It's estimated that more than 107,000 people in the United States died due to opioid overdoses in 2021. Washington Post journalist Scott Higham notes it's "the equivalent of a 737 Boeing crashing and burning and killing everybody on board every single day." In the new book, American Cartel, Higham and co-author Sari Horwitz make the case that the pharmaceutical industry operated like a drug cartel, with manufacturers at the top; wholesalers in the middle; and pharmacies at the level of "street dealers." The companies collaborated with each other " and with lawyers and lobbyists " to create legislation that protected their industry, even as they competed for market share. "It really is the companies that run the show," Higham says. "People were dying by the thousands while these companies were lobbying members of Congress ... to pass legislation and to lobby members of the Department of Justice and try to slow down the DEA enforcement efforts." Big pharma fought to create legislation that would limit the DEA's ability to go after drug wholesalers. The efforts were effective; more than 100 billion pills were manufactured, distributed and dispensed between 2006 and 2014. Meanwhile, both federal and state DEA agents are frustrated by the ways in which their enforcement efforts have been curtailed. Right now there are 40,000 Americans who are in jail on marijuana charges. And not one executive of a Fortune 500 company involved in the opioid trade has been charged with a crime.