Purdue Pharma: Origins and Legal Implications of the Opioid Crisis

By: Katherine Lewis

Editor’s note: This article is the first of a two-part series on the legal and ethical implications of the modern opioid crisis. The second can be found here.

In 2016, Forbes magazine named the Sackler family the 19^th richest family in America with a net worth estimated at $13 billion. The wealth of this family comes from their complete ownership of Purdue Pharma, founded by Drs. Arthur, Mortimer, and Raymond Sackler in 1952. In 1995, Purdue Pharma launched a new product, OxyContin, which consists of Oxycodone, a semi-synthetic opiate. The dangers of OxyContin, which is prescribed as a powerful painkiller, became abundantly clear in the years following the release that the drug “[exposed] users to the risks of opioid addiction, abuse, and misuse.”

In 2017, as requested by President Trump, the US Department of Health and Human Services declared a public health emergency to address the opioid crisis at a national level. According to the Centers for Disease Control and Prevention (CDC), the opioid crisis claimed nearly 400,000 lives (including deaths from prescription and illegal opioid use) from 1999-2017. The first wave of this epidemic began in the 1990s, with the rising popularity of prescription opioids such as OxyContin. The CDC estimates that “as many as one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction.” Amidst the tragedy of this epidemic, however, some, such as the Sackler family, have built an empire of personal fortune.

In the first nine months of 2013, the Sackler family alone made $400 million from the profits of Purdue Pharma. However, sales began to drop at the end of the year, leading to an intense campaign to increase the prescription of OxyContin in order to increase the company’s profits. According to a 2018 lawsuit filed by the Massachusetts attorney general against the company, “Purdue deceived doctors and patients to get more people on dangerous drugs, at higher doses, for longer periods.” Although the lawsuit was filed in June 2018, only 77 pages were originally released. In January 2019, however, all 277 pages of the complete unredacted version was made available. The lawsuit claims that Purdue has always been aware of the severe risks of addiction and death associated with opioid prescription and use, but that the company, “obscured them, including by falsely stating and implying that ‘appropriate’ patients [wouldn’t] get addicted.”

In addition to the release of publications which downplayed the risks of addiction and death, Purdue launched a campaign to encourage doctors to prescribe higher doses of OxyContin, which increases both the risk of addiction and the company’s profits. Purdue specifically targeted doctors whom they believed could be pressured into distributing more of its products. The lawsuit states: “To make sure doctors prescribed more opioids, Purdue tracked Massachusetts doctors’ prescriptions, visited their offices, bought them meals, and asked them to put patients on Purdue drugs.” Purdue spent $40,000 per visit and reportedly visited their top 100 targets in Massachusetts an average of over 200 times each.

The lawsuit goes on to state that Purdue justified this sales campaign by “[peddling] the false notion that patients suffered from ‘pseudoaddiction’” and that they promoted “a series of falsehoods to push patients away from safer drugs.” This campaign was highly successful, as Purdue’s top targets distributed more opioids at higher doses and for longer periods of time than other Massachusetts doctors and nurses who also prescribed Purdue drugs, but who did not receive visits from company representatives. In comparison to these doctors and nurses, those who were visited by Purdue’s sales representatives were “at least ten times more likely to prescribe Purdue opioids to patients who overdosed and died.” This lawsuit is one of hundreds previously filed which accuse the Sackler family of profiting from the opioid epidemic.

A similar case, filed by Oklahoma Attorney General Mike Hunter in June of 2017, recently became the first of these cases to be officially settled. On March 26^th 2019, Purdue Pharma and the state of Oklahoma arrived at a settlement that requires the company to immediately pay $270 million “to fund addiction research and treatment in Oklahoma and pay legal fees.” Of this payment, $102.5 million–along with $75 million to be paid by the Sackler family themselves over the course of 5 years–will be used to fund a new National Center for Addiction Studies and Treatment at Oklahoma State University in Tulsa. According to the Washington Post, however, it is estimated that “abating the opioid crisis in the state [will] cost more than $8.7 billion over the next 20 years.” The state of Oklahoma is also pursuing similar cases against Johnson & Johnson as well as Teva Pharmaceutical Industries. While this case may mark the beginning of “the reckoning for the worst drug epidemic in US history,” it is impossible to place a monetary value on the hundreds of thousands of lives lost due to the opioid epidemic.