In the US opioid-maker Purdue is bankrupt. Its global counterparts make millions | Hacker News Reader

In the US opioid-maker Purdue is bankrupt. Its global counterparts make millions

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84 pointsMilnerRoute89 comments

That's the weirdest thing about this whole saga. Opioids are not illegal, they haven't been removed from insurance or Medicare coverage, and doctors are still free to over-prescribe them with little to no repercussions.

It's kind of like if Ford got sued out of existence for every traffic death, but every other manufacturer got to keep making cars.

Fraud is illegal.

The Sacker family leadership was behind the fraudulent claim that Oxycontin was a non-addictive opioid that was suitable for the treatment of everyday pain.

They should be stripped of their ill gotten opioid gains.

They have been. The Sacklers are social pariahs and outcasts. Their liabilities far exceed their net worth. They had to move away from New York to Florida in order to afford something resembling their old lifestyle. Their family name has been taken down from all the museums they funded. Being upper class people, they still have a lot of wealth earning potential going forward, and you can feel assured that whatever they earn, most of it will go to paying the people who've brought cases against them.

When people sell drugs like cocaine or heroin and the consumer dies, they dealer is prosecuted for their death. The Slacker family has assisted with more deaths than any single street dealer and are not held to the same standards. This show how much political and monetary sway they still have. Slacker family highlights how perverse the US legal system is towards such individuals and how people are still not equal under the law.

Slacker family should be in jail for lying to the FDA about how their product was not addictive and for all the deaths they assisted with.

Yes but the Sacklers would have no income if they're languishing in jail stamping license plates. That means less money to pay the people who brought cases against them. Think about it. Liabilities don't just take their wealth, but their future wealth too.

What a terrible argument. Let's have drug dealers roam the streets because they can pay reparations or taxes. Lol.

I know bro. Last time I was walking down fifth avenue, I saw Richard Sackler getting a dirty water dog and I was so trembling with fear of that gangster that I dove into a manhole cover.

Right, wait until a family member of yours gets addicted to another drug they popularize and then you can act like a smug internet person.

> The Slacker family has assisted with more deaths than any single street dealer and are not held to the same standards

That is because the street dealer did not grounded a company. Companies get away with a lot of crimes in US, compared to individuals. See DuPont for examples.

Huh? Since when do drug dealers get ‘prosecuted for the deaths’ of folks who OD on their products, assuming it was unintentional?

Prosecuted for selling illegal substances yeah. But that’s different.

Here are a few examples. Note that the Slacker family are not low level, they are the top echelon of the OxyContin pushers. [1] [2] [3]

[1] https://www.npr.org/2017/06/17/533327584/the-controversy-ove... [2] https://www.cbsnews.com/news/fentanyl-deaths-homicde-charger... [3] https://theappeal.org/the-lab/explainers/charging-dealers-wi...

Wonderful. I can't see how a society that stops believing in individual responsibility is going to keep believing in individual autonomy too. We've been seeing the same cultural shift in technology. SB1047 in California seeks to hold developers liable when other people misuse their AI models. There's also people who want to hold normal developers liable when people get hacked due to bugs in their code. If writing code and sharing it is a form of expression, that means no more freedom of expression. People are even being held liable for expression of beliefs too. It's a slippery slope that leads to not being allowed to do anything the state doesn't tell you to do.

That’s California in a nut shell.

Be as weird and unique as you want, as long as it’s an ‘ok’ kind of weird and unique and you’ve filled out the right forms and gotten the correct insurance first.

Or if you’re homeless, do whatever.

I agree it's pretty bogus but it does seem to happen in some jurisdictions. A recent example is Matthew Perry's ketamine dealer.

The Sacklers have not been stripped of the fraudulent earnings that they have previously taken from the company.

> The Sacklers strip-mined Purdue to avoid billions in settlement

https://www.fiercepharma.com/pharma/going-straight-to-top-ar...

Oh no, they have to live in Palm Beach? The Florida punishment for murdering 5 people in cold blood is a needle in your arm. What should be the punishment for murdering a million?

Kissinger ? /s

> The Sacker family leadership was behind the fraudulent claim that Oxycontin was a non-addictive opioid that was suitable for the treatment of everyday pain.

So was the FDA.

More precisely, the FDA’s trust was betrayed by Dr. Curtis Wright IV who did not follow their ethical policies and allowed Purdue to write parts of his review, and then accepted a job with them:

https://www.corporatecrimereporter.com/wp-content/uploads/20...

The FDA clearly did not have adequate internal controls but I think equating the two is misleading since their failure was in not detecting fraud rather than perpetrating it.

Ford should get sued out of existence if they knowingly shipped defective cars while internally knowing that their cars kill people. The Purdue people knew that their public statements about the addictiveness of Oxycontin were wrong.

They came pretty close with the Ford Pinto, after determining that the wrongful death lawsuits would be cheaper than doing a recall.

https://www.spokesman.com/blogs/autos/2008/oct/17/pinto-memo...

Didn't GM do this as well with their ignition switches?

As in, they knew it was a problem, but decided it'd be cheaper to deal with repercussions instead of fixing it.

I’ve got the beginning of a movie staring Edward Norton and Brad Pitt that you might be interested in.

You mean the Ford Pinto case that was actually real, and lead to 27 deaths?

https://medium.com/@GallowayJefcoat/tyler-durden-was-right-a...

Purdue is responsible for somewhere between a quarter million and half a million excess deaths due to opiates. It's a shocking number. The Pinto scandal is rightfully notorious, but this is a different order of magnitude.

Only if you believe people aren't responsible for their own actions. Pintos would explode when you're rear-ended due to fuel tank defects. Opioids won't kill you if you take them as your doctor prescribes. Cars in general are a dangerous thing though. Even when they're built to generally accepted standards, they kill about as many people per year as opioids. Just like there's people who abuse drugs, there's drivers who drive recklessly. However, unlike abusing opioids, driving recklessly will kill others.

> Opioids won't kill you if you take them as your doctor prescribes.

The whole point is that Purdue recklessly lied about the effectiveness of Oxycontin and the duration of action, leading people to seek out street drugs when they had breakthrough pain, and doubled down by saying "just prescribe more oxy" when it became obvious that it only lasted 8 hours, not 12, because all of their profits were based on a 12 hour extended duration of effect. Even if taken as prescribed, they were basically selling a recipe for a heroin OD. They're responsible for a lot more than 27 deaths.

“ Opioids won't kill you if you take them as your doctor prescribes”

They will give you an addiction if used as prescribed. Purdue knew that their 12 hour interval doesn’t work but they still sold it as such.

they will give some percentage of people an addiction, sure, but it isn't 100%.

Now imagine a version where the steering cuts out every hour in every Pinto and they still don't recall.

That sounds like present day active safety systems on some cars.

I counted one erroneous steering override every 20 miles on mine until I disabled the feature deep in the car settings menu. (Turning off lane keeping wasn’t enough - the car still overrides steering in “emergencies” by default. It still seems to override sometimes, but it hasn’t done anything dangerous recently).

I talked to people with vehicles that have similar capabilities, all under five years old.

Other than the rivian and tesla owners, every person I talked to experienced similar problems.

Footsoldiers of the Sacklers seem to crawl out of the woodwork repeatedly. The Sacklers knew of the degree of addiction opiods caused, practically bribed doctors to prescribe them when entirely unnecessary, all while strategically whitewashing their sins through philanthropy.

Why would we as a society make the most effective class of painkillers illegal as a response to the bad actions of one company?

(Pre-edit: Why would we make a highly effective class of severe painkillers illegal because of one bad actor?)

Well, the issue with opioids has always been how addictive they are - literally since the beginning. It’s ’chasing the dragon’ for a reason.

Considering both Heroin and Oxy were such big issues because the pharmaceutical companies pretended their formulations were less addictive when that was not only not the case, but they were worse, I guess what we should be banning is anything that isn’t uncut opium eh?

Have you ever seen an old lady become addicted to morphine? Regardless, "this is why we can't have nice things", because of people, because of addicts who die from drug overdose and we are all blaming the drugs for it and preventing people from having access to painkillers for their chronic pain.

It should not even to be said, but pain fucking sucks, and no one should wish it to anyone. Being "addicted" to opioids for pain (or depression & anxiety) is not good, but in the same vain that it is not good to be healthy for you to take NSAIDs on a daily basis, but that is just life for you.

Sure, I am all up for a physically harmless, non-addictive alternative, but until then, let people who have chronic pain (or acute pain, does not matter) decide.

I have, and I’ve seen old ladies die from OD’ng on morphine. I’ve also seen relatives in hospice get blessed relief from morphine overdoses.

I’m not saying opiates are ‘bad’. I’m saying they are powerful. And seductive.

And that IMO the worst part of the Oxy crisis (and heroin before that) isn’t that it was an opiate. It was that the manufacturer got to lie about how it was less addictive, when it actually was more addictive. And that meant people were less cautious, and it caused more damage.

The same thing that makes opiates powerful is the same thing that makes them dangerous. And destructive.

> I have, and I’ve seen old ladies die from OD’ng on morphine. I’ve also seen relatives in hospice get blessed relief from morphine overdoses.

How did that even happen in the first place? Something seems missing: history of substance abuse, suicide, etc.

> And that IMO the worst part of the Oxy crisis (and heroin before that) isn’t that it was an opiate. It was that the manufacturer got to lie about how it was less addictive, when it actually was more addictive. And that meant people were less cautious, and it caused more damage.

I agree, I am in favor of harm reduction techniques and regulations instead of an outright prohibition, etc.

> The same thing that makes opiates powerful is the same thing that makes them dangerous. And destructive

In all fairness, opiates never caused euphoria in me (yes, real opioids neither). They do help with depression and anxiety, along with some of my symptoms of MS.

Oftentimes opiates are (not exactly the substance itself) an issue because we do not know the purity. You can only do so much for someone, but it has definitely been an on-going issue (fentanyl laced anything is a major issue).

How did it happen?

Old people are in pain too, and sometimes that spirals out of control just like anyone else.

Which part? MS? Opiates not causing euphoria? Or what are you referring to?

I know, what I'm trying to say is that we should not deprive them of the options to reduce their pain because some self-destructive junkie (who probably has their own issues) decided to kill themselves.

I was asked how I saw an old lady die from an opiate overdose.

Oh yeah I'm curious about the specifics.

If you saw it, I can assure you, you wouldn’t.

We made an entire class of medications (cannabinoids) illegal because of one bad actor (Regan), why wouldn't we do it again?

Because that was the wrong decision and a disaster.

People who are in pain need effective pain medications bruh

That's the problem now though. Doctors do not like to prescribe these things anymore, even when they're warranted.

I have a family member going through cancer. This type causes extreme pain. The doctors recommended a Tylenol course first, because they were afraid he was just drug seeking.

So he sat in misery for two months before we finally had a good doctor prescribe appropriate opioid medication. Now he can focus enough to eat and walk instead of just being in pain.

It's almost like there should be a nuanced view of problems.

The only way to deal with this is to go after the execs personally who are responsible for corporate wrongdoing.

How about the doctors? Every single one knew oxycontin was addictive. That they have a convenient scapegoat does not absolve them. In fact I place far more culpability on them and their medical licenses than I do a pharmaceutical company making laughably obvious false claims.

Not a single doctor I personally knew at the time thought these drugs were non-addictive. That the narrative has shifted so much is an utter joke.

I know friends ran out of the industry due to pushing back. If you go after the sacklers, you need to go after every single doctor and related medical care professional who was involved in the over prescribing of these drugs. That would be difficult and expose the wide-scale fraud that is the medical establishment.

This stuff is a simple scapegoat for society to blame an extremely complex and endemic societal issue on while pretending "no one knew!". Bullshit.

Some of us have not forgotten.

Opioids continue to be over-vilified. They're very useful and beneficial drugs.

What makes you say "over-villified"? They are a very dangerous yet effective tool, true. However, Western society is still reeling from the opiod crisis. I have a hard time feeling like it's over-villified, from my perspective it is only now feeling appropriately villified.

> What makes you say "over-villified"?

This article, of course. The obsession with investigating every possible company that has ever been remotely associated with the Sacklers. Etc.

> Tactics used to persuade U.S. doctors that potent painkillers could be safely prescribed have been used abroad, an investigation shows.

Well we’re just recovering from a phase where they were overprescribed so there’s a natural overvilification. Lots of people that do need opioids for their pain are now getting refused.

They've been underprescribed for probably a decade now. We started overcorrecting long, long ago.

https://www.cdc.gov/mmwr/volumes/66/wr/mm6626a4.htm#:~:text=....

> First, average daily MME per prescription decreased after 2010, both nationwide and in most counties. The largest decreases occurred from 2010 to 2012, following publication of two national guidelines defining high-dose opioid prescribing as >200 MME/day (15,16). ... Nationally, opioid prescribing rates leveled off from 2010 to 2012, and then decreased by 13.1% from 2012 to 2015. ... This pattern, along with the trends in overall numbers of opioid prescriptions, might reflect fewer patients initiated on opioid therapy after 2012...

Has it really been that long? It feels like the opioid epidemic was not that long ago.

Well, ten years is both a long time and not that long, you know? But yes US prescriptions peaked in ~2012.

Opioid dependency lags prescription rates pretty significantly - it can take years before someone is in a position to shake the addiction.

it got started with massive overprescription of opioids in the 2000s, then the government belatedly cracked down on that, and a lot of people who got addicted switched to street drugs, which is when the crisis became obvious to the public.

'Western society' might be a stretch.

Agreed

The United States. That's apparently all of Western society now according to the gp comment.

Canada had a heroin problem for a while. Is that still a thing? And you really don't hear much about European countries having an opioid crisis. Am I just not getting my news from the right places?

They did, they were actually the dealers, even going to war so they could keep selling it to parts of asia [1], just was a long time ago.

There's also a reason the movie Trainspotting is set where it is.

Given the massive reduction in harvesting of opium plants in Afghanistan recently, it does look like there are going to be issues [2].

[1] https://en.wikipedia.org/wiki/Opium_Wars

[2] https://www.politico.eu/article/europe-heroin-alternatives-n...

It's easier on people emotionally to blame the drug rather than blame the person.

When highly addictive drugs with rapidly diminishing efficacy are readily prescribed for the treatment of chronic pain, people should absolutely be blamed - but not the patients.

What is the alternative?

It doesn’t sound like you’re familiar with the case and why it’s being brought against Purdue Pharma. There is a whole lot more to this than “the drug” and “the person”.

I watched the Netflix series Painkiller five times in a row. I watched the entire Sackler deposition. My heart goes out to the people who have lost loved ones. I simply disagree with the anger and outrage.

I agree. If you think they're bad I really hope you don't get a kidney stone.

Archived version: https://archive.li/VY7F3

I sort of liked the purity of Percocet if only it hadn’t been so loaded with Tylenol.

Why not make a pure 5mg opioid and lemmon Quaaludes again ?

well you can guess why. but i agree with you

Its US liabilities and creditors exceed its US assets

Bankrupt doesn't mean you don't have any money, it means someone else sorts out whats in that particular bucket of assets

I’m not familiar with what people actually want to occur or how it makes sense, I feel like its a derivative of prosperity preaching where a code of behavior is rewarded with wealth and therefore opposing behavior is punished with no wealth for an arbitrary indefinite time period, but I don’t see anything supporting that in all of history

Don't people just want things like this to pierce the corporate veil so the Sacklers could be individually prosecuted, and probably put away for life?

After the fraudulent marketing claiming that their formulation was non-adictive, I certainly want to see the profits from Oxycontin clawed back from the Sackler family.

Fraudulent marketing was the least of what they did.

Among other things, they set the recommended dosage and timing to maximize addictiveness (by repeatedly making the patients high, and then putting them in withdrawal).

I’ve wondered about this too. On the one hand there are situations that deserve it. On the other hand I can see it opening up a new uncertainty for business. How do you draw the line?

It's quite strange to me that business leaders love talking about how they are being rewarded for taking risks when it's used to justify disproportionate executive pay and stock buybacks for investors, but in all discussions of economic and even criminal regulation surrounding businesses, a business being made to accept some liability for putting others at risk is considered too risky for business. At present, large swaths of the business world are heavily subsidized by the government, can write off operating losses on their taxes, are often funded by hedge funds and investors who don't seem to mind them being deeply unprofitable for many years, and hold things like the IP rights produced by any worker they've employed as a treasure trove of potential value to sell off for the benefit of the owners should the business fail. On top of that, we must also believe that it's good and right that it is nearly impossible to prosecute any actual decision-maker within a company for criminal conduct done or harm caused by that company, or else business is just too risky and the economy might collapse?

To me this doesn't even warrant consideration, it's ridiculous on its face and perverts the notion of rule of law

> nearly impossible to prosecute any actual decision-maker

Not really.

https://en.wikipedia.org/wiki/Elizabeth_Holmes

https://en.wikipedia.org/wiki/Jeffrey_Skilling

https://www.justice.gov/usao-mn/pr/minnesota-executives-sent...

https://www.reuters.com/legal/us-biotech-executive-sentenced...

Yes, nearly impossible as I said before. The "nearly" qualifier acknowledges that this does sometimes nonetheless happen

Also notable is that in the cases you've presented, the harm was not to the lives of poor addicts, but to the fortunes of rich investors, which seems a lot more like the kind of thing the courts will hear out

The Sacklers made enough money to have some left over for bri.. political contributions.

They’re permanently immune to personal consequences now.

Murderous intent seems like a pretty easy line...? If you know your product is unsafe and then proceed to sell it anyway, well, it's hard to have sympathy for your moral ambiguity.

How unsafe? Cars are rolling death machines, especially to pedestrians, but we sell plenty of them anyway. I don't have particular sympathy for Ford or Honda, but I think they should continue to exist.

With cars they go under testing certification that defines their safety level, which is readily available. In this particular drug case they fraudulently misrepresented the risks of the product.

Surely you're not implying that auto manufacturers have never misrepresented anything about their products, and gotten into legal trouble because of it.

I'm all for opening up new uncertainties for businesses. Especially when they involve criminal intent.

I don't know about that but what's going on is the court is rejecting what the Sacklers want, which is getting out of the civil liability claims against Purdue. You can do that if the bankruptcy plan provides for co-debtor stays. Sometimes the co-debtors get approved with it, sometimes not. In this case? Not.

So some of the Sacklers' assets can be considered when settling accounts w Purdue's creditors?

No it's just that the sacklers didn't get civil immunity from their misconduct which they wanted in exchange for giving up some of their assets to creditors.

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