When OxyContin came on the market, in 1995, physicians were understandably wary of the addictive potential of a powerful new opioid. As Patrick Radden Keefe reports, the manufacturer, Purdue Pharma, aggressively marketed OxyContin to physicians, claiming that the drug’s delayed-release mechanism could limit the risk of addiction. Instead, OxyContin led to many new addictions, and many addicted patients eventually sought street drugs like heroin. Steven May started at Purdue Pharma as a sales rep in 1999, and years later went on to allege fraud against Purdue as a participant in a whistle-blower lawsuit (which was dismissed on procedural grounds). May tells Keefe that he was trained to market the drug as one “to start with and to stay with,” despite seeing early on its addictive potential.

Purdue Pharma is a privately held company controlled by members of the Sackler family, who have a net worth of thirteen billion dollars. The Sacklers have donated handsomely to cancer research, medical schools, art museums, and universities. But Keefe tells David Remnick that the Sacklers have donated “nothing for the opioid crisis. Nothing for addiction treatment. If there is any sense in that family that they bear any moral culpability for where we are today, they’re not acting on it.”