The journalist Patrick Radden Keefe, this week in Barcelona.Albert Garcia / EL PAÍS
Promoting
The Empire of Pain
(Reservoir Books; Edicions del Periscopi, in Catalan) is proving “uncomfortable” for the American journalist Patrick Radden Keefe (Dorchester, 45 years old). "At the presentations in the US, people come at the end and tell me: 'After reading your book, I am not going to get vaccinated against covid-19, I no longer trust pharmaceutical companies," he acknowledges in the Catalan capital, where he has done the same. own this week at the Center for Contemporary Culture of Barcelona and, later, at the Telefónica Foundation and the Book Fair in Madrid. He was injected with Pfizer, a laboratory that appears in the investigation as responsible, in the fifties, for advertisements about drugs endorsed by doctors ... that did not exist. The ideologue of that campaign was the physician Arthur Sackler, the beacon of a pharmaceutical saga that ended up creating OxyContin in 1995,gateway to the fearsome opiates to fight pain ... with a prescription. Since then, more than 400,000 overdoses have died and millions of addicts in the US alone - a plague. The flip side: $ 35 billion in sales (about € 30 billion) and more than $ 13 billion (about € 11 billion) in profits for the Sackler family.
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On Radden Keefe's face — slightly rosy;
light blue eyes, beard, short hair that submits incipient angelic curls — both his ability to make unheard-of confessions and his discipline to herculeanly gather information are condensed (200 interviews, 40 documentation boxes, 58 pages of notes after three years of labor, in his latest book) and that give rise to exemplary pieces of investigative journalism such as the successful
Do not say anything,
about the old Cainite struggles within the IRA, or now
The Empire of Pain
.
Both have made him one of the most reputable reporters of the moment.
Aesthetics and rigor, affability and toughness, which mutate into exciting themes that seem arid and far removed from the average reader but which, after passing through their sieve, turns into fascinating stories of the human factor, as he once again demonstrates with some little pills.
Arthur and Richard, an American story.
“I love it because it is paradoxical: it seeks immortality by challenging death as a doctor and humanity wanting to leave a mark; It's like a Saul Bellow character, he wanted everything, even the hardest: marry his passion for medicine with commerce, ”says Radden Keefe of Arthur Sackler, founder of the noxious pharmaceutical empire. "He embodies the American dream: in one generation, he goes from an emigrant with his hands in his pocket to a multimillionaire," he sums up. The son of a Jew who landed in New York in 1904, a medical student with second-hand books, the oldest of three brothers who paid for his career, he ended up working and acquiring an advertising agency specializing in pharmaceutical products. From there,in 1963 he succeeded in making the tranquilizer Valium the first drug to reach 100 million dollars in revenue (issued in 60 million prescriptions).
Arthur changes rules and charges for bonuses based on sales; In addition, through magazines such as
Medical Tribune
, which reach a million doctors for free (it gets the laboratories to pay for them), it "informs" doctors that minor tranquilizers do not create addiction; if anything, the patient needs more doses or, failing that, he already has a previous pathological dependence. "He laid the ideological and commercial foundations of the entire dynasty," the journalist summarizes today.
The nephew, Richard, will complete the process: Purdue Frederick, the small pharmaceutical company that his uncle bought in 1952, will invent a pill wrapper that works like a drop by drop, dosing its contents.
That is what you will apply to a substance, oxycodone, derived from heroin, to avoid the risks of addiction.
Arthur became as rich (175 million dollars in 1986, according to
Forbes)
as an invisible philanthropist: his name does not appear in any of his companies but the mysterious last name was displayed in exclusive rooms of the Metropolitan Museum in New York (Met) or the Smithsonian The result of understanding philanthropy (he was a compulsive collector) not as a charity but as a business deal.
OxyContin pills in a US pharmacy.Toby Talbot / AP
Richard, however, turned the family into a multimillionaire with OxyContin, but also indifferent and oblivious to the suffering caused by his addiction and the more than 2,500 civil lawsuits that were brought against them.
A portrait of the evolution of capitalism?
“Although the first generation carried the seed of evil with them, they still moved by parameters of altruism, more or less healthy ambition and innovation;
the second has already grown up rich and was more interested in getting money than in diversifying the firm;
but in the third there is almost only greed: they are a bad photocopy of a photocopy, ”says Radden Keefe.
For a $ 20 plate.
The success of the Sacklers is not understood without the discovery of a family-owned pharmaceutical market analysis company: doctors internalized that oxycodone (an opioid synthesized as early as 1917) was milder than morphine, collapsing their reluctance to use it. prescribe this substance to his patients for fear that they would fall into addiction. Until then, morphine was reserved for terminally ill cancer patients. Purdue would not get them wrong, on the contrary: it insisted that its innovative dispenser would also avoid the risk of potential dependencies. They spared no expense. 700 vendors visited more than 100,000 physicians, mostly general practitioners due to their little experience in prescribing opiates for the treatment of pain, a field that was a gold mine: in 1994,one in three Americans suffered pain without treatment, especially in rural and mining areas which, coincidentally, were the most frequented by OxyContin vendors.
Purdue published countless articles in official-looking magazines claiming that only 1% of patients would develop addiction, although this was never scientifically verified previously.
In five years, they organized more than 7,000 seminars for toilets, paid for by the company.
Because studies showed that, starting with $ 20 meals, the predisposition of doctors to prescribe something changed, even if they denied it.
On meals alone, the company was spending $ 9 million.
Those who were invited to weekend conferences prescribed twice as much product on average as those who were not.
In 1999, the drug was already generating $ 20 million per week.
Black market for pills.
Richard Sackler got OxyContin approved in December 1995 by the US health authority, the FDA, in record time: 11 months and 14 days. One of the keys: Purdue staff helped the FDA formulate clinical studies on the drug's efficacy and safety. 30 drafts were necessary until the final draft. "It was even written in the leaflet: 'It is believed that ...' and, in subsequent trials, they blamed each other for the redaction," says Radden Keefe. The then head of the FDA would end up at Purdue, with a salary of $ 400,000 the first year. Hiring members of the Health Administration would be common, as would former US Justice officials and posh consultants such as former New York Mayor Rudolph Giuliani,that would help the 18 lawyers that the pharmaceutical company had on its staff. They were going to need them: two years after OxyContin was marketed, sellers warned that doctors were detecting a high dependence on the drug and a growing black market for prescriptions and pills, which consumers were crushing to neutralize the
pill
dispenser
.
A new fashionable drug ... that was obtained with a prescription.
At Purdue, where they knew about these practices and effects almost from day one, they continued to sell the product and prohibited their salespeople from leaving a written record of these incidents.
"It could be worse," Richard Sackler said of 59 poisoned deaths in one state.
The company paid $ 50 million to a law firm to defend itself and get the State Attorney General to lower charges or remove the Sackler names from the lawsuits.
A corrupt system.
"Commerce, the market, has hijacked medicine in the US and corruption can no longer be stopped: the book is the story of a unique family, but also of a system that has allowed all this," says Radden Keefe. “The whole system is corrupt: the pharmaceutical industry is driven by huge economic benefits and is not regulated as it should be: governments are captives of these firms, they work hand in hand with them, they are in league with the companies they should control; here we are talking about a drug that generated 35,000 million dollars and there is nothing that such a figure cannot corrupt, "he denounces. And remember that the
lobby
of pharmaceutical companies spend eight times more than arms companies to pressure states and legislators in their favor. "Opioids kill more people today than weapons in the US, which has a very uncontrolled traffic, but opioids is not much further away; they are different dangers, such as that of the disinformative influx of technology, but the modes of influence of all these
lobbies
are very even ”. Distressing in these times of covid-19: "We already see that pharmaceutical companies have not even wanted to talk about releasing licenses against the pandemic ... We must not be naive with them, but not so radical as not to be vaccinated," he adds.
Dance with investigative journalism.
"My obsession is always to find out who and how the story is explained, who and how the stories are constructed," says the journalist about his work.
“
Don't say anything
is a battle over who imposes the different accounts of the IRA's past;
When I published
my first article on the subject
in
The New Yorker
in 2017, despite the fact that their practices were already known, the Sackler family was socially applauded, their name was in the museums, but it did not appear in the trials: they had rewritten history , they had the power of the story ”.
Arthur M. Sackler, the founder of the pharmaceutical empire.SMITHSONIAN'S FREER & SACKLER GALLERIES
Radden Keefe always begins his reports with people, never with abstract ideas or theses. “Don't talk to me about astrophysics but about a specific astrophysicist and his dilemmas; the technique is like that of Virgilio with Dante, who guides him through hell: if there is a good character, I will follow him ”. And the reader, with him. Then there is the strategic sowing of figures and details: “As a child I loved fables loaded with symbols and objects and as a reader and writer I look for those details that exude a story; if you know how to recognize them, it is like an archaeological find and they are pure gold for the narrative, which you only have to wear afterwards ”. His third weapon is the millimeter reconstruction of the events, including what happens in the head of each protagonist. “You have to generate intimacy: if the reader sees the character from afar, with a spyglass, that won't work.But I never imagine anything, not a single word; I paid a person out of pocket to verify all the statements and data that I use in the book and to the Sackler family, who refused to see me, I sent them more than a hundred questions ”.
An unconditional fan of reporters such as David Graham (who advised him for
Don't say anything)
and Katherine Boo, he admits that today working at
The New Yorker
makes him a privileged person in the trade: “I can choose the topics, I have at least six months to do them, write 15,000 words and travel without too many limitations;
but although I am aware that the business model of the trade is changing, the magazine today does not lose money with this journalism and many books are still sold, and on paper ”.
But these are bad times: “In the United States, the local press has had a much worse time, where newspapers that were doing a lot of research in their area have disappeared.
In any case, I will dance with this type of journalism as long as there is music.
