Lou Ortenzio was a beloved family physician in West Virginia until he popped his first Vicodin to ease a headache after a long day at the office seeing patients, starting a slide into addiction where Ortenzio took 20-30 pills a day. After building a habit that exhausted the free samples supplied by pharmaceutical reps, he started to write prescriptions in his kids’ names. As Sam Quinones reports at The Atlantic, Ortenzio lost his house, his wife, and his kids to his addiction but now, after getting clean, he’s trying to help others conquer their drug problems so that they too, can start over.

By 2006…physicians were writing 130 opioid prescriptions for every 100 West Virginians…Nothing ended an appointment quicker than pulling out a prescription pad.

As a physician in a small community with limited resources, Ortenzio did a bit of everything: He made rounds in a hospital intensive-care unit and made house calls; he provided obstetric and hospice care. Ortenzio loved his work. But it never seemed to end. He started missing dinners with his wife and children. The long hours and high stress taxed his own health. He had trouble sleeping, and gained weight. It took many years, but what began with that one Vicodin eventually grew into a crippling addiction that cost Ortenzio everything he held dear: his family, his practice, his reputation.

“It went from a dozen [salesmen] a week to a dozen a day,” Ortenzio remembered. “If you wrote a lot of scrips, you were high on their call list. You would be marketed to several times a day by the same company with different reps.”

Most drug companies in America adopted the new sales approach. Among them was Purdue Pharma, which came out with a timed-release opioid painkiller, OxyContin, in 1996. Purdue paid legendary bonuses—up to $100,000 a quarter, eight times what other companies were paying. To improve their sales numbers, drug reps offered doctors mugs, fishing hats, luggage tags, all-expenses-paid junkets at desirable resorts. They brought lunch for doctors’ staff, knowing that with the staff on their side, the doctors were easier to influence. Once they had the doctor’s ear, reps relied on specious and misinterpreted data to sell their product. Purdue salespeople promoted the claim that their pill was effectively nonaddictive because it gradually released an opioid, oxycodone, into the body and thus did not create the extreme highs and lows that led to addiction.

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