Foreign Correspondent

A secretive billionaire family pushes a pill that triggers more deaths than guns or car crashes. From backwoods Appalachia to hi tech San Francisco, Conor Duffy investigates America's opioid scourge.

Nan Goldin and thousands of Americans like her are coming after the Sacklers.

"We have to bring down the Sackler family!" she yells in a protest rally in New York. "They should be in jail next to El Chapo."

Goldin, a noted photographer, was addicted to Oxycontin, an opioid painkiller that's twice the strength of morphine.

This little pill – backed by aggressive marketing to doctors and consumers - made the Sackler family its $13 billion fortune. It also tripped an emergency that kills 900 Americans each week and grips two million more in addiction.

Oxycontin was supposed to ease pain for the terminally ill. But via their private company Purdue Pharma, the Sacklers flogged it for everything from stress to crook backs.

"I can't explain how happy I am today. I mean, it's just wonderful," gushed a construction worker in a 1999 Oxycontin ad.

Purdue and the Sacklers now face a welter of lawsuits alleging they knew how addictive Oxycontin would be. It could be the biggest class action ever.

"We're going to get a tobacco-sized verdict against Purdue Pharma," says ex-Oxycontin addict Patrick Kennedy, son of the late Senator Edward Kennedy and nephew of JFK.

Purdue, abetted by doctors and pharmacies, showered one West Virginian county's 20,000 people with 12 million Oxycontin pills – that's 600 apiece.

"That drug just about wiped out this county," says local sheriff Martin West. The sheriff estimates more than a fifth of his county is now addicted to opioids, heroin, ice or alcohol.

Rocky Kuhn was a champion boxer as a boy. Later, he was addicted to opiates like so many of his old schoolmates.

"My graduating class – probably a third of ‘em are dead already," he tells reporter Conor Duffy. "And I'm just 33 years old. We didn't have a chance. Nobody had a chance."

All too late, authorities restricted Oxycontin – which became a gateway to more lethal but cheaper drugs. Pill addicts first turned to heroin and now to fentanyl, a lethal synthetic opioid 40 times stronger than heroin.

The opioid epidemic may have just crested in America's east, but not in the laid-back west coast. San Francisco has long tolerated an open drug culture, but city streets now brim with heroin and fentanyl addicts – 80 per cent of whom started on opioid pills.

"There are more injecting drug users in San Francisco – about 25,000 - than there are high school students – 16,000," says a furious city attorney Dennis Herrera, who is behind one of the mega writs against Purdue and the Sacklers.

"This is a major, major problem that is happening right here in one of the richest cities in the country – and despite our efforts, we're being overwhelmed."

While Herrera does battle in the courts, it's up to drug harm reduction workers like Paul Harkin to confront the epidemic in the city streets.

"We're seeing more fentanyl enter cuts in the drugs – and overdose deaths this year are gonna be up," he says, as he hands out clean needles.

One of his clients is George, who went from pills to injecting fentanyl-laced heroin. His self-described "King Kong" habit might soon kill him, but he seems more worried about younger addicts.

"It's like fuck man, I hate to see people out here so young and they have no get-back," he says.

"It's like there's no return. It's a point of no return."