“New
York state Attorney General Letitia James says the family that owns
Purdue Pharma, maker of the opioid OxyContin, used Swiss bank
accounts to transfer $1 billion from the company to itself.
“The
allegation, which came in court documents filed late Friday
(September 13, 2019), indicates that the Sackler family is trying to
keep its wealth free from potential liability in other court cases
involving Purdue Pharma's role in
the opioid
crisis.”
The death and destruction
caused by Purdue and their prescription OxyContin devastate the
nation. The company helped convince innocent Americans that opioid
medications weren’t just for those in agony from cancer or major
surgery – but that drugs like OxyContin, an opioid formula, could
be used for much more manageable forms of short-term as well as
chronic pain.
The corporation did this
without credible research or secondary concern. Their actions of
releasing and promoting the drug were reckless and criminally
misleading. According to the Centers for Disease Control and
Prevention, in as little as three to five days, exposure to opioids
can start some people – like those genetically vulnerable – on a
trajectory towards addiction. Purdue Pharma directed attempts to play
down the dangers of the opioid painkiller while littering their
campaign for OxyContin with biases and inaccurate characterizations.
This is a story of greed,
unimaginable wealth, and corporate murder. In the face of facts,
Purdue and the Sacklers … and even the Food and Drug Administration
are responsible for the opioid epidemic.
Oxy Abuse
To accuse a pharmaceutical
company and the government of being key players in the worst health
epidemic in U.S. history may seem like a conspiracy theory; however,
the reality is shockingly evil. All have played a major part, and
overdose deaths have risen steadily, quadrupling in the U.S. since
1999 as prescriptions soared.
“The
opioid epidemic, and addiction more broadly, have become the defining
public health crisis of our generation.”
-- Nora
VolkowDirector, National Institute on Drug Abuse,
National
Institutes of Health
In 1996 Purdue Pharma
introduced their new drug, a time-released formulation of oxycodone
they called OxyContin. Incredibly, the drug was touted as having a
low risk of addiction. Purdue trained its sales representatives to
carry the message that the risk of addiction was “less than one
percent.”
(Meier B.
Pain Killer. Emmaus, PA: Rodale Press; 2003.)
Purdue backed OxyContin
with an aggressive marketing campaign. Key components of this effort
were pain-management and speaker-training conferences in sunshine
states such as California and Florida, attended by more than 5,000
physicians, nurses and pharmacists, many of whom were recruited to
serve on Purdue’s speakers' bureau.
The company also used a
bonus system to incentivize its pharmaceutical representatives to
increase OxyContin sales. The average bonus exceeded the
representatives’ annual salaries.
In 1998, as Purdue hawked
OxyContin for conditions such as arthritis and back pain, it decided
to "increase communications" with patients, company records
show. Their goal was stated as a strategy to "convince patients
and their families to actively pursue effective pain treatment. The
importance of the patient assessing their own pain and communicating
the status to the health care giver will be stressed."
"Fear should not
stand in the way of relief of your pain," a pivotal marketing
brochure said. The OxyContin slogan in 1999 was: “The One to Start
With and the One to Stay With.”
The New York Times
reports that according to a court filing, Richard Sackler, the
son of a company founder, said sales representatives should advise
doctors to prescribe the highest dosage of the powerful drug because
it was the most profitable.
In one email (2001),
Richard Sackler suggested blaming addicts when the growing problem of
opioid abuse became apparent in the early 2000s."We have to
hammer on abusers in every way possible," he wrote when he was
president of Purdue Pharma. "They are the culprits and the
problem. They are reckless criminals."
Kaiser Health News (August
17, 2018) reports on Purdue and what the New York attorney general's
office called operating a "public nuisance" in it sales
tactics and marketing of opioids …
“Purdue's six-page
pamphlet for patients, provided to the Florida attorney general, was
titled 'OxyContin: A Guide to Your New Pain Medicine.' 'Your health
care team is there to help, but they need your help, too,' the
pamphlet says. It says OxyContin is for treating 'pain like yours
that is moderate to severe and lasting for more than a few days.'
“To patients or
family members worried about addiction, Purdue's pamphlet said: 'Drug
addiction means using a drug to get “high” rather than to relieve
pain. You are taking opioid pain medication for medical purposes. The
medical purposes are clear and the effects are beneficial, not
harmful.'"
Dr. G. Caleb Alexander, a
physician at the Center for Drug Safety and Effectiveness at Johns
Hopkins Bloomberg School of Public Health, said the sales pitch was
"simply not true" and called it "a smoking gun"
for Purdue's role in the opioid epidemic.
Of course, Purdue's
marketing and promotion amplified the prescription sales and
availability of opioids. The extraordinary amount of money spent in
promoting a sustained-release opioid was unprecedented.
During OxyContin's first 6
years on the market, Purdue spent approximately 6 to 12 times more on
promoting it than the company had spent on promoting MS Contin, or
than Janssen Pharmaceutical Products LP had spent on Duragesic, one
of OxyContin's competitors.
(“Prescription
Drugs: OxyContin Abuse and Diversion and Efforts to Address the
Problem.” Washington, DC: General Accounting Office; December
2003.)
As early as 2001,
pressured by Big Pharma and pain sufferers, the Food and Drug
Administration made a fateful decision and, with no new science to
back it up, expanded the use of Oxycontin to just about anyone with
chronic ailments like arthritis and back pain. A small label change
allowed the industry to sell more pills at higher doses.
"There
are no studies on the safety or efficacy of opioids for long-term
use."
– Ed
Thompson, 60 Minutes
Since then, the FDA has
approved other opioids for wide prescribing even as evidence mounted
that the drugs were addictive, open to abuse, and often not effective
for long-term use. The administration has been accused of being
complicit in the epidemic by failing to use its powers to protect the
public as the death toll escalated.
Nationally, the increasing
availability of OxyContin has been associated with higher rates of
abuse as it became the most prevalent abused prescription opioid by
2004. Individuals of all ages abuse OxyContin – by 2013, the
National Institute on Drug Abuse (NIDA) reported 6,973,000 people
aged 12 and up have used OxyContin nonmedically in their lifetimes.
(Cicero T,
Inciardi J, Munoz A. “Trends in abuse of OxyContin and other opioid
analgesics in the United States: 2002–2004.” J Pain.
2005;6:662–67.)
Finally, in the middle of
the deadly Opioid Epidemic, the FDA specified that strong painkillers
like OxyContin should only be used for severe, chronic pain from
conditions like arthritis and cancer. The damage had been done, and
the fallout continues.
"We have learned the
hard way that many patients develop opioid [addiction] when using
these medicines as prescribed," says Dr. Alexander.
Yet, many critics claim
the FDA has not learned from its mistakes. Just consider that the
division that approves new opioid drugs receives 75% of its funding
from the industry. This puts the FDA in the posture of a business
partner of Big Pharma rather than a regulator.
Anesthesiologist Raeford
Brown puts it like this:
“I think
that the FDA has learned nothing. The modus operandi of the agency is
that they talk a good game and then nothing happens. Working directly
with the agency for the last five years, as I sit and listen to them
in meetings, all I can think about is the clock ticking and how many
people are dying every moment that they’re not doing anything. The
lack of insight that continues to be exhibited by the agency is in
many ways a willful blindness that borders on the criminal.”
Aftermath
What remains? Today enough
opioid prescriptions are written each year in the U.S. to give every
adult American his or her own one-month supply. Roughly 21 to 29
percent of patients prescribed opioids for chronic pain misuse them.
Past misuse of prescription opioids is the strongest risk factor for
starting heroin use, especially among people who became dependent
upon or abused prescription opioids in the past year.
(Vowles
KE, McEntee ML, Julnes PS, Frohe T, Ney JP, van der Goes DN. “Rates
of opioid misuse, abuse, and addiction in chronic pain: a systematic
reviewand data synthesis.” Pain. 2015.)
So
…
Since
1999, more than 700,000 people in the US have died of drug overdoses,
mostly driven by an increase in opioid-related deaths. That’s
comparable to the number of people who currently live in big cities
like Denver and Washington, DC.
Every day, more than 130
people in the United States die after overdosing on opioids. The
misuse of and addiction to opioids – including prescription pain
relievers, heroin, and synthetic opioids such as fentanyl – is a
serious national crisis that affects public health as well as social
and economic welfare. Some
estimates predict that hundreds of thousands more could die in the
next decade of opioid overdoses alone.
The Centers for Disease
Control and Prevention estimates that the total "economic
burden" of prescription opioid misuse in the United States is
$78.5 billion a year, including the costs of healthcare, lost
productivity, addiction treatment, and criminal justice involvement.
Holding Purdue
Accountable
Payback? Nothing can bring
back the innocent lives lost to the opioid crisis. Nothing can
compensate for the misery. The AMA Journal of Ethics explains the
damage in one year:
“In 2010, 16,651
Americans died from prescription opioid overdoses. For each death
there were 15 drug-treatment center admissions, 26 prescription
opioid-related emergency room visits, 115 people who met criteria for
prescription opioid abuse or addiction, and 733 people who used these
medications nonmedically (that is, for the feeling that the drug
provided).”
(Gary M.
Reisfield, MD. “OxyContin, the FDA, and Drug Control.”
AMA
Journal of Ethics. April 2014.)
Still, Purdue and the
Sacklers should pay and pay heavily for their greedy handiwork. As
German Lopez, Senior Correspondent for Vox states:
“The rise in opioid
misuse, addiction, and overdose originally began with the
proliferation of prescription painkillers – which were
overprescribed by doctors, allowing the drugs to flow not just to
patients but to the friends and family of patients, teens rummaging
through parents’ medicine cabinets, and the black market.”
Although Purdue Pharma has
secured support from 23 states and thousands of local governments for
a multibillion-dollar deal that could enable the drugmaker to resolve
much of the opioid litigation it faces through a planned bankruptcy
restructuring, 25 states and the District of Columbia oppose the
deal, in part because they believe it will not yield as much as
projected, and because some feel the Sackler family is not
contributing enough of its personal wealth to the total.
The New York AG's office,
which is among the plaintiffs opposing the deal, also alleged that
Mortimer Sackler hid his ownership of an Upper Eastside townhouse in
Manhattan through a shell corporation and that he failed to disclose
its existence in the litigation.
If the Sacklers, with
their ill-gotten billions, continue to lowball victims, hide their
assets, and skirt responsible settlements, they should be forced to
give until they bleed. More power to New York in their drive to get a
much larger settlement.
And, not just settlements
from Purdue and the Sacklers – it's time for the government to own
up to its part in the carnage and pay back. Purdue must think so. The
company says the Physicians for Responsible Opioid Prescribing tried
to get the FDA to regulate Oxycontin in 2012 but failed. Purdue
claims it “was” and “is” simply following FDA guidelines in
how it markets the deadly opioid.
“The FDA rejected these
proposed restrictions,” claims Purdue.
Still, the FDA – in all
its so-called “wisdom” and actions like approving new and more
potent opioids – says that making painkillers less likely to be
abused is a “public health priority.” Have things changed?
Dr. Sidney Wolfe, a former
member of the FDA’s drug safety committee and a founder of the
Public Citizen Health Research Group, said the FDA had been given
every opportunity to act but “can no longer be trusted” because
it is heavily swayed by the drug industry which provides the bulk of
the funding for the FDA’s drug approval division. And he believes
the agency’s “dangerously deficient oversight” is continuing to
fuel the opioid epidemic.
Without a doubt, it is
clear that the greedy pharmaceutical industry has been built off the
backs of helpless, “legalized” addict-patients. There is plenty
of righteous blame pointed directly at agencies and industries that
scratch each other's evil itch for maximum profits.
No comments:
Post a Comment