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Andres Marroquin

ENGL 1302

Professor Woods

14 November 14, 2021

The Devil Works Hard—Purdue Worked Harder

The misuse of drugs is nothing new to this country, as it has been classified as a known issue since early 19th century. Drugs like cocaine, heroin, and steroids can be found to be the most well-known that can cause an addiction. Besides the legal troubles that you can find yourself in, most of us are aware of why we should not consume drugs in the first place. However, all that change in the 80s and 90s when pharmaceutical companies recognized pain to be a problem that needed to be addressed adequately. Their solution to the problem was to address the issue by creating oxycodone-based opioids, but this time, the opioids could be consumed long term and they were labeled as “non-addictive” by the FDA, even though this was far from the truth. No one could have expected that a new drug addiction problem, as big as cocaine, was emerging in the United States. People were flabbergasted to find that this drug causing issues was not one that you can find in the streets from a local drug dealer or brought from another country by cartels—but rather, accessible by prescription through your trusted physician. At this time, opioids were used to treat short term pain after surgery, but this was evolving into another issue, and people were becoming addicted to the relief. Although former board members of Purdue refuse to admit they caused the epidemic crisis, my argument will discuss the ways I believe Purdue and other companies knew that manufacturing opiates was going to cause people to become addicted from the start but managed to use the “pain treatment” movement as the reason to give everyone access through a local pharmacy, that could be prescribed by any physician—all you needed was a broken arm or simple pain like a toothache.

Opioid addiction was not something new that emerged in the 90s, it dated back decades ago with low impact in the nation. People at the time had addictions to drugs like heroin or cocaine and only had contact with opioids when it came to a big surgery. However, in 1995 when the American Pain Society launched a campaigning targeting pain as a “fifth vital sign”, meaning it should be looked at the same way heart rates and blood pressure are, the increase of pain medication prescriptions saw a surge in the country. Because pain was not a physical issue that was a quick fix anymore, pharmaceutical companies found a way to keep a patient for longer by getting them addicted. That’s when Purdue came out with a drug named OxyContin, knowing this drug was addictive (something they admitted to back in 2007) they did everything in their power to say otherwise. The drug was quick to gain popularity as it gave addicts a quick heroin-like euphoria when taking it. “Purdue Pharma and other companies promoted their opioids heavily. They lobbied lawmakers, sponsored continuing medical-education courses, and funded professional and patient organizations and sent representatives to visit individual doctors” writes Deweerdt in her article about all the ways Purdue managed to push the opioid. The president and chairman of Purdue, Richard Sackler would go on doctor visitation rides with his sales team to make sure sales would continue to rise. Sackler’s priority was clearly no longer the health of the clients’ needing medication, but rather ensuring that Purdue would continue to profit off vulnerable populations that were needing pain medications. According to Lurie, Purdue Pharma created a “Pain Movement” with the pure motive of profit for the company. Their movement was so influential across the country, they were able to control and manipulate big names in government and politics. Purdue was able to get away with something no other pharmaceutical company with a schedule II had done before.

Even though the FDA was aware that OxyContin contained oxycodone, they approved the drug anyways with “black box” warning in the back. Having done so, only made the tablet more addictive to abuse once people started building a higher tolerance for the drug. But this approval made wonders for the company. It also helped Purdue promote that this drug was not addictive and a breakthrough in the field, which made it easier for its salespeople to close the deals with physicians that had little knowledge. Doctors were writing more than six million prescriptions per year. Sujata S Jayawant and Rajesh Balkrishnan write on their article the times the FDA took action to check Purdue and its labels once “reports of illegal use, misuse, abuse, and diversion of OxyContin prompted the FDA to take immediate action.” But at the time, Purdue had lobbied and even hired people from different government agencies with political ties that would help fend off any counter against their product. This was not the only way politics helped Purdue distribute this narcotic. From early on the company funded and collaborated with organizations to serve as “front groups.” The way the health-care system is structured in the United Stated also contributes to how easily it was to overprescribed opioids. While political figures tried to bring down Purdue, it was also politics who helped give the company many years of glory at the expense of several deaths. Until the last days of Purdue, politics still helped the company. “We only have the laws that we have” said Judge Drain in response to the concerns from a letter a victim wrote about the Sackler’s. It was said that Purdue moved their company’s address to the town where the judge goes easy on these types of cases. Their “pain movement” helped Purdue gain the political power needed to reach any town across country, no matter how big or small, and their effect would impact just about any who would pay a visit to the doctor.

“Racial attitudes and socio-economic trends also helped the opioid epidemic to gain foothold in the United States” wrote Sarah DeWeerdt. It is apparent that countless patients did not ask for this, but we associate those with drug addictions as self-inflicted, however, this is an immense misconception that has been clouded in our minds for many years while companies like Purdue made billions in profit at the expense of people’s lives. It is an eye-opener to come across this matter because this is not something that is explained as a societal norm. We are educated on the war on drugs, but we aren’t told how our local doctor’s office is minting new opioid addicts every day since the 90s. According to research, Purdue had initially focused their opioid marketing in white rural and suburban communities. Research also shows that 90% of heroin abusers are also white. Sadly, this epidemic problem is only growing bigger and international. For example, spikes in overdoes have grown in the black community with some deaths having a mixture of other substances and opioids. It is outrageous to know that it was Purdue’s goal to specifically targeted “physicians who did not necessarily have adequate training in pain management, encouraging them to prescribe it as a first choice even when it wasn’t necessary” and targeted doctors who served patients with low risk for addictions to prescription drugs. And even though they pled guilty to the charges that cost them $650 million in fines, instead of stopping production of the narcotic they decided to formulate and making it more potent while making it harder to crush and snort. Their efforts to slow down the epidemic did nothing. Abusers would switch to heroin, since its supply increased, and price dropped drastically. With people addicted to opioids are 13 times more likely to switch to heroin than a person who has never consumed opioids. Until this day, not a single person has been held accountable for the 47,000 deaths in 2017, or the 50,000 that happened in 2019 alone from prescribed opioids.

After two decades and a longstanding legal battle against them, the Purdue Pharma settlement has been finalized, and the outcome was far from a happy ending to the ones who needed it. Although the company is being dissolved and the Sackler family must give up all their ownership of the company, plus they must pay a $4.3 billion dollar fine that comes with a ten-year installment plan, no Sackler family has been charged or will see a second behind bars. It’s absurd they have publicly claimed several times they have done absolutely nothing wrong. Kathe Sackler, a board member of Purdue has said during a House panel testimony, “there is nothing I can find that I would have done differently.” I believe many systems (medical, government, political, etc.) might have learned from this and have improved in ways to prevent this sort of epidemic from happening again, but it’s certainly failed the hundreds of thousands of people dying caused by opioids addiction and the families fighting for justice. The fact that the legal system cannot prosecute any member of the Sackler family after all their wrongdoing and will not be able to once the settlement has been reached is just unreal but not very surprising. The outcome of this situation failed the people who were in physical need and believed the product this company offered was a solution, it failed the people that made Purdue and its board members extremely wealthy. Justice was not served, and the opioid crisis has not been resolved, it has only bettered, and I believe a good reason for that is because of how easily we can access information that people in the 90s did not. We can only hope that technological improvement, policies, and awareness can help us or the people closest to us from falling into an addiction when facing these circumstances. It is saddening to read in an article from NPR, Alexis Pleus, an opioid activist said it best, “the settlement does not address the victims, it never did address the victims and we just want that to be our final record.”

Citations:

DeWeerdt, S. (2019, September 11). Tracing the US opioid crisis to its roots. Nature News. Retrieved November 10, 2021, from https://www.nature.com/articles/d41586-019-02686-2. 

Lurie, J. (2019, August 29). Unsealed documents show how Purdue Pharma created A "pain movement". Mother Jones. Retrieved November 10, 2021, from https://www.motherjones.com/crime-justice/2019/08/unsealed-documents-show-how-purdue-pharma-created-a-pain-movement/. 

Mann, Brian. “As Purdue Pharma Bankruptcy Nears Approval, Family Members Write about the Human Toll.” NPR, NPR, 9 Aug. 2021, www.npr.org/2021/08/09/1025171160/victims-of-purdue-pharmas-painkillers-read-their-letters-to-the-court. 

Jayawant, Sujata S, and Rajesh Balkrishnan. “The Controversy Surrounding Oxycontin Abuse: Issues and Solutions.” Therapeutics and Clinical Risk Management, Dove Medical Press, June 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC1661612/. 

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