Purdue Pharmaceuticals manufactures Oxycontin. Oxycontin is the most widely used opioid. Opioid abuse has caused at least 200,000 deaths.
The New York Times reports that an internal Justice Department investigation determined that Purdue was warned about the highly addictive nature of its prize product but did not change its marketing and promotion of Oxycontin.
According to Forbes, the Sacklers are now worth $14 Billion. Aside from endowing museums and universities, the Sacklers are major supporters of charter schools. Jonathan Sackler founded ConnCAN in Connecticut and 50CAN to spread the charter school gospel.
Purdue Pharma, the company that planted the seeds of the opioid epidemic through its aggressive marketing of OxyContin, has long claimed it was unaware of the powerful opioid painkiller’s growing abuse until years after it went on the market.
But a copy of a confidential Justice Department report shows that federal prosecutors investigating the company found that Purdue Pharma knew about “significant” abuse of OxyContin in the first years after the drug’s introduction in 1996 and concealed that information.
Company officials had received reports that the pills were being crushed and snorted; stolen from pharmacies; and that some doctors were being charged with selling prescriptions, according to dozens of previously undisclosed documents that offer a detailed look inside Purdue Pharma. But the drug maker continued “in the face of this knowledge” to market OxyContin as less prone to abuse and addiction than other prescription opioids, prosecutors wrote in 2006.
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.
But top Justice Department officials in the George W. Bush administration did not support the move, said four lawyers who took part in those discussions or were briefed about them. Instead, the government settled the case in 2007.
Prosecutors found that the company’s sales representatives used the words “street value,” “crush,” or “snort” in 117 internal notes recording their visits to doctors or other medical professionals from 1997 through 1999.
The 120-page report also cited emails showing that Purdue Pharma’s owners, members of the wealthy Sackler family, were sent reports about abuse of OxyContin and another company opioid, MS Contin.
Diane Ravitch's blog 
Reblogged this on David R. Taylor-Thoughts on Education.
OxyContin deaths are the strange fruit of the unregulated free market. Not surprising that its advocates in Pharma want to do the same thing for education. Not likely that the result will be any better. Less equity. Less quality. More segregation. More profit for the few.
“OxyContin deaths are the strange fruit of the unregulated free market.”
Thank you, Mr Camins. I scanned the closed comment thread at the NYT article for a while, looking to see how many get this, gave up. Just a lot of vilifying of corporate greed, & ranting at Bush, Obama, Trump for letting it happen, for not jailing execs, etc. This is a systemic issue, as your apt metaphor implies. They can round up all the usual suspects, shame them & blame them, jail them or not: the next fiasco will keep coming round the next corner without systemic change.
Purdue did not need to be told that Oxycontin was highly addictive.
Their business model was BASED on that fact, just as the business model of tobacco companies was/is based on the addictiveness of nicotine.
I used to work in health care prior to 2002. I worked with a physician who wouldn’t prescribe Oxy to any of his patients because of it’s addictive qualities. Everyone….Dr’s, RN’s, Pharmacists, drug reps knew, but few were willing to admit it or to turn down those free lunches and fancy golf outings being given away by Purdue Pharma in exchange for writing scripts. It was (and still is) sinful. I hope some fancy pants lawyer will take on the Sackler family/Purdue Pharma, just like they did the tobacco companies.
The sad truth is that once the tobacco companies were legally tethered in the USA, they moved business to less restricted (often third world and developing) countries and continued to rake in the massive revenue. The same appears to be happening with opiate pills now being dispensed under other names in non-USA and often third world/developing countries.
This is where you’re really grateful for (some) state AG’s. They fill in when the federal government refuses to do their job.
In Ohio COUNTIES are banding together to sue on this. I was shocked by that. Really unusual. They’re doing it because no one else in government will and they are getting killed with the costs of the epidemic.
Purdue should be presented with a giant bill and ordered to pay it. I don’t know why we’re getting stuck with the tab for their greed and irresponsibility.
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.”
They really have to start prosecuting powerful people. The justice system will have zero credibility unless they start treating these people like they treat everyone else.
They should not be able to buy their way out of prison and they do, over and over and over.
Look at the report and the role of the lawyer, Alice S. Fischer in NOT prosecuting anyone in the Sackler family or Purdue Pharma. She was in a key position and made a political decision to look the other way. She also had no experience, ever, in a criminal court as a prosecutor. https://en.wikipedia.org/wiki/Alice_S._Fisher
Well, don’t worry.
In Ohio, politicians have dumped the addiction problem on public schools to solve, like they dump everything else.
My son’s school has now been ordered to cure addiction, along with stopping gun violence, ending poverty, providing health care and turning in high standardized test scores.
They scolded some public schools on addiction prevention and called it a day’s work. We haven’t seen them since. Call this one “solved”.
“Purdue Pharmaceuticals manufactures Oxycontin. Oxycontin is the most widely used opioid. Opioid abuse has caused at least 200,000 deaths.”
Oxycontin, Purdue’s extended release version of oxycodone and acetaminophen, as a percentage of total US opioid related pharmaceutical sales was 2%. They have quit marketing it, eliminating 50% of its sales force. Now that certainly implies that it was very heavily marketed, not unusual in the pharmaceutical industry.
Oxycontin is not the most widely used opioid. That is not true. At all!
Of those 200,000 deaths caused by “opioid abuse” probably the maximum percent of deaths caused by Oxycontin is probably no more than 3%-still too many. The problem here is Diane’s usage of Oxycontin-a brand name instead of the generic drug name of “oxycodone/acetaminophen” and in this case extended release versions-not an uncommon wrong usage at all-think Kleenex, Tampax, Tylenol, Motrin, Kool-Aid, Jello, etc. . . where the brand name becomes the item, much to the delight of the manufacturer.
My object here is not to defend Purdue Pharma in its marketing strategy for Oxycontin-that was abhorrent, but they make a lot of other pharmaceuticals than just Oxycontin. When I was purchasing hospital pharmaceuticals back in the 80s Purdue was one of the major supplies of generic drugs (and they still are), helping us to keep pharmaceutical costs down.
My object is to get the terminology straight for with false words we give false impressions.
It’s possible that a disproportionate percentage of the abuse related deaths were indirectly caused by Oxycontin and/or the way Purdue marketed Oxycontin (thereby changing the way doctors viewed opioid prescriptions)
This may seem somewhat counterintuitive given that Oxycontin was actually intended to reduce addiction with it’s slow release mechanism.
But the reality is that the slow release didn’t work as stated and many patients complained about the painkilling effects wearing off hours before the end of the claimed 12 hour effectiveness period.
So Purdue recommended increasing the dose, rather than giving a lower dose more frequently. Higher dose is more likely to lead to addiction (and also overdose or even death)
From an LA Times investigation
http://www.latimes.com/projects/oxycontin-part1/
OxyContin taken at 12-hour intervals could be “the perfect recipe for addiction,” said Theodore J. Cicero, a neuropharmacologist at the Washington University School of Medicine in St. Louis and a leading researcher on how opioids affect the brain.
Patients in whom the drug doesn’t last 12 hours can suffer both a return of their underlying pain and “the beginning stages of acute withdrawal,” Cicero said. “That becomes a very powerful motivator for people to take more drugs.”
// End of quotes
Also because Purdue claimed lower addiction risk because of the time release mechanism, they assured doctors that it was ok to prescribe Oxycontin for stuff fhat did not really merit the use of opioids
Purdues very agressive marketing campaign completely changed the way that many doctors viewed opioid prescriptions. Where they used to only prescribe them for the worst pain, they started prescribing them for lots of less serious stuff (including for routine dental stuff)
Aside from all the harm they caused through addiction and death, Purdue also caused harm in another way. Their actions have resulted in a swing in the other direction which has made it hard for people who legitimately need opioids to get them.
Thanks for that info, SDP. As I said I’m more interested in writing/using the correct information and in no way condone what Purdue did, not that it surprised me, being quite familiar with the whole pharma industry.
I certainly am aware of the effects as stated in your last sentence-as I sit here with a heating pad on my lower back, saving my few hydrocodone/acetaminophens tabs that I have for hyper intense pain, or at night so I can fall asleep. I’d prefer oxycodone/acetaminophen but the doc is prescribing “afraid” now. Trying to get some simple relief is a pain in the ass!
Duane
I know you were not condoning Purdue and I am sorry that you can’t get the relief you need.
The pharma industry – and many doctors — in the US have made a lot of people suffer unnecessarily on both ends of the spectrum.
In defense of the medical community, the role of the well-intentioned “pain as the fifth vital sign” and patient satisfaction scores tied to hospital reimbursement in the current opioid epidemic must be recognized. Incredible pressure has been put on doctors and nurses to not “undertreat” pain. A patient’s report of 7 out of 10 pain has been made a clinical failure. Pharmaceutical companies likely simply exploited this well-meaning medical campaign. It’s not difficult to see some of the parallels between this and education and high-stakes testing. We seem to be obsessed with measuring the unmeasurable and making huge messes for ourselves.
SDP said above, “It’s possible that a disproportionate percentage of the abuse related deaths were indirectly caused by Oxycontin and/or the way Purdue marketed Oxycontin (thereby changing the way doctors viewed opioid prescriptions).”
I think this is key.
My eldest died at 23 (in 2010) of a longtime, acutely [but intermittently] painful autoimmune disease; eventually other painful autoimmune conditions piled on (as tends to happen). His condition was compounded by poor tolerance/ rare side effects to drugs (even OTC) – and also by mental disease (bipolar): bp episodes triggered intense flare-up of the autoimmune syndrome; bp mood could only be lightly controlled due to severe side affects to mood stabilizers; bp challenges to executive function created barriers to alternative pain treatment, e.g., meditation, biofeedback etc.
But what killed him was most certainly the pain meds, even tho titrated carefully by pain mgt expert, often (including at the end, when he tried to step my over-opiated son down to methadone) in hospital setting. The ME said ‘inconclusive.’ My MD friends said his symptoms reflected SFCA (sudden fatal cardiac arrest), most likely ‘torsades de pointes’, a fatal arrhythmia caused by lengthened heart-contractions (QT interval) – a risk inherent in opioid treatment… I later learned there was one tiny study out there suggesting that the transition from high-opioid dose to methadone is fraught w/ high risk for this outcome, particularly in chronic-pain patients. But the study had never gotten traction, because all US stats for methadone death got lumped into ‘drug [-addiction] deaths. (My pain-mgt MD had not heard of it!)
We encountered reckless, pharma-propagandized prescribing only from the [very excellent on other counts] rheumatologist, who jumped straight from oxycontin [ineffective due to its short-term 4-hr bell-curve effect, despite claims of slow release] – to Fentanyl patches! which induced repressed breathing on the first two [& only] tries. To his credit, the rheum handed us off immediately to his most-respected pain-mgt MD, who went back to oxycontin trials & worked up from there.
It took 2-1/2 yrs of pain meds to kill him. It was very difficult to build up tolerance to opioids due to his ‘brittleness’ to meds, but it happened. There were never any ‘highs’ in the search for relief from pain. But there is no doubt an intricate and poorly-understood relationship between opioid-tolerance/ addiction and pain relief. And along the way, he met sufferers- ( I remember another young musician who’d had vertebrates fused) – who either had insufficient insurance, or who got meds from non-experts [i.e. orthopedists et al outside the pain-mgt field] – who tried to buy meds off my son or went to the street.
I bring all this up just to add to the hopper: chronic pain-relief is a very big piece of the opioid-addiction epidemic. One must remember the historical context. US had long criminalized any use of opioids, even for palliative care in terminal cancer. As recently as the late ’60’s, I had relatives who died screaming from cancer pain. Over the next 20 yrs (by late ’80’s), things changed, but opioids were still restricted to those w/a short-term death sentence. In the ’90’s, awareness trickled into mainstream US: over in UK, they ‘understood’ that opioids, when applied judicially to pain relief, did not result in addiction! Criminalization of opioids for pain relief began to be viewed as a combination of Puritanism & DEA fighting drug wars. Meanwhile, the occurrence of chronic-pain autoimmune diseases like MS, Crohn’s, lupus, IBD, fibromyalgia, once-rare arthritic syndromes, celiac, etc were becoming more common [soon to escalate in the 2000’s].
Circling back to the Big Pharma push for ‘low-addictive-risk’ oxycontin et al starting in mid-’90’s: this was the point at which deregulation & trickle-up big corp $ formed a perfect storm with the public skepticism re: no opioids for medical pain, & the growing market for pain-relief. Sabler et al pandered to DEA/ MD’s’ better angels by claiming that ‘slow-release’ opioids had no addiction risk. Dereg/ corp-pay-to-play was in place to shoosh the almost immediate evidence that this was a lie… Meanwhile, in the medical field, Oxycontin was just the gateway drug that led to morphine, fentanyl, then hi-dose slow-release morphine, all in the endless search to — as my son’s rheumatologist used to say to the pain-med-specialist – buy some time until the next, better biologic injectible becomes available.
Tho I think in our case, doctors did best they could in the context of the info available to them, some of that info was skewed by Big Pharma [i.e., unregulated free capitalism per A Camins above], & some by DEA [i.e., political meme ‘law & order’ butting into medicine], both of which sell, as Lara says above, “measuring the unmeasurable.
So tragic what your son went through. I’m so sorry.
Thanks Lara.
I cannot fathom what it would be like to lose a child. No words here.
With regards to the history, it might be instructive to look farther back in history to the early national period. In the early 1800s, alcohol addiction was rampant, and the predominant English paradigm was that each individual was responsible for dealing with whatever came upon the individual. Sufferers from chronic pain were obliged to use alcohol and become addicted. Small wonder that addiction rates were very high, and that temperance reform attacked the substance by making people feel guilty if they imbibed.
All our readers are no doubt aware of the use of opium to open the Chinese market to European trading at that same time. I would be amazed if close study, now impossible of course, would have found that chronic pain was a part of that country’s addiction, an addiction that brought down a once great empire.
Fast forward to what you laid out as the history above. History may not really repeat itself, but it certainly plays a tune based on the same theme. In this case it is a sad symphony.
Thanks Roy. It helps to share when it seems relevant. You acquire years of hard-won experience and detailed knowledge that could maybe help others, then who can you talk to about it? Hard to find forums parallel to this one. For a few yrs there was a bulletinboard on his rare illness, gone now. DBSA was a great help, they have bipoar parent support forums. But the opioid piece is something few want to discuss in the context of physical illness. I have a fair amount in common w/those who’ve lost a child to drug OD & finally reaching out to a friend in that situation.
Your comments on the history: on target! Predatory colonialism.
As I type, Democracy Now is on tv: they’re devoting the whole show to the opiod crisis.
You can watch it tomorrow (or more likely, the day after) at democracynow.org
Thanks! Just watched it online, good show.
For poetry fans, I highly recommend William Brewer’s award-winning collection “I Know Your Kind” (Milkweed Editions, 2017). Here’s a link to the opening poem, “Oxyana, West Virginia”: http://www.benningtonreview.org/brewer
“Dreamland” (2015 Sam Quinones a writer for the LA Times covers much of the historical material
Currently, in the Massachusetts/New Hampshire area most of the opioid overdose deaths are fentanyl related. (85% in MA per Gov Baker) and counterfeit street pills laced with fentanyl are an acute cause of concern.
this is a Better title, Sackler Family Billionaires Pharmaceuticals manufactures base on Opioid abuse- less dramatic more factual