This chapter discusses how the pharmaceutical industry’s actions affected the accomplishments of the Decade of Pain Control and Research, which began on January 1, 2001, following almost two decades of rising concern over the inadequate treatment of chronic pain in the United States. To tell the story of this decade we must describe the accompanying problem of drug diversion and abuse. The development in 1995 of a new opioid product called OxyContin, its aggressive marketing, the morbidity and mortality associated with its misuse, and the eventual felony conviction in 2007 of the drug’s sponsor for fraudulent claims and marketing practices, affected the Decade in unexpected ways. The response by Congress and the regulatory community to what they termed an “epidemic” of prescription drug abuse produced long-lasting policy changes. The chapter also touches on the peculiar and sometimes troubling relationship between the regulators and the regulated.