Sacklers Directed Efforts to Mislead Public About OxyContin, Documents Indicate
nytimes.com
nytimes.com
"As part of the 2007 settlement agreement, the board of Purdue Pharma, which included members of the Sackler family, signed a corporate integrity agreement with the federal government promising that the company would not violate the law in the future."
This is essentially a large driver of America's social and environmental problems. An individual lacking in resources found guilty of a crime serves jail time, probation and generally faces life changing repercussions. When a corporation is found guilty of crimes that may very well include the deaths of dozens/hundreds of people they pay a fine. Not a business crushing fine, just a slap on the wrist. The fact that individuals made all of the decisions that led to the companies crimes is for the most part ignored. Large corporations are essentially given impunity to pursue 'share holder value'. The only time individuals are prosecuted is if they negatively affect those same shareholders such as with Enron, etc.
We allow pharmaceutical companies to addict and destroy lives, chemical companies to dump carcinogens into drinking water, coal plants to pollute our air but its ok because its a corporation doing it and they are rich.
Removing the shield that protects individual decision makers from criminal prosecution would go a long way towards fixing this country. People would be much more hesitant to order something illegal if they were personally sent to jail for it.
>Based on their findings after a four-year investigation, the prosecutors recommended that three top Purdue Pharma executives be indicted on felony charges, including conspiracy to defraud the United States, that could have sent the men to prison if convicted.
https://www.nytimes.com/2018/05/29/health/purdue-opioids-oxy...
However, political appointees at DOJ stepped in.
>Political appointees at the Justice Department, following a closed-door meeting with a high-powered Purdue Pharma legal team advised by Rudolph Giuliani, refused to back Brownlee’s recommendations. The prosecutor was left in the wind, and the executives, who insisted they did nothing wrong, only had to plea to the misdemeanor charge.
http://time.com/5311359/purdue-pharma-oxycontin-lawsuit-opio...
https://www.cbsnews.com/news/opioid-crisis-attorney-mike-moo...
Let them rot. Make an example of them. Otherwise, bring out the guillotine because apparently the robber barons of the Neo-Guilded Age need to be taught a lesson in noblesse oblige.
The only people who accidentally OD on Oxycontin are going to be either those who for some reason take the highest dose without any previous tolerance, or else toddlers who get into them. The overwhelming majority of people dying from Oxycontin are going to be those who mix it with alcohol, heroin, fentanyl, methadone, benzos, grapefruit juice, etc. It's all but impossible to overdose on if used as directed.
When sold legally, it's less expensive than Starbucks even if it's not covered by insurance. If people are forced to access illegal substitutes, that's because of bad government policy and not because of the company.
Non-intentional there is more along the lines of excluding suicides committed using their product.
but yes, the corporate veil is too thick, as shown by poor societal outcomes like this one. however, let's not throw out the baby with the bath water--we should lower the burden of proof for prosecuting such wrongdoings without completely losing the innovative effects of the corporate form. (we also need political reform so that policy makers can promote prosocial behavior, like proactively internalizing externalities like this rather than trying to clean it up after the fact).
I don't understand how someone proposed this with a straight face. Signing something agreeing to not break the law more is a confession that you've already done so.
(At the time, Morphine addiction was a huge crisis, with many people getting addicted to Morphine when using it as directed by a doctor.)
There was a huge scandal when, about 10 years after Heroin entered the marketplace, it came out that Heroin turns into Morphine in the brain. It also enters the brain much faster.
(This, BTW, means that Heroin is an extremely powerful painkiller. The UK used to use it for medical purposes until very recently.)
I wasn't surprised when it came out that Oxycotin was highly addictive. I knew it was just the same thing over again. A drug company markets an opiate as safe until everyone realizes it's not safe at all. It only took about 110 years for most people to forget about Bayer's Heroin scandal for someone to get away with it again.
A good example of this is Ephedrine. https://en.wikipedia.org/wiki/Ephedrine
It was widely used in 'weight loss' pills up until 2004, whenever it was restricted due to a combination of it's chemical similarity to amphetamine/methamphetamine (allowing for easy clandestine synthesis of more powerful psychoactive compounds), and people dying because they didn't realize they were taking completely unregulated substances on par in seriousness with other, culturally/politically demonized stimulants.
If one were to compare the 2d structures of both ephedrine and amphetamine/methamphetamine, even with no chemistry knowledge, one can see how similar these molecules actually are. Not to imply that molecular similarity necessarily always leads to similar pharmacological effects, but in this case it certainly does.
Even what one might call a 'high dose' (but still under the prescribing guidelines max limit) of prescribed amphetamine is still rather benign, unless one has a pre-existing condition which increases the risk of adverse health effects.
I believe they still use it as "diamorphone".
Overly cautious drug policy (such as an outright ban on heroin (or any drug)) can deny powerful remedies to those who can benefit from them.
This article is well worth reading for anyone wishing to be informed about the background before discussing which parties might ultimately be responsible for abuse.
The number of people who have lost their addiction fueled by this drug is astounding.
Prosecutors press charges.
The general public cannot, never has.
They can SUE, but that's civil, not criminal.
The standard in a criminal trial is much higher ("beyond a reasonable doubt") than in a civil trial ("preponderance of the evidence").
Basically, in a civil lawsuit, if it goes to the jury they only need to be 50.0000000001% convinced. In a criminal trial it's more like 95%.
And it's pretty common: A friend of mine who wasn't even around the person who overdosed, he had simply split an opiate purchase with him and then parted ways, was just arrested on 2nd degree murder charges within the last few months.
If my friend, who bore no ill will, gets sent to prison for murder, while the people who got him in his position (addicted to opiates after receiving prescribed pain medication) walk free, then that's textbook political corruption.
I was constantly astounded by the open corruption in the Pharma industry and complete lack of informed consent as to risk of side effects, how studies data was presented or skewed when being used, who was paying for studies (almost always the company making the product), how much advertising was being done at the med school level and by the economics of a drug with serious side effects (it’s almost always profitable to sell the drug anyway. The class action payments usually don’t even come close to the profits generated).
Most of the data in this article about the Sacklers and Oxy has been known and available for 10+ years. I remember working on a piece about the skewed addiction numbers. It was literally being marketed as “non-addictive”. Obviously a lot of good people work in Pharma and there are lifesaving medicines, yes. But the profits to be made are so vast and the companies so beholden to shareholders that we should ALWAYS demand full informed consent from our doctors on ALL medical interventions.
Example: commercials for Lipitor claim a 1/3rd reduction in the risk of heart attack by taking the drug. Your doctor prescribes it because it’s the _standard of care_ for your profile. Chances are high he hasn’t read any studies recently. What you both don’t know is that 1/3rd stat comes from a company-funded study in which 100 high-risk patients taking Lipitor who had already had a heart attack were compared to 100 high-risk patients who had not had a heart attack and who were not taking the drug. Over the course of the study (years I think) 2 people in the first group had a heart attack, and 3 of the non-drug group had a heart attack. Ok sure it’s 1/3rd but it’s actually only a 1% decrease in YOUR risk. Set that against all the side effects of taking the drug for years including the mental side effects now taking the spotlight. And those in the study were _high risk patients_ who already had a heart attack. And they were men only. At the time of the commercials there was no study on its effects on women. Yet 45% of the entire US adult population as of 2009 was on a cholesterol lowering medication. 45%! There so much info like this, on bypass surgery, stents, quitting smoking drugs...the list goes on.
The company I worked for had some smart, dedicated people but they couldn’t figure out a way to properly monetize it and the company shuttered after a few years. I think there’s definitely room for some disruption there still and I hope someone can figure it out. I for one would pay handsomely for a data-driven service that gives me all the info on offered drugs so I can make true informed consent. I’m guessing doctors would like it too since none of them have time to actually read studies and pick them apart.
The point: take whatever medication or do any surgery you need but BE AS INFORMED AS POSSIBLE before you do. We are often scared of our doctors’ authoritarian pronouncements that are all too often are based on unsound evidence, even if it is the “standard of care”. Find a doctor you can work WITH to get the best care for you. If you can’t do that become your own advocate aknd read as much of the literature is possible. You can’t afford not to.
> become your own advocate
Really resonates with me. Almost every time I go home and hang out with my parents, they share a new horror story about some close call with their medical treatments. (They've both had--and beat--cancer.) Last trip they were telling me about one of the days my Dad was getting chemotherapy; they needed to get a blood draw before the chemo was administered, and the cancer doc had instructed _them_ to make sure the phlebotomist installed a catheter for the initial blood draw, because (if I understood correctly) the extra needle hole in the vein from the blood draw can cause the chemo meds to leak & stagnate near the hand (which risks _the hand_...) But the phlebotomist didn't ask/confirm/want to, apparently because of some damn billing difficulty since the labwork division was different than the oncology division.
My conclusion is that there's a huge opportunity for more patient advocacy to really improve people's lives. Your "data for informed consent" angle sounds like a way more scalable path toward something like that!
https://www.newyorker.com/magazine/2017/10/30/the-family-tha...
At this point there is not doubt in my mind that deceit is part of the "company culture" of Purdue/Sackler, their MO. They should be held accountable. They should be publicly held accountable.
Everyone should realise that the Sacklers that sponsors this museum, or that library, or that park, have been for the last decades willingly pushing this drug while knowing full well that something was wrong. They patented a slow-release opioid but knew it was impossible to make sure that patient wouldn't crush the pills; they never reached out to the authorities when small town doctor ordered more drugs than could ever be needed. I mean, they literally have just patented a drug (September 2018) that let you go through the withdrawal of Oxycoting more easily.
They created the problem, leaving tens of thousand dead in their track while profiting immensely from it, now they want to profit from the recovery as well? Despicable business practice, despicable business.
Here are the new documents [1] themselves, as far as I can tell, but I can't find many of the referenced quotes in there (the "hammered" quote and the "blizzard" quote are the most colorful ones).
[1] https://www.apnews.com/4e2da888ede44c3db129b46d76504778
[2] https://int.nyt.com/data/documenthelper/569-purdue-pharma-do...
--but was he incorrect?
Sackler was correct by definition. It is evidenced that people become addicted to oxycontin _while_ taking it as instructed. Then they get physically sick when they stop, and have been powerfully psychologically conditioned to seek opioids.
If abuse means succumbing to the physiological compulsion to re-dose a drug you are addicted to, then one is addicted but not an abuser the day before the prescription runs out. But the next day they are either an addict in withdrawal, or an abuser.
Which one would you be? Could you quit a heavy opioid habit cold turkey? Good for you, but apparently lots of people can't.
People who are given prolonged high-dose self administered opioids should give informed consent to the serious risk of addiction. It's easy to argue in retrospect that, in fact, every reasonable person knows about this problem, but it is well evidenced that Purdue marketed it's product as having a low risk of addiction. I have never heard of a doctor saying: "You can take these pain pills for a couple of months. When you stop you'll get really sick for a very long time, and have a pernicious and overpowering psychological compulsion to take more opioids." That's what real informed consent would look like. People are angry at Purdue because they were dishonest.
Returning to the question of personal responsibility for addiction, if huge numbers of people don't quit a drug they got addicted to while using as directed, it is true but not helpful call them abusers. If opioid addicts could just quit anytime, we wouldn't be talking about this in the first place. How large a fraction of the population must fail in a way that is predictable by circumstance before we stop attributing failure entirely to a lack of individual virtue?
Even if your policy position on drug addicts is “kill em all and let god sort em out”, blaming abusers is not getting it sorted here on earth. If we want to make progress in this area we might have try something else.
What exactly is wrong with people making the most use of this drug as they see fit in their own lives? Is it wrong for people with chronic pain to take what they need? Why should doctors and others be able to prevent people from treating their pain?
"Purdue launched OxyContin with a marketing campaign that attempted to counter this attitude and change the prescribing habits of doctors. The company funded research and paid doctors to make the case that concerns about opioid addiction were overblown, and that OxyContin could safely treat an ever-wider range of maladies."
20 years later, I think we know how it turned out. Something like 75% of opioid addicts start with pills.
Because they probably do.
Pain is a stimuli people will do a lot to avoid. But pain also exists for a reason. You generally can't trust people in pain to self medicate.
Evolution did not give humans the ability to feel pain just to fuck with them.
Pain prevents you from unnecessarily straining damaged body parts, keeping you from harming yourself further and making your condition worse.
On painkillers you might hurt yourself doing something as simple as walking up a set of stairs, just because you didn't notice you placed your foot badly.
My personal story is of a loved one needlessly suffering mind boggling amounts of pain for half a year because the DEA had so scared our doctors.
Luckily the surgery was a 100% success and she doesn't need to rely up on the steaming pile of crap that is the DEA's interference in the medical community.
This is also a real problem, but I think a strong argument can be made that the Sacklers fraud is responsible for it too. A lot of the fear and under-prescription that now happens is a direct result of a strong backlash that itself was in response to the opioid epidemic and the massive damage that resulted. If that had never happened, then rather then the pendulum swinging way too far towards opioids everywhere and then (as is so often the case) right back over the neutral to suspicious of any opioids allowed for anyone anywhere, it could have been more steady state. Doctors would have known how serious the drugs were and been careful with prescriptions all along. Those who really needed them would get them, those who didn't would be directed elsewhere. If it never became such a political cause with so much rightful public interest and anger, then none of would intrude on the medical process.
So really the Sacklers may well have screwed people over coming and going. People who would have been fine without were turned into addicts and had their lives ruined, and now people with horrendous chronic pain have to suffer with it and have their lives ruined.
>Purdue Pharma contended that OxyContin, because of its time-release formulation, posed a lower threat of abuse and addiction to patients than do traditional, shorter-acting painkillers like Percocet or Vicodin.
That claim became the linchpin of the most aggressive marketing campaign ever undertaken by a pharmaceutical company for a narcotic painkiller.
“We have to hammer on abusers in every way possible,” Mr. Sackler wrote in an email in 2001, when he was president of the company, Purdue Pharma. “They are the culprits and the problem. They are reckless criminals.”"
Addiction is a physical and biological process as opposed to a willful individual choice and any company that produces drugs and studies their affects on the body should be at the forefront of understanding that. It appears that Sackler willfully chose to paint people addicted to his product in a negative light in pursuit of profits.
These are people that are prescribed this medication by their doctors whom they trust. These doctors in turn are pressured / bribed by the pharmaceutical companies to act as dispensaries for these pills to the detriment of the patients they are supposed to be protecting.
Opioids are not an effective treatment for most people with long term pain. They develop a tolerance for the opioids, and so they end up with an addiction, taking very large quantities of opioids, and still being in pain.
The pain system in your body gets used to the opioids faster than the breathing system. Over time, the difference between the amount of opioids you need to help the pain and the amount of opioids that make you stop breathing gets smaller and smaller. This has a very predictable bad end result.