Chapter 17
Orlando, Florida, 2013
Members of The Alliance felt like they’d been knocked to the canvas by a series of quick blows. They had been raided by the DEA and had their opioid distribution operations shuttered. Attempts to lobby the Justice Department had failed and the federal courts had ruled against them. Costs were running into the tens of millions in lost revenue and fines.
To turn things around, the industry deployed a strategy straight from Big Tobacco’s playbook: Deceive and deflect.
The Alliance hired APCO Worldwide, a multinational company based in Washington, D.C., with a long history of helping corporations and industries in trouble with the law, the press, or both. With nearly six hundred employees and more than $100 million in annual revenues, APCO was one of the largest crisis communications companies in the world. It started in the 1980s as a spin-off from a large Washington law firm, Arnold & Porter. The company, originally called APCO Associates, would represent controversial clients without sullying the good name of the law firm.
In 1993, APCO took on a damaged brand—the tobacco giant Philip Morris—and created a front group to challenge the science linking tobacco and secondhand smoke to cancer. APCO called the group The Advancement of Sound Science Coalition. An internal plan outlining the mission of the center would surface years later. It was created to “encourage the public to question the validity of scientific studies,” and APCO enlisted medical experts and other key opinion leaders or influencers to amplify the tobacco industry’s message. Only years later did the public and the press learn that Philip Morris was financing the covert disinformation campaign and pulling every string.
For $515,000, The Alliance would get its own covert makeover. APCO’s plan was rolled out in two phases. In the first, the PR outfit set up three focus groups, interviewing key opinion leaders, pharmacists, and law enforcement officials. APCO wanted to identify negative perceptions of the drug industry, figure out how to mitigate them, and test rebranding messages that would resonate with the public, the press, and Capitol Hill. The campaign also sought to determine who the public believed was responsible for drug abuse and the opioid epidemic. “Who’s to blame?” APCO asked in its binders of material prepared for The Alliance. The majority of those surveyed said “users,” followed by “drug dealers” and then “doctors.” Members of The Alliance were relieved to find themselves near the bottom of the list. “Distributors rank very low on the ‘who’s to blame’ list for prescription drug diversion and misuse,” the members of The Alliance were informed at an executive committee meeting on June 2, 2013, at the JW Marriott Orlando, Grande Lakes, a luxurious resort.
APCO also created talking points, an “educational tool kit” for the press and the public, and a scale ranking the risks The Alliance faced. At the top was “DEA enforcement actions,” followed by “negative and/or inaccurate media coverage of the industry.”
In phase two of the project, APCO created a forty-four-page “Crisis Playbook” to repair the image of the drug companies, shift public opinion, and combat the DEA and negative news stories about the industry. The playbook contained several key talking points to repeat to the public and news media: The drug companies protected patient rights and provided unfettered access to legitimate prescriptions. The DEA was being overly aggressive and preventing patients from obtaining the medicine they needed.
The playbook proposed responses for the industry to deploy, depending upon the situation. If the DEA had suspended the registration of a drug company for shipping excessive orders, the playbook suggested that The Alliance consider using the suspension as “an opportunity” to “push its message of misdirected DEA enforcement with national media.” The playbook also proposed informing “relevant members of Congress about the action to head off greater criticism.” The playbook included other talking points to use with reporters, such as arguing that the “DEA appears to be pursuing a path of conflict, rather than collaboration with our industry.” It also sought to shift the blame for the epidemic to drug users and the DEA itself.
APCO urged The Alliance to repeat the message that its members did not have access to the DEA’s ARCOS database. The playbook recommended asking: How are the drug distributors supposed to know how many pain pills are being sold? It left out one important fact: The DEA database is based on sales information provided by the drug distributors themselves.
Six months after the Orlando meeting, on December 11, the Alliance members gathered at their headquarters in Arlington for a “DEA Strategy Task Force Meeting.” Executives from McKesson, Cardinal, and AmerisourceBergen were there. So too was Tom Twitty, a senior vice president of H.D. Smith, a midsized drug distributor based in Springfield, Illinois. A director of APCO and an attorney for The Alliance also sat in.
The executives identified “three areas of attack” as part of their DEA strategy. They agreed to form a broader coalition, enlisting more companies and pharmaceutical trade associations. Aside from the drug distributors, it would include Teva Pharmaceuticals, a large opioid manufacturer that had purchased Cephalon—the company that created the Austin Powers-Dr. Evil spoof. They also decided to use the material from APCO to conduct a “targeted media outreach” campaign. It was time, they agreed, to push back against the DEA and the proliferation of negative news stories around the country, “rather than making no public statement and letting the public only hear what the media puts out, such as calling us ‘pill mills,’” Twitty wrote in an email to the owners of H.D. Smith.
One of the most important elements of the strategy was a classic Washington counterattack: Identify members of Congress who might be willing to introduce legislation to derail the DEA’s enforcement campaign. That work, Twitty told his colleagues, was now under way.