186 - The Opioid Crisis with Patrick Radden Keefe

Patrick Radden Keefe is an award-winning staff writer at The New Yorker and the bestselling author of Empire of Pain: The Secret History of the Sackler Dynasty. In this episode, Patrick tells the story of the Sackler family and Purdue Pharma - makers of the pain management drug OxyContin, providing the backdrop for the ensuing opioid epidemic and public health crisis. He reveals the implicit and sometimes explicit corruption of all parties involved in the development, approval, and marketing of OxyContin, leading to a cascade of unintended consequences including addiction and death. He explains the unfortunate lack of accountability for the current crisis, as well as what it all means for those with legitimate pain management needs. Finally, he examines the difficult path ahead towards finding a solution.

Show notes page: https://bit.ly/3dv2HFS

We discuss:
00:00:00 - Intro
00:00:10 - Patrick’s investigation into distribution and use of drugs in our society
00:06:32 - The scale of of the opioid crisis
00:09:19 - The Sackler brothers: family life, career in the pharmaceutical industry, and role in the current crisis
00:17:05 - Purdue Pharma: origins, early years, and move towards pain management drugs
00:27:15 - The development of OxyContin: its conception, marketing, and the controversy around the FDA approval process
00:46:21 - Early reports of OxyContin addiction and unintended consequences and how Purdue Pharma sidestepped responsibility
00:54:35 - The many paths to addiction and abuse of OxyContin and the ensuing downfall of Purdue Pharma
01:06:33 - Peter’s personal experience with OxyContin
01:19:44 - Pain—the “fifth vital sign,” how doctors are trained in pain management, and the influence of money
01:30:17 - Other players that helped facilitate the eventual opioid crisis
01:39:48 - Lack of accountability following the investigation and prosecution of Purdue and the Sackler family
01:54:36 - Legacy of the Sackler family and their disconnect from reality
02:04:12 - Patrick’s views on the regulation and use of pain management drugs
02:07:46 - The difficult path forward


The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 35 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.

Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).

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