American Cartel: Inside the Battle to Bring Down the Opioid Industry (Part I)

In the last 16 years, I’ve done a fairly massive amount of study on the subject of opioid addiction. So when this new book, American Cartel, came out, I purchased it as soon as possible.

My own learning curve on this topic started in 2006 when I went to work in a drug rehab facility. I was soon introduced to the concept of “doctor-shopping.” Someone told me that was how they had gotten their hands on drugs and I had to ask someone else what that meant.

Then I talked to another person about how she had stolen prescription pads and written her own prescriptions which she then filled in the pharmacy. She went to jail for a while where, as she put it, she learned to be a better criminal when she got out. She didn’t stop using the pills until the DEA arrived to arrest her as she sat in her car in a pharmacy drive-through lane—with her kids in the car. 

And worst of all, I listened to a young woman’s story about her addiction to OxyContin. She had been working as a stripper—exotic dancer, if you prefer— and was four months pregnant without even knowing it. One night after injecting OxyContin, she began to miscarry and ended up in the emergency room. She said she sat in the ER for hours while nurses came to measure her hormone levels so they could tell when her baby was dead. She tried to call her family and ask them to come help her but they had dismissed her from their lives so she had to go through this trauma all alone. 

I’ve been working in this field long enough that I have seen the landscape change dramatically, again and again. Some changes I could predict but knew I could not change. Some, like the arrival of fentanyl, blindsided me and pretty much everyone except those who put the trafficking channels in place to flood the country with this powerful and deadly substance. 

I try to keep up with the best books that come out that can advance my knowledge and understanding of this field. I’ve traveled to the U.S.-Mexico border to get my own understanding of that region where the Mexican traffickers have so much control. I’ve paid my own way to two Prescription Drug and Heroin Summits in Atlanta, once in 2015 and again in 2017, to listen to bright and dedicated individuals with valuable knowledge and experience to share. 

At one of those Summits, I attended a session run by Joe Rannazzisi from the Drug Enforcement Administration. Joe was the director of the arm of the DEA that was supposed to keep prescription drugs from being diverted to the illicit market. I don’t remember at all what he said but I remember the impression he made on me. He gave a powerful, passionate and even fiery presentation. I knew that this was a man operating at a very high level of determination and intention. He was insistent on making a difference, he was going to get his job done. This was a man of integrity. 

I spoke to him after the session and again, I have no idea what was said. I only knew I had to acknowledge his for his presentation and unwavering dedication. 

Some time later, I sent him a message to tell him that I had written to the White House when there was an opening for the job of director of the Office of Drug Control Policy—we call that person the Drug Czar. I told him I had recommended him for the job. He responded:

Ms. Hadley, Thank you for the vote of confidence! Although I appreciate your endorsement, Several Senators and Congressman on both sides were not happy with my enforcement strategy against large corporations so I doubt that I will ever see a political appointment to ONDCP or DEA.  However, I appreciate your that you took the time to send a letter suggesting my name for the Director position. I am retired now but I am still active in trying to address the prescription/synthetic drug abuse problem through speaking and compliance work. Take care and stay safe,  Joe Rannazzisi

In 2017, Joe was featured in a cover story in the Washington Post. The story described how the DEA had made it impossible for him to do his job effectively and so he was forced to retire. I wrote to him again and thanked him for his passion to right the wrongs in this area. I cited a few other people I’d met who were also making a difference, such as Kevin Sabet of Smart Approaches to Marijuana. 

He wrote back:

Ms. Hadley, Thank you for your kind words of support. The individuals you mentioned are very fine men who are fighting the good fight and I am humbled to be included in their ranks. I am not going away….too many people lost and not enough help from our government or the industry. It is a shame that the states have to force change through the courts but at this moment in time I don’t see the industry changing or the Federal Government getting aggressive. I really believe that our elected officials believe that this will soon leave the public eye and they can go back to business as usual. I decided that I cannot sit back and let that happen. Take care and stay safe,  Joe Rannazzisi

Now, with the publication of American Cartel, I finally got the rest of his story. The first half of American Cartel tells the story of how the DEA was forced to change by The Alliance, a cartel of drug manufacturers who had no intention of letting the DEA change anything about their business model. And Joe stood in the way of their being able to do business exactly as they chose. So he had to go. And the only way to accomplish that goal was through changing the law in America that enabled him to do his job. So that’s exactly what they did. 

In my next article, I’ll outline that campaign to destroy the power of the DEA to prevent diversion of pills to the illicit market. Instead, the pharmaceutical companies, the distributors (middlemen), pharmacies like Walgreens and unscrupulous doctors would just keep raking in the cash. All the while, tens of thousands more American would die from opioid overdoses made possible by millions upon millions of pills flooding the landscape.