The Family Behind the Opioid Epidemic

According to the Centers for Disease Control and Prevention, more than 200,000 people died from a prescription opioid overdose between 1999 and 2017 [1]. Furthermore, opioid-related overdose deaths have steadily increased. Overdose deaths were five times higher in 2017 compared to 1999.

In an effort to address this “public health crisis,” the United States Surgeon General Jerome Adams issued an advisory for Americans to carry naloxone [2]. While national efforts target the growing epidemic, a question remains: when did the opioid problem become an epidemic in the first place? When did we have a formal public health crisis on our hands?

1996.

In 1996, Purdue Pharma launched a revolutionary pain pill: OxyContin [3]. Along with their new blockbuster drug, Purdue launched a huge marketing campaign. The campaign aimed to undermine the addictive potential of opioids, which was long established in the medical community. The company condemned physicians for denying proper pain management to their patients. They claimed untreated pain was a problem of “epidemic” proportions, affecting 100 million Americans. Drug manufacturers worked together to promote the idea of “pseudoaddiction”—the concept that a person showing symptoms of addiction simply needed more opioids [4]. They falsely claimed OxyContin should be used to manage chronic pain because it had less addictive potential than Vicodin or Percocet and it was safer than NSAIDs at high doses [3].

Sales representatives from Purdue, as well as other manufacturers, targeted inexperienced providers—they advertised in medical journals and provided discount cards to further promote their agenda [4]. Sales representatives were rewarded with tens of thousands of dollars in bonuses and trips to tropical islands for their hard work.

Despite the lack of scientific evidence to back their marketing campaign, prescriptions for opioid drugs quadrupled across the country between 2000 and 2011 [4]. As opioid-related deaths increased concomitantly with the increase in prescriptions, Purdue denied the dangers of OxyContin. In a 2001 email, Richard Sackler, one of the Purdue oligarchs, highlighted the importance of blaming the patient – “we have to hammer abusers…they are the culprits and the problem. They are reckless criminals” [3].  

One of the first criminal cases against Purdue occurred in 2007. Purdue pleaded guilty to felony charges that they knowingly deceived physicians and patients about OxyContin’s potential for abuse. That same year, the family behind Purdue Pharma launched a new company called Rhodes [5]. Rhodes started selling generic opioids in 2009 and had a larger stake in the opioid market by 2016.

The story of Purdue Pharma does not end with Rhodes.

In 2014, Purdue launched Project Tango: a scheme to increase company profits by selling a treatment for the very problem they created [5]. Purdue pursued a plan to sell naloxone. Most recently, they received a patent for a new form of buprenorphine administered by mouth via film. They also fast-tracked an application for an injectable overdose treatment through the Food and Drug Administration. Their goal: to be an “end-to-end” pain provider.  

In March of this year, Purdue reached a $270 million lawsuit settlement with the state of Oklahoma for their role in fueling the opioid epidemic [6]. Thirty-five other state cases are pending against Purdue. This does not include a suit brought forth by 1,600 cities, counties, and Native American tribes currently in federal litigation.

Purdue is a family run company. Three brothers—Arthur, Mortimer, and Raymond Sackler—began their pharmaceutical empire in 1952 with laxatives. All three trained as psychiatrists and worked as pharmaceutical researchers [7]. The Sackler family has grown into its own type of dynasty, with its three branches dispersed between England and New York. They are one of the richest families in the U.S., worth an estimated $13 billion. Moreover, they have a reputation as one of the top philanthropists supporting culture and education across the globe. Their name is displayed at Harvard, the Smithsonian, and the Metropolitan Museum of Art. They also fund research and professorships at MIT, Columbia, and Stanford.

In the past, lawsuits against Purdue Pharma have not named members of the Sackler family for their personal role in the opioid epidemic. A turning point occurred March 28, 2019 when the New York Supreme Court filed a suit against Purdue, which named eight members of the Sackler family [5]. The suit has three aims: to take funds the company hid in offshore accounts belonging to family members, to take back transferred assets, and to stop them from disposing property. Basically, this would prevent the company from filing bankruptcy in order to protect their assets from litigation.

A spokesman for the family denied the allegations calling them, “a misguided attempt to place blame where it does not belong for a complex public health crisis” [5]. The opioid epidemic takes 130 lives every day [1]. Whether or not the Sacklers will be charged for engineering one of the biggest public health problems in America is yet to be determined. But surely this crisis may be traced back to one family, with one brilliant painkiller that hit the market in 1996.

Tina Samsamshariat

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Tina Samsamshariat is a member of the class of 2022 at the University of Arizona College of Medicine - Phoenix. She received her Bachelor of Science from the University of California, Los Angeles and her MPH from the University of Southern California. She enjoys surfing, climbing, and rap music. Twitter: @TSamsamshariat

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