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Justice at the end of the opioid epidemic?
Sensemaker audio

Justice at the end of the opioid epidemic?

Justice at the end of the opioid epidemic?

A big opioid case has been settled in court. Purdue Pharma, one of the drugs companies behind the opioid epidemic has been dissolved, and the family that ran it agreed to pay a mammoth $4.5 billion court settlement. The payout will go to help victims of the crisis, but is money enough? What about justice?


Transcript

Nimo Omer, narrating: Hi, I’m Nimo – and this is Sensemaker – from tortoisemedia.com

One story every day to make sense of the world.

Today, an enormous opioid epidemic lawsuit has come to a close. 

But has it ended in justice?

***

In 1996, Purdue Pharma, a US pharmaceutical company, launched a new drug: OxyContin. 

It was an opioid based painkiller, modelled on the sort used for cancer pain and end-of-life care. 

What no one could know back then was that it would go on to cause an epidemic of addiction which would kill hundreds of thousands of people.

***

The problem Purdue Pharma was staring at in 1996 was that, if it could only sell OxyContin for cancer and end-of-life care, the market was limited. To make more money Purdue needed to target a different set of people: people with chronic pain. 

At the drug’s launch event Dr Richard Sackler, a Purdue executive and nephew of the company’s founder, Arthur Sackler, vowed to market it so aggressively there would be [Quote] “a blizzard of prescriptions that will bury the competition.”

That marketing campaign was really persuasive. Here’s a 1997 ad for OxyContin. 

“The fact remains that the main area we can improve on, and the approach that’s available to every doctor with a prescription pad is just for us to do a better job or prescribing strong pain medication and I mean opioids.” 

Alan Spanos, MD, Purdue Pharma video, 1997

The guy speaking there is a doctor, he’s sitting in his office, wearing a shirt and tie. He’s there to project authority and expertise – and, crucially, to appeal to other doctors.

Because until the 1990s, it just wasn’t commonplace to prescribe opioids for people with chronic pain. They were reserved for patients with cancer and terminal illnesses for a reason. That’s because opioid drugs are extremely addictive. 

So, a big part of Purdue Pharma’s marketing campaign was to convince doctors firstly that opioids were appropriate for chronic pain and, secondly, that OxyContin’s formula was the best and safest opioid to prescribe. 

OxyContin had this special coating which meant the painkillers were released gradually. The drugmakers said this made them less likely to be abused. 

All the way along, Richard Sackler was really involved in the sales pitch: 

“Richard Sackler is really one of the most active of these family members, he was the son of one of the founders of the company, one of the three brothers who originally took it over, would be regularly asking for sales reports and he would be coaching people on how they should go out and push OxyContin to doctors.” 

Patrick Radden Keefe, PBS News

And Purdue’s strategy worked. Between 1997 and 2002, OxyContin prescriptions for non-cancer pain rose from 670,000 to 6.2 million – and the company was raking in billions of dollars. 

But on Wednesday last week, all of that came – officially – to an end. Purdue Pharma was dissolved – in other words, the company no longer exists – as part of a huge court settlement.

“Late today a federal bankruptcy judge gave conditional approval to a multi-billion dollar plan to settle lawsuits against Purdue Pharma, the maker of OxyContin.” 

NBC news

It was the culmination of thousands of lawsuits filed by local, state and federal governments, all of them suing Purdue and the Sackler family over the costs of the opioid epidemic – an epidemic they say the company helped to create…

*** Ad break ***

While Purdue Pharma and the Sackler family were making billions, a crisis was beginning to unfold. 

Because the trouble is, like any other opioid, OxyContin is addictive. Very addictive. And it’s potent; twice as strong as morphine. 

The massive tidal wave of prescriptions of OxyContin and other opioid drugs kept on growing and growing. For the last two decades, across much of America, prescription narcotics were relatively easy to obtain – and a big black market grew up. 

There were plenty of pills to sell – and plenty of drug dependent people willing to buy them.

Thousands of people started misusing OxyContin: 

“People could crush the pills and then snort or inject them, doing that bypassed the prescription’s time release formula, giving the user a stronger, more immediate high.”

Newsy

As opioid prescriptions climbed, so did addiction – and so did overdoses and deaths.

Between 1999 and 2017, nearly 400,000 Americans died from opioid-related drug overdoses. 

***

Concerns about OxyContin’s potential for abuse started early. In 2001 Connecticut’s attorney general called for Purdue to reformulate the drug to prevent abuse and addiction. 

Then, in 2007, the company paid out $600 million dollars after pleading guilty to misleading the public about the drug’s addiction risks. Three top Purdue executives were convicted on criminal charges for “misbranding” OxyContin. 

By then, there was a clear and direct link between OxyContin, addiction and drug abuse. But still Purdue and the Sacklers kept pushing for more and more sales. 

Internal documents from the company – revealed by journalists and court filings – show that Richard Sackler was one of the people leading the charge: 

“He really comes across in email after email after email on these various accounts as somebody who was almost obsessed with the sales of the drug to a point where you get to a stage just a few years ago where sales of OxyContin start to level off and there’s an obvious reason for that which is that doctors have woken up to the fact the this drugs is killing people, opioids are killing people. We now have some 200,000 who have died opioid related deaths in the last few decades. So sales are levelling of and this clearly drives him nuts. So he’s saying we need to keep pushing, we want bigger doses of the drug for longer periods of time which is exactly what anyone looking at this soberly will tell you is a recipe for addiction.”

Patrick Radden Keefe, PBS news

Even so, the Sacklers have not admitted any responsibility for their role in the opioid epidemic.

The settlement last Wednesday will at least mean compensation. The Sacklers agreed to pay out a total of $4.5 billion to individual victims and families affected by the opioid crisis – and to support drug rehab programmes. 

But one of the conditions of the payout is that the Sackler family don’t have to admit any wrongdoing – and the family will get immunity from any future lawsuits. 

The opioid crisis has destroyed communities, ruined lives and left thousands of families bereaved. 

The Sackler money might help rebuild those lives – and prevent more people from dying. 

But it can never make up for what has been lost. 

Today’s episode was written and produced by Ella Hill.