In 1998, the tobacco industry, which had been sued by dozens of states, entered into the largest civil-litigation settlement in history, agreeing to pay two hundred and forty-six billion dollars. Tobacco and opioids are different in significant ways. The F.D.A. approved OxyContin as a medicine, and, whereas tobacco can kill you even when used as directed {or make you well - see link above}, Purdue would argue that this isn’t the case with OxyContin. Mike Moore, who, as Mississippi’s attorney general, played a key role in the tobacco litigation, noted another difference: the tobacco companies had more money to spare than Purdue does. “To resolve the opioid problem, you’re going to need billions,” he said. “Treatment alone could be fifty billion dollars or more. And you need prevention and education programs on top of that.”
Moore is now working with Paul Hanly and other attorneys to bring a fresh wave of lawsuits against Purdue and other pharmaceutical companies. Ten states have filed suits, and private attorneys are working in partnership with dozens of cities and counties to bring others. Many public officials are furious at the makers of powerful painkillers. Prescriptions are expensive, and taxpayers often foot the bill, through programs like Medicaid. Then, as the ruinous consequences of opioid addiction take hold, the public must pay again—this time for emergency services, addiction treatment, and the like. Moore feels that the Sackler family, as the initial author and a prime beneficiary of the epidemic, should be publicly shamed. “I don’t call it Purdue. I call it the Sackler Company,” he said. “They are the main culprit. They duped the F.D.A., saying it lasted twelve hours. They lied about the addictive properties. And they did all this to grow the opioid market, to make it O.K. to jump in the water. Then some of these other companies, they saw that the water was warm, and they said, ‘O.K., we can jump in, too.’ ” There may be significant legal distinctions between a tobacco company and an opioid producer, but to Moore the ethical parallel is unmistakable: “They’re both profiting by killing people.”
One day in August, 2015, a plane landed in Louisville, Kentucky, and Richard Sackler stepped out, surrounded by attorneys. Eight years earlier, the State of Kentucky had sued Purdue, charging the company with deceptive marketing. Greg Stumbo, the state attorney general at the time, initiated the suit; the son of a cousin of his had fatally overdosed on OxyContin. Purdue fought the suit with its customary rigor, pushing to move the proceedings elsewhere, on the ground that the company could not get a fair trial in Pike County, Kentucky—the rural stretch of coal country where the state intended to try the case. In support of this motion, the company commissioned a demographic study of Pike County and submitted it to the court, as an illustration of potential bias in the jury pool. The report was revealing in ways that Purdue may not have intended: according to the filing, twenty-nine per cent of the county’s residents said that they or their family members knew someone who had died from using OxyContin. Seven out of ten respondents described OxyContin’s effect on their community as “devastating.”
A judge ruled that Purdue could not shift the venue for the trial, and so Richard Sackler flew to Louisville. He gave a deposition at a law firm. Four lawyers questioned him about his role in the development and the marketing of OxyContin. Tyler Thompson, the lead attorney, told me that Sackler’s demeanor during the session reminded him of Jeremy Irons’s portrayal of Claus von Bülow, the aristocrat accused of murdering his wife, in the 1990 bio-pic “Reversal of Fortune.” “A smirk and a so-what attitude—an absolute lack of remorse,” Thompson said. “It reminded me of these mining companies that come in here and do mountaintop removal, and leave a mess and just move on: ‘It’s not my back yard, so I don’t care.’ ” Mitchel Denham, a former litigator in the Kentucky attorney general’s office, also attended the deposition. “It was surreal,” he recalled. “We were face to face with the guy whose company had helped to create the opioid epidemic.” Denham told me that, in preparing for trial, he discovered a photograph of the 1997 Pikeville High School football team. “Nearly half the players had died of overdoses, or were addicted,” he said. “It was going to be a pretty good visual.”
But Denham never presented the photograph to a jury, because before the case could go to trial Purdue settled, for twenty-four million dollars. This was a coup for the Sacklers. The settlement was more than Purdue’s original offer—half a million dollars—but still totally incommensurate with Pike County’s needs; Purdue admitted no liability; and, in settling, the company sealed from public view both Richard Sackler’s deposition and internal documents obtained through discovery. Purdue has sometimes claimed to have never “lost a case” related to OxyContin, but it’s more accurate to say that the company has never allowed a case to go to trial, often settling rather than litigating the culpability of the company—and the Sacklers—in open court. “That’s the main reason these folks don’t go to trial,” Denham said. “Because all these documents could end up in the public record.” The Kentucky prosecutors were required to destroy millions of documents, or return them to Purdue. The medical-news Web site STAT subsequently sued to unseal Richard Sackler’s deposition. A state judge ruled in its favor, but Purdue appealed. I spent several months trying to obtain a copy of the deposition, but, because it remains under a protective order while Purdue appeals the matter, no lawyer would share it with me. Mike Moore said, “The idea that they’re fighting so hard to keep this deposition hidden should tell you something.”
Richard Sackler stepped down as Purdue’s president in 2003, but stayed on as co-chairman of the company’s board. After spending several years as an adjunct professor of genetics at Rockefeller University, he moved to Austin, Texas, in 2013. He lives in a modern hilltop mansion on the outskirts of the city, in an area favored by tech entrepreneurs. According to tax disclosures from his personal foundation, he has continued giving money to Yale, but his largest donation in 2015 was a hundred-thousand-dollar gift to a neoconservative think tank, the Foundation for Defense of Democracies. Through a representative, Sackler declined to speak with me. I contacted a dozen other members of the Sackler family, but none of them would answer questions about OxyContin. Jo Sheldon, a London-based media adviser, called me, and said that she works with some of the Sacklers. (She would not identify which ones.) When I told her that I had questions for the Sacklers, she said that my inquiries would be better directed to Purdue. She said of the Sacklers, “Some of them are still quite involved in Purdue, but some have absolutely nothing to do with it,” apart from depositing checks.
Given the sometimes fractious nature of the Sackler family, it was striking that they were united in their silence on the subject of OxyContin. These were urbane, expensively educated, presumably well-informed people. Could they conceivably be unaware of the accumulated evidence about the tainted origins of their fortune? Did they simply put it out of mind? “Greed can get people to rationalize pretty bad behavior,” Andrew Kolodny had told me. Someone who knows Mortimer, Jr., socially told me, “I think for him, most of the time, he’s just saying, ‘Wow, we’re really rich. It’s -flicking- cool. I don’t really want to think that much about the other side of things.’ ”
Paul Hanly, the lawyer, said that the Sacklers’ steadfast refusal to address the legacy of OxyContin may just be a legal tactic—and a shrewd one. “The more interviews you give, the more targets you create for lawyers like me, and for government investigators,” he said. I wondered whether philanthropy might represent, for at least some of the Sacklers, a form of atonement {it is often simply for tax reasons}.
But, when you consider the breadth of the family’s donations, one field is conspicuously lacking: addiction treatment, or any other measures that might serve to counter the opioid epidemic.
In August, 2010, Purdue quietly replaced OxyContin with a drug that was subtly different. The company had been granted patents for a reformulated version of OxyContin. If you crushed these new pills, they became not a fine, dissolvable powder but an unwieldy gummy substance. Purdue had received F.D.A. approval for the reformulation, in part, by touting the ostensible safety of the new product. The F.D.A. had approved a label, the first of its kind, that included a claim about the drug’s “abuse deterrent” properties.
In an interview, Craig Landau, Purdue’s C.E.O., told me, “A very large proportion of Purdue’s R. & D. efforts post-2001 was dedicated toward addressing the specific vulnerability of the original OxyContin product.” To a casual observer, it might have seemed that the makers of OxyContin, after years of obstructing efforts to curb the disastrous impacts of their painkiller, had finally seen the error of their ways. But Purdue was almost certainly motivated by another consideration: it needed to block competition from generic drugs. Arthur Sackler had often used the pages of the Medical Tribune to criticize generics. In 1985, the paper had published a story, “Schizophrenics ‘Wild’ on Weak Generic,” describing how “all hell broke loose” at a veterans’ hospital after the psychiatric unit switched from a brand-name antipsychotic to a generic. (According to the Times, the F.D.A. investigated and found that the story was bogus, because “the generic had been introduced six months before the purported problems began.”) I spoke with a leading patent lawyer who frequently represents manufacturers of generic drugs, and she said that companies often make a minor tweak to a branded product shortly before the patent expires, in order to obtain a new patent and reset the clock on their exclusive right to produce the drug. The patent for the original OxyContin was set to expire in 2013.
Purdue had long denied that the original OxyContin was especially prone to abuse. But, upon receiving its patents for the reformulated drug, the company filed papers with the F.D.A., asking the agency to refuse to accept generic versions of the original formulation—because they were unsafe. The F.D.A., ever obliging, agreed, blocking any low-cost generic competition for Purdue. For more than a year, Purdue continued to sell the original formulation of OxyContin in Canada. According to a recent study, OxyContin sales in Windsor, Ontario—just across the border from Detroit—suddenly quadrupled, a clear indication that the pills were being purchased for the U.S. black market. Through I.M.S. tracking data, Purdue would have been able to monitor the Canadian surge, and to deduce the reason for it. (The company acknowledges that it was aware of the spike in sales, and maintains that it alerted authorities, but will not say when it did so.)
By the time Purdue reformulated OxyContin, the country was in the middle of a full-blown epidemic. Andrew Kolodny, the addiction specialist, told me that many older people remain addicted to the reformulated OxyContin, and continue to obtain the drug through prescriptions. These people purchase the drug legally, and swallow the pills whole, as instructed. “That’s Purdue’s market now,” Kolodny said. Younger people, who can less readily secure prescriptions for pain—and for whom OxyContin may be too expensive—have increasingly turned to black-market substitutes, including heroin. As Sam Quinones details in his 2015 book, “Dreamland: The True Tale of America’s Opiate Epidemic,” heroin dealers from Mexico fanned out across the U.S. to supply a burgeoning market of people who had been primed by pill addiction. This is one dreadful paradox of the history of OxyContin: the original formulation created a generation addicted to pills; the reformulation, by forcing younger users off the drug, helped create a generation addicted to heroin. A recent paper by a team of economists, citing a dramatic uptick in heroin overdoses since 2010, is titled “How the Reformulation of OxyContin Ignited the Heroin Epidemic.” A survey of two hundred and forty-four people who entered treatment for OxyContin abuse after the reformulation found that a third had switched to other drugs. Seventy per cent of that group had turned to heroin.
Perhaps the most surprising aspect of Quinones’s investigation is the similarities he finds between the tactics of the unassuming, business-minded Mexican heroin peddlers, the so-called Xalisco boys, and the slick corporate sales force of Purdue. When the Xalisco boys arrived in a new town, they identified their market by seeking out the local methadone clinic. Purdue, using I.M.S. data, similarly targeted populations that were susceptible to its product. Mitchel Denham, the Kentucky lawyer, told me that Purdue pinpointed “communities where there is a lot of poverty and a lack of education and opportunity,” adding, “They were looking at numbers that showed these people have work-related injuries, they go to the doctor more often, they get treatment for pain.” The Xalisco boys offered potential customers free samples of their product. So did Purdue. When it first introduced OxyContin, the company created a program that encouraged doctors to issue coupons for a free initial prescription. By the time Purdue discontinued the program, four years later, thirty-four thousand coupons had been redeemed.
Purdue Pharma now acknowledges that there is an opioid crisis, but maintains that it has taken every available step to address it, from sponsoring “prescription monitoring” programs in some states to underwriting drug-abuse education. Craig Landau, the C.E.O., told me, “If the Holy Grail is a pain medicine that is safe and effective for patients with severe pain but carries no abuse risk, we haven’t found it yet.” He added that the company has been trying to develop “non-opioid pain products.” Purdue likes to emphasize that there are many other powerful painkillers, and that OxyContin never had more than two per cent of the market for opioids. This is true in terms of the number of prescriptions. But most painkillers are prescribed for very short periods—following surgery, for instance—and in relatively small doses, whereas OxyContin’s sales have been driven by long-term, high-dose prescriptions. If one measured market share by the actual volume of narcotics administered, OxyContin’s would be considerably higher. Some doctors I spoke with estimated that it could be as high as thirty per cent.
The United States accounts for roughly a third of the global market for opioid painkillers. But, as politicians and journalists have raised alarms over the addiction crisis, many American doctors have grown leery, again, of prescribing these drugs. In a statement, Purdue acknowledged that even patients “who take OxyContin in accordance with its F.D.A.-approved labeling instructions will likely develop physical dependence.” The company maintains that physical dependence is different from addiction, but Jane Ballantyne, the president of Physicians for Responsible Opioid Prescribing, said that, for patients, this can be a meaningless distinction: if they find themselves unable to stop taking a drug, for fear of crippling withdrawal, “at a certain point that might as well be addiction.” The drugstore chain CVS, which has been accused of profiteering from opioids, recently announced that it plans to limit prescriptions for powerful doses to one week’s worth, a change that could have a major impact on the abuse of these drugs. It may also be that OxyContin has achieved market saturation. In recent years, American clinicians have issued about a quarter of a billion opioid prescriptions annually. Last year, in Ohio, a state particularly hard hit by the epidemic, 2.3 million residents—roughly one in five people in the state—received a prescription for opioids. In 2012, the Milwaukee Journal Sentinel published a story about pain patients who had offered testimonials about the wonders of OxyContin in Purdue promotional videos. Johnny Sullivan, the construction worker who had talked about OxyContin easing his back pain, became addicted to the drug. In 2008, while driving home from a hunting trip, he apparently blacked out; he flipped his truck, and died instantly. In a Purdue brochure, Sullivan is quoted as saying that OxyContin pills “don’t put me in a stupor or make me groggy.”
David Juurlink, the Toronto doctor, told me that opioids are problematic even for users who don’t succumb to addiction. “Opioids really do afford pain relief—initially,” he said. “But that relief tends to diminish over time. That’s, in part, why people increase the dose. They are chasing pain relief from a drug that has failed. I see all these people who are convinced they are one of the ‘legitimate’ pain patients. They’re on a massive dose of opioids, and they’re telling me they need this medication, which is clearly doing them harm. For many of them, the primary benefit of therapy, at this point, is not going into withdrawal.”
Even Russell Portenoy, the Purdue-funded doctor who advocated for wider long-term use of opioids, has reassessed his views. “Did I teach about pain management, specifically about opioid therapy, in a way that reflects misinformation?” he said to the Wall Street Journal in 2012. “I guess I did.” (In a statement, Portenoy told me that he has “refocussed” his approach to pain management, adding, “No funder has had any undue influence over my thinking.”)
In his defense, Portenoy has pointed out that, two decades ago, doctors did not know what they know now about opioids and addiction. The Sackler family and Purdue Pharma could have taken responsibility in a similar spirit: apologizing for their role in unleashing a national catastrophe while noting that, during the nineties, they had relied on a series of mistaken assumptions about the safety of OxyContin. But Purdue has continued to fight aggressively against any measures that might limit the distribution of OxyContin, in a way that calls to mind the gun lobby’s resistance to firearm regulations. Confronted with the prospect of modest, commonsense measures that might in any way impinge on the prescribing of painkillers, Purdue and its various allies have responded with alarm, suggesting that such steps will deny law-abiding pain patients access to medicine they desperately need. Mark Sullivan, a psychiatrist at the University of Washington, distilled the argument of Purdue: “Our product isn’t dangerous—it’s people who are dangerous.”
Last year, the C.D.C., which formally declared an opioid epidemic in 2011, introduced the first set of guidelines to help reduce the prescribing of strong painkillers like OxyContin. “Opioids should not be considered first-line or routine therapy for chronic pain,” the guidelines said, recommending that doctors first consider “non-pharmacologic” approaches, such as physical therapy, and “non-opioid pharmacologic” treatments.
Purdue and other pharmaceutical companies have long funded ostensibly neutral nonprofit groups that advocate for pain patients. The C.D.C. guidelines were nonbinding, yet many of these organizations fought to prevent the agency from releasing them. This kind of obstruction is typical at both the state and the federal level. A recent series by the Associated Press and the Center for Public Integrity revealed that, after Purdue made its guilty plea, in 2007, it assembled an army of lobbyists to fight any legislative actions that might encroach on its business. Between 2006 and 2015, Purdue and other painkiller producers, along with their associated nonprofits, spent nearly nine hundred million dollars on lobbying and political contributions—eight times what the gun lobby spent during that period.
Since Purdue made it more difficult to grind OxyContin pills, prescriptions have reportedly plummeted by forty per cent. This suggests that nearly half of the original drug’s consumers may have been crushing it to get high. As David Juurlink pointed out to me, it is a misnomer to call the reformulation an “abuse deterrent.” It can still be abused—and is, widely, by people who become addicted by swallowing the pills, just as the bottle instructs. But Purdue, facing a shrinking market and rising opprobrium, has not given up the search for new users. In August, 2015, over objections from critics, the company received F.D.A. approval to market OxyContin to children as young as eleven.
Forbes estimates that the Sacklers continue to receive some seven hundred million dollars a year from the family companies, and, as the Sacklers are surely aware, the real future of OxyContin may be global. Many big companies, once their sales plateau in America, look abroad. After introducing OxyContin in the U.S., Purdue moved into Canada and England. At the University of Toronto, the company sponsored a class on pain management for medical and dental students. The instructor was a member of Purdue’s speakers’ bureau. Students received a complimentary textbook, produced by Purdue, that described oxycodone as a “moderate” opioid. The course was discontinued after students and doctors criticized it; one of the critics was Rick Glazier, a physician at the university, whose son, Daniel, had fatally overdosed on OxyContin in 2009.
As OxyContin spread outside the U.S., the pattern of dysfunction repeated itself: to map the geographic distribution of the drug was also to map a rash of addiction, abuse, and death. But the Sackler family has only increased its efforts abroad, and is now pushing the drug, through a Purdue-related company called Mundipharma, into Asia, Latin America, and the Middle East. Part of Purdue’s strategy from the beginning has been to create a market for OxyContin—to instill a perceived need by making bold claims about the existence of large numbers of people suffering from untreated chronic pain. As Purdue moves into countries like China and Brazil, where opioids may still retain the kind of stigma that the company so assiduously broke down in the United States, its marketing approach has not changed. According to a Los Angeles Times reportfrom 2016—well after the Sacklers’ playbook for OxyContin had been repudiated by the medical establishment as possibly the main driver of the opioid epidemic—Mundipharma commissioned studies showing that millions of people in these countries suffered from chronic pain. The company has organized junkets, and paid doctors to give presentations extolling OxyContin’s virtues. In fact, certain doctors who are currently flogging OxyContin abroad—“pain ambassadors,” they are called—used to be on Purdue’s payroll as advocates for the drug in the U.S.
The Times report described Joseph Pergolizzi, Jr.—a Florida doctor who runs a pain-management clinic and hawks a pain-relieving cream of his own invention on cable TV—giving paid talks in places like Brazil about the merits of OxyContin. In Mexico, Mundipharma has asserted that twenty-eight million people—a quarter of the population—suffer from chronic pain. In China, the company has distributed cartoon videos about using opioids for pain relief; other promotional literature cites the erroneous claim that rates of addiction are negligible. In a 2014 interview, Raman Singh, a Mundipharma executive, said, “Every single patient that is in emerging markets should have access to our medicines.” The term “opiophobia” has largely fallen into disuse in America, for obvious reasons. Mundipharma executives still use it abroad.
“It’s a parallel to what the tobacco industry did,” Mike Moore told me. “They got caught in America, they saw their market share decline, so they export it to places with even fewer regulations than we have.” He added, “You know what’s going to happen. You’re going to see lots and lots of death.” In May, several members of Congress wrote to the World Health Organization, urging it to help stop the spread of OxyContin, and mentioning the Sackler family by name. “The international health community has a rare opportunity to see the future,” they wrote. “Do not allow Purdue to walk away from the tragedy they have inflicted on countless American families simply to find new markets and new victims elsewhere.” David Kessler, the former F.D.A. commissioner, believes that the destigmatization of opioids in the U.S. represents one of the “great mistakes” of modern medicine. When I asked for his thoughts on Mundipharma’s efforts to market OxyContin abroad, he said, “It gives me a sick feeling. It makes me ill.”
Earlier this year, Peter Salovey, the president of Yale, announced that the university will rename a residential college that was named for John C. Calhoun, because Calhoun’s “legacy as a white supremacist and a national leader who passionately promoted slavery as a ‘positive good’ fundamentally conflicts with Yale’s mission and values.” This move, which was not without its critics, was emblematic of a broader trend to look back skeptically at individuals who were venerated in earlier epochs, and ask how they should be judged by the moral standards of today. At Oxford, a Rhodes Scholar from South Africa recently led a campaign to take down a statue of Cecil Rhodes.
One great fortune—and reputation—that has evaded such scrutiny is that of the Sacklers, a family whose dubious business practices are not an artifact of previous centuries but an ongoing reality. If present statistics are any indication, in the time it likely took you to read this article six Americans have fatally overdosed on opioids. Yet Yale appears to be in no hurry to rename its Raymond and Beverly Sackler Institute for Biological, Physical and Engineering Sciences, or its Richard Sackler and Jonathan Sackler Professorship of Internal Medicine. Perhaps it’s because the Sacklers, unlike the Calhoun family, still have a fortune to give away.
“It’s amazing how they are left out of the debate about causation, but also about solutions,” Allen Frances, the Duke psychiatrist, said of the Sacklers. “A truly philanthropic family, looking at the last twenty years, would say, ‘You know, there’s several million Americans who are addicted, directly or indirectly, because of us.’ Real philanthropy would be to contribute money to taking care of them. At this point, adding their name to a building—it rings hollow. It’s not philanthropy. It’s just a glorification of the Sackler family.” According to the American Society of Addiction Medicine, more than two and a half million Americans have an opioid-use disorder. Frances continued, “If the Sacklers wanted to clear their name, they could take a very substantial fraction of that fortune and create a mechanism for providing free treatment for everyone who’s become addicted.” Alfred Nobel, the inventor of dynamite, created the Nobel Peace Prize. In recent years, several philanthropic organizations run by the descendants of John D. Rockefeller have devoted resources to addressing climate change and critiquing the environmental record of the oil company he founded, now called ExxonMobil. Last year, Valerie Rockefeller Wayne told CBS, “Because the source of the family wealth is fossil fuels, we feel an enormous moral responsibility.”
Mike Moore, the former Mississippi attorney general, believes that the Sacklers will feel no pressure to emulate this gesture until more of the public becomes aware that their fortune is derived from the opioid crisis. Moore recalled his initial settlement conference with tobacco-company C.E.O.s: “We asked them, ‘What do you want?’ And they said, ‘We want to be able to go to cocktail parties and not have people come up and ask us why we’re killing people.’ That’s an exact quote.” Moore is puzzled that museums and universities are able to continue accepting money from the Sacklers without questions or controversy. He wondered, “What would happen if some of these foundations, medical schools, and hospitals started to say, ‘How many babies have become addicted to opioids?’ ” An addicted baby is now born every half hour. In places like Huntington, West Virginia, ten per cent of newborns are dependent on opioids. A district attorney in eastern Tennessee recently filed a lawsuit against Purdue, and other companies, on behalf of “Baby Doe”—an infant addict.
Purdue executives won’t be able to settle every case against them, Moore believes. “There’s going to be a jury somewhere, someplace, that’s going to hit them with the largest judgment in the nation’s history,” he said. Paul Hanly noted that, in the face of a crippling judgment, Purdue may have to declare bankruptcy. “But I’m certainly not going to walk away if they do,” he said. “At that point, I would start looking closely at individual liability on the part of the Sacklers.”
Robin Hogen, the former Purdue communications executive, said, “I don’t want to be portrayed as an apologist for what is clearly a public-health crisis. But I wanted to make sure you spoke to someone who had very high regard for the Sackler family. The Sacklers were first class in everything they did.” I asked him what he would say to the doctors and the public-health officials who believe that the heirs of Raymond and Mortimer Sackler bear some moral responsibility for the epidemic. “I’m not a doctor,” Hogen demurred. “I really can’t comment.”
The Sacklers have always excelled at the confidence game of marketing, and it struck me that the greatest trick they ever pulled was to write the family out of the history of the family business. I was reminded of Arthur Sackler’s admonition that you should endeavor to leave the world a better place than it was when you came into it, and I wondered about the moral arithmetic of the Sacklers’ deeds. But the family, through a Purdue representative, declined to comment.
I recently went to Amagansett, on Long Island, to meet a man I’ll call Jeff. At a restaurant, he told me about his struggles with addiction. A decade ago, when he was a teen-ager, he started abusing opioids. They were “everywhere,” he recalled. He particularly liked OxyContin, for the “clean high” it provided. After sucking the pill’s red coating off, he crushed the rest with the edge of a cigarette lighter, then snorted it. He didn’t inject it. “When I was growing up, I always told myself, ‘I’ll never stick a needle in my arm,’ ” he said.
In a soft, unflinching tone, Jeff recounted the next decade of his life: he kept abusing painkillers, met a woman, fell in love, and introduced her to opioids. One day, his dealer was out of pills and said, “I’ll sell you a bag of heroin for twenty bucks.” Jeff was reluctant, but when withdrawal set in he acquiesced. At first, he and his girlfriend snorted heroin. “But you build up a tolerance, just like with the pills,” he said, and eventually they started injecting it. They were high when they got married. Jeff’s wife gave birth to a boy, who was addicted to opioids. “The doctors weaned him off with droplets of morphine,” he said.
After a long stretch in rehab, Jeff has been sober for more than a year. His baby is healthy, and his wife is clean, too. Looking back, he said, he feels that an impulsive youthful decision to snort pills set him on a path from which he could not deviate. “It was all about the drug,” he said. “I just created a hurricane of destruction.”
We left the restaurant and strolled along a leafy side street flanked by grand houses. During the worst years of his addiction, Jeff worked as a tradesman in the area. I had asked him to show me a property that he had serviced, and we stopped outside a sprawling estate that was mostly hidden behind dense shrubbery. It was the home of Mortimer Sackler, Jr. Jeff, who knew about the family, appreciated the irony. “I couldn’t tell you how many times I was on that property, sitting in a work truck, snorting a pill,” he said.
We reached an ornamental wooden gate, beyond which was a yard dominated by a stately weeping willow. As I was admiring the tree, Jeff said that, for the people who maintained the grounds, it was “a pain in the ass.” Whenever the wind picks up, he explained, branches break and scatter all over the lawn. “But the place has to be flawless,” he said. “There can’t be a leaf on the ground.” So a crew comes by regularly, to clear away the mess. ♦
This article appears in the print edition of the October 30, 2017, issue, with the headline “Empire of Pain.”
