Sacklers–who made $11B off opioid crisis–to pay $225M in damages | Hacker News Reader

Sacklers–who made $11B off opioid crisis–to pay $225M in damages

arstechnica.com

Dupont made more than $30 billion profit selling Teflon for almost 50 years, polluting the environment by dumping untreated toxic waste from the manufacturing process into virgin West Virginia landscapes the whole time.

In February 2017, DuPont settled over 3,550 lawsuits for $671 million.

Dark Waters Trailer https://www.youtube.com/watch?v=RvAOuhyunhY

We really have to stop letting wealthy people and corporations buy their way out of legal problems. Fines and settlements clearly don't stop bad behavior as banks and polluters have been showing repeatedly. The whole thing feels like a protection racket where it's ok to do illegal stuff as long as the government gets its cut.

Either somebody has to go to jail or the fines have to be on a level that they lose all of their illicit profits and more. Not just a part as it is now.

We really shouldn’t let people become so wealthy that they can make public policy, whether it’s for profit or altruistic reasons.

IMHO, If corporations are people, then corporations can go to jail.

^ THIS! So much this. Citizen's United is an abomination, but while it stands its tenets should at least be applied consistently. Also, there's a difference between capitalism and corporatism. I say that as the owner of a C-Corp.

Seriously. This still leaves the door open for the next drug crisis to make a (literal) killing and get a slap on the wrist in ten years.

What's next? I wouldn't be surprised if Pfizer started pushing Xanax and other benzodiazepines as a way to tie patients over while they wait the 2-6 weeks from talking to their PCP for a psychiatry referral and actually seeing a therapist.

The Benzo crisis is already here.

"Disgorgement" is the word I think you're looking for.

No we just need to completely get rid of all regulations and Corporations will totally stop doing nefarious things becuz of da market...

They only do bad things now because those Commie Democrats put regulations on them.

FB made $100s of billion off of selling users privacy and were only fined $5B.

Lots more examples of other companies as well.

Yeah, that has just little to do with the topic at hand. When you have a Facebook account, you sign a deal "your life for free stuff". Most people chose the free stuff. The only reason they can bring a suit at all is because people can't be assumed to be as aware as Facebook would like to paint them.

However, drug addiction is something entirely different. You don't expect people to override doctors decisions. Yeah you should question, but most people don't have the expertise to do so. The same is true with Facebook, however the premise is different, i.e. Facebook didn't sign the Hippocratic oath to only do good to people. So obviously people should be wary. And most of all, the harm done is virtual and not noticeable, to the individual that is.

This is just the people who were caught. There are literally hundreds for more every case you ever hear about.

The Sackler's settlement doesn't even scratch the top 10 of the largest corporate fines of the last two years, and is less than 1/20th of what Facebook paid for privacy violations in 2019.

Source: https://www.quiverquant.com/sources/violations

I know everybody loves to hate on the Sacklers, but my life was dramatically better when I had access to opioids. Because of the "crisis" it has gotten really difficult to get them, even for people who need them. There are days when it's difficult to do much more than lie in bed in agony, but nobody beyond a small community of other pain sufferers seems to care.

I'm at least grateful for the few good years I did get thanks to opioids, before they became radioactive. I hope some day we can swing the pendulum back toward compassion a bit.

Everybody seems to want politicians and cops (DEA) deciding who should get them and who shouldn't. That may be an impossible mindset to change.

I hear what you're saying, but it feels like you should be placing your blame on the sacklers too - if they hadn't pushed opioids on people who didn't need them, fueling the crisis, then there would not have been this backlash you describe.

Like, we shouldn't be mad at opioids, we should be mad at drug pushing profiteers.

That's a reasonable point, although if they hadn't helped make doctors more comfortable with using them, then I may not have ever gotten them in the first place as they would be stingy with them like they are now. Hard to know where I would have landed.

Did doctors not prescribe opioids for pain management before the Sacklers? My understanding was that they did but were hesitant, which considering the nature of opioids seems entirely reasonable.

When I had routine surgery a few years back the doctor insisted I take a prescription for Oxy, even though I told him I was fine. I filled it at his insistence and within a couple days could feel my body building dependence and craving more. I switched to ibuprofen as it freaked me out to feel how strong it was. It seemed very irresponsible to prescribe Oxy for something as mild as my case.

For debilitating chronic pain? For sure, these need to available. If anything Purdue pharma made this situation worse for those that actually need these drugs.

“make doctors more comfortable with using them” is a bit of an understatement.

The Sacklers lied to doctors and told them that OxyContin wasn’t addictive. They and their henchmen should be strapped to a gurney and sent off with a IV drip of OxyContin.

TL;DR: I think it is reasonable to blame Purdue for the reduced access to opioids we are now stuck with.

Purdue caused more addiction to occur, which in turn caused reduced access to the opioids that existed prior to the creation of Purdue's nuisance product.

Also, perverse incentives caused by the patent and licensing system motivated them to make OxyContin unnecessarily addictive in it's formulation and dosing schedule, in order to engage in patent "ever-greening" of an existing substance.

Oxycodone has been around for a long time, but was doesed and administered more safely in older products.

Purdue did some pretty perverse things to support their patent and regulatory rationale for OxyContin. To gain approval as a superior and patent-able alternative to the other extant gerneric hydrocodone and oxycodone products, it was claimed to require less frequent (but larger) doses. The result was that large numbers patients found that when taken as directed it provided superior pain relief, followed by a return of pain, in conjunction with hours of opioid withdrawals until the next dose. Early on in the product's life cycle doctors were encouraged to increase the dose but not the dosing schedule when patients complained, in part because the alternative would have undermined the rationale for the existence of the product.

Although this was probably an undesired side effect from the point of view of Purdue, they could hardly have designed a better way to cause drug addiction. Millions of people took this product and many became addicted. Purdue went far out of their way to publicize people as criminals rather than address the fundamental problem with the way the product was administered. It seems to be evidenced that the more effective administration schedules of other already existing products cause less addiction, so at the margin, Purdue caused many more drug addicts to exists than would have otherwise.

If they had not done this, or had been willing to adequately address the problems, we would probably still have easier access now to the opioids that already existed. The problem has grown to such a scale that it is now very hard to "put the genie back in the bottle."

I think it might be even worse than that, that everything they did rolled back pain care. Law enforcement was already on a moralizing crackdown on pain doctors in the 90s and 2000s, and any ground that was gained in justifying pain care in that context was then stomped on by Purdue. It's one thing if they burned their own bridges, but to burn the bridges of all of your customers is a new level in retail aggression. "If we aren't the ones to give it to you, you can't have it at all."

Agree. The notion that this is just free market rewarding business people providing some market need is beyond the pale.

While you're clearly in pain and vindictive for lack of access to effective treatment, putting "crisis" in quotes like it's a manufactured epidemic with no real impact is extremely disingenuous.

In 2018 ~130 people died every day in the US overdosing on opioids[1]. I'm sure they're effective for you but if people are not responsible enough to be trusted taking them without killing themselves then you might as well be arguing to legalize heroine for treatment as well. It would probably be even more effective.

And for the record I do think it probably should be legal for treatment anyway.

[1] https://www.drugabuse.gov/drug-topics/opioids/opioid-overdos...

Just so this doesn’t come off like too radical an idea: legalization of all drugs has been a position of The Economist since 1989. “Legalize, Control, Discourage.”

https://www.economist.com/leaders/1989/01/21/hooked-on-just-...

The majority of opioid deaths are due to fentanyl or cut opioids, something that would not exist if there were a regulated legal market.

> In 2018 ~130 people died every day in the US overdosing on opioids

Alcohol kills literally twice that number of people per day and is a factor in nearly half of all violent crime and is a quarter of a trillion dollar market, and yet we seem to fine with that trade-off even though it has absolutely ZERO therapeutic application.

> putting "crisis" in quotes like it's a manufactured epidemic

The epidemic might not be manufactured, but given the numbers re: alcohol the outrage certainly seems to be. It's a moral panic, imo.

From your link:

"including prescription pain relievers, heroin, and synthetic opioids such as fentanyl"

So recreational drug abusers are included in the count? I believe the OP was only taking prescription drugs.

Is there a count somewhere of just the overdoses on prescribed opioids?

It's tricky to meaningfully separate these cases, as many opioid addictions start with prescriptions and move to more available opioids when the prescriptions end.

This is substantially less common than is widely believed.

This varies a lot by area, but it isn't rare.

From what I can tell, the link between Purdue Pharma and the Sackler's campaign to get opioids prescribed to patients with pain - and indeed, their use to relieve pain in general - and the widespread opioid addiction and overdoae crisis seemed to be extremely tenuous and mostly pushed for political reasons. Basically, we wanted someone big and high-profile to blame that fitted into all our nice neat existing narratives about evil megacorporations and the wealthy, and plenty of journalists and prosecutors were willing to give that to us.

OxyContin/oxycodone (30mg tablet)

2002 8.8 million pills

2011 781.5 million pills

The US didn't experience a massive increase of numbers of people in pain.

You may have a point here but it's hard to know without more context. For example: why only OxyContin/oxycodone listed here? oxycontin was still a fairly new drug in 2002. Also there are numerous other opioids available, many of those "new pills" might have been replacing other opioids. Also you seem to completely rule out the possibility that there was untreated or under treated pain out there (which I strongly suspect is the case).

Again I'm not saying you're wrong, just that it's not possible to know from the context in your post alone.

I think that maybe then you too should be mad at the Sacklers.

They intentionally and knowingly deceived the market that opioids were safe. Had they not done that maybe the opioid epidemic would not have happened and you could still have access to the medicine that you are grateful for.

Please do read up on how horrible they are.

do you have a reference to just how bad they were? I'd like to learn more. This whole sackler thing has been scaring me shitless because as a biochemist thinking about going back into biochemistry, my brain runs around in circles about how badly a small bit of uncertainty could be turned around in circles to screw me over, even if I believed what I did was in the best interest of most people (like what happened to Merck + Vioxx).

Prosecutors have been going after Purdue and the Sackler's for over a decade now. Forty seven states have sued Purdue pharma over the opioid crisis with twenty nine of those states specifically naming members of the Sackler family in the suits. So if you want primary documents, you have more than you can read.

Here's an excerpt from a recent New Yorker article:

The 2007 case was not supposed to end the way it did. For four years, prosecutors in the Western District of Virginia gathered evidence on Purdue, subpoenaing millions of documents. They found a widespread pattern of illegal misconduct in which Purdue systematically misled doctors (and the general public) about the risks associated with OxyContin. In September, 2006, the prosecutors detailed their damning evidence in a hundred-and-twenty-page memo, suggesting that the wrongdoing at Purdue was so pervasive, and so consistent, that it could have been authorized only by the company’s leaders. This memo, an internal government document, was not made public until August, 2019, when the Times published excerpts of it showing that the prosecutors had intended to bring felony charges against three top Purdue executives: Michael Friedman, Howard Udell, and Paul Goldenheim. The full memo, which I have reviewed, describes the Sacklers as “The Family” and notes that the company was owned and controlled by the brothers Mortimer and Raymond Sackler and their heirs. (The heirs of a third Sackler brother, Arthur, sold their interest in the company prior to the introduction of OxyContin.) The company “trained its sales representatives” to use “false and fraudulent” claims about OxyContin, the memo states. The prosecutors noted that the three executives they intended to charge “reported directly to The Family.”

https://www.newyorker.com/news/news-desk/the-sackler-familys...

Thanks!! The new yorker article is exactly what I was looking for.

I both think that opioids should be more legalized/available and that if people break the current law, they should face consequences for doing so. If we have a punishment/deterrence-based society, then it seems like the deterrent is not working well for many large corporations. Giving a fine that is a tiny percentage of their money doesn't seem to penalize the behavior much, and more importantly, may not lead to behavioral change. I believe some people need to be held criminally liable and go to prison to stop some of the harmful behaviors.

I think the challenge is that even if someone saves 100 lives, if they kill 1, they face criminal consequences. Maybe coming from the assumption we're supposed to do things to help people, I dunno.

Apparently your pain and suffering is less important than getting the Sacklers.

Why aren't you a candidate for legal thc? I'm genuinely interested as it comes up a lot as the new solution for former legitimate opioid users.

As someone who uses both (irregularly, only as necessary), legal thc / CBD doesn't even remotely compare. I have to get so high to even approximate the pain relief from an opioid that I'm completely nonfunctional.

I had my first back surgery at 18, my second at 25, and I've been staving off 5 separate herniated discs since. I'm in a good place now (barring literally today), but I can't stress enough how useless you end up being, mentally, to take enough thc/cbd to relieve your pain enough to be functional. Really, I just trade my disfunction of one type for disfunction of another type, which is only acceptable because sometimes you simply can't handle the pain.

OP: I've had a lot of luck finding relief with tramadol. It may not be sufficient for your pain or work for you, but it's a schedule IV instead of a schedule II - my doctor can even call it in. In my experience, doctors don't treat you as a drug seeker if you suggest it - they almost seem relieved that you're not asking for the radioactive stuff. Just throwing it out as a possibility.

For myself, for the rare times each year I need it now, it has been wonderful: most of the opioids were almost putting me into a frenzy - not really the right word since it wasn't as strong as the word frenzy implies, but I would get pretty amped up and anxious. Tramadol offers me relief but I stay fairly even keeled - I can even keep working, for instance, something I can't say I can accomplish when I'm using enough THC/CBD to achieve relief. I wouldn't drive on it or sign a contract, but I'd put it on par with having a couple of beers at lunch.

Just a warning, Tramadol reacts very badly in some people. Like myself, just a single pill will cause me to have tonic-clonic seizures leading up to a grand-mal seizure later on in the day.

Tramadol also has a bunch of shit in it, I feel like it's a 'dirty' drug. For example, it's very closely related to the chemical structures of antidepressants. This can be helpful, but not when you need to stop it. You also can't really take any serotonergic medicine either as you'd be at a very high risk of serotonin syndrome. Nobody wants that.

Honestly, old and true medicines really do work. I'm not saying the Sacklers are awesome, they're fuckin'evil and didn't value human lives - but the drug works for those who need it.

And Cannabis is not legal in New Zealand, at least yet. We'll find out on the 30th if it's going to be...

(I have to be on it after burning my entire left arm, and chest with burning hot oil - I also educate myself on medicines as I used to work in said sector, and I do have seizures and Tramadol is well known to lower the seizure threshold very very fast)

I wish I had known about the serotonin part earlier; I destroyed my back today on the dumbest thing and took one so I could get some work done. I wasn't taking an SSRI when I used tramadol more frequently, but I am now, and I probably wouldn't have had I known.

Sigh. I really don't know what to do in these scenarios, it's nothing but bad choices :(

Best thing anyone can do is to familiarise themselves with what they take, and what the key indications are with mixing medication and what happens when you stop. In NZ we have medsafe (https://www.medsafe.govt.nz/), a govt website that lists everything they give out. There's also the The New Zealand Formulary (http://nzformulary.org/)

An example here is that too many doctors believe that Pregabalin has no withdrawals. They're very wrong. Here, they will prescribe it for anything. It works really well too, but there's a lot of hidden bullshit. As an example, they give it to people with epilepsy, but one of the main contradictions is that it can actually cause seizures. So when that started happening for me, they put me on clonazepam (2mg, six times a day).

When I burned myself, I told the hospital I did not want either medicine. There's no point in taking Pregabalin if I have to take so much clonazepam to fix the side effects.

A week later (while still in hospital) I had a panicked pharmacist for the ward visit me and he's like "omg we weren't giving you these two" and I said, "nah mate, it's fine. I feel okay apart from the pain" and he's like, "hang on, you just stopped 12mg of clonazepam a day and you feel fine?" and so I said yes, it's because it simply stopped working and my body has decided it doesn't work on me anymore, which is why I can't take the Pregabalin either... and the stupid thing is the Pregabalin is probably one of the best things I could take right now due to it's amazing nerve pain relief. I'd rather not have seizures though, nor have to find the right kind of benzo to help. I doubt I'd find one that's different enough from the rest to help.

As someone who takes tramadol daily, and has done for about 7 years, I respect that it isn't the best option. But right now I don't have better alternatives. Yes, I've taken breaks for up to a month (without needing to ween, never upped my dosage).

Cannabis doesn't work. Paracetamol/acetaminophen, ibuprofen, NSAID's don't work.

Morphine, codeine and tramadol do. Tramadol is the best of a bad bunch.

I have used it extensively over the years but it doesn't work all that well for me and comes with really bad side effects (like making me super tired, which makes it really hard to work), making me insatiably hungry, etc. I've tried all kinds of different combos and it's a nice tool for the toolbox, but it's by no means a replacement for me.

I might also add I don't enjoy being high at all. I really prefer to have a clear head, especially during the day while I'm working. I've tried strains that are supposed to be good for that but they don't really work on the pain.

What condition do you have?

You had a "clear head" on opioids?

You've got to be kidding, right?

Unfortunately, unjust settlements like this are common place in our country, and after the outrage cycle dies down, this will be forgotten like the others. Nothing changes. What can we possibly do?

Start by reforming the justice system. It is badly broken at all levels. It's slow speed, incredibly expensive interactions, and hard-to-understand system of laws need a big time upgrade. We need relatively simple laws that ordinary folks can understand, and a much faster time-to-judgement. It is really the complexity and cost of the system that leads to so many of these unjust outcomes, because hardly any actors in the system actually want to present their case and hear a verdict out of a judges mouth, because to get there takes years and millions of dollars.

Justice cannot happen without input from the those who are on the other side, the indicted.

You quickly realize justice TRIES to be a really bad cop. And then the indicted /convicted have to make deals for something that is terribly unfair. Just imagine negotiating with a person like Kamala.

When I see light weight no benefit deals like this, I think that it looks like both prosecutor and defendant got away with murder with little effort.

Further, let's stop the rhetoric that severe punishments will stop bad crimes. Not true. Even the lightest of punishments can stop crimes simply with shame. If more people get caught and are able to reconcile for their crimes, that would be sufficient to prevent 95 percent of future crimes.

This is all true, but I think its a symptom of a more fundamental problem, which is the complexity of the system, and the attendant speed and cost problems that drive agents to these outcomes. If the system worked transparently and quickly, then a lot of the other problems would go away. Plea deals should be the exception, not the rule.

The Sacklers engaged in unethical behavior to get people hooked on something that made them money. Easy opioid prescriptions created thousands of (mostly) functional addicts who were getting their fix in a high-quality control form via their doctor on a monthly basis. That's bad but that's not an opioid "crisis". You don't get a crisis because of a few evil billionaires. More things have to go wrong. What really turned the opioid problem into a crisis is when the feds cracked down. The doctors had to cut the junkies off or lose their licenses. The junkies predictably switched to the street for their supply with predictably tragic results.

The Sacklers may have done unethical, arguably evil, things to make a buck but there's plenty of blame that should be cast in the direction of other parties here.

So since the market created functional drug addicts that’s ok and the government caused the problem by trying to stop the market from creating drug addiction?

If somebody tried to stop a train that was speeding along a wrong way by putting a wall on its way, it would end in a trainwreck.

If you care about the passengers, that won't be a responsible thing to do, though technically the train would be stopped.

So, a trainwreck is what we see :(

Genuinely curious the alternative you would suggest.

I think people can still access opioids legally, albeit much less easy than before. There are plenty of treatment options and the right answer isn’t to let drug addicts keep on ruining their own lives and the people around them. The train has to slow down and people have to get off the train.

Granted, the government can do much more to help people get treatment and stop punishing users. But they damn sure do need to punish people who intentionally create drug addicts and that’s what this is about.

Determine people who have opioids prescribed without a real need.

Wean them off gradually, using known programs for quitting opioids. Work with them as with patients, for once they are addicts, they are the suffering party.

Make the makers / prescribers which acted in bad faith to foot the bills. They made the damage, let them pay for repairing it.

I agree with everything you just said there. What parts do you not see happening? It seems like the proceeds of the DOJ settlement and the unwinding of Purdue start to make funds available for treatment and remediation of some of the issues.

Also what of punitive action against the makers / prescribers would you expect? I think the article hits on the perceived justice lack of justice against the Sackler family.

The government showed up to a grease fire and poured water on it. They're in the murky area where incompetence, negligence and malice meet.

The only thing the public wants is a scapegoat. An evil face to jeer at, some one or group of people to blame for a problem before moving onto the next hyperbolic issue. Otherwise perception of a problem is too diffuse, complicated, and nuanced to process in an iota of thought. Don't bother considering the fact this company acted in good faith with the law, or the blind faith people put into a medical system fundamentally designed to profiteer from peoples' lives, and dismal support for the mental or physical health of our nation's poor and struggling. Because if you look hard enough for someone to blame and it'll eventually come full circle, because we collectively decided to co-opt a society based purely on self-interest.

I don't want a scape goat.

I want a justice system that is capable of approaching some approximation of justice.

For me, personally, I don't think it's just to intentionally and knowingly profit off of the suffering and despair of those in pain with a chemical you damn well know is addictive and then walk away considerably richer than you started after "justice" is meted out.

Now - I agree 100% that the issue is much more complicated than this one family, and this one company, and I'm damn well on board for pushing to restructure our current for-profit medical system (I believe it's abusive to both practitioners as well as "patients")

But we cannot allow criminals to walk into a bank, steal 100 dollars, fine them 10 and call it justice.

This ruined disenfranchised families and communities across the country. The least we could start with is some fucking jail time.

What the hell, they lured millions into a long-term addiction to a very potent drug that is brutally hard to break in the best of cases, knowingly and out of naked greed. How on earth can you call that merely "unethical, arguably evil"? How can not call that a freaking crisis? Millions of addicts that you can't get off their substance without terrible suffering? Sure, more things have to go wrong to let it get THIS bad, but once you get that many people hooked, you're at least 90% there, because I really don't think there is a way out that doesn't imply immense suffering. This is a crime against humanity, not just an "unethical" business move.

You're massively under estimating how many tablets the sacklers sold.

I’d challenge this timeline. The crisis was widely announced and understood before the crackdowns you mention. I don’t at all deny the negative effects that came from crackdowns. As you say they shifted a prescription drug crisis to one that more and more is a heroin and fentanyl crisis, but the crisis existed before, at least in the popular imagination and discourse.

This is a misleading headline. It is part of an $8.3B settlement.

Edit: I should have read the whole article. The $225M is against the $11B the family has siphoned from Purdue.

No- the $8.3B settlement was against the company, but the Sackler family has already drained $10.7B in cash out of the company.

They've known this was coming and drained as much as they could- from Dec 2019: https://arstechnica.com/science/2019/12/sacklers-siphoned-ne...

It's the first line of the article:

"The infamous megarich Sackler family will pay $235 million in civil penalties as part of a controversial $8.3 billion settlement with the US Department of Justice."

Further, the family owned all of Purdue Pharma. The company settlement is also a direct cost to the Sackler family. If the company has an $8.3 billion settlement with the DOJ, that is the family paying $8.3 billion from their asset as it was 100% owned by them.

The headline is slightly misleading, even if the Sacklers are scumbags. The headline is blatantly attempting to pretend the only cost to the Sackler family is $235m. You can tell by the article's opening, aggressive tilt; very colorful phrasing like "infamous megarich" - which is ars firing up the outrage machine in the first line to prep a reaction for the rest of the article.

But the $8.3B is not coming out of the $10.7B that the family extracted.

The title is not misleading at all- the family which profited $10.7B is paying $225M.

The company already entered bankruptcy proceedings last year.

Correct. I do believe what they did was quite evil, and they should be disgorged of all profits - and if that bankrupts them then all the better. While 8.3bn is still not the 11bn they made in profits, it's still significantly more than 225mn. The headline is misleading.

They, personally, are paying 225 million.

The company, of which they likely will not retain control, is settling for ~8billion.

Importantly, the company itself DOES NOT HAVE THAT MUCH MONEY. It is expected to pay it off over time, assuming it remains solvent.

The Sacklers, on the other hand, have drained nearly 10 billion dollars from the company account into their personal estate, and are retaining all but 225 million of it.

---

My hot take - They can keep the fucking money, let them buy as much ramen from the prison commissary as they'd like.

I see, thanks for the correction. I agree with your hot take.

Incorrect- the family has already drained $10.7B from the company and are only being fined $225M themselves- they are not responsible for any other portion of the $8.3B.

The family will lose control of the company in bankruptcy but they knew this was coming and drained it ahead of time. DoJ is letting them get away with it.

I see, thanks for the correction. I thought the I guess if they wholly owned the company then legally they should be allowed to transfer the cash/profits, generally speaking. But if there was ongoing prosecution and they did it specifically to avoid having to actually pay the 8.3bn bill being stuck with the company then that definitely sounds illegal. If they transferred the profits to personal accounts then they should still be personally liable for all of it.

In their defense, they really wanted make a ton of money, really didn't want to pay a huge fine. So, you know, it all kind of worked out. For them.

What happened to all that money they made? I find it hard to believe they can spend that much money.

No no, they still have the money, they just didn't want to pay a big fine so they paid a small one instead.

It's "The War on Drugs Sold by Outsiders", commonly shortened to "The War on Drugs".

Any confusion is intentional.

Wait, what about plowing all of the money back into research? Are you saying that's a less than honest diversion from the issue of their extortionate prices?

You’re being sarcastic, in their defense, right?

I believe they're using "the American dream" as the defense. So, yes, it's sarcastic, but maybe not in the way you were thinking.

I'm not sure I was sarcastic so much as I was bitterly cynical.

Big Pharma is an easy villain to hate (and there's a lot to hate) but why aren't the doctors who prescribed all these drugs being held accountable as well?

Because the doctors were lied to by Big Pharma. they advertised Oxycontin to doctors as a drug that would not create addiction and claimed that is was safe to prescribe in large doses and for ongoing treatment.

Both should be held accountable. Unfortunately people like to identify single villains or problems instead of realizing that there are many bad players. this is the problem with the whole US health system. Pretty much all parties involved (except the patient) make a lot of money but when people look for a solution they always they to find the one root cause. In reality it's hospitals, doctors, insurance companies, pharmaceutical companies and many others that live well off this insane system.

Some are. There's been quite a few stories of doctors who got shut down for running what the news likes to call "pill mills". Most doctors just didn't overprescribe all that much, though.

Since this will inevitably turn to a discussion of opioids, here are some counter-narrative facts that surprised me:

1. The narrative is that some poor guy took pain meds for a legimate reason then ended up addicted. While this does occur, it's actually not very common.

> Among people who are prescribed opioids, addiction is relatively uncommon. The percentage of patients who become addicted after taking opioids for chronic pain is measured in the single digits; studies show an incidence from less than 1 percent to 8 percent. Most of the estimates are skewed toward the low end of this range, when those at risk (due to a history of substance abuse or, to a lesser but meaningful extent, a concurrent mental illness) are removed from the sample.

2. Most addicts had a history of drug abuse.

> People who abuse pills are rarely new to drugs. The federal government’s 2014 National Survey on Drug Use and Health, for example, revealed that more than three-fourths of misusers had used non-prescribed benzodiazepines, such as Valium or Xanax, or inhalants. A study of Oxycontin users in treatment found that they “were not naive individuals with accidental addictions who were introduced to painkillers by their physicians as reported by the media … [Instead they had] extensive drug use histories.”

It's hard to bring this up without straying into classism or victim blaming. The reality is that most people without comorbidities and abuse history are quite safe, and these are drugs we need.

[1] https://www.theatlantic.com/ideas/archive/2019/08/what-ameri...

One thing to note about this settlement is that it does not make them immune from additional criminal charges in the future. I don't know how likely it is we would ever see criminal charges here, but it isn't a "sweetheart deal" in that sense.

For reference, this is ~7.5 cents per prescription given out in the US from 2006 to 2018.

I've no idea how to break that down into a per pill basis, but it's likely to be much less than a cent per pill.

I very much doubt that the Sacklers profited less than a cent per pill though.

https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html

Imagine those numbers on a smaller scale. "Son, your greedy schemes that made you $11 hurt a lot of people, so you have to give back 25 cents."

These cases are damn hard to win. Surprised they even got more than 100 million.

But the legal bill... easily hundreds of million.

It pays so well to be the bad guy. I imagine this fact would be an extra sting to anyone that lost a loved one and there is nothing anyone can do in their lifetime to change the system to prevent it. Been this way since the dawn of time.

Running the math for reference:

$225,000,000 ÷ $11,000,000,000 ≈ 2.0%

what kind of legal bill would this have all required to pull-off?

All animals are equal , but some are more equal than others.

Read that as Slackers ...

They also have to relinquish control of the company. That’s arguably the main force of the punishment.

Was their stake in the company seized? Or did they have to sell? The latter isn't much of a punishment.

So they have to give up control of their company and they still have billions in profits..? How is that a punishment?

Meanwhile the person that robbed a gas station is rotting in jail... If only they were billionaires, if they robbed millions at scale they’d only have to transfer ownership of their LLC.

Surprised that a parent of a child lost to opioids hasn’t put a Lapua Magnum in at least one of these guys.

Reply on news.ycombinator.com