Chapter 35
Washington, D.C., October 2017
Shortly after Donald Trump was inaugurated as the forty-fifth president of the United States in January 2017, he pledged to make combating the opioid epidemic a top priority. He named Tom Marino, the champion of The Alliance and one of the first members of Congress to back his nascent presidential campaign, as the nation’s next drug czar. Whatever elation drug industry executives may have felt following Marino’s September 1, 2017, nomination quickly dissipated.
Weeks later, The Alliance and its members learned that the Washington Post and 60 Minutes were preparing to publish a joint investigative report into the role the industry had played in the passage of the Marino-Blackburn bill, blunting the DEA’s enforcement efforts. To confront the impending public relations crisis, The Alliance crafted talking points for the news media and members of Congress. Among them: Drug distributors were “logistics companies,” they did not drive the demand for opioids, and the bill was a bipartisan effort “to address abuse and misuse” of opioids.
The prospect of a damning joint report by two of the country’s leading news outlets led to a flurry of emails by industry officials. The communications chief for AmerisourceBergen, Gabriel Weissman, wrote to his colleagues on October 10 that he had “synched up” with his counterparts at Cardinal Health and McKesson. Together, they had decided to let The Alliance take the lead and defend the industry’s role in the Marino-Blackburn bill—a move that would keep the Big Three drug distributors out of the public spotlight. “I’ve been screaming for [The Alliance] to take the bullet for us,” Weissman wrote.
Five days later, on Sunday, October 15, the Post published the joint investigative report under the headline “The Drug Industry’s Triumph over the DEA.” That evening, 60 Minutes correspondent Bill Whitaker introduced the broadcast version of the report. “In the midst of the worst drug epidemic in American history,” Whitaker began, “the U.S. Drug Enforcement Administration’s ability to keep addictive opioids off U.S. streets was derailed—that according to Joe Rannazzisi, one of the most important whistleblowers ever interviewed by 60 Minutes.”
Halfway through the interview, Whitaker leaned in and asked Joe to tell the American public what he had witnessed while running the DEA’s diversion division. “You know the implication of what you’re saying,” Whitaker said, “that these big companies knew that they were pumping drugs into American communities that were killing people, and they went out of their way to try to stop legislation, or to put in legislation that would allow them to keep doing this, almost with no concern about the impact that it was having on Americans.”
“That’s not an implication, that’s a fact,” Joe said. “That’s exactly what they did. They felt that their best interests to preserve the way they do business, their business model, to preserve their profits, was to spend a little money and get a bill passed that takes away DEA’s authority and helps them continue on their merry way towards, you know, distributing drugs. And if people die, well, too bad. That’s exactly what happened.”
Joe’s stunning statement was the culmination of a long internal process. Since retiring, he had been reluctant to go public. But the year before he’d agreed to speak on the record to the Washington Post for a series on opioids. Those stories won awards but were mostly drowned out by presidential campaign coverage. Joe’s appearance on 60 Minutes as part of the Post’s collaboration with the revered news magazine landed at a better moment in the news cycle. Suddenly the story got traction. Other news outlets picked it up. It was getting amplified—big time.
Several members of Congress admitted that they didn’t understand the ramifications of the bill. One of those was Democrat Joe Manchin III, who represented Paul Farrell’s home state of West Virginia in the Senate. “They made it and camouflaged it so well, all of us were fooled,” Manchin said. “All of us. Nobody knew.” Marsha Blackburn tried to back away from the bill she cosponsored, saying it may have had “unintended consequences.”
Marino’s nomination was doomed. The joint Washington Post/60 Minutes investigative report detailed the industry’s efforts to secure passage of the bill. It documented how the industry helped to write the legislation, lobbied members of Congress, wrote hostile questions for lawmakers to ask Joe and other DEA officials when they testified on the Hill, and poured hundreds of thousands of dollars into the political campaigns of the sponsors and cosponsors of the bill. The report also noted that John Mulrooney, the DEA’s chief judge, had just written a blistering 115-page article about the Marino-Blackburn bill for the Marquette Law Review. He said the new law represented a “dramatic diminution of the agency’s authority.” It was “all but logically impossible” for the DEA to immediately suspend a drug company’s operations for failing to comply with federal law. “If it had been the intent of Congress to completely eliminate the DEA’s ability to ever impose an immediate suspension on distributors or manufacturers, it would be difficult to conceive of a more effective vehicle for achieving that goal.” Mulrooney also criticized the provision allowing drug companies to submit corrective action plans before they could be sanctioned by the DEA. He compared it to allowing bank robbers to “round up and return ink-stained money and agree not to rob any more banks.”
The day after the report appeared, several lawmakers called the White House to demand that Marino’s nomination be pulled. Manchin told reporters that he was “horrified” by the findings and couldn’t “believe that the [Obama] administration did not sound the alarm on how harmful that bill would be for our efforts to effectively fight the opioid epidemic.”
The Democrat from West Virginia also wrote to Trump, noting that the drug companies that had sent millions of pain pills into his state were the same companies behind the Marino-Blackburn bill. “As the report notes, one such company shipped 20 million doses of oxycodone and hydrocodone to pharmacies in West Virginia between 2007 and 2012. This included 11 million doses in one small county with only 25,000 people in the southern part of the state: Mingo County,” the senator said. “As the number of pills in my state increased, so did the death toll in our communities, including Mingo County.”
Neither Manchin nor any of his ninety-nine colleagues in the Senate had objected to the bill, ensuring that it passed without a recorded vote.
Two days after the report appeared, Marino withdrew from consideration for the drug czar post. Trump made it official on his Twitter feed on October 17, adding, “Tom is a fine man and a great Congressman!”
In the days that followed, the industry and its allies on Capitol Hill pushed back. Republican Orrin Hatch of Utah, who had guided the bill through the Senate, took to the floor of the Senate to excoriate the reporting.
“I think we need to be candid about what’s going on here,” Hatch said. “Opponents of the current administration are trying to derail the president’s nominee to be head of the Office of National Drug Control Policy, Representative Tom Marino, by mischaracterizing and trying to rewrite the history of a bill that he championed.”
A group calling itself the Academy of Integrative Pain Management issued a letter of support for the legislation and Hatch’s floor remarks. It was one of several pain patient advocacy groups to come forward to back the bill, many of them funded by drug companies.
“We felt that some balance in enforcement actions needed to be struck, and that the Ensuring Patient Access and Effective Drug Enforcement Act did just that,” the Academy of Integrative Pain Management said in its letter. What the academy didn’t disclose: It had received more than $1.2 million from opioid manufacturers between 2012 and 2017.
The counterattacks continued, but with little impact on the political reality: Marino was out and Joe had taken on the mantle of whistleblower.