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Comment by xeckr | Hacker News Reader

I don't understand the hatred directed at the Sacklers. Oxycodone is, just like all other opiates, highly effective at suppressing pain, potentially addictive, and deadly in large enough doses. This has been common medical knowledge for millennia. Why do so many people believe that they are responsible for overdose deaths?

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Because they marketed an opioid as an "extended release" form when they knew from their own internal studies that the pain relief only lasted the standard 6 hours instead of the 8 hours that were claimed. As a result, people would find themselves taking more to stay on top of their symptoms and the resulting ramp in use would leave people debilitated.

It was also pitched as abuse resistant (something about it being hard to grind up the pills), which they also knew to be untrue.

This provides a good overview of how Purdue accelerated opiate marketing: https://www.newyorker.com/news/news-desk/the-sackler-familys...

> A recent study, by a team of economists from the Wharton School, Notre Dame, and rand, reviewed overdose statistics in five states where Purdue opted, because of local regulations, to concentrate fewer resources in promoting its drug. The scholars found that, in those states, overdose rates—even from heroin and fentanyl—are markedly lower than in states where Purdue did the full marketing push. The study concludes that “the introduction and marketing of OxyContin explain a substantial share of overdose deaths over the last two decades.”

This is a correlation study—I understand that increasing marketing efforts leads to an increase in physician prescription, but those overdose deaths were caused by a tiny fraction of patients refusing to follow the script as issued by their physicians. Whose fault is that?

It's especially tough for me because they clearly pushed their sketchy marketing and sales tactics because they honestly believed they were helping people, and in their lifetimes the medical industry lauded them as heroes for "safe" and affordable ways to ease suffering.

Right now people have no problem suppressing research they don't like about the negative effects of marijuana or anti-depressants or whatever their de jour personal treatment is - in 20 years if something bad really comes to light everyone is going to pretend that they knew all along and that everything was a smoking gun. Hindsight is 20/20 and history is written by the victors.

because the way they encouraged doctors to push it to everyone, regardless if they needed it or not. they aggressively marketed and pushed the drug in situations that didnt call for it

How much of this issue have you investigated already?

It’s worth skimming through the Massachusetts AG complaint about their actions, and the strategies employed by Purdue (of which the Sacklers always held the majority of board seats)

https://www.reuters.com/investigates/special-report/assets/u...

https://www.britannica.com/science/opioid

> Although a different formulation of oxycodone, manufactured by Merck & Co., was removed from the market in 1990 because of a high risk of addiction, members of the Sackler family downplayed the dangers of OxyContin, deceiving doctors into thinking that it was weaker than morphine and convincing them to prescribe the drug liberally

Because they marketed it as a non-addictive opioid because it was extended release and encouraged doctors always to prescribe the maximum amount despite internal testing showing the extended release was bogus and it was still addictive?

Exactly. It took the collaboration of many different people, all of which also profited from it, to bring about the opioid crisis.

The vendor who sells many different things seems to be at least a bit less culpable than the provider who sells just their thing while lying about certain effects of it. Yes, we can examine how we got into this situation where doctors take drug advice from the people who make the drugs but the people who lied for profit deserve the lion's share of the criticism.

In practice, even many of the general public knew that what the vendor was selling was addictive and dangerous -- there are some reports even in this thread. So it's hard for the vendor to claim ignorance, even more so when often they also stood to profit from the lie (repeat customers).

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