“The records show that Tsai — who worked for McKinsey from 2007 to 2015, according to his LinkedIn page — helped develop a marketing strategy for tramadol sold under the brand name Ultram ER, an effort that involved cultivating relationships with doctors who became prolific prescribers.”

San Francisco’s new health director helped McKinsey market tramadol by targeting high-prescribing doctors. McKinsey paid over $1 billion in opioid settlements. The mayor’s office calls him a 23-year-old entry-level staffer. He now runs a department with a roughly $3 billion budget.