opioid epidemic and how it spread across the United States. Drug overdoses are now the leading cause of death for Americans under the age of 50. the latest statistics show there was an increase of opioid-related deaths and overdoses during Trump’s first year in office. According to the Centers for Disease Control and Prevention, drug overdose deaths involving opioids rose to about 46,000 for the 12-month period that ended October 2017, up about 15 percent from October 2016. The epidemic has been so widespread that life expectancy is falling in the United States for the first time in 50 years.
The New York Times published a confidential Justice Department report this week that found manufacturers of the drug OxyContin had access to information showing it was addictive as early as 1996, the first year after the drug hit the market. Purdue Pharma executives were told OxyContin was being crushed and snorted for its powerful narcotic, but still promoted it as less addictive than other opioid painkillers. This report is especially damning because Purdue executives have testified before Congress that they were unaware of the drug’s growing abuse until years after it was on the market.
Barry Meier talking:
the basic outlines are this. As you noted, Purdue Pharma has claimed that it first became aware of OxyContin’s growing abuse in early 2000. That was about four years after its introduction. In fact, what this document showed is that the company had extensive information about OxyContin’s abuse in 1997, 1998, 1999.
and concealed that information, didn’t tell the FDA, didn’t tell doctors, didn’t tell patients. And this was a very damning report. I mean, the crimes were so significant that the prosecutors, who spent four years investigating the company, recommended that three top executives of Purdue Pharma be indicted on a—for a series of felony crimes, like conspiracy to defraud the United States, false statements and things of that nature. Unfortunately, their efforts were blocked by top administration officials within the Justice Department.
What took place is the following. Purdue Pharma was given permission to market OxyContin as less prone to abuse and addiction than competing narcotics. drugs like Vicodin and others. It was a gift from the FDA. They took that gift, and they ran with it. They told doctors not only that it might be less prone to abuse and addiction, but that it would be less prone to abuse and addiction. In 2007, they admitted, basically, lying to doctors, lying to patients, by misrepresenting what they had been allowed to say.
What we didn’t know was that during the course of the investigation that led to that confession, the federal government had also uncovered information to show that not only had they mismarketed the drug, they were aware, almost from the beginning, that people were abusing OxyContin, significantly abusing OxyContin, and they concealed that information. Had they sent a warning about that to the public, OxyContin would have never become a billion-dollar drug, and thousands of peoples of lives—thousands of lives wouldn’t have been affected by it.
– book came out like over 15 years ago, Pain Killer. That’s before the company was indicted and the corporate officials were indicted.
Rudolph Giuliani was hired in 2002. A lot of the reporting I did for the Times in 2001 was aimed at the overaggressive marketing of OxyContin by Purdue Pharma, as well as, you know, the growing reports, public reports, about the drug’s abuse. They then came under scrutiny by the FDA, by the DEA, and they felt that they needed a public defender—a fixer, if you will. The person they brought in to do that was Rudolph Giuliani. And so he went in, with his reputation as a former prosecutor, mayor and so forth.
– right after the 2001 September 11th attacks, when he was called “America’s Mayor.”
And sort of he took that reputation, and he sold it to corporations. And one of the corporations he sold it to was Purdue Pharma. And so, he became their sort of front man, if you will, their fixer, went to meet with DEA officials, with other officials, and basically spouted the company’s line. I mean, I have no idea what Rudy knew about what was in the company’s files, whether he was privy to the information that prosecutors later discovered. But he became, essentially, the person who tried to smooth things over with government officials.
– And was particularly powerful because he was a cancer survivor himself and spoke about what it means to reduce pain.
he made a very compelling argument. I mean, this drug has valuable uses. It’s needed in certain situations. But, you know, what Purdue had done was to basically market this drug as a cure-all for all kinds of pain. And with the vast availability of the drug, it poured out onto the streets, and that led to this wave of abuse and addiction.
there were people at the very—at the senior levels of the Criminal Division. Alice Fisher was then the head of the Criminal Division. This is under George W. Bush. Alberto Gonzales was the attorney general at that time. So, essentially, what happened was, in September of 2006, this very small group of prosecutors, as you noted, in far western Virginia, forwarded a report, a confidential report, to the Justice Department recommending that serious felony indictments be brought against the executives of Purdue. That report contained extensive exhibits, emails, records, that they planned to present to a grand jury to support the call for their indictments. It was backed by the local U.S. attorney there, and man by the name of John Brownlee. And it was backed, in fact, by mid-level officials within Justice Department headquarters.
But on October 11, 2006, two weeks before these prosecutors were scheduled to go before a grand jury and seek these indictments, there was an 11th hour meeting at the Justice Department. Purdue brought in its high-powered legal defense team, met with top Justice Department officials, like Alice Fisher. And after that meeting, there was a chill on the case. And basically, people like John Brownlee were told, “We are not going to give you the resources to support this prosecution. You’re on your own, if you want to do it.” And Brownlee had no resources. He had this small group of people who had spent four years, you know, 24 hours a day, investigating this company. They were facing a company of unlimited financial and legal firepower. And they really had no choice but to settle the case at that point.
“Starting in 2007, the year of the settlement, distributors of prescription drugs sent enough pain pills to West Virginia over a five-year period to supply every man, woman and child … with 433 of them.” This is according to a report in the Charleston Gazette-Mail.
– the death toll, writing, “In 2016, 64,000 Americans died from drug overdoses. That number equals the population of cities such as Portland, Maine; Lynchburg, Virginia; and Santa Fe, New Mexico. It was as if, in one year, a plague had entered one of these towns and killed every single inhabitant.”
we’re in the midst of the greatest public health disaster of the 21st century. It started out with the drug like OxyContin, and it has morphed, since then, into a kind of hydra-headed beast. On the one hand, you have the misuse and abuse of prescription drugs. And on the other hand, you have this growing death toll from counterfeit versions of drugs like fentanyl. So we’re in this very, very complicated situation. And, you know, the kind of policies that the government is now proposing may not get us out of it. I mean, we’re going to need a real extreme effort to get out of it.
in 20 years, 250,000 people have died.
That’s just from prescription painkillers alone. That’s from legal drugs. That’s from drugs that companies are allowed to produce, sell legally, and that are prescribed by doctors. And that alone is a stunning, startling figure.
– ad from Purdue Pharma. 1998. the ad to market OxyContin. It features Dr. Alan Spanos of North Carolina. [In india, i think its illegal to show ad for Pharmaceuticals. now i worry these people will come to india to change our law.]
in the late 1990s, there was a movement to promote—you know, treat pain much more aggressively than it had been in the past. A lot of that movement was funded by Purdue Pharma, people like Dr. Alan Spanos. And there were these tropes, if you will, that the addiction rate is less than 1 percent. It was a total lie. There was no basis for that figure. But it was repeated, repeated, repeated, and it sort of got ingrained into the medical culture. And as a result of that, doctors prescribed more and more of these drugs, you know, in good belief.
In fact, that video—they made another video, I believe, with Dr. Spanos that involved a patient. And that patient wasn’t even on OxyContin. He was on a totally ’nother drug, it came out. So, I mean, it was this massive public relations campaign, that was funded, in large part, by Purdue Pharma, to sell OxyContin.
– the Sackler family is a fascinating family. As you know, their names are, you know, on every museum in the United States—here in New York at the Metropolitan, and at the National Gallery in Washington. Their names are on wings. Their names are very prominent. On the elevators, on everything, you name it. But when it comes to the drug, where they make their fortune we don’t see their name.
there were three brothers, Arthur, Raymond and Mortimer. Arthur was the eldest. And he was sort of this kind of, I guess, you know, evil genius, if you will. He invented the modern-day drug advertising industry. All the ads that we see on TV today or in print are kind of the result of Arthur Sackler’s genius, or lack thereof, as you see it. And he kind of wedded together the pharmaceutical industry and the medical profession. He made doctors shills for drug companies. He created medical journals that were really kind of fake medical journals, because drug advertisers had to pay to get their studies into those medical journals. So he created all these deceptive marketing and advertising practices that are commonplace today. He died in 1986, before OxyContin was created.
But to get his brothers into the drug industry, he bought this tiny little firm called Purdue Frederick, that was located here in New York, in Greenwich Village, as it turned out. They basically sold a lot of kind of crazy stuff. And eventually, in the mid-1990s, they decided to get into the pain medication business. They first bought a drug called MS Contin, which was a long-acting form of morphine, and they marketed it mainly to cancer specialists, where the drug was very, very valuable in dealing with cancer pain. But then, in the mid-1990s, as this drive to treat pain more aggressively began to unfold, they began to sell OxyContin, which is a long-acting form of the narcotic oxycodone. And this became the most aggressive, high-powered marketing campaign for a prescription narcotic in drug industry history. It was financed with Sackler money. The Sacklers were the principal beneficiaries of it. There were something like $31 billion worth of OxyContin sales in subsequent years. And the Sacklers became, I believe, the 14th or 15th richest family in the United States.
– Purdue Pharma distributes another video, featuring seven patients who used OxyContin to deal with chronic pain. One of the patients was named Johnny Sullivan. After appearing in that promotional video for Purdue Pharma, Johnny Sullivan became a severe addict to OxyContin and other opioids. In 2008, he died in a car crash when he fell asleep at the wheel. His wife said, because of his addiction, he would often nod off.
this drug, for some patients, has been a godsend. But for many, many others, it has turned into a nightmare. We focus a lot about—on the subject of addiction, and rightly so. But not long ago, I interviewed a pain specialist, who had been sort of on the bandwagon promoting these drugs when they first came out. And he said to me, “You know, addiction is not the real problem with these drugs. It’s not the only problem with these drugs.” These drugs caused patients to emotionally opt out of life, you know, to become couch potatoes, to become withdrawn, to reject their family members and lose social contact. They had all other—they have all other kinds of troubling side effects. And so, you know, there is now a generation of patients who, effectively, are emotionally dependent upon these drugs.
I’m not a $600-an-hour lawyer. I don’t come up with, you know, statements like that. But let me put it in simple terms. Purdue Pharma violated the trust of doctors and patients. It lied to them. The Justice Department discovered reams of information, which, in their minds, showed that this company also concealed extraordinarily powerful information pointing to the abuse of these drugs, early—early on, when it was first marketed.
The lie was that OxyContin would be less prone to abuse and addiction than competing painkillers. They admitted that they had told that lie in 2007, and paid $600 million in fines. I mean, that was a drop in the bucket where OxyContin sales were concerned. But they admitted that they had lied.
the entire predicate of the company’s marketing campaign was based on a lie. I mean, that’s the simplest way of putting it. The Food and Drug Administration had given them permission to say, “This drug might be less prone to abuse and addiction.” They trained their sales reps to say it was less prone to abuse and addiction. Sales reps would go—and sales reps didn’t know what the reality was, but they would go to doctors and pharmacists and say, “You know, you can’t inject OxyContin. You can’t extract the oxycodone from OxyContin and inject it, because like the junkie will get a heart attack, they’ll drop over and die. This is a safe drug. This is much safer.” It was all an incredible lie. And at the same time, the company was concealing what was probably the most significant information they needed to tell doctors, which was this drug was being widely abused.
Laura Nagel was the head—a key figure within the DEA at the time of this episode. She was in charge of the division of DEA that went after the diversion of legal drugs onto the street. It wasn’t sort of the narcs, you know, the guys who busted people for selling heroin or cocaine, but it was the diversion division which dealt with the misuse of prescription drugs.
She was a hero. She was a fighter. She saw what was going on. She realized that this company, A, was overly aggressively—you know, was promoting this drug, you know, to the nines, that people were dying from this drug. She tried to call them to account. And they essentially unleashed as much legal and lobbying firepower on her to basically try to roll her over.
She basically backed off, just like everyone else in those days who came up against Purdue Pharma.
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Barry Meier
author of Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic. He was the first journalist to shed a national spotlight on the abuse of OxyContin
— source democracynow.org