What blame should be placed on Perdue Pharmaceutical for their role in the Opioid Crises? What penalties if any should they face?

Question Description

I’m working on a political science discussion question and need a reference to help me understand better.


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Text Book

Dreamland: The True Tale of America’s Opiate Epidemic; Sam Quinones

  • read from Part IV”american” through end of the book.


Video Lectures:

Addiction Stigma Still Exists Among Physicians | MDedge: 

Finding the Brain’s Addiction Switch | Steven Laviolette | TEDxWesternU: 

Eliminating the Shame and Stigma of Addiction | Kathryn Helgaas Burgum | TEDxFargo: 



1. Discussion:


By the mid-week deadline based on your readings and the video lectures answer each of the questions/prompts below with 1-2 paragraphs using concepts from the text or your own research (be sure to cite correctly).


  • What blame should be placed on Perdue Pharmaceutical for their role in the Opioid Crises? What penalties if any should they face?
  • What can we do as a nation to solve the Opioid crises?
  • What can we do as individuals to help solve the Opioid crises?

2. Journal


The Reflective Journal is an assessment of your understanding of assigned readings, course lectures, and videos. It is also a means in which you demonstrate how you will apply your readings and observations in your day to day to life.



1 2 To my girls 3 CONTENTS The Xalisco Boys Heroin Cells in the United States Xalisco County in Nayarit, Mexico Timeline PREFACE: Portsmouth, Ohio Introduction PART I Enrique Dr. Jick’s Letter All from the Same Town Liberace in Appalachia The Adman Enrique Begins The Molecule Delivered Like Pizza Enrique Alone The Poppy Easier than Sugarcane Just a Phone Call Away Enrique Adrift Searching for the Holy Grail The Pain Pain and the Pro Wrestler The Man Comes The Revolution All About the 501s The Landmark Study Enrique Redeemed We Realized This Is Corporate Purdue 4 The Man and the Nayarit Swing with OxyContin The Man at Home What’s OxyContin? Smack Clans in the Sanctuary Liberace Shows the Way The Man in the Heartland Bodies Are the Key to the Case Enrique on Top Heroin Like Hamburgers Tar Pit PART II Two-Thousand-Year-Old Questions Collision: Ground Zero Canaries in Coal Mines Fifty, Hundred Cases a Month Junkie Kingdom in Dreamland A Criminal Case “Took Over the OxyContin Belt” The Final Convenience A Tidal Wave Forming Pentecostal Piety, Fierce Scratches “We Was Carrying the Epidemic” More Cases Than Car Crashes A Pro Wrestler’s Legacy Great Time to Be a Heroin Dealer The Criminal Case PART III “Now It’s Your Neighbor’s Kid” Like Cigarette Executives No Scarface, No Kingpins A Parent’s Soul Pain PART IV America 5 The Treatment Is You The Internet of Dope Nobody Can Do It Alone PART V Up from the Rubble Acknowledgments Source Notes A Note on the Author By the Same Author 6 The Xalisco Boys Heroin Cells in the United States U.S. cities where the traffickers from Xalisco, Nayarit, have heroin cells (stars) or have at one time had cells working (dots). In most cases, the market for their black tar heroin stretches far beyond each city, sometimes for hundreds of miles. 7 Xalisco County in Nayarit, Mexico 8 A word on terminology: I have used the term “opiate” throughout this book to describe drugs like morphine and heroin, which derive directly from the opium poppy, and others that derive indirectly, or are synthesized from drugs derived, from the poppy and resemble morphine in their effects. These derivative drugs are often described as opioids. But I felt that going back and forth between the two terms throughout the book would confuse the lay reader. TIME LINE 1804: Morphine is distilled from opium for the first time. 1839: First Opium War breaks out as Britain forces China to sell its India-grown opium, and the British take Hong Kong. A second war erupts in 1957. 1853: The hypodermic syringe is invented. Inventor’s wife is first to die of injected drug overdose. 1898: Bayer chemist invents diacetylmorphine, names it heroin. 1914: U.S. Congress passes Harrison Narcotics Tax Act. 1928: What eventually becomes known as the Committee on the Problems of Drug Dependence forms to organize research in pursuit of the Holy Grail: a nonaddictive painkiller. 1935: The Narcotic Farm in Lexington, Kentucky, opens as federal prison/drug rehabilitation and research center. 1951: Arthur Sackler revolutionizes drug advertising with campaign for antibiotic Terramycin. 1952: Arthur, Raymond, and Mortimer Sackler buy Purdue Frederick. 1960: Arthur Sackler’s campaign for Valium makes it the industry’s first $100 million drug. 1974: The Narcotic Farm closes and is transformed into a medical center and prison. 1980: Jan Stjernsward made chief of the cancer program for the World Health Organization. Devises WHO Ladder of pain treatment. 9 New England Journal of Medicine 1980: The publishes letter to editor that becomes known as Porter and Jick. Early 1980s: First Xalisco migrants set up heroin trafficking businesses in the San Fernando Valley of Los Angeles. 1984: Purdue releases MS Contin, a timed-release morphine painkiller marketed to cancer patients. 1986: Drs. Kathleen Foley and Russell Portenoy publish paper in the journal , opening a debate about use of opiate painkillers for wider variety of pain. 1987: Arthur Sackler dies, having revolutionized pharmaceutical advertising. Early 1990s: Xalisco Boys heroin cells begin expanding beyond San Fernando Valley to cities across western United States. Their pizza-delivery-style system evolves. 1996: Purdue releases OxyContin, timed-released oxycodone, marketed largely for chronic-pain patients. 1996: Dr. David Procter’s clinic in South Shore, Kentucky, is presumed the nation’s first pill mill. 1996: President of American Pain Society urges doctors to treat pain as a vital sign. 1998: “The Man” takes Xalisco black tar heroin east across the Mississippi River for the first time, lands in Columbus, Ohio. 1998: In Portsmouth, Ohio, Dr. David Procter has an auto accident that leaves him unable to practice medicine but still capable of running a pain clinic. He hires doctors who go on to open clinics. Late 1990s: Xalisco Boys heroin cells begin to spread to numerous cities and suburbs east of the Mississippi River. 1998–99: Veterans Administration and JCAHO adopt idea of pain as fifth vital sign. 2000: Operation Tar Pit targets Xalisco heroin networks— the largest joint DEA/FBI operation and first drug conspiracy case to stretch from coast to coast. Pain 10 2001: Injured workers covered under Washington State’s workers’ comp system start dying of opiate overdoses. 2002: Dr. David Procter pleads guilty to drug trafficking and conspiracy and serves eleven years in federal prison. 2004: Washington State Department of Labor & Industries Drs. Gary Franklin and Jaymie Mai publish findings on deaths of injured workers due to overdoses on opiate painkillers. Mid-2000s: Xalisco black tar heroin cells are now in at least seventeen states. Portsmouth, Ohio, has more pill mills per capita than any U.S. town. Florida’s lax regulations make it another center of illicit pill supply. 2006: Operation Black Gold Rush, a second DEA operation targeting Xalisco heroin cells across the country. 2007: Purdue and three executives plead guilty to misdemeanor charges of false branding of OxyContin; fined $634 million. 2008: Drug overdoses, mostly from opiates, surpass auto fatalities as leading cause of accidental death in the United States. 2010: Drug violence between Los Zetas and Sinaloa cartels spreads to Xalisco, Nayarit. 2011: Ohio passes House Bill 93, regulating pain clinics. 2013: The College on the Problems of Drug Dependence turns seventy-five without finding the Holy Grail of a nonaddictive painkiller. 2014: Actor Philip Seymour Hoffman dies, focusing widespread attention for the first time on the United States’ opiate-abuse epidemic and the transition from pills to heroin in particular. 2014: The FDA approves Zohydro, a timed-release hydrocodone painkiller with no abuse deterrent. It also approves Purdue’s Targiniq ER, combining timed-release oxycodone with naloxone, the opiate-overdose antidote. 11 PREFACE: Portsmouth, Ohio In 1929, three decades into what were the great years for the blue-collar town of Portsmouth, on the Ohio River, a private swimming pool opened and they called it Dreamland. The pool was the size of a football field. Over the decades, generations of the town grew up at the edge of its crystal-blue water. Dreamland was the summer babysitter. Parents left their children at the pool every day. Townsfolk found respite from the thick humidity at Dreamland and then went across the street to the A&W stand for hot dogs and root beer. The pool’s french fries were the best around. Kids took the bus to the pool in the morning, and back home in the afternoon. They came from schools all over Scioto County and met each other and learned to swim. Some of them competed on the Dreamland Dolphins swim team, which practiced every morning and evening. WIOI, the local radio station, knowing so many of its listeners were sunbathing next to their transistor radios at Dreamland, would broadcast a jingle—“Time to turn so you won’t burn”—every half hour. The vast pool had room in the middle for two concrete platforms, from which kids sunned themselves, then dove back in. Poles topped with floodlights rose from the platforms for swimming at night. On one side of the pool was an immense lawn where families set their towels. On the opposite side were locker rooms and a restaurant. Dreamland could fit hundreds of people, and yet, magically, the space around it kept growing and there was always room for more. Jaime Williams, the city treasurer, owned the pool for years. Williams was part owner of one of the shoe factories that were at the core of Portsmouth’s industrial might. He bought more and more land, and for years Dreamland seemed to just get better. A large picnic area was added, and 12 playgrounds for young children. Then fields for softball and football, and courts for basketball and shuffleboard, and a video arcade. For a while, to remain white only, the pool became a private club and the name changed to the Terrace Club. But Portsmouth was a largely integrated town. Its chief of police was black. Black and white kids went to the same schools. Only the pool remained segregated. Then, in the summer of 1961, a black boy named Eugene McKinley drowned in the Scioto River, where he was swimming because he was kept out of the pool. The Portsmouth NAACP pushed back, held a wade-in, and quietly they integrated the pool. With integration, the pool was rechristened Dreamland, though blacks were never made to feel particularly comfortable there. Dreamland did wash away class distinctions, though. In a swimming suit, a factory worker looked no different from the factory manager or clothing-shop owner. Wealthy families on Portsmouth’s hilltop donated money to a fund that would go to pay for summer passes for families from the town’s East End, down between the tracks and the Ohio River. East End river rats and upscale hilltoppers all met at Dreamland. California had its beaches. Heartland America spent its summers at swimming pools, and, down at a far end of Ohio, Dreamland took on an outsized importance to the town of Portsmouth. A family’s season pass was only twenty-five dollars, and this was a prized possession often given as a Christmas present. Kids whose families couldn’t afford that could cut a neighbor’s grass for the fifteen cents that a daily pool pass cost. Friday swim dances began at midnight. They hauled out a jukebox and kids spent the night twisting by the pool. Couples announced new romances by walking hand in hand around Dreamland. Girls walked home from those dances and families left their doors unlocked. “The heat of the evening combined with the cool water was wonderful,” one woman remembered. “It was my entire world. I did nothing else. As I grew up and had my own children, I took them, too.” 13 In fact, the cycle of life in Portsmouth was repeated over and over at Dreamland. A toddler spent her first years at the shallow end watched by her parents, particularly her mother, who sat on a towel on the concrete near the water with other young moms. When the child left elementary school, she migrated out to the middle section of Dreamland as her parents retreated to the grass. By high school, she was hanging out on the grass around the pool’s ten-foot deep end, near the high dive and the head lifeguard’s chair, and her parents were far away. When she married and had children, she returned to the shallow end of Dreamland to watch over her own children, and the whole thing began again. “My father, a Navy Vet from WWII, insisted that his 4 children learn not only how to swim but how not to be afraid of water,” one man wrote. “My younger sister jumped off the 15-foot high diving board at age 3. Yes, my father, myself & brother were in the water just in case. Sister pops up out of the water and screams . . . ‘Again!’” For many years, Dreamland’s manager, Chuck Lorentz, a Portsmouth High School coach and strict disciplinarian, walked the grounds with a yardstick, making sure teenagers minded his “three-foot rule” and stayed that far apart. He wasn’t that successful. It seems half the town got their first kiss at the pool, and plenty lost their virginity in Dreamland’s endless grass. Lorentz’s son, meanwhile, learned to swim before he could walk and became a Dreamland lifeguard in high school. “To be the lifeguard in that chair, you were right in the center of all the action, all the strutting, all the flirting,” said John Lorentz, now a retired history professor. “You were like a king on a throne.” Through these years, Portsmouth also supported two bowling alleys, a JCPenney, a Sears, and a Montgomery Ward with an escalator, and locally owned Marting’s Department Store, with a photo studio where graduating seniors had their portraits taken. Chillicothe Street bustled. Big U.S.-made sedans and station wagons lined the street. People cashed 14 their checks at the Kresge’s on Saturdays, and the owners of Morgan Brothers Jewelry, Herrmann’s Meats, Counts’ Bakery, and Atlas Fashion earned a middle-class living. Kids took the bus downtown to the movie theater or for cherry Cokes at Smith’s Drugstore and stayed out late trick-or-treating on Halloween. On Friday and Saturday nights, teenagers cruised Chillicothe Street, from Staker’s Drugs down to Smith’s, then turned around and did it again. Throughout the year, the shoe factories would deduct Christmas Club money from each worker’s paycheck. Before Christmas, they issued each worker a check and he would cash it at the bank. Chillicothe Street was festive then. Bells rang as shoppers went shoulder to shoulder, watching the mechanical puppets in displays in store windows painted with candy canes, Christmas trees, and snowmen. Marting’s had a Santa on its second floor. So, in 1979 and 1980, Portsmouth felt worthy to be selected an All-American City. The town had more than forty-two thousand people then. Very few were wealthy, and the U.S. Labor Department would have gauged many Portsmouthians poor. “But we weren’t aware of it, nor did we care,” one woman recalled. Its industry supported a community for all. No one had pools in their backyards. Rather, there were parks, tennis and basketball courts, and window-shopping and levees to slide down. Families ice-skated at Millbrook Park in winter and picnicked at Roosevelt Lake in summer, or sat late into the evening as their kids played Kick the Can in the street. “My family used to picnic down by the Ohio River in a little park, where my dad would push me so high on the swings I thought I’d land in Kentucky,” another woman said. All of this recreation let a working-class family feel well-off. But the center of it all was that gleaming, glorious swimming pool. Memories of Dreamland, drenched in the smell of chlorine, Coppertone, and french fries, were what almost everyone who grew up in Portsmouth took with them as the town declined. 15 Two Portsmouths exist today. One is a town of abandoned buildings at the edge of the Ohio River. The other resides in the memories of thousands in the town’s diaspora who grew up during its better years and return to the actual Portsmouth rarely, if at all. When you ask them what the town was back then, it was Dreamland. 16 INTRODUCTION In the middle-class neighborhood on the east side of Columbus, Ohio, where Myles Schoonover grew up, the kids smoked weed and drank. But while Myles was growing up he knew no one who did heroin. He and his younger brother, Matt, went to a private Christian high school in a Columbus suburb. Their father, Paul Schoonover, co-owns an insurance agency. Ellen Schoonover, their mother, is a stay-at-home mom and part-time consultant. Myles partied, but found it easy to bear down and focus. He went off to a Christian university in Tennessee in 2005 and was away from home for most of Matt’s adolescence. Matt had attention deficit hyperactivity disorder and schoolwork came harder to him. He started partying—smoking pot and drinking —about his junior year in high school. The two brothers got to know each other again when Matt joined Myles at college for his freshman year in 2009. His parents were never sure when exactly Matt began using pills that by then were all over central Ohio and Tennessee. But that year Myles saw that pills were already a big part of Matt’s life. Matt hoped school would be a new beginning. It wasn’t. Instead, he accumulated a crew of friends who lacked basic skills and motivation. They slept on Myles’s sofa. Myles ended up cooking for them. For a while he did his brother’s laundry, because Matt could wear the same clothes for weeks on end. Matt, at six feet six and burly, was a caring fellow with a soft side. His cards could be heartfelt and sweet. “I love you, mommy,” he wrote the last time to his mother, after his grandmother had been hospitalized for some time. “All this stuff with grandma has made me realize you really don’t know how long you have on this earth. You’re the best mom I could ask for.” Yet the pills seemed to keep him in a 17 fog. Myles once had to take him to a post office so he could mail their mother a birthday card, as Matt seemed otherwise incapable of finding the place. Myles was a graduate teaching assistant and saw kids his brother’s age all the time. It seemed to him that a large chunk of Matt’s generation could not navigate life’s demands and consequences. Myles had taught English in Beijing to Chinese kids who strove ferociously to differentiate themselves from millions of other young people. American kids a world away had enormous quantities of the world’s resources lavished on them to little result; they coasted along, doing the bare minimum and depending on their parents to resolve problems, big and small. At year’s end, Matt returned home to live with his parents. Myles spent the next years at Yale getting a master’s degree in Judaic and biblical studies and never knew all that happened later. At home, Matt seemed to have lost the aimlessness he displayed in college. He dressed neatly and worked full-time at catering companies. But by the time he moved home, his parents later realized, he had become a functional addict, using opiate prescription painkillers, and Percocet above all. From there, he moved eventually to OxyContin, a powerful pill made by a company in the small state of Connecticut—Purdue Pharma. In early 2012, his parents found out. They were worried, but the pills Matt had been abusing were pharmaceuticals prescribed by a doctor. They weren’t some street drug that you could die from, or so they believed. They took him to a doctor, who prescribed a weeklong home detoxification, using blood pressure and sleep medicine to calm the symptoms of opiate withdrawal. He relapsed a short time later. Unable to afford street OxyContin, Matt at some point switched to the black tar heroin that had saturated the Columbus market, brought in by young Mexican men from a small state on Mexico’s Pacific coast called Nayarit. Looking back later, his parents believe this had happened months before they knew of his addiction. 18 But in April 2012, Matt tearfully admitted his heroin problem to his parents. Stunned, they got him into a treatment center. Myles hadn’t spoken to his brother for some time when he called his parents. “He’s in drug rehab,” said his mother. “What? For what?” Ellen paused, not knowing how to say it. “Matt is addicted to heroin.” Myles burst into tears. Matt Schoonover came home from three weeks of rehab on May 10, 2012, and with that, his parents felt the nightmare was over. The next day, they bought him a new battery for his car, and a new cell phone. He set off to a Narcotics Anonymous meeting, then a golf date with friends. He was supposed to call his father after the NA meeting. His parents waited all day for a call that never c …
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