The Los Angeles Times reported on its stunning investigation of L.A. Oxycontin rings that distributed millions of dollars of opiates, all with the knowledge and apparent silent approval of drugmakers such as Purdue Pharma.

In 2008, a convicted felon and his business partner leased office space on a seedy block near MacArthur Park. They set up a waiting room, hired an elderly physician, Eleanor Santiago M.D., and gave the place a name that sounded like an ordinary clinic: Lake Medical. The doctor began prescribing the opioid painkiller OxyContin – in extraordinary quantities. In a single week in September 2008, Santiago issued orders for 1,500 pills, more than entire pharmacies sold in a month. In October, it was 11,000 pills. By December, she had prescribed more than 73,000, with a street value of nearly $6 million.

To keep the OxyContin flowing, Lake Medical needed people whose time was cheap. For that, there was no place better than skid row. For as little as $25, homeless people served as straw patients and collected prescriptions for “80s”, 80-milligram pills with the strength of 16 Vicodin tablets and very popular on the streets. It required just a few hours at the clinic, then they were driven, often in groups, to a pharmacy, where a capper acting as a chaperone paid the bill in cash. He then took the pills back to the Lake Medical ring leaders who packaged them in bulk for sale to drug dealers.

A physician writing a high volume of “80s” was a red flag for anyone trying to detect how OxyContin was getting into the black market. The number of prescriptions Santiago was writing wasn’t merely high. It was jaw-dropping. Many doctors would go their entire careers without writing a single “80s” prescription. Santiago doled out 26 in a day.

Purdue Pharma, the maker of OxyContin, tracked the surge in prescriptions. A sales manager went to check out the clinic and the company launched an investigation. It eventually concluded that Lake Medical was working with a corrupt pharmacy in Huntington Park to obtain large quantities of OxyContin. Yet Purdue did not shut off the supply of highly addictive OxyContin and did not tell authorities what it knew about Lake Medical until several years later when the clinic was out of business and its leaders indicted. By that time, 1.1 million pills had spilled into the hands of mobsters, the Crips gang and other criminals. The pills from Lake Medical coursed out of L.A. An informant would later tell an FBI agent that East Hollywood’s White Fence gang trafficked pills to Chicago.

Legitimate pharmacists from La Canada-Flintridge, Glendale, Moreno Valley and elsewhere complained to Purdue. Company executives and lawyers received at least 11 reports about Santiago in the four months after they first suspected her. For example, on June 10, an Encino pharmacist sent an email to her Purdue sales rep with the subject line “urgent question.” The pharmacist said she was being asked to fill prescriptions written by Santiago and other Lake Medical doctors for “lots of Oxy patients.” “I want to make sure Dr office is legit,” Tihana Skaricic wrote. “So wondering….if you know ‘behind the scenes.” No one at Purdue ever got back to Skaricic. Eventually she and some other pharmacists decided on their own to turn away business from Lake Medical.

And the Los Angeles Times investigation found that, for more than a decade, Purdue collected extensive evidence suggesting illegal trafficking of OxyContin and, in many cases, did not share it with law enforcement or cut off the flow of pills. A former Purdue executive, who monitored pharmacies for criminal activity, acknowledged that even when the company had evidence pharmacies were colluding with drug dealers, it did not stop supplying distributors selling to those stores. Purdue knew about many suspicious doctors and pharmacies from prescribing records, pharmacy orders, field reports from sales representatives and, in some instances, its own surveillance operations.

Purdue had access to a stream of data showing how individual doctors across the nation were prescribing OxyContin. The information came from IMS Health, a company that buys prescription data from pharmacies and resells it to drugmakers for marketing purposes. That information was vital to Purdue’s sales department. Representatives working on commission used it to identify doctors writing a small number of OxyContin prescriptions who might be persuaded to write more. By combing through the data, Purdue also could identify physicians writing large numbers of prescriptions – a potential sign of drug dealing.

And the data at its fingertips was astounding. At one San Marino store, Huntington Pharmacy, monthly orders for “80s” were up nearly 20-fold over the previous year. At another in East L.A., orders jumped 400% in two months. A small shop in Panorama City, Mission Pharmacy, became the top seller of OxyContin in the entire state of California. Mission was a top supplier to the Lake Medical ring In Southern California there was a troubling spike in sales at St. Paul’s Pharmacy in Huntington Park from filling prescriptions for Lake Medical. Purdue added those store names to a long list of problematic pharmacies across the country.

A private, family-owned corporation, Purdue has earned more than $31 billion from OxyContin, the nation’s bestselling painkiller. A year before Lake Medical opened, Purdue and three of its executives pleaded guilty to federal charges of misbranding OxyContin in what the company acknowledged was an attempt to mislead doctors about the risk of addiction. It was ordered to pay $635 million in fines and fees.

In the end, the Lake Medical ring was brought down by a team of state, federal and local investigators who collected tips from citizens and spent hours staking out the clinic, interviewing witnesses and turning junior ring members into informants. When Lake Medical closed in 2010, after a year and a half in business, Purdue had still not shared its wealth of information on the clinic with the authorities, according to law enforcement sources.