Thursday, October 26, 2017

Family that brought us OxyContin, and arguably the opioid epidemic, is profiled in 2 magazines

Arthur Sackler (Wikipedia photo)
As President Trump prepared to declare a limited public-health emergency in response to the deadly opioid epidemic, Esquire magazine and The New Yorker published fascinating articles on the secretive family that made a fortune selling OxyContin and arguably spurred the epidemic: the Sacklers of New York.

If you've heard of the Sacklers, it's not likely in connection with drugs. The name is attached to art museums and university institutions all over the world. But the family has stayed mostly silent on the genesis of their multi-billion-dollar fortune. "The family’s leaders have pulled off three of the great marketing triumphs of the modern era: The first is selling OxyContin; the second is promoting the Sackler name; and the third is ensuring that, as far as the public is aware, the first and the second have nothing to do with one another," Christopher Glazek writes for Esquire.

Physician and pharmaceutical promoter Arthur Sackler bought Purdue Pharma in 1952 at the age of 39; his two brothers Mortimer and Raymond, also doctors, ran the business and bought out Arthur's share after he died in 1987. By that time, Purdue was in the process of developing OxyContin.

Purdue's aggressive advertising had helped Valium become America's most-prescribed medication in the 1960s. In the 1990s OxyContin succeeded partly for the same reason. OxyContin was popular for chronic pain sufferers because it didn't have the stigma of morphine. And though it was 50 percent stronger than morphine, many doctors incorrectly believed it was much less powerful -- a misconception Purdue actively encouraged. Doctors thought that addicts would stay away from a time-released narcotic, but it was the opposite: OxyContin had a breakthtaking amount of oxycodone in one pill, and addicts soon discovered they could access it all at once by crushing the pill and snorting it.

"The vehicle of that fortune was OxyContin, but its engine, the driving power that made them so many billions, was not so much the drug itself as it was Arthur’s original marketing insight, rehabbed for the era of chronic-pain management," Glazek writes. "That simple but profitable idea was to take a substance with addictive properties—in Arthur’s case, a benzo; in Raymond and Mortimer’s case, an opioid—and market it as a salve for a vast range of indications."

Patrick Radden Keefe writes for The New Yorker, "Sales representatives marketed OxyContin as a product 'to start with and to stay with.' Millions of patients found the drug to be a vital salve for excruciating pain. But many others grew so hooked on it that, between doses, they experienced debilitating withdrawal. Since 1999, two hundred thousand Americans have died from overdoses related to OxyContin and other prescription opioids. Many addicts, finding prescription painkillers too expensive or too difficult to obtain, have turned to heroin. According to the American Society of Addiction Medicine, four out of five people who try heroin today started with prescription painkillers."

In 2007, Purdue Pharma agreed to pay a civil penalty of $600 million for misleading doctors, patients and regulators about the addictive nature of OxyContin. That avoided a trial and testimony, but Richard Sackler had to give a deposition in a suit filed by the state of Kentucky, similarly charging the company with deceptive marketing that had created the epidemic, costing the state dearly. The suit was filed in Pike County, at the eastern end of the state; in a bid to get the case moved, Purdue Pharma did a survey that “was revealing in ways that Purdue may not have intended: according to the filing, twenty-nine per cent of the county’s residents said that they or their family members knew someone who had died from using OxyContin,” Keefe reports. “Seven out of ten respondents described OxyContin’s effect on their community as “'devastating.'”

The case was settled for $24 million, but not before Richard Sackler had to give a deposition, Keefe reports: “Tyler Thompson, the lead attorney, told me that Sackler’s demeanor during the session reminded him of Jeremy Irons’s portrayal of Claus von B├╝low, the aristocrat accused of murdering his wife, in the 1990 bio-pic 'Reversal of Fortune.'  "A smirk and a so-what attitude—an absolute lack of remorse,' Thompson said. 'It reminded me of these mining companies that come in here and do mountaintop removal, and leave a mess and just move on."” The deposition remains sealed; Purdue Pharma is appealing the judge's ruling, in a suit by the medical-and-science news site Stat, that it should be public.

There's much more in the two long articles, but here's a passage from Esquire with ironic resonance. In a memoir, Arthur's second wife Marietta Lutze said he became obsessed with collecting art: 
"Boxes of artifacts of tremendous value piled up in numerous storage locations," she wrote. "There was too much to open, too much to appreciate; some objects known only by a packing list." Under an avalanche of "ritual bronzes and weapons, mirrors and ceramics, inscribed bones and archaic jades," their lives were "often in chaos. . . . Addiction is a curse, be it drugs, women, or collecting."

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