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Comment by simplecomplex | Hacker News Reader

They didn’t directly contribute to the opioid crisis. At worst they were found guilty of deceptive marketing which is obviously highly political considering doctors ultimately prescribed them. Purdue wasn’t running commercials telling consumers to take OxyContin. Blaming Purdue for the opioid crisis is absurd. They make the drug, the doctors choose to buy and prescribe them, and people choose to take them at the advice of their doctor. How does Purdue have more responsibility than doctors and addicts?

Nobody addicted to opium was “tricked” into it. All legal opium is prescribed by a licensed doctor for godsakes!

Fining them isn’t helping people with opiate addiction. If we were to bankrupt the Sackler family tomorrow nobody addicted to opium is magically going to kick the habit.

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As someone who is healthcare adjacent they absolutely directly contributed to the opioid crisis.

Highly addictive drugs aren't a thing you just start and stop taking... Opioids are intensely addictive and Purdue repeatedly marketed Oxycotin as a non-addictive Opioid, there is even video of a Sackler talking about how much the sales team should be pushing the non-addictive qualities[1] as a benefit when dealing with Doctors. They also used the ye olde drug rep hard sell sales tactics to push it on Doctors in exchange for monetary compensation and in kind compensation when the US made direct monetary compensation illegal.

Purdue is a huge part of this crisis, but they shouldn't be singled out - the marketing that pharma companies engage is constantly contributing to the ill health of Americans through toxicity, unnecessary side effects, stress from financial pressures and, sometimes, direct poisoning.

Please do a bit more research into this crisis and it's causes.

1. Specifically, false qualities that Purdue actively hide evidence of.

I’ve worked plenty with drug addiction and am a recovering addict.

The idea that marketing is responsible for drug addiction is delusional.

The idea that doctors are so stupid as to not know Oxy is addictive is laughably untrue.

If you want to blame anyone blame the people ordering patients to consume opiates. The lack of supervision and education is the doctor’s responsibility not the drug maker. Every doctor in the US knows Oxy is addictive and has for a very long time. Doctors overprescribe OxyContin not pharmaceutical companies.

If you want to play a blame game there is no way Purdue comes out on top. Doctors are the ones who put opiates in peoples hands https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140023/es

No one person is to blame and trying to do so will just leave you frustrated as that person passes the buck, this whole market is rotten from PBMs, Pharmaceutical Manufacturers, Payors, Pharmacies and Providers - both individual doctors and institutions like clinics and hospitals that set guidelines for preferred treatment options and guidance of care.

I've emigrated but when I was still working in the US a co-worker of mine was given a 90 day script after an injury, which is far _far_ more than is appropriate for mild pain relief. He was a neuroscientist and enraged that a doctor would prescribe him such a stupidly dangerous quantity, he just grunted and bore it for two days then got over it.

...Except doctors are very busy people who often rely necessarily on drugmaker-published literature to update their knowledge on those products and ailments. They don't generally have the ability to conduct their own research. Therefore, your assertion that all doctors 'knew' that these drugs were addictive is simply untrue.

Now, there is definitely a spectrum of responsibility/guilt that could be applied to all parties here. In some ways, the buck even stops with the patient: it's their decision what to put in their mouth and swallow, and no one was holding a gun to their head and forcing them to take the meds they were prescribed. But that of course is a very skewed view on the subject of addiction.

The crux of the issue is how society decides to assign blame. Collectively, we seem have a hard time dumping more responsibility on patients. Plenty of doctors have been fined, lost licenses, and gone to prison. Heck, my own childhood physician lost his license. But we also understand that many doctors who made mistakes deserve some leniency because they were tasked with helping people in pain.

But the drug companies...it's hard to imagine that they deserve even a shred of clemency. Their only job was to produce a product and represent it truthfully. Their failure mode was knowing, made them vast sums, and destroyed many lives.

I would not go as far to say they're blameless, but you're correct we knew as far back as 2003-2004 that oxycontin was highly addictive.

NPR story from 2005 - https://www.npr.org/templates/story/story.php?storyId=506167...

Can you clarify who the "we" is who knew this in 2003?

I think it's unfair to say that was general knowledge before 2017 or so.

I remember seeing news reports back that far - particularly about how people were crushing the drug.

Reporting about Reporting in 2003 - https://www.cjr.org/united_states_project/orlando-sentinel-o... (and the pressure applied by Perdue Pharma on the paper after)

2005 - https://www.npr.org/templates/story/story.php?storyId=506167...

2007 - http://www.nbcnews.com/id/20327132/ns/health-health_care/t/p...

Purdue knowed about the drug was highly addictive in 2003. The raw components in Oxycontin were known to be highly addictive before the drug hit the market. Oxycontin was supposed to "solve" the addiction problem, thus it got special drug labeling saying it was less addictive than other drugs of its class.

They had data that it did not solve the problem but they massaged the data, and hid the data that showed it was addictive, and then later hid the data that after the drug was on the market of the ways it was being abused.

Misleading Doctors and the FDA since 1996

https://www.nytimes.com/2018/05/29/health/purdue-opioids-oxy...

I upvoted you not because I believe Purdue shouldn't be held responsible but because doctors definitely contributed to this crisis. They are not innocent in all this. They've been benefiting from big pharma to push their drugs.

I think you may not have all the information here. People are coming forward and testifying that their Purdue bosses instructed them to lie to insurers in order to get prescribed opioids paid for.

There is evidence that they knowingly lied to doctors and patients telling them that fentanyl was safe and less addictive than many other lesser opioids.

There is evidence that they knowingly increased pressure on sales even after it came to light that opioids were much more addictive and lethal than they thought.

There is also evidence that the sacklers were heavily involved in all of this.

I'd say yes, they definitely contributed to the epidemic in a large way.

Oh, and not to forget, they are also implicated in bribing doctors to overprescribe their opioids to people.

Not quite that simple. For one, oxy HAS been marketed to consumers (still one of only two countries in the world to allow Rx marketing to consumers - the other being New Zealand who is phasing it out and only introduced it as part of a trade agreement with the US).

Purdue also downplayed the addictiveness of new formulations in their advertising -to physicians-.

They also built disingenuous "self regulation" systems because they knew of the issue, and wanted to keep the wolves at bay, but the only thing the program was really designed to do was to shield Purdue. The very vast majority of over prescribing identified by this program was not reported to authorities until after the authorities had already acted (ie. when Purdue realized they would not lose any revenue from the report because the physician had already had his script writing ability pulled).

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