It was perversely perfect that I’d first read about the federal government’s $8 billion settlement with Purdue Pharma — the company singly most responsible for killing 450,000 Americans with opioid drug overdoses over the past 20 years — while waiting in line for a prescription at the Rite Aid pharmacy on the Mesa, staffed, I should add, with the kindest, most competent behind-the-counter team in town.
I checked my cell phone for news only after having scanned the bounty of anti-constipation medications lining the wall next to the pharmacists’ window. The prominent location given to these digestive tract aids, it turns out, is also perversely perfect.
My first reaction to the deal was one of elation; members of the Sackler family who own Purdue Pharma — creators of Oxycontin — had been literally getting away with murder for decades. Eight billion dollars seemed like a lot of money. But as I waded into the fine print, I would learn that the Department of Justice would charge no Sackler with a crime. There would be no arrests. No jail time. No satisfaction of even a perp walk.
Depending on which translation you choose to go with, the name Purdue can mean one of two things. “For God” is the first. “Lost” is the other.
Talk about your perverse perfection.
It’s not like this is the first rodeo for the Sacklers or Purdue. Back in 2007, the Department of Justice required the company to pay out $645 million in fines because of illegal marketing strategies that effectively turned millions of unwitting dupes into millions of unwitting dope fiends.
The timing of the “deal” comes just a couple of weeks before the presidential election. That’s not the least bit coincidental. The Journal of the American Medical Association (JAMA) determined that in 2016, candidate Donald Trump did significantly better in counties with the highest concentrations of Oxycontin prescriptions. Typically, these are poorer, rural counties marked by high unemployment. JAMA found Trump did well enough in counties that were both rural and poor. But throw in high Oxy prescriptions rates, and JAMA found he did 18 percent better.
That, I would say, qualifies as perfectly perverse.
Once elected four years ago, Trump talked a lot of about the crisis of opioid addiction, a scourge — many have pointedly noted — that disproportionately afflicts the white demographic. It remains unclear, however, just how much he’s actually done. With opioid deaths spiking again in response to COVID — after having flattened out somewhat in prior years — Trump clearly needs a credible illusion of a rabbit he can pull out of his hat.
An $8 billion slap on the wrist is just that.
Santa Barbara County, however much it’s supported anyone but Trump, has hardly been immune. From 2014 to April of this year, Santa Barbara County has recorded 435 deaths from opioid overdoses. Not all of those, it should be noted, involved Oxycontin or even prescription opioids. Roughly two-thirds fell into the prescription drug camp. Maybe two-thirds of these were deemed accidental.
That’s a lot. It’s even more when you consider that since January 2018, no fewer than 1,051 overdoses were interrupted with applications of naloxone, which reverses the effect of the opioids and prevents an overdose from becoming fatal. Not all 1,051 would have otherwise resulted in a dead body. But more than a few would.
I had a coffee shop friend — a one-legged bike fiend, itinerant yoga instructor, writer, and teller of tall tales — who claimed to have been saved from what might have been fatal overdoses no fewer than 13 times, though not all here in Santa Barbara where he no longer resides. He was motivated, he explained, by a desire to see God. It didn’t work out as hoped. The naloxone, he complained, ruined what would have otherwise been a perfectly good high. And God, he said, didn’t take kindly to the intrusion. In fact, he was downright pissed.
My friend must have been using a brand that didn’t mean “For God” in French.
The numbers jump all over the place and are hard to keep on top of. Ten years ago, for example, Santa Barbara County was home to 99 million legally dispensed opioid pills. That’s enough for every man, woman, and child in Santa Barbara to take 34 a year. I have no idea what it is now.
I see the attraction. A few months ago, I went in to have a tooth pulled. Two wound up having to come out. I asked my dentist for some medication. He asked how much. I figured I could make do with four but asked for 16. It had been a rough year, and nothing takes the edge off, I’d learned from previous surgeries, as gently as Percocet. I wound up taking less than half the prescribed load. Nothing, it turns out, binds one’s bowels quite so tightly. I remember an interview with a guy who took care of many of the famous beat poets in their old age. What did they talk about? the interviewer asked. The answer, it turns out, was less than enthralling. All former junkies, they spent their dotage reminiscing — ad nauseum — about the agonies of constipation.
Earlier this month, the Washington Post reported that the government agency charged with addressing the opioid epidemic — the Office of National Drug Control Policy (ONDCP) — had gone through no fewer than seven directors between Trump’s election and 2018. The first nominee was Congressmember Tom Marino from Pennsylvania, whose name was withdrawn after it came to light he’d backed legislation that allowed opioid manufactures even more unfettered access to vulnerable communities than they already had.
The agency issued its first report after Trump was elected in 2019. Such reports typically include lots of data describing the problem, proposed solutions, and the metrics by which success — or failure — can be measured. That first report was just 23 pages. During the last term of the Obama administration, the reports averaged 103 pages. The Government Accounting Office — a federal watchdog agency — concluded the agency directors had no clue what they planned to do or how they would do it, should they ever get a clue.
As for Purdue Pharma — and the perfidious Sackler clan — it’s self-evident the punishment doesn’t fit the crime. In a more just world, perhaps they would have been force-fed their own product until they went out — like poor Elvis Presley, the great American imitator and an even greater American original — face first in the shag of his bathroom carpet, ass in the air, the victim of a fatal heart attack brought on by opiate-induced constipation.
That, in my book at least, would be both perfect and perverse.
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