Documentary filmmaker Alex Gibney investigated the opioid crisis. He says it was created by pharmaceutical companies, distributors, pharmacists and doctors, all looking to profit.



Opioid addiction is destroying American lives and devastating entire communities. The CDC estimated more than 66,000 overdose deaths from opioids in the 12-month period ending September 2020. A new two-part HBO documentary starting tonight claims that the opioid epidemic is a crisis and a crime, a crime committed by pharmaceutical companies, distributors, pharmacists and doctors all looking to profit.


UNIDENTIFIED PERSON: W-I-I-F-M - what's in it for me? That's all they're thinking.

MARTIN: "The Crime Of The Century" is directed by Alex Gibney. I talked with him last week. The film alleges that Purdue Pharma and members of the Sackler family who own the company laid the groundwork for the entire opioid epidemic, a claim both the company and the family deny.

ALEX GIBNEY: It's a marketing campaign designed to spread the use of opioids from immediate use after major surgery or end-of-life cancer pain to widespread use for all sorts of pain medications on the assertion, which is really nothing more than that by Purdue, that you really can't get addicted.

MARTIN: And as you say, they were pushing doctors to expand the definition of pain, of breakthrough pain in particular, right?

GIBNEY: And definitely pushing doctors to accept the idea that pain was the fifth vital sign, that there was nothing more important than treating patients' pain, even if it was knee pain for an 18-year-old from a sports injury. You know, OK, have some OxyContin, it'll be fine. And don't worry, you won't get addicted.

MARTIN: That may be morally reprehensible to a lot of people, but was any of that illegal?

GIBNEY: Well, it depends. Purdue, the company, did plead guilty to a felony of misbranding. And there was a rather robust prosecution memo from the Department of Justice, which we were able to obtain a copy of, which actually was prepared to indict a number of Purdue executives for a series of felonies, including fraud, misrepresentation and conspiracy to commit fraud.

MARTIN: You allege that it was essentially covered up, shelved, for political reasons.

GIBNEY: Yes. We don't know exactly - I mean, we tried very hard to find out exactly how it happened. But we do know that a number of senior prosecutors in the Department of Justice found this 120-page prosecution memo extremely convincing. And so they were shocked and surprised when the Department of Justice itself, after pressure from representatives of Purdue, notably, you know, former U.S. DOJ officials like Mary Jo White and Rudy Giuliani, decided not to prosecute the executives and to work out a deal that essentially held Purdue criminally responsible. They - a number of executives pled guilty to misdemeanors. A fine was paid, but most importantly, the key evidence in the prosecution memo was never revealed. It was buried. I mean, we contend in the film that hundreds of thousands of lives were lost as a result of that burying of evidence.

MARTIN: I want to get into some of the personal narratives that you tell through this film, specifically of a woman named Carol Bosley, who died of an opioid overdose in 2009. Her doctor was a man named Lynn Webster. Can you tell us about him?

GIBNEY: Yeah. Lynn Webster was a kind of a key opinion leader. He received speaking fees from a number of key pharmaceutical companies, including Purdue, to preach the gospel of the opioid, the idea that no dose was too high, that pain was really the issue, not addiction. And he ran a pain clinic, the Lifetree Pain Clinic in Salt Lake City. And one of his patients was a woman named Carol Bosley, who had suffered a terrible neck injury as a result of a car accident. And he was treating her for pain. She became terribly addicted to opioids as a result of prescription of a number of narcotics. And she died of an overdose.

MARTIN: I want to play a clip from the film. Carol's husband, Roy, sat down with you, and this is how he remembers one of his last conversations with Dr. Webster. Let's listen.


ROY BOSLEY: And I'll never forget - he made a statement and I'm still baffled by it. He said, a chronic pain sufferer cannot be an addict. I am her physician. I will prescribe the medications that I think she needs, and she will be under my care, and that will be the end of it.

MARTIN: Dr. Webster maintains that he did nothing wrong. All over the country, we should say, doctors were doing this, right? He wasn't the only one by any stretch of the imagination. He believed that he was helping, didn't he?

GIBNEY: I think he did. I think that one of the problems that enters into this equation that's even bigger than the opioid crisis is the problem of economic incentives in medicine. And nowhere is that more evident than in the opioid crisis where the incentive, whether you internalize it, whether you recognize it consciously or not, is to prescribe more and more and more because you're making more money.

MARTIN: You also paint the picture of an entire system. We're talking about the doctors. We're talking about the drug companies, the manufacturers, the salespeople individually, pharmacies. Has the system that allowed this to happen been dismantled in any way over the past couple of years?

GIBNEY: Not at all. I mean, I think that there is now some reticence to prescribe opioids as liberal as doctors had done back in, say, the late '90s, early 2000s. That has changed. And the CDC has issued guidelines which have changed things. But now one of the big problems is that an enormous demand has been created because you have a lot of people who are addicted. And suddenly now the illicit fentanyl market has entered the country in a way that is becoming evermore dangerous and undergirded by a system that really doesn't have proper attention paid to those who are addicted or an understanding of how supply and demand is working when it comes to these dangerous drugs.

MARTIN: The new film is called "The Crime Of The Century." Alex Gibney is the filmmaker. Thank you so much.

GIBNEY: Good to be with you, Rachel.


MARTIN: NPR reached out to Purdue Pharma, members of the Sackler family and Dr. Lynn Webster, who all denied all of the allegations in this film.