Pain Hustlers

Books on Tape. Sept. 2023. 9:17 hrs. ISBN 9780593909195. Audio. $76. CRIME
In his compelling, infuriating work, journalist Hughes (Literary Brooklyn) documents the destruction wrought by Insys Therapeutics, a small pharmaceutical company that developed an innovative way to deliver the fentanyl-based drug, Subsys. Spraying Subsys under the tongue delivers fentanyl at “a speed akin to hospital IV drugs.” Company founder John Kapoor claimed he was inspired to develop Subsys while watching his wife suffer from excruciating cancer pain. The FDA approved Subsys solely to treat “breakthrough” pain (pain that gets through all layers of protection, including other opioids) and said it should be prescribed with great discretion. Insys instead bribed doctors through a sham speaker program to liberally prescribe Subsys, destroying countless lives in their quest for profit. Narrator Mike Chamberlain’s tone expresses the gravity of what happened at Insys and the opioid crisis more broadly, but he also makes the most of Hughes’s self-effacing humor, which is a welcome relief in this enraging story of corporate greed.
VERDICT Emily Blunt and Chris Evans star in a recently-released Netflix film based on the book, but Hughes’s riveting account about the opioid epidemic stands on its own as a work of outstanding narrative nonfiction that should find a place in most libraries.
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