When opioid overdose and addiction rates started spiking back in the early '00s, Purdue Pharma ordered its salesforce to blame the addict.
"We have to hammer on abusers in every way possible," then Purdue Pharma president Richard Sackler wrote in an email. "They are the culprits and the problem. They are reckless criminals."
Blame the Addict
The tendency to blame the addict is as old as addiction itself. So it's a cinch previous profiteers have chosen to scapegoat their very customers when goings got rough. But Purdue Pharma's efforts reached a new low, as well as a new high. After all, the drug company's Oxycontin had already become the most prescribed painkiller on the planet. It wouldn't be long before it would also be the most lethal prescription drug in history.
Sackler's addict demonization directive came to light in a new 274-page memorandum provided by Massachusetts Attorney General Maura Healey. Massachusetts was one of the first states to sue Purdue Pharma over its role in creating America's opioid crisis. And Healey was one of the first Attorneys General to specifically lay the blame on the Sackler Family themselves. This latest salvo details a chain of command that she alleges implicates eight Sackler family members, as well as nine Purdue board members or executives.
An earlier version of the memo, filed on Dec. 21, was more than half redacted, after Purdue Pharma argued to withhold information about the Sacklers. Some sections remain blacked out in Tuesday's filing.
In addition to blaming the addict, Sackler also sought to ensure loyalty among Purdue Pharma employees after criminal probes into the company's marketing tactics led to guilty pleas in 2007 by some of the drugmaker’s top executives. the head of the clan that owns the company took note of the risks they all faced.
Purdue’s business posed a "dangerous concentration of risk," warned a secret 2008 memo. And it was vital to have loyal subordinates in place to provide a legal shield.
"People who will shift their loyalties rapidly under stress and temptation can become a liability from the owners’ viewpoint," wrote Sackler.
A Blizzard of Prescriptions
Doctors would be so pleased with OxyContin’s effectiveness that they’d write a "blizzard of prescriptions that will bury the competition," according to the suit. But it was Purdue's aggressive marketing that ensured the blizzard of prescriptions would indeed be written.
Purdue's hyper-aggressive marketing continued even after the 2007 guilty pleas. In fact, AG Healey's suit alleges the company actually double-downed on its efforts in Massachusetts, sending even more sales reps to meet with doctors, nurses and pharmacists to pressure them to prescribe even more OxyContin.
Immediately after the 2007 convictions then-CEO John Stewart began planning to expand Purdue's Massachusetts sales force, even though Purdue sales reps were already visiting Massachusetts prescribers more than 1,000 times each month. The company also influenced state legislation and financially backed medical facilities and universities so they could tout Purdue opioids.
Healey describes Richard Sackler as a micromanager, obsessed with profits.
One Massachusetts sales rep was ordered to increase prescriptions by 62 percent. Purdue also threatened to fire two other Massachusetts reps because the physicians they visited hadn't written enough opioid prescriptions. In fact, then-sales vice president Russell Gasdia said firing all the reps would "send a message."
In the past 11 years Purdue sales representatives visited Massachusetts prescribers and pharmacists more than 150,000 times.
The death toll from prescription opioid is now over 200,000.
Paying the Piper
The Sacklers are one of the richest families in America. And Purdue Pharma is one of the most profitable companies on the planet. So it makes perfect sense that AG Healey et al would go after the Oxycontin-maker's bankbook. But when a company can drop $600 million in fines without even blinking, something more than financial considerations are in order. And it is here where AG Healey's efforts are most commendable.
Yes, it's far too late to put the opioid cat back in the bag. And no, there's no way to accurately calculate the actual costs of the crisis. But it's important to hold criminals accountable for the crimes they commit. We mean real criminals. Not the unfortunates targeted by Purdue Pharma's blame the addict campaign. Criminals like Richard Sackler and his cast of money-hungry killers.