ILLUSTRATION BY SAM KERRBloomberg Pursuits October 30, 2017GAME CHANGERROGER CRYSTAL WAS THE
on-call surgeon at University
College Hospital in London
on July 7, 2005, when a
series of explosions in the
Underground killed 56 people
and injured more than 700.
Terror victims streamed into
his operating room. Even so, his
toughest case that day, he says, was
a heroin addict who’d contracted a
flesh-eating infection from a dirty needle.
“He was lying there with his liver and intes-
tines exposed, and all he wanted to do was shoot
up on heroin,” Crystal says. “That’s when I realized just how
bad a disease addiction can be, how dysfunctional the circuitry
of the brain can become.”
He could provide care at the individual level, but the problem
of addiction required a population-level solution. Crystal quit
his medical career to pursue an MBA from London Business
School, then did a stint at Goldman Sachs Group, worked on
acquisitions and licensing deals at GE Healthcare, and consulted
for companies that treat diabetics. When the opportunity arose
to become chief executive officer of Lightlake Therapeutics in
2009, Crystal saw his opportunity.
Researchers at Lightlake—now called Opiant
Pharmaceuticals Inc.—were developing a version of
the drug naloxone, which blocks addiction pathways
in the brain, that could be administered as a nasal
spray. Naloxone had been used since the early 1970s
to reverse heroin overdoses, but per U.S. regulations
it could only be marketed for use intravenously,making it relatively hard to
use—one study found it to be
effective only 59 percent of
the time when administered
by a layperson.
The intranasal formulation
is easy to administer and can
be counted on to work every
time. “It’s as user-friendly as it
gets,” says Dr. Nora Volkow, head of
the National Institute on Drug Abuse,
which helps fund Opiant’s research.
“People don’t realize, because it’s not sexy—
you’re just changing the delivery system—but to be
able to deliver the drug at concentrations equivalent to injec-
tion is a big, big deal.” In 2015 the company received U.S. Food
and Drug Administration approval for its naloxone product,
Narcan, which is now available over the counter in most states.
Crystal’s next goal is a heroin vaccine: a one-time treatment
that would trick the body into thinking heroin molecules are
a disease, prompting the immune system to destroy the drug
before it reaches the brain.
In the past, it’s been difficult to secure funding for clinical
trials of a drug that would most benefit people who tend to be
incarcerated or uninsured and likely unable to afford
expensive treatment. With the income from Narcan
to bolster it, Crystal thinks Opiant can be a critical
bridge between scientists and the world of retail
medicine. “You have the most brilliant minds, who
are restricted by being in a government or academic
setting,” he says. “Then you have our company: We’re
that transition zone out of clinical development.” Roger Crystal
The doctor turned pharmaceutical executive is figuring out how
to treat addiction on a mass scale. By Darius Rafieyanb. 1976, Manchester,
England- Is an amateur triathlete
Still owns the
headlamp he used as
an ENT surgeon