The death toll from opioid overdoses has steadily climbed in the United States over the last two decades. Unlike previous drug crises, the opioid epidemic was sparked by U.S. drug manufacturers and further stoked by those same drug companies, pharmaceutical distributors, pharmacies and doctors.

Numerous books have been written on this topic, notably DEATH IN MUD LICK by Eric Eyre, the Charleston Gazette-Mail reporter who broke the story about the drug distributors dumping over 780 million oxycodone and hydrocodone pills into West Virginia between 2007 and 2021. Additionally, Patrick Radden Keefe’s EMPIRE OF PAIN highlighted the Sackler family’s role in secretly creating the epidemic and the manner in which they worked to avoid liability at all costs.

"AMERICAN CARTEL is a must read that demonstrates the continued importance of high-quality investigative journalism in today’s world and how greed allowed a national emergency to sweep the country unchecked."

AMERICAN CARTEL by Scott Higham and Sari Horwitz tells a broader story of the epidemic. It chronicles how a small group of DEA agents and an array of lawyers worked diligently for years to stop these bad actors from flooding the market with opioids and make them pay for the horrific mess they created. The book is an expansion of an award-winning series that the authors and others wrote for The Washington Post called “The Opioid Files.”

The sheer scope and magnitude of the crisis and the number of parties involved is demonstrated by the four-page Cast of Characters that appears at the beginning of the book --- which includes DEA agents, DOJ employees, the plethora of lawyers on both sides, the drug manufacturers and distributors, the pharmacies, the Congressional office holders who influenced policy, and the federal judges --- as well as by the chart showing how the opioids found their way into the hands of consumers.

To set the stage for how the epidemic began, Higham and Horwitz explain how Purdue Pharma (the Sackler family’s company) changed the narrative on pain management. They then promoted the untruth that opioids were not addictive while simultaneously paying doctors to speak at medical conferences and in advertisements about the benefits of oxycodone. Other drug companies followed suit, and soon opioids were flooding the markets in inconceivable numbers as pill mills popped up and internet purchases skyrocketed.

When several Drug Enforcement Administration (DEA) agents began sounding the alarm, they were met with unexpected resistance, which they had never encountered on the job before at the DEA. Over time, they came to understand that they were pitted against large American corporations that wielded political influence and wealth at an unprecedented level and had absolutely no regard for human life. Greed was their sole motivating factor.

Eventually lawsuits were filed, and a complex consolidation pulled many of those into a mega-lawsuit. Discovery related to the suits uncovered proof of the drug companies’ blatant disregard for the people they were knowingly pushing towards addiction, including a “Beverly Hillbillies” parody that mocked users (calling them “Pillbillies”), acknowledging that opioids were as addicting as Doritos, and other highly inflammatory evidence.

While the book starts slow and requires an immense amount of focus to become familiar with the various parties and events, it picks up as it progresses and most of the key individuals and corporations are introduced. The last half reads like a thriller, though if it were fiction, the “bad guys” would seem comically drawn and unrealistic. The actions these drug companies and distributors engaged in seem so over the top that it's hard to fathom that they and the scores of people working for them actually behaved so abominably.

AMERICAN CARTEL is a must read that demonstrates the continued importance of high-quality investigative journalism in today’s world and how greed allowed a national emergency to sweep the country unchecked.