A four-year investigation into the world of synthetic drugs—from black market factories to users & dealers to harm reduction activists—and what it revealed. A deeply human story, Fentanyl, Inc. is the first deep-dive investigation of a hazardous and illicit industry that has created a worldwide epidemic, ravaging communities and overwhelming and confounding government agencies that are challenged to combat it. “A whole new crop of chemicals is radically changing the recreational drug landscape,” writes Ben Westhoff. “These are known as Novel Psychoactive Substances (NPS) and they include replacements for known drugs like heroin, cocaine, ecstasy, and marijuana. They are synthetic, made in a laboratory, and are much more potent than traditional drugs” —and all-too-often tragically lethal. Drugs like fentanyl, K2, and Spice—and those with arcane acronyms like 25i-NBOMe—were all originally conceived in legitimate laboratories for proper scientific and medicinal purposes. Their formulas were then hijacked and manufactured by rogue chemists, largely in China, who change their molecular structures to stay ahead of the law, making the drugs’ effects impossible to predict. Westhoff has infiltrated this shadowy world. He tracks down the little-known scientists who invented these drugs and inadvertently killed thousands, as well as a mysterious drug baron who turned the law upside down in his home country of New Zealand. Westhoff visits the shady factories in China from which these drugs emanate, providing startling and original reporting on how China’s vast chemical industry operates, and how the Chinese government subsidizes it. Poignantly, he chronicles the lives of addicted users and dealers, families of victims, law enforcement officers, and underground drug awareness organizers in the United States and Europe. Together they represent the shocking and riveting full anatomy of a calamity we are just beginning to understand. From its depths, as Westhoff relates, are emerging new strategies that may provide essential long-term solutions to the drug crisis that has affected so many. “Timely and agonizing. . . . An impressive work of investigative journalism.” —USA Today “Westhoff explores the many-tentacled world of illicit opioids, from the streets of East St. Louis to Chinese pharmaceutical companies, from music festivals deep in the Michigan woods to sanctioned ‘shooting up rooms’ in Barcelona, in this frank, insightful, and occasionally searing exposé. . . . Westhoff’s well-reported and researched work will likely open eyes, slow knee-jerk responses, and start much needed conversations.” —Publishers Weekly “Our 25 Favorite Books of 2019” —St. Louis Post-Dispatch “Best Books of 2019” —Buzzfeed “Best Nonfiction of 2019” —Kirkus Reviews “50 Best Books of 2019” —Daily Telegraph “Best Nonfiction Books of 2019” —Tyler Cowen “Best Books of 2019” —Yahoo Finance

A TELEGRAPH BOOK OF THE YEAR An undercover investigation into the synthetic-drug epidemic. A new group of chemicals is radically transforming the recreational-drug landscape. Known as Novel Psychoactive Substances (NPS), they range from so-called ‘legal highs’ like Spice, to synthetic opioids — most famously, the deadly fentanyl. Designed to replicate the effects of established drugs like cocaine, ecstasy, marijuana, and heroin, NPS are synthesised in laboratories. They are cheap to produce and easy to transport. They are also extremely potent and often deadly. Originally developed for medicinal purposes, and then hijacked by rogue chemists, who change their molecular structures to stay ahead of the law, these chemicals’ effects can be impossible to predict. What we do know is that they have triggered the biggest drug epidemic that America has ever seen, and which is now spreading internationally. In Fentanyl, Inc., award-winning investigative journalist Ben Westhoff goes undercover to infiltrate the shadowy world of synthetic drugs — becoming, in the process, the first journalist to infiltrate a Chinese fentanyl lab. He tracks down the drug baron in New Zealand who unintentionally helped to start the synthetic-drug revolution; prowls St. Louis streets with a former fentanyl dealer to understand how the epidemic started; and chronicles the lives of addicts and dealers, families of victims, law enforcement officers, and underground drug-awareness organisers in the US and Europe. Fentanyl, Inc. is essential reading on a global calamity we are only just beginning to understand.

A comprehensive portrait of a uniquely American epidemic -- devastating in its findings and damning in its conclusions The opioid epidemic has been described as "one of the greatest mistakes of modern medicine." But calling it a mistake is a generous rewriting of the history of greed, corruption, and indifference that pushed the US into consuming more than 80 percent of the world's opioid painkillers. Journeying through lives and communities wrecked by the epidemic, Chris McGreal reveals not only how Big Pharma hooked Americans on powerfully addictive drugs, but the corrupting of medicine and public institutions that let the opioid makers get away with it. The starting point for McGreal's deeply reported investigation is the miners promised that opioid painkillers would restore their wrecked bodies, but who became targets of "drug dealers in white coats." A few heroic physicians warned of impending disaster. But American Overdose exposes the powerful forces they were up against, including the pharmaceutical industry's coopting of the Food and Drug Administration and Congress in the drive to push painkillers -- resulting in the resurgence of heroin cartels in the American heartland. McGreal tells the story, in terms both broad and intimate, of people hit by a catastrophe they never saw coming. Years in the making, its ruinous consequences will stretch years into the future.

Apple Best Books of 2021 Longlisted for the Andrew Carnegie Medal * Shortlisted for the Zocalo Book Prize From the New York Times bestselling author of Dreamland, a searing follow-up that explores the terrifying next stages of the opioid epidemic and the quiet yet ardent stories of community repair. Sam Quinones traveled from Mexico to main streets across the U.S. to create Dreamland, a groundbreaking portrait of the opioid epidemic that awakened the nation. As the nation struggled to put back the pieces, Quinones was among the first to see the dangers that lay ahead: synthetic drugs and a new generation of kingpins whose product could be made in Magic Bullet blenders. In fentanyl, traffickers landed a painkiller a hundred times more powerful than morphine. They laced it into cocaine, meth, and counterfeit pills to cause tens of thousands of deaths-at the same time as Mexican traffickers made methamphetamine cheaper and more potent than ever, creating, Sam argues, swaths of mental illness and a surge in homelessness across the United States. Quinones hit the road to investigate these new threats, discovering how addiction is exacerbated by consumer-product corporations. “In a time when drug traffickers act like corporations and corporations like traffickers,” he writes, “our best defense, perhaps our only defense, lies in bolstering community.” Amid a landscape of despair, Quinones found hope in those embracing the forgotten and ignored, illuminating the striking truth that we are only as strong as our most vulnerable. Weaving analysis of the drug trade into stories of humble communities, The Least of Us delivers an unexpected and awe-inspiring response to the call that shocked the nation in Sam Quinones's award-winning Dreamland.

From the Pulitzer Prize–winning New York Times reporter who first exposed the roots of the opioid epidemic and the secretive world of the Sackler family behind Purdue Pharma, Pain Killer is the celebrated landmark story of corporate greed and government negligence that inspired an upcoming Netflix series. “This is the book that started it all. Barry Meier is a heroic reporter and Pain Killer is a muckraking classic.”—Patrick Radden Keefe, author of Empire of Pain Between 1999 and 2017, an estimated 250,000 Americans died from overdoses involving prescription painkillers, a plague ignited by Purdue Pharma’s aggressive marketing of OxyContin. Families, working class and wealthy, have been torn apart, businesses destroyed, and public officials pushed to the brink. Meanwhile, the drugmaker’s owners, Raymond and Mortimer Sackler, whose names adorn museums worldwide, made enormous fortunes from the commercial success of OxyContin. In Pain Killer, Barry Meier tells the story of how Purdue turned OxyContin into a billion-dollar blockbuster. Powerful narcotic painkillers, or opioids, were once used as drugs of last resort for pain sufferers. But Purdue launched an unprecedented marketing campaign claiming that the drug’s long-acting formulation made it safer to use than traditional painkillers for many types of pain. That illusion was quickly shattered as drug abusers learned that crushing an Oxy could release its narcotic payload all at once. Even in its prescribed form, Oxy proved fiercely addictive. As OxyContin’s use and abuse grew, Purdue concealed what it knew from regulators, doctors, and patients. Here are the people who profited from the crisis and those who paid the price, those who plotted in boardrooms and those who tried to sound alarm bells. A country doctor in rural Virginia, Art Van Zee, took on Purdue and warned officials about OxyContin abuse. An ebullient high school cheerleader, Lindsey Myers, was reduced to stealing from her parents to feed her escalating Oxy habit. A hard-charging DEA official, Laura Nagel, tried to hold Purdue executives to account. In Pain Killer, Barry Meier breaks new ground in his decades-long investigation into the opioid epidemic. He takes readers inside Purdue to show how long the company withheld information about the abuse of OxyContin and gives a shocking account of the Justice Department’s failure to alter the trajectory of the opioid epidemic and protect thousands of lives. Equal parts crime thriller, medical detective story, and business exposé, Pain Killer is a hard-hitting look at how a supposed wonder drug became the gateway drug to a national tragedy.

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

The inside story of a band of entrepreneurial upstarts who made millions selling painkillers—until their scheme unraveled, putting them at the center of a landmark criminal trial. • SOON TO BE THE MAJOR MOTION PICTURE PAIN HUSTLERS STARRING EMILY BLUNT AND CHRIS EVANS "Unfolds with the velocity and verve of a Scorsese film…A tour de force."—Patrick Radden Keefe, New York Times bestselling author of Empire of Pain and Say Nothing John Kapoor had already amassed a small fortune in pharmaceuticals when he founded Insys Therapeutics. It was the early 2000s, a boom time for painkillers, and he developed a novel formulation of fentanyl, the most potent opioid on the market. Kapoor, a brilliant immigrant scientist with relentless business instincts, was eager to make the most of his innovation. He gathered around him an ambitious group of young lieutenants. His head of sales—an unstable and unmanageable leader, but a genius of persuasion—built a team willing to pull every lever to close a sale, going so far as to recruit an exotic dancer ready to scrape her way up. They zeroed in on the eccentric and suspect doctors receptive to their methods. Employees at headquarters did their part by deceiving insurance companies. The drug was a niche product, approved only for cancer patients in dire condition, but the company’s leadership pushed it more widely, and together they turned Insys into a Wall Street sensation. But several insiders reached their breaking point and blew the whistle. They sparked a sprawling investigation that would lead to a dramatic courtroom battle, breaking new ground in the government’s fight to hold the drug industry accountable in the spread of addictive opioids. In The Hard Sell, National Magazine Award–finalist Evan Hughes lays bare the pharma playbook. He draws on unprecedented access to insiders of the Insys saga, from top executives to foot soldiers, from the patients and staff of far-flung clinics to the Boston investigators who treated the case as a drug-trafficking conspiracy, flipping cooperators and closing in on the key players. With colorful characters and true suspense, The Hard Sell offers a bracing look not just at Insys, but at how opioids are sold at the point they first enter the national bloodstream—in the doctor’s office.

As an adult book, Sam Quinones's Dreamland took the world by storm, winning the NBCC Award for General Nonfiction and hitting at least a dozen Best Book of the Year lists. Now, adapted for the first time for a young adult audience, this compelling reporting explains the roots of the current opiate crisis. In 1929, in the blue-collar city of Portsmouth, Ohio, a company built a swimming pool the size of a football field; named Dreamland, it became the vital center of the community. Now, addiction has devastated Portsmouth, as it has hundreds of small rural towns and suburbs across America. How that happened is the riveting story of Dreamland. Quinones explains how the rise of the prescription drug OxyContin, a miraculous and extremely addictive painkiller pushed by pharmaceutical companies, paralleled the massive influx of black tar heroin--cheap, potent, and originating from one small county on Mexico's west coast, independent of any drug cartel. Introducing a memorable cast of characters--pharmaceutical pioneers, young Mexican entrepreneurs, narcotics investigators, survivors, teens, and parents--Dreamland is a revelatory account of the massive threat facing America and its heartland.

Award-winning journalist and New York Times bestselling author Gerald Posner reveals the heroes and villains of the trillion-dollar-a-year pharmaceutical industry and delivers “a withering and encyclopedic indictment of a drug industry that often seems to prioritize profits over patients (The New York Times Book Review). Pharmaceutical breakthroughs such as anti­biotics and vaccines rank among some of the greatest advancements in human history. Yet exorbitant prices for life-saving drugs, safety recalls affecting tens of millions of Americans, and soaring rates of addiction and overdose on pre­scription opioids have caused many to lose faith in drug companies. Now, Americans are demanding a national reckoning with a monolithic industry. “Gerald’s dogged reporting, sets Pharma apart from all books on this subject” (The Washington Standard) as we are introduced to brilliant scientists, incorruptible government regulators, and brave whistleblowers facing off against company exec­utives often blinded by greed. A business that profits from treating ills can create far deadlier problems than it cures. Addictive products are part of the industry’s DNA, from the days when corner drugstores sold morphine, heroin, and cocaine, to the past two decades of dangerously overprescribed opioids. Pharma also uncovers the real story of the Sacklers, the family that became one of America’s wealthiest from the success of OxyContin, their blockbuster narcotic painkiller at the center of the opioid crisis. Relying on thousands of pages of government and corporate archives, dozens of hours of interviews with insiders, and previously classified FBI files, Posner exposes the secrets of the Sacklers’ rise to power—revelations that have long been buried under a byzantine web of interlocking companies with ever-changing names and hidden owners. The unexpected twists and turns of the Sackler family saga are told against the startling chronicle of a powerful industry that sits at the intersection of public health and profits. “Explosively, even addictively, readable” (Booklist, starred review), Pharma reveals how and why American drug com­panies have put earnings ahead of patients.

The Essence of Analgesia and Analgesics is an invaluable practical resource for clinicians giving pain relief in any clinical setting, describing the pharmacologic principles and clinical use of all available pain medications. As well as detailed overviews of pain processing and analgesic theory, sections are dedicated to oral and panteral opioid analgesics, neuraxial opioids, NSAIDs, local anesthetics, anticonvulsant type analgesics, NMDA antagonists, alpha adrenergic analgesics, antidepressant analgesics, muscle relaxants, adjuvant medications, and new and emerging analgesics. The concise format of the chapters allows for quick and easy reading and assimilation of information. Enhanced by summary tables and figures, each chapter provides an overview of a particular drug, covering chemical structure, mode of activity, indications, contraindications, common doses and uses, advantages and disadvantages, and drug related adverse events. Key references are also provided. Edited by leading experts in pain management, this is essential reading for any clinician involved in pain management.