first thing to go because the state attorneys general, and I write about this in the book, negotiated that the victim's settlement, that $750 million, would all come from Sackler money. So, if they get rid of the releases, the states will still get paid, but the victims won't get paid. And it was just another setup from day one. What we want is criminal charges. We want criminal charges. So, even if this appeal is successful, there's still no criminal case on the docket right now.

Ralph Nader: It's a very limited appeal to be sure. But isn't there some hope from the cities and states that are now suing the giant pharmacies--Walgreens [Company], CVS [Pharmacy], and others for reckless prescribing? Do you see any opportunity there to get more funds back for the recovery process of the victims?

Ryan Hampton: No. I see a recovery process for the states, which is something we didn't have enough time to talk about, but all of the money in the multidistrict litigation in these pharmacies will be going to government creditors. It's one of the maddening parts of this whole process. The only apparatus for victims to participate – actual human beings – was through the Purdue bankruptcy. Actual individuals will not be receiving any money for past harms done to them because the government has stepped in and said that they have administrative claim over this, and they will recover all the money. Of course they will probably do some good with it, build a better system, hopefully. It won't become a tobacco 2.0, hopefully. But the actual humans whose lives were destroyed by this product/these products/these companies, there is no mechanism other than the Purdue Pharma bankruptcy for any recovery, which is why I am hyper concerned on how this appeal happens, that if they don't protect that $750 million for victims, we have been completely robbed of any single shred of justice that we could have.

Ralph Nader: Well, you know what, listeners, the cities and states that are suing the pharmacies also sued the company. They're all claiming that they had to pay a lot of social service funds for all the victims that they had to try to help and they want to recover that money. And if they do recover that money, obviously a good deal of it should go back to trying to reduce the problem in the first place and help some of the patients that can be helped in this way. So, that's the circuitous way of saying that there is some sliver of hope left. But you and a lot of others working on this, want justice, not just compensation. You want criminal prosecution.

Ryan Hampton: That's absolutely right.

Ralph Nader: And that looks like that's been dissipated by this grotesque bankruptcy system they have for corporations. Steve, David, I'm sure you want to ask Ryan some questions or make some points in the remaining time.

David Feldman: Pete Buttigieg, our Secretary of Transportation, worked for McKinsey [& Company] and they're a management consulting group. Can you tell me the role that McKinsey played in all this? And McKinsey also invests in for-profit treatment centers as does Mitt Romney’s Bain Capital. There's big money in treating opiate addiction. So, the second part of my question is can somebody kick opiate addiction without going through a for-profit rehab center?

Ryan Hampton: So, it's a two-part question there. I'll just first say with McKinsey, McKinsey had a huge role to play in the opioid overdose crisis, but also in the Purdue case. So, specific to Purdue, I went through dozens of internal McKenzie documents. I talked about some of them in Unsettled. But they advised Purdue to incentivize insurance companies to keep paying for OxyContin and keep paying for the opioids by offering rebates for even people who have died from overdoses because so many people were dying from overdoses, they thought that if Purdue offered a drug rebate based on those deaths that the insurance companies would keep paying. They also advised Purdue on how to deal with grieving families who were losing loved ones to the overdoses, how to message that. McKinsey paid a settlement of close to $500 million for a full release for their role in the overdose crisis. They are a super evil consulting company. I can't stand anything that has the sentence McKinsey on it. To your second part around for-profit rehab…

Ralph Nader: Just to interrupt, Ryan, in your book, you quote the rare apology, according to the New York Times that McKinsey issued in December 2020. I guess this is on the occasion just before they agreed to pay 47 states and the District of Columbia 573 million dollars. Here's McKinsey's statement. “As we look back at our client service during the opioid crisis, we recognize that we did not adequately acknowledge the epidemic unfolding in our communities or the terrible impact of opioid abuse and addiction on millions of families across the country.” That's an apology with monetized glasses on, wouldn't you say?

Ryan Hampton: Yeah, no, absolutely. It's kind of ridiculous too because McKinsey was working for Purdue advising them up until just the last couple of years. They knew what was happening. Purdue's role in the overdose crisis isn't something that just happened in the last five years. McKinsey knew exactly what they were up to, but Purdue had a lot of money and they had a lot of money to pay. And the almighty dollar always wins out when you get two companies like that together.

To your second question on for-profit rehabs, absolutely people can find help and get better without having to go through some of these for-profit rehabs. Let's remember that a lot of these for-profit rehabs… the addiction treatment business in this country is a $30 billion annual industry. They benefit from repeat customers I went through so many for-profit rehabs that did not work. And I ended up going through revolving doors. Over half of them don't offer evidencebased care that we know works [i.e.,] evidence-based treatment medications for opioid use disorder. That is a crime in itself! It is a hugely underregulated industry in this country that has an extraordinary criminal underbelly to it.

If treatment is available and treatment should be available on demand. In my opinion it should be free. It should be covered 100% under Medicaid or Medicare. We should be treating addiction in primary care facilities. We should be treating it in hospital emergency rooms. This cottage industry of for-profit $30 billion industry of these fancy Malibu rehabs is broken. It is broken. But it rakes in the dollars because they prey on the intersection of greed and fear. It's greedy companies, greedy rehabs that prey on fearful families. And they tell these families when their loved one needs help, that if they don't get to their facility, if they don't mortgage their house, if they don't open up a credit line to pay $30,000, $40,000 cash a month to get their loved one in there, that they will die; their loved one will die. It's criminal. My mother went into debt when I was using for over 10 years, close to $0.5 million that she doesn't have that we're still paying off today--almost a decade later we are still paying off today at an extraordinary interest rate from many of these same individuals and same companies. It's a crime.

Steve Skrovan: Ryan, I would like you to describe a scene that you do so well at the very beginning of your book about a protest that you attended in 2018 in front of the Purdue Pharma building. And if you could describe that, recreate that for our listeners, and what you saw going on - on the third floor. I think that would probably put a human emotional face on all of this. Ryan Hampton: In August of 2018, I led a protest with a dear friend of mine, Cheryl Juaire, who lost her son to an OxyContin overdose several years ago and who actually lost her second boy, her second son in June to an opioid overdose. We led a protest of about 500 family members, people impacted, people whose lives were destroyed by OxyContin, in front of Purdue pharma's headquarters. It was a summer day. It was very loud. You could hear people shouting from the rooftops. There were signs of friends and family members that we had lost. There was a lot of anger; there was a lot of rage. We wanted the company at the time to divest their profits into harm reduction treatment, supportive services for grieving families. And it was a serious moment for us. And as we were making this request from a bullhorn in front of the office of Purdue in Stamford, Connecticut, there was a line of police officers protecting the building. They were there because Purdue asked them to be there to protect the company. And you could look up onto the third floor where there was a balcony and there were a few Purdue employees who had their phones out and they were taping us. But they weren't just taping us. They were laughing at us. They were pointing at us and laughing at us as we were making this plea as we were there spilling our hearts out, just full of grief and emotion and passion. They thought it was a joke. And you know, I think it was a telltale sign for what was to come. I think that the Sacklers still think we're a joke. And in certain respects, I think some of us feel foolish, especially on the advocacy front, because we fought so hard for so long for so many years and look at the outcome that's about to happen.

It's sad, but I would say, you know, Ralph mentioned hope. While my belief in justice for my community is genuine, my faith in the justice system is tarnished right now. But I still believe that on the other side of this, some good can come. I think a lot of people have worked very hard to put transparency into this process and hopefully Unsettled has done that and we can all work together to ensure this doesn't happen again, because unless we reform the system, this will continue to happen. It may not be opioids. It'll just be another deadly issue or evil corporation using these laws that have harmed so many victims across this country.

Ralph Nader: You know, Ryan, some listeners may be skeptical now and say, “Well, it's consumers’ own fault. They should have been more careful.” But in your book, you show the amazing level of deceptive advertising saying no serious side effects, mislabeling, seductive marketing, and a lot of this promotion found its way to the doctor's office too. And they bought into this as well and that misled of course their own patients. That's why your book is all about the details that listeners should really be very aware of because this is an addiction culture. There are going to be other addictions, other corporations like Purdue Pharma. They already exist. [chuckle] It's not just the tobacco, nicotine drug companies; it's all over. And we need to get rid of this bankruptcy system. We need the rule of law. We need tougher federal and state criminal laws, tough penalties, in personam indictments and convictions of the corporate crooks and those who benefit directly from these kinds of crimes. It should be a big political issue for campaigns. We should demand every candidate running for office to answer the question, what's your position on corporate crime? What are you gonna do about corporate crime? Why are you so soft on corporate crime?

Ryan Hampton: Exactly.

Ralph Nader: Well, we're out of time, unfortunately. It's worth reading this book only for the conclusion, not just the rest of the book. The conclusion is titled “The Way Out”. We've been talking with Ryan Hampton, author of the book, Unsettled: How the Purdue Pharma Bankruptcy Failed the Victims of the American Overdose Crisis. And it's really a snapshot of a lot more that's going on around this country that has to be corrected. These politicians have got to be held accountable or replaced at the local, state, and national level because we have very small reach toward these big companies. Again, the only countervailing force to deal with them is our government--state and federal, and it starts with the Congress as well. Thank you very much, Ryan, and good luck on your future efforts because you're not going to give up, and you have a broad-range vision of what needs to be done--not just palliative, but preventive.

Ryan Hampton: Thank you, Ralph. Thank you.
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