We’re in the midst of an opiate epidemic, and it’s killing Americans at an alarming rate. In John Oliver’s latest report, he unpacks the alarming history of the epidemic, and how the drug companies we entrust with our health helped create it.

The current epidemic isn’t exactly a new development, but as Oliver points out, our current pharmaceutical conundrum hasn’t been around forever. Opiates were hardly prescribed in the 90s except in the most extreme cases of pain management. How did we go from that to nearly half a million opiate-related deaths between 2000 and 2014? The answer, as John Oliver explains, lies in greedy drug companies.

When Oxycontin was developed by Purdue in the late 90s, the company marketed it aggressively—in itself not unusual. Oliver points out that what made Purdue’s campaign bad was how grossly it misrepresented the product’s addiction potential. Not only did the company invent the term “pseudo-addiction” to discredit the seriousness of patient dependence, but it also claimed actual addiction befell “less than 1 percent” of those prescribed Oxycontin. That figure, as Oliver notes, is culled from a New England Journal of Medicine letter to the editor—a section which is in no way peer reviewed or up to scientific standards.

Advertisement

Easily the shadiest and most disgusting example Oliver gives involves the company Insys getting fentanyl into the hands of people who didn’t really need it. Fentanyl is among the strongest opioids readily available. It’s so potent that addicts have been dying in droves recently as batches of heroin have been cut with it. While only approved for use in treating cancer pain, Insys found a loophole to get this powerful drug prescribed to patients, and to get insurance companies to pay for it. As a former Insys employee explains how conversations would take place regarding non cancer patients:

[The insurance companies] would always ask ‘does the patient have cancer?’ ‘uh huh.’ That’s what we would say... I wasn’t blatantly saying ‘yes.’

While several of the companies responsible have paid out multi-million dollar settlements over the years for misleading advertisements, little has been done to curb prescription rates, make alternative therapies available, or provide those already addicted with the help they need.