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American Cartel: Inside the Battle to Bring Down the Opioid Industry
The definitive investigation and exposé of how some of the nation's largest corporations created and fueled the opioid crisis—from the Pulitzer Prize-winning Washington Post reporters who first uncovered the dimensions of the deluge of pain pills that ravaged the country and the complicity of a near-omnipotent drug cartel.
AMERICAN CARTEL is an unflinching and deeply documented dive into the culpability of the drug companies behind the staggering death toll of the opioid epidemic. It follows a small band of DEA agents led by Joseph Rannazzisi, a tough-talking New Yorker who had spent a storied thirty years bringing down bad guys; along with a band of lawyers, including West Virginia native Paul Farrell Jr., who fought to hold the drug industry to account in the face of the worst man-made drug epidemic in American history. It is the story of underdogs prevailing over corporate greed and political cowardice, persevering in the face of predicted failure, and how they found some semblance of justice for the families of the dead during the most complex civil litigation ever seen.
The investigators and lawyers discovered hundreds of thousands of confidential corporate emails and memos during courtroom combat with legions of white-shoe law firms defending the opioid industry. One breathtaking disclosure after another—from emails that mocked addicts to invoices chronicling the rise of pill mills—showed the indifference of big business to the epidemic’s toll. The narrative approach echoes such work as A Civil Action and The Insider, moving dramatically between corporate boardrooms, courthouses, lobbying firms, DEA field offices, and Capitol Hill while capturing the human toll of the epidemic on America’s streets.
AMERICAN CARTEL is the story of those who were on the front lines of the fight to stop the human carnage. Along the way, they suffer a string of defeats, some of their careers destroyed by the very same government officials who swore to uphold the law before they begin to prevail over some of the most powerful corporate and political influences in the nation.
AMERICAN CARTEL is an unflinching and deeply documented dive into the culpability of the drug companies behind the staggering death toll of the opioid epidemic. It follows a small band of DEA agents led by Joseph Rannazzisi, a tough-talking New Yorker who had spent a storied thirty years bringing down bad guys; along with a band of lawyers, including West Virginia native Paul Farrell Jr., who fought to hold the drug industry to account in the face of the worst man-made drug epidemic in American history. It is the story of underdogs prevailing over corporate greed and political cowardice, persevering in the face of predicted failure, and how they found some semblance of justice for the families of the dead during the most complex civil litigation ever seen.
The investigators and lawyers discovered hundreds of thousands of confidential corporate emails and memos during courtroom combat with legions of white-shoe law firms defending the opioid industry. One breathtaking disclosure after another—from emails that mocked addicts to invoices chronicling the rise of pill mills—showed the indifference of big business to the epidemic’s toll. The narrative approach echoes such work as A Civil Action and The Insider, moving dramatically between corporate boardrooms, courthouses, lobbying firms, DEA field offices, and Capitol Hill while capturing the human toll of the epidemic on America’s streets.
AMERICAN CARTEL is the story of those who were on the front lines of the fight to stop the human carnage. Along the way, they suffer a string of defeats, some of their careers destroyed by the very same government officials who swore to uphold the law before they begin to prevail over some of the most powerful corporate and political influences in the nation.
416 pages, Hardcover
Published July 12, 2022
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Displaying 1 - 30 of 108 reviews
December 29, 2022
If you are a fan of Patrick Radden Keefe’s ‘Empire of Pain’ and were similarly consumed by the tale of the Sackler family and the roots of the opioid crisis, this book will probably interest you as well.
The authors, Washington Post investigative journalists, are digging deeper into one part of this story – the DEA fight against Big Pharma and distributors responsible for selling millions of pills to Americans. It is a well-written, fast-paced book that reads like a thriller. You will find here even more examples of the moral corruption of the pharmaceutical business and its connection to DC politics. Unfortunately, the problem is widespread and while the Sackers may be the most famous case, thanks to Radden Keefe’s investigation, their behavior is not isolated nor uncommon.
Thanks to the publisher, Twelve Books, and NetGalley for an advanced copy of this book.
The authors, Washington Post investigative journalists, are digging deeper into one part of this story – the DEA fight against Big Pharma and distributors responsible for selling millions of pills to Americans. It is a well-written, fast-paced book that reads like a thriller. You will find here even more examples of the moral corruption of the pharmaceutical business and its connection to DC politics. Unfortunately, the problem is widespread and while the Sackers may be the most famous case, thanks to Radden Keefe’s investigation, their behavior is not isolated nor uncommon.
Thanks to the publisher, Twelve Books, and NetGalley for an advanced copy of this book.
July 9, 2022
The opioid crisis is the gift that keeps on giving, a whack-a-mole reality show. Generic drug manufacturers, distributors, pharmacies, pain clinics, and really anyone involved with the distribution of "legal" prescription pain relievers has weighed the cost of incurring multi-million dollar fines for knowingly flooding America with addictive drugs, versus the benefit of billions in profits to be made. Two Washington Post reporters carry the story beyond the Purdue Pharma/Sackler family scandal right up to the lobbyists working Congress to defang the DEA, the legal guns for hire, and our failed legal system, that jails the little guy, but not the powerful people who created our modern death by overdose society. I could not put it down.
July 21, 2022
American Cartel is yet another book that uncovers the serious, disgusting depths opioid manufacturers, distributors, and pharmacies have gone to in order to market, target, and fill communities with pills.
I learned a lot from this book, and I really appreciated that it was understandable and accessible for those who may not have much background knowledge or information on this topic.
Every time I read a book about the opioid epidemic, I get angry. Yet I continue to read them, because knowing about this is SO IMPORTANT.
These companies have ruined communities, destroyed families, and stigmatized this medication that actually serves a critical purpose for those suffering from chronic pain and other conditions. If you aren’t infuriated, then you’re not paying enough attention.
This book has crucial information, and I highly recommend it. Highly.
I learned a lot from this book, and I really appreciated that it was understandable and accessible for those who may not have much background knowledge or information on this topic.
Every time I read a book about the opioid epidemic, I get angry. Yet I continue to read them, because knowing about this is SO IMPORTANT.
These companies have ruined communities, destroyed families, and stigmatized this medication that actually serves a critical purpose for those suffering from chronic pain and other conditions. If you aren’t infuriated, then you’re not paying enough attention.
This book has crucial information, and I highly recommend it. Highly.
September 16, 2023
The authors, two reporters for the Washington Post, make this a page turner. What happens when drug companies earning insane amounts of money and our illustrious members of Congress conspire to leave the DEA without power to enforce laws? Thousands of Americans die and no one admits fault. The situations described are beyond infuriating. Thank you to Goodreads Giveaways for my copy of the book.
January 4, 2023
Another year gone by and another opioid book completed. I think this is either the third or 4th I have read in the last 4 years. They're all different in their own harrowing ways. Communities being ravaged, families being torn and no executives going to jail. A complete and utter failure of what democracy is. The opioid epidemic is bipartisan in its inception but unlike most controversial, emotional and political issues... It's not polarized politically by either side. Think about that. In this time period everything is polarized, easy slam dunk issues are turned into weird endless cultural wars. An example would be the origins of Covid, gain of function research is still being conducted despite its dangers. It's not even discussed, it never even was mentioned in any of the political topics. Dusted underneath the rug for another pointless issue that gins up both sides. The feelings surrounding the opioid epidemic is one where both sides come together, to tarnish politician's, corporations and media outlets for failing them. This is what democracy looks like, it's something that looks foreign in todays age but because its tragedy is potent and reaching from the lower to the upper echelon of American economic classes. It's opposition is staunchly bipartisan. Rightly so.
A simple heuristic I look at is the amount of holds a type of book has at my local library. The opioid books have the most amount of copies and most amount of holds on them. It's almost like you can feel the pain from the number of people who put requested to hold the book.
Think about the risks a stereotypical drug lord has.
1. Assassination from a rival cartel.
2. Assassination from someone in your own cartel.
3. Killed by the police, military or special forces.
4. Captured and put into jail, serving multiple life sentences.
Now think about the risk a corporate America executive has.
1. His or her name gets leaked and faces minimal backlash publicly. Mind you not from major news outlets.
Thats literally it, your company has to pay a fine, you admit no wrong doing and you never see inside of a cell. At least a drug kingpin faces some justice but a opioid executive can be far more effective than any drug lord and still receive no risks except for some momentary public blame.
The one exception is the Sackler family, because they clothed themselves in with so many institution's. Embarrassing whomever allowed them so much influence that makes them a target but even then, they will never see inside a jail call. Still walk away with billions.
The book highlights the revolving door, how government officials cash out on their service and join a corporation in which they swore to protect the public from. It lays out how pharmaceutical companies lobbied agencies trying to regulate them by forcing out specific agents who were trying to stop the flood of pills. It shows how politician's were stopping agencies from doing their jobs after they received donations and it shows the trial cases from an in-depth view.
I think this book is close to 5 stars, its just that the book spends a lot of time going through the lawyers personalities that took away from the purpose of the book. A lot of these lawyers were gigantic douchebags, I am sure they wanted to help these communities ravaged by the epidemic of pills but often times it felt like they were more focused on their image than the people who suffered the most.
This is why I gave it 4 stars.
A simple heuristic I look at is the amount of holds a type of book has at my local library. The opioid books have the most amount of copies and most amount of holds on them. It's almost like you can feel the pain from the number of people who put requested to hold the book.
Think about the risks a stereotypical drug lord has.
1. Assassination from a rival cartel.
2. Assassination from someone in your own cartel.
3. Killed by the police, military or special forces.
4. Captured and put into jail, serving multiple life sentences.
Now think about the risk a corporate America executive has.
1. His or her name gets leaked and faces minimal backlash publicly. Mind you not from major news outlets.
Thats literally it, your company has to pay a fine, you admit no wrong doing and you never see inside of a cell. At least a drug kingpin faces some justice but a opioid executive can be far more effective than any drug lord and still receive no risks except for some momentary public blame.
The one exception is the Sackler family, because they clothed themselves in with so many institution's. Embarrassing whomever allowed them so much influence that makes them a target but even then, they will never see inside a jail call. Still walk away with billions.
The book highlights the revolving door, how government officials cash out on their service and join a corporation in which they swore to protect the public from. It lays out how pharmaceutical companies lobbied agencies trying to regulate them by forcing out specific agents who were trying to stop the flood of pills. It shows how politician's were stopping agencies from doing their jobs after they received donations and it shows the trial cases from an in-depth view.
I think this book is close to 5 stars, its just that the book spends a lot of time going through the lawyers personalities that took away from the purpose of the book. A lot of these lawyers were gigantic douchebags, I am sure they wanted to help these communities ravaged by the epidemic of pills but often times it felt like they were more focused on their image than the people who suffered the most.
This is why I gave it 4 stars.
August 19, 2022
Richie’s Picks: AMERICAN CARTEL: INSIDE THE BATTLE TO BRING DOWN THE OPIOID INDUSTRY by Scott Higham and Sari Horwitz, Grand Central Publishing/Twelve, July 2022, 416p., ISBN: 978-1-5387-3720-0
“I was dreaming when I wrote this
So sue me if I go too fast
But life is just a party
And parties weren’t meant to last”
– Prince, who died at 57 from a fentanyl overdose.
“A federal judge on Wednesday ordered three of the nation’s largest pharmacy chains — CVS, Walgreens and Walmart — to pay $650.5 million to two Ohio counties, ruling that the companies must be held accountable for their part in fueling the opioid epidemic.
The decision is a companion piece to a November jury verdict that found the companies had continued to dispense mass quantities of prescription painkillers over the years while ignoring flagrant signs that the pills were being abused.
The ruling is the first by a federal judge that assigns a firm money figure against the pharmacy chains for their roles in the opioid crisis. Here, the judge, Dan A. Polster of United States District Court in northern Ohio, who has overseen more than 3,000 cases in the opioid litigation, ruled that the pharmacies bore responsibility for one-third of the amount that Ohio’s hard-hit Lake and Trumbull counties need to address the continuing damage wrought by the epidemic.”
– NY Times, “CVS, Walgreens and Walmart Must Pay $650.5 Million in Ohio Opioids Case” (8/17/2022)
Do you know anyone who is addicted to opioids? I do.
Between reading and reviewing books for young people, I occasionally read adult nonfiction. I don’t usually write about those books here. But in the case of AMERICAN CARTEL, I’m hoping that librarians adding it to their teen collections will enable young people to become educated on this topic, possibly helping themselves or a friend, sibling, cousin, or parent to understand the epidemic of opioid addiction. It could well save a life.
AMERICAN CARTEL is an up-to-the-minute history of the opioid epidemic in America, by a pair of Pulitzer-winning Washington Post journalists. The authors are public figures, often featured on TV and in newspaper articles. For example, they were frequently quoted this week regarding the announcement of the Ohio decision. Judge Polster, quoted above, is an important character in this book.
It’s mind-boggling to think about the hundreds of millions of addictive opioid pills that were dumped into circulation by drug manufacturers, drug distributors, pill mills aka pain clinics, and the quack doctors who staffed them. Those pills have sown a lot of misery and death.
AMERICAN CARTEL is a gripping expose that reveals the dirty side of free enterprise in America. We see both commercial enterprises and physicians turning a blind eye to the addiction caused by these pills, because pushing them was so profitable. As a result, hundreds of thousands of Americans have been and still are living dead-end lives, overdosing, and dying.
“‘Eighty-one million pills distributed to a community of a hundred thousand people or less isn’t a substantial factor in the opioid epidemic. It will cause an opioid epidemic. I want to start with that premise,’ Paul told the judge.
– from attorney Paul Farrell’s closing statement in a trial chronicled by the authors.
The star good-guy in the story is Joe Rannazzisi, who was a previous chief of the Drug Enforcement Administration’s Office of Diversion Control. He did such a great job that drug manufacturers, distributors, and sellers lobbied and donated to politicians in order to pressure them to change the laws and remove Joe’s enforcement tools. They actually exerted sufficient pressure to get Joe fired in 2015. Joe has spent much of the subsequent time testifying about the opioid epidemic. (You can see him in the 2017 60 Minutes segment, “The Whistle Blower,” here: https://www.youtube.com/watch?v=Hd-43...)
There are many bad guys. They include well-known members of Congress bought by the drug companies; and former DEA executives and attorneys who have chosen to make a lot of money by leaving their government gigs, going to work for Big Pharma, and helping the manufacturers and distributors more effectively evade regulation and oversight. This industry-regulator-industry revolving door has been a target of good government reformers for decades, but has never been fixed. The result of failing to rein it in has been deadly.
AMERICAN CARTEL exposes the workings of industry and government and how they can operate to the detriment of Americans. It’s fascinating, heartbreaking, and enlightening, a must-have for any high school library collection.
Richie Partington, MLIS
Richie's Picks http://richiespicks.pbworks.com
https://www.facebook.com/richiespicks/
https://twitter.com/richiespicks
richiepartington@gmail.com
“I was dreaming when I wrote this
So sue me if I go too fast
But life is just a party
And parties weren’t meant to last”
– Prince, who died at 57 from a fentanyl overdose.
“A federal judge on Wednesday ordered three of the nation’s largest pharmacy chains — CVS, Walgreens and Walmart — to pay $650.5 million to two Ohio counties, ruling that the companies must be held accountable for their part in fueling the opioid epidemic.
The decision is a companion piece to a November jury verdict that found the companies had continued to dispense mass quantities of prescription painkillers over the years while ignoring flagrant signs that the pills were being abused.
The ruling is the first by a federal judge that assigns a firm money figure against the pharmacy chains for their roles in the opioid crisis. Here, the judge, Dan A. Polster of United States District Court in northern Ohio, who has overseen more than 3,000 cases in the opioid litigation, ruled that the pharmacies bore responsibility for one-third of the amount that Ohio’s hard-hit Lake and Trumbull counties need to address the continuing damage wrought by the epidemic.”
– NY Times, “CVS, Walgreens and Walmart Must Pay $650.5 Million in Ohio Opioids Case” (8/17/2022)
Do you know anyone who is addicted to opioids? I do.
Between reading and reviewing books for young people, I occasionally read adult nonfiction. I don’t usually write about those books here. But in the case of AMERICAN CARTEL, I’m hoping that librarians adding it to their teen collections will enable young people to become educated on this topic, possibly helping themselves or a friend, sibling, cousin, or parent to understand the epidemic of opioid addiction. It could well save a life.
AMERICAN CARTEL is an up-to-the-minute history of the opioid epidemic in America, by a pair of Pulitzer-winning Washington Post journalists. The authors are public figures, often featured on TV and in newspaper articles. For example, they were frequently quoted this week regarding the announcement of the Ohio decision. Judge Polster, quoted above, is an important character in this book.
It’s mind-boggling to think about the hundreds of millions of addictive opioid pills that were dumped into circulation by drug manufacturers, drug distributors, pill mills aka pain clinics, and the quack doctors who staffed them. Those pills have sown a lot of misery and death.
AMERICAN CARTEL is a gripping expose that reveals the dirty side of free enterprise in America. We see both commercial enterprises and physicians turning a blind eye to the addiction caused by these pills, because pushing them was so profitable. As a result, hundreds of thousands of Americans have been and still are living dead-end lives, overdosing, and dying.
“‘Eighty-one million pills distributed to a community of a hundred thousand people or less isn’t a substantial factor in the opioid epidemic. It will cause an opioid epidemic. I want to start with that premise,’ Paul told the judge.
– from attorney Paul Farrell’s closing statement in a trial chronicled by the authors.
The star good-guy in the story is Joe Rannazzisi, who was a previous chief of the Drug Enforcement Administration’s Office of Diversion Control. He did such a great job that drug manufacturers, distributors, and sellers lobbied and donated to politicians in order to pressure them to change the laws and remove Joe’s enforcement tools. They actually exerted sufficient pressure to get Joe fired in 2015. Joe has spent much of the subsequent time testifying about the opioid epidemic. (You can see him in the 2017 60 Minutes segment, “The Whistle Blower,” here: https://www.youtube.com/watch?v=Hd-43...)
There are many bad guys. They include well-known members of Congress bought by the drug companies; and former DEA executives and attorneys who have chosen to make a lot of money by leaving their government gigs, going to work for Big Pharma, and helping the manufacturers and distributors more effectively evade regulation and oversight. This industry-regulator-industry revolving door has been a target of good government reformers for decades, but has never been fixed. The result of failing to rein it in has been deadly.
AMERICAN CARTEL exposes the workings of industry and government and how they can operate to the detriment of Americans. It’s fascinating, heartbreaking, and enlightening, a must-have for any high school library collection.
Richie Partington, MLIS
Richie's Picks http://richiespicks.pbworks.com
https://www.facebook.com/richiespicks/
https://twitter.com/richiespicks
richiepartington@gmail.com
February 9, 2024
Impeccably researched and heart breaking.
November 29, 2022
This book is a testimony of capitalism at it's worst. I speak this as someone who does not dislike capitalism. Business is a powerful force in the world, but in this case, it was for pure evil. Executives at some of the largest pharma company distributors ignored clear opioid drug-abuse problems that killed tens of thousands and ravaged every town across the country. Single-pharmacy orders that would give every person in a town hundreds of doses were never questioned by these distributors. "It's all about how much money can be made."
Give this book a read. It follows the complexities of drug distribution, a team of DEA agents, the laws that were lobbied into place that green-lighted big business to hide illegal activity, and the following (and recent) lawsuits with tens of billions in settlements issued and to-be issued in the next few years. It's a heartbreaking, frustrating thriller of a read.
Give this book a read. It follows the complexities of drug distribution, a team of DEA agents, the laws that were lobbied into place that green-lighted big business to hide illegal activity, and the following (and recent) lawsuits with tens of billions in settlements issued and to-be issued in the next few years. It's a heartbreaking, frustrating thriller of a read.
April 8, 2024
I get what they were trying to do, but this was very tone deaf. Came off as a heroic copaganda story instead of a retelling of court cases and events. Would have been better as a documentary or movie rather than a book. Seemed more for entertainment than for diffusion of information
April 9, 2024
It was okay
July 14, 2022
This page turner reveals that front line agents were trying to save lives but they were thwarted and even persecuted by some of their former colleagues who went through the revolving door of government to the industry they once policed and regulated.
Having lost my son in 2001 and following closely the mushrooming opioid epidemic I always wondered why no one in power was doing anything concrete to stop it? Now the sickening details are being revealed.
My hope is this book generates more jaw dropping outrage not at just to the people who participated but to the system that actually encouraged the nefarious behavior that has claimed over a million lives and counting.
This is a true crime book and with 1 in 3 Americans now affected by drug use the system needs to change and people need to know the truths in this jaw dropping book.
Having lost my son in 2001 and following closely the mushrooming opioid epidemic I always wondered why no one in power was doing anything concrete to stop it? Now the sickening details are being revealed.
My hope is this book generates more jaw dropping outrage not at just to the people who participated but to the system that actually encouraged the nefarious behavior that has claimed over a million lives and counting.
This is a true crime book and with 1 in 3 Americans now affected by drug use the system needs to change and people need to know the truths in this jaw dropping book.
October 23, 2022
such a horrible story - and so important that it’s told. Written well and the audio is read well.
December 25, 2022
This book gives an overview on the ongoing opioid crisis that has wreaked havoc on countless communities across the nation. There’s definitely more attention and emphasis on the legal battles and litigation involved between the large pharma companies, distributors, pharmacies, and users. At many points, I felt like I vicariously experienced the pressure, excitement, disappointment, intensity, and all varieties of emotions that happen in the inside of a courtroom, from the plaintiff and defendants bars, the witnesses, the judge, and other onlookers. I do think that overall the perspective was largely skewed towards the plaintiffs and their supporters, and we didn’t get to hear much at all from the defendants side. They were mostly portrayed as the bad guys who didn’t say much besides trying to defend and justify their behavior. But perhaps that may also just be representative of their relative silence regarding their role in this epidemic on the whole. Overall really great read!
June 16, 2023
Excellent book. The Sacklers are just the tip of the iceberg – this incredible exposé reveals evils spanning the entire length of the opioid supply chain, specifically highlighting the middle-man distributors who have flown somewhat under public radar. Higham and Horwitz are captivating storytellers who strike the perfect balance between detail and pace; American Cartel was a masterpiece of research and storytelling and a true page-turner.
June 6, 2023
3.5 stars
Important book about how both drug distributors (i.e. the middlemen) and govt officials have contributed to the opioid crisis. I'm glad I read it, but the writing did not flow as well for me as others in this subgenre (Dopesick, Empire of Pain etc.)
Important book about how both drug distributors (i.e. the middlemen) and govt officials have contributed to the opioid crisis. I'm glad I read it, but the writing did not flow as well for me as others in this subgenre (Dopesick, Empire of Pain etc.)
June 10, 2023
Prepare to be outraged. There is no shortage of outrage in today’s world over much smaller issues but this one is legitimately huge. The authors do an incredible job of provided quoted details of years of meetings, hearings and judgements. The story reads like a fast paced John Grisham litigation thriller novel except that it’s sadly real. While this book like a documentary is the vision of things from one perspective, I still think it’s worthy of widespread readership. I truly believe the community at large would be well served to check this book out.
August 5, 2023
one thing journalists are gonna do, is write a fucking page turner!!!
August 10, 2023
A bit dry. Lots of courtroom quotes. A terrible tragedy that could have been prevented.
April 9, 2024
I’m so tired of reading about the opioid crisis…we know who did it and why - great narrative ig and easy read
July 16, 2023
Everyone needs to read this book.
February 11, 2024
Gripping
July 28, 2022
Not done yet, but, thus far, this is the best public policymaking reporting I have ever read
February 5, 2025
Told like a story which I preesh. About the opioid epidemic which I was obsessed with a few months ago
January 4, 2023
Reads like a movie.
American Cartel tells the insider story of the US drug epidemic from 2005 - present and an unconventional true crime novel. Extremely well researched to the point of reading like a movie.
The narrative is broken up into two segments: 2005 - 2016 which highlights the difficulties of building a case against 'big pharma' and 2016 - 2022 which discusses the intricacies of prosecuting those earlier findings.
I feared that the novel might be dry despite the topic, but that was never the case. Occasionally I found myself mired in names and places, but the relevant figures tend to feature in successive chapters which was helpful for continuity. In a pinch I would either revisit the semi-daunting 'cast list' at the front of the book (extremely helpful resource) or feign ignorance working off context clues in order to push forward.
Because sometimes needing to know what happened next was more important that making sure I knew who exactly said what.
Short easy-to-digest chapters make for a bigger impact as Higham and Horwitz highlight the struggles of the 'underdogs' vs. corporate drug manufacturers and distributors. I would argue that highly successful DEA operatives and litigation lawyers are not exactly pitiable- white privilege at its finest; but for the most part their intentions are admirable throughout.
It has been a long time since I have been able to read a full non-fiction novel in one or two sittings, and despite knowing the outcome of the case, I could not tear myself away from this read. For anyone who has been impacted by the national opiate crisis (directly or indirectly) or are curious to learn more- I strongly encourage you to pick up this book.
Warning, however: if you do, prepare to be outraged.
[Thank you to NetGalley and Twelve Books for a free copy of this book in exchange for an honest review.]
American Cartel tells the insider story of the US drug epidemic from 2005 - present and an unconventional true crime novel. Extremely well researched to the point of reading like a movie.
The narrative is broken up into two segments: 2005 - 2016 which highlights the difficulties of building a case against 'big pharma' and 2016 - 2022 which discusses the intricacies of prosecuting those earlier findings.
I feared that the novel might be dry despite the topic, but that was never the case. Occasionally I found myself mired in names and places, but the relevant figures tend to feature in successive chapters which was helpful for continuity. In a pinch I would either revisit the semi-daunting 'cast list' at the front of the book (extremely helpful resource) or feign ignorance working off context clues in order to push forward.
Because sometimes needing to know what happened next was more important that making sure I knew who exactly said what.
Short easy-to-digest chapters make for a bigger impact as Higham and Horwitz highlight the struggles of the 'underdogs' vs. corporate drug manufacturers and distributors. I would argue that highly successful DEA operatives and litigation lawyers are not exactly pitiable- white privilege at its finest; but for the most part their intentions are admirable throughout.
It has been a long time since I have been able to read a full non-fiction novel in one or two sittings, and despite knowing the outcome of the case, I could not tear myself away from this read. For anyone who has been impacted by the national opiate crisis (directly or indirectly) or are curious to learn more- I strongly encourage you to pick up this book.
Warning, however: if you do, prepare to be outraged.
[Thank you to NetGalley and Twelve Books for a free copy of this book in exchange for an honest review.]
November 7, 2022
Covers the legal battle against drug distributors in great (and well-written) detail but gives a very limited view of the wide range of problems and unethical behavior that have led to our opioid crisis and doesn't make you feel the human toll of this crisis as well as some other books on this topic do.
July 24, 2022
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 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.
Reviewed by Cindy Burnett
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 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.
Reviewed by Cindy Burnett
September 29, 2025
American Cartel: Inside the Battle to Bring Down the Opioid Industry, Scott Higham and Sari Horwitz, 2022, 400 pages, ISBN 9781538737200, Dewey 338.476153.
Federal law requires narcotics distributors to refuse to fill suspiciously-large orders. They shipped billions of pills, knowing the quantities far exceeded legitimate use. Hundreds of thousands of people died of overdoses.
The first 26 chapters are a depressing litany of failure, a slow-motion train wreck: we see the drug-law-enforcement agents trying to protect the public, while the drug industry controls politicians to enfeeble the DEA, 2005-2016. pp. 1-132.
The rest of the book is more hopeful. It's about civil litigation 2016-2022, including 4,000 lawsuits filed against the opioid industry, rolled into one case, settled for $26 billion--none of which will go to victims or their families. It will go to opioid-addiction treatment and prevention. No company admitted wrongdoing; all are shielded from future lawsuits. No executive was charged with anything. The companies' stock prices rose 3% the day the settlement was announced. pp. 318-319.
The drug industry buys the support of congressional committee members for tens of thousands of dollars. (Cheaper than dirt.) Congress enacts laws to tie the hands of the Drug Enforcement Agency. (Obama signed a law hamstringing the DEA in 2016. p. 146.) The drug industry reaps hundreds of billions of dollars yearly. Countless lives are destroyed. 93,000 Americans died of drug overdoses in 2020. pp. 98, 192, 232, 259, 260.
For drug czar, President Trump in 2017 nominated Tom Marino, darling of the opioid industry. p. 173.
Many Drug Enforcement Agency agents leave the DEA for high-paying jobs with the companies they once regulated. pp. 28, 61. They know how to write laws to tie the DEA's hands. p. 98.
Obama's attorney general, Eric Holder, had represented the opioid industry as a lawyer at Covington & Burling, to which he returned in 2015. pp. 101, 123. A former Obama associate attorney general defended drug companies from 2018 to 2022. pp. 251, 319.
Oxycodone was selling on the street for $900 per thirty 30-milligram pills ($1 million a kilo), as of 2008. The manufacturing cost is tiny. p. 35.
Federal law requires narcotics distributors to refuse to fill suspiciously-large orders. They shipped billions of pills, knowing the quantities far exceeded legitimate use. Hundreds of thousands of people died of overdoses.
The first 26 chapters are a depressing litany of failure, a slow-motion train wreck: we see the drug-law-enforcement agents trying to protect the public, while the drug industry controls politicians to enfeeble the DEA, 2005-2016. pp. 1-132.
The rest of the book is more hopeful. It's about civil litigation 2016-2022, including 4,000 lawsuits filed against the opioid industry, rolled into one case, settled for $26 billion--none of which will go to victims or their families. It will go to opioid-addiction treatment and prevention. No company admitted wrongdoing; all are shielded from future lawsuits. No executive was charged with anything. The companies' stock prices rose 3% the day the settlement was announced. pp. 318-319.
The drug industry buys the support of congressional committee members for tens of thousands of dollars. (Cheaper than dirt.) Congress enacts laws to tie the hands of the Drug Enforcement Agency. (Obama signed a law hamstringing the DEA in 2016. p. 146.) The drug industry reaps hundreds of billions of dollars yearly. Countless lives are destroyed. 93,000 Americans died of drug overdoses in 2020. pp. 98, 192, 232, 259, 260.
For drug czar, President Trump in 2017 nominated Tom Marino, darling of the opioid industry. p. 173.
Many Drug Enforcement Agency agents leave the DEA for high-paying jobs with the companies they once regulated. pp. 28, 61. They know how to write laws to tie the DEA's hands. p. 98.
Obama's attorney general, Eric Holder, had represented the opioid industry as a lawyer at Covington & Burling, to which he returned in 2015. pp. 101, 123. A former Obama associate attorney general defended drug companies from 2018 to 2022. pp. 251, 319.
Oxycodone was selling on the street for $900 per thirty 30-milligram pills ($1 million a kilo), as of 2008. The manufacturing cost is tiny. p. 35.
April 10, 2023
American Cartel by Scott Higham and Sari Horwitz is an encapsulation of the government success and failures at the beginning of the Opioid Epidemic.
Different from other books I’ve read, in American Cartel, we follow DEA agent Joe Rannazzisi and his struggles to hold the drug companies accountable for the enormous number of opioid pills being shipped out. During his time in the DEA, congress passed a bill making it almost impossible for the DEA to hold companies accountable for shopping massive amounts of pills. We also follow the lawyers who decide to bring a case against the drug companies.
It is infuriating (but not surprising) to read how little the drug companies cared about the people it was providing drugs to. The drug companies became the drug dealers, not caring whether people were addicted or dying if they got their cut of the profits.
I would recommend this book to anyone interested in how Big Pharma operates or how the Opioid Crises developed. If you’re interested in this topic, I also recommend adding Empire of Pain: The Secret History of the Sackler Dynasty, In Pain: A Bioethicist's Personal Struggle with Opioids, and The Hard Sell: Crime and Punishment at an Opioid Startup.
Rating: 4/5
Genre: Non-Fiction
Different from other books I’ve read, in American Cartel, we follow DEA agent Joe Rannazzisi and his struggles to hold the drug companies accountable for the enormous number of opioid pills being shipped out. During his time in the DEA, congress passed a bill making it almost impossible for the DEA to hold companies accountable for shopping massive amounts of pills. We also follow the lawyers who decide to bring a case against the drug companies.
It is infuriating (but not surprising) to read how little the drug companies cared about the people it was providing drugs to. The drug companies became the drug dealers, not caring whether people were addicted or dying if they got their cut of the profits.
I would recommend this book to anyone interested in how Big Pharma operates or how the Opioid Crises developed. If you’re interested in this topic, I also recommend adding Empire of Pain: The Secret History of the Sackler Dynasty, In Pain: A Bioethicist's Personal Struggle with Opioids, and The Hard Sell: Crime and Punishment at an Opioid Startup.
Rating: 4/5
Genre: Non-Fiction
August 17, 2022
4.5 stars.
Of all the books I’ve read on the opioid crisis, I think this is the one that made my blood boil the most, because it dealt with drug distributors (we call them wholesalers in the trade) and the layers of distribution down to individual pharmacies—the parts of the trade that involved me and other pharmacists I knew. The store I co-owned got its drugs from McKesson—the warehouse they came from is mentioned several times in the book. Frankly, it makes me want to take a long hot shower every time I think about working with them. But that’s a personal, visceral reaction.
As for the book—meticulously researched and laid out (no surprise, since their series on the same subject won a Pulitzer for the Washington Post) and packing a huge punch. The biggest flaw is that—much like the cases it describes—it’s just too big, too complex, and has too many characters to do justice to in a single book. Even the cast of characters at the book’s beginning is of limited value. It was also a disappointment that the book couldnt be held up a few months to allow comment on the verdict.
But that is not a commentary on the subject matter, which needs to be read by anyone involved in the health care industry. Stunning and horrifying are the first two adjectives that come to mind, but they certainly arent the only ones. Hang on through the difficult first hundred pages and you wont be able to put it down.
Of all the books I’ve read on the opioid crisis, I think this is the one that made my blood boil the most, because it dealt with drug distributors (we call them wholesalers in the trade) and the layers of distribution down to individual pharmacies—the parts of the trade that involved me and other pharmacists I knew. The store I co-owned got its drugs from McKesson—the warehouse they came from is mentioned several times in the book. Frankly, it makes me want to take a long hot shower every time I think about working with them. But that’s a personal, visceral reaction.
As for the book—meticulously researched and laid out (no surprise, since their series on the same subject won a Pulitzer for the Washington Post) and packing a huge punch. The biggest flaw is that—much like the cases it describes—it’s just too big, too complex, and has too many characters to do justice to in a single book. Even the cast of characters at the book’s beginning is of limited value. It was also a disappointment that the book couldnt be held up a few months to allow comment on the verdict.
But that is not a commentary on the subject matter, which needs to be read by anyone involved in the health care industry. Stunning and horrifying are the first two adjectives that come to mind, but they certainly arent the only ones. Hang on through the difficult first hundred pages and you wont be able to put it down.
September 25, 2023
Infuriating to think about the cavalier attitudes some people had about the opioid crisis. The callousness of some of the drug companies and distributors and doctors and everyone along the way who did not do the right thing was maddening. This book seemed to be mostly about the injustice of it all. And how power and money corrupts. It seems as though in the US, we've gotten comfortable with the idea of our happiness, power and money to be more important than the lives of our fellow human beings. It's gross. And I'm not sure how it stops.
I only gave this three stars because I had a hard time following along with who everyone was. My brain was not in the right space to pay close attention and I found myself zonig out, especially during the first half of the book.
But-I really did love the narrator. He read the book with a voice that dripped with disdain for the drug companies and distributors.
I'm hoping that this crisis can stop and that everyone involved can find healing.
I only gave this three stars because I had a hard time following along with who everyone was. My brain was not in the right space to pay close attention and I found myself zonig out, especially during the first half of the book.
But-I really did love the narrator. He read the book with a voice that dripped with disdain for the drug companies and distributors.
I'm hoping that this crisis can stop and that everyone involved can find healing.
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