pain pill kingpins

The unredacted 274 page complaint may not be as compelling to read as The Godfather saga, but it most definitely makes the Sackler Family look like the Corleones. Only these pain pill kingpins also took a page from Pablo Escobar.

Sackler vs Corleone

Balzac said that behind every great fortune is a great crime. That goes double for families. In the Corleones' case it was liquor pushing, and the opportunities brought about by Prohibition. In the Sacklers' case, it was pill pushing, and the wide open market of prescription medicine.

While the Corleones relied upon word-of-mouth to get the word out about their speakeasies, the Sacklers relied upon targeted medical advertising of their own devising. The results would revolutionize the prescription drug market.

The year was 1942. Arthur Sackler, one of three doctor brothers and guiding light of the family, had taken a copywriting job at William Douglas McAdams, a small ad agency that specialized in the medical field. The ostensible reason was to help pay his medical-school tuition. In the end, it would lay the groundwork for the family fortune. Arthur proved so adept at this work that he eventually bought the agency. Then he started applying Madison Avenue pizzazz and trickery to pharmaceutical company marketing. As both a doctor and an adman, Arthur displayed a Don Draper-style intuition for the alchemy of marketing. He recognized that selling new drugs requires a seduction of not just the patient but also of the doctor who writes the prescription.

So Sackler devised campaigns that appealed directly to clinicians. He placing splashy ads in medical journals. And he directly distributed literature to doctors’ offices. When Sackler saw that physicians were most heavily influenced by their own peers, he enlisted prominent ones to endorse his products. He also cited scientific studies. Studies which were often underwritten by Sackler himself.

"Most of the questionable practices that propelled the pharmaceutical industry into the scourge it is today can be attributed to Arthur Sackler," Allen Frances told The New Yorker. Frances should know. He's chairman of the Department of Psychiatry at Duke University School of Medicine.

Sackler Family Saga

Arthur Sackler’s techniques were often blatantly deceptive. Other times they were blatantly cutthroat. In the '50s, he produced fake Dr. business cards recommending a new Pfizer antibiotic called Sigmamycin. During the '60s, he got rich marketing the tranquillizers Librium and Valium to everyone from first year college students 'facing a new life of anxiety' to people with no psychiatric symptoms whatsoever. By 1973, American doctors were writing more than a hundred million tranquillizer prescriptions a year.

Like the Mafia, the Senate held hearings. Edward Kennedy called widespread tranquilizar prescriptions “a nightmare of dependence and addiction.” Estes Kefauver’s subcommittee assailed the family don with pointed questions. But like all dons, Sackler was a formidable interlocutor — slippery, aloof, and impeccably prepared.

And like the Mafia families, impeccably connected, including to Henry Welch, chief of the antibiotics division of the F.D.A. Sackler paid Welsh nearly three hundred thousand dollars. In exchange he received Welch’s help in promoting certain drugs. Welch eventually resigned in scandal. Sackler didn't even receive a slap on the wrist.

The Sacklers hasn't received their due as a family yet either. So they set out to buy it. In 1974, the brothers gave the Metropolitan Museum of Art three and a half million dollars to construct the wing housing the Temple of Dendur. It is now known as the Sackler Wing. That gift beget an astounding range of institutions. Among them are the Sackler Gallery, in Washington; the Sackler Museum, at Harvard; the Sackler Center for Arts Education, at the Guggenheim; and the Sackler Wing at the Louvre. There are also Sackler institutes and facilities at Columbia, Oxford, and a dozen other universities. The Sacklers also continue to endow professorships and underwrite medical research.

According to Forbes, the Sacklers are now one of America’s richest families, with a collective net worth of thirteen billion dollars. That's more than the Rockefellers or the Mellons.

Pain Pill Kingpins

The Sackler Family fortune didn't really reach astronomical proportions till 1995. That was the year that the family's Purdue Pharma unleashed OxyContin on an unsuspecting public. And the year an unsuspecting public started becoming astronomically addicted.

We wrote about the family's demonizing of their customers in Blame the Addict. The new redactions put numbers to the diabolical marketing. And those numbers are obscene.

Take 2013. The Sacklers earned $400 million in the first three quarters. That wasn't enough. When profits fell off in quarter four the Sacklers had Purdue Pharma undergo an intense push to increase sales representatives' visits to doctors and other prescribers. It worked. One physician alone subsequently wrote an additional 167 prescriptions for OxyContin.

As WBUR reports, the newly unredacted lawsuit claims Purdue paid members of the Sackler family more than $4 billion between 2008 and 2016. Oddly enough, 2008 also happens to be just one year after Purdue pleaded guilty to a felony and agreed to stop misrepresenting the addictive potential of its highly profitable painkiller, OxyContin. It was also the year Purdue paid the Sacklers $250 million in June. Then paid them another $199 million in September. Not a bad summer haul for a family of felons.

In 2009, Purdue paid $2.7 million to settle suits brought about by families of those lost to OxyContin. It also spent $121.6 million to ramp up marketing efforts of OxyContin. That year's take? $335 million.

Omerta

Like all organized crime families, the Sacklers have remained mostly mum on the avalanche of lawsuits, including the recently redacted suit brought by Massachusetts Attorney General Maura Healey. Like a Cartel kingpin caught in a corner, Purdue Pharma on the other hand have come out swinging.

The company issued a statement claiming Healey's complaint is "part of a continuing effort to single out Purdue, blame it for the entire opioid crisis, and try the case in the court of public opinion rather than the justice system." Rather rich considering Purdue's efforts to stigmatize its own client base.

Purdue further claims the complaint fails to acknowledge that most opioid overdose deaths currently are the result of fentanyl. Even richer considering fentanyl is generally added to heroin, and that four out of five people who try heroin began with pain pill addictions. In other words, without OxyContin they never would've overdosed on fentanyl in the first place.

But it is the Sackler Family's insatiable greed which makes them pain pill kingpins along the lines of a Pablo Escobar. Remember, it's made half a billion dollars a year, every year, since pleading guilty to felony deception. Even worse, the family is now behind the effort to market the anti-addiction drug Suboxone.

"Addictive opioids and opioid addiction are 'naturally linked,'" Kathe Sackler allegedly wrote in September 2014, in a pitch for a secret plan called Project Tango.

"It is an attractive market," followed Purdue staff. "Large unmet need for vulnerable, underserved and stigmatized patient population suffering from substance abuse, dependence and addiction."

Purdue predicted that 40-60 percent of the patients buying Suboxone for the first time would relapse and have to take it again. THat of course meant more revenue. And while Project Tango never officially got off the ground, there's now no contesting the increasing prevalence of Suboxone in the addiction treatment arena. Seems the Sacklers now wish to treat the legion of addicts they themselves created. Pain pill kingpins indeed.

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