Ryan Hampton - Unsettled: How the Purdue Pharma Bankruptcy Failed the Victims of the American Overdose Crisis

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This book is for all those who were counted out.

Your stories and your voices matter. Never stop fighting.

And for Sean, my heartI couldnt have done this without you.

When I sat down to write American Fix in 2017, the world was a very different place from what it is now. It feels silly to say that, but at the time I had no idea what we were in for. I was early in my recovery then. Idealistic. Untested. I was convinced that the Sackler family had single-handedly engineered the crisis and that they alone were responsible for the widespread, tragic carnage in our homes and communities. I believed that exposing the Sacklers and mobilizing people would be enough to right the scales of justice. That the karmic balance of the universe would correct itself if enough people got involved. If I just believed enough.

Im glad I felt that way at the time. The fire in my belly hasnt gone out, but the things Ive learned and experienced over the last few years have seasoned me. I was on the front lines of the anti-Sackler protests for years. If there was a rally, I was there. I stayed in the homes of parents whod lost kids to overdoses, mourned my dead friends, and pushed for meaningful legislation to change the way our nation treats substance use disorder. I was out-front, waving the banner and yelling at anyone who would listen. I considered myself an expertand I was, but my expertise had limits, and the next few years showed me how narrow my perspective really was.

As a cis white man and a vocal advocate, I knew I could do a lot of good on the front lines. Loud voices get attention, and attention makes change. Yet, I knew I couldnt be the only voice. I couldnt speak for people from other groups, especially historically marginalized populations. I learned to be more mindful about how I talked about recovery as I learned more about other peoples experiences. I knew addiction recovery was a transpolitical issue, but not until after the Black Lives Matter movement grabbed headlines and elevated the message of challenging old ideas about race, values, and identity did I really grasp the idea of intersectionality. Your mileage may vary. While we describe addiction as the great equalizer, it was increasingly apparent to me that neither addiction nor recovery made people equal. Substance use disorder had inequitable effects on people. Addiction revealed privilege, security, and safety. If people were white, insured, middle-class or higher, and employed, they were more likely to survive. Take those qualities away, and the odds declined dramatically. A Black, trans, homeless woman on the South Side simply didnt have the same chance that a white cis woman with tenure at Berkeley did. Pretending otherwise was cruel and insincere.

I tried to bring the same sensitivity to other relationships within my community. For example, I finally started to understand the importance of protecting the rights of pain patients and people who use opioids for managing chronic conditions. I saw that a lot of the legislation and regulation that was designed to curb overdoses harmed pain patients, too; even well-intended regulatory fixes ignored patients and created massive upheaval in their lives. My long-held fantasy of destroying Purdue had more than one crack in it. Maybe abolishing opioid manufacturers wasnt the answer after all. If anything, I began to see how simplistic my view had been. I grew and listened and did the work and stayed willing. I am incredibly grateful for the people who took the time to educate me, answer my questions, and challenge my long-held beliefs. They prepared me for the journey I took in Unsettled, and I am a better person for it.

Learning how to use my voice was difficult, important work. Ironically, just as I felt I was making progress, I opted to silence myself to do something that was even more important to mebearing witness to the bloodbath of the Purdue bankruptcy. I agreed to say nothing, but I couldnt shut off my feelings, and in the end, I couldnt betray my principles and let these secrets die in darkness. I wrote Unsettled in real time, as the case was unfolding. The book youre holding in your hands represents how I felt in the moment, as well as where I was in my life, where America was, and what happened during the excruciating Chapter 11 proceedings, Purdues eventual restructuring, and the Sackler familys exit from any true accountability. This is real, its raw, and large sections of it are recollected from my memory. I listened to hundreds of hours of testimony and lawyer talk. I sat in countless meetings. I read thousands of documents. At some point, I couldnt keep it to myself.

Throughout the bankruptcy, I struggled to keep quiet. It made my blood boil to see the Sacklers continue to perform for the media, offering a few reputation-polishing facts but never telling the whole truth. Other parties involved, who I thought had undertaken with me not to discuss the case during the proceedings, sang like canaries. Not me. This book was the outlet for my anger, and in retrospect I believe it made witnessing the process bearable. My only recourse was to take my rage and my frustration and, once again, funnel it onto paper.

In a perfect world, would Purdue even exist? I cant say. A friend asked me if we couldnt just pull OxyContin off the market. It was a sassy question, but I had to give a serious answer. No. We cant. Ironically, we have to keep selling it.

As I write this, Purdue is currently worth a little more than $1 billion on paper. The settlement they reach will be ten to twelve times that value. If theyre going to pay their debts, they have to keep selling Oxy, as a restructured company. I had an idea to liquidate the company, take that billion dollars, give it to the victims, and call it a day. Walk away. My suggestion was practically laughed out of the room.

Progress is often less expensive than maintaining the status quo, and when it comes to implementing change, were so often told theres no money for that. There is money. Other people wanted to get paid more than they wanted to do something meaningfulsomething that could potentially save millions of lives. The paycheck won out, every time.

The goal of my work has never been to ban or outlaw opioids. Opioids arent the problem. Greed is. Reckless capitalism is. Gross wealth inequality is. A so-called justice system that shields the ultrawealthy from the consequences of their actions is. A government that plays strictly within the lines, rarely advocating for the people they claim to represent, is. And a culture that misunderstands addiction as a moral failing is. We have ways of correcting and improving these systems, but reform is slow, and too often good ideas die by a thousand cuts. What we need in this country is universal health care, evidence-based prevention, recovery support on demand, housing for everyone, harm reduction in every communityand the list goes on and on. We need more than a hotline or a handful of Facebook pages. We need to build on the wildly effective foundation of existing mutual-aid networks and recovery community organizationsfunding dreamers, outsiders, people with lived experience, and frontline providers who make a real difference.