NEW: OxyContin made the Sackler family billions—but now, after 400,000 opioid deaths, it’s made them near-pariahs. David Sackler says his family feels “absolutely terrible,” but insists, “we didn’t cause the crisis.”
Photograph by Peter Hapak.
Yet even as the rage around the Sacklers has escalated, no one in the various branches of the family that are still involved in Purdue has spoken to the press. The three Sackler brothers who founded the company in 1952, including David’s grandfather Raymond, have all passed away. But David, who runs a family investment office and served on Purdue’s board of directors from 2012 to August 2018, thinks it is time for at least one Sackler to share his version of events with the public.
It is not until later in the conversation that he brings up the countless lives that have been devastated by the drug Purdue sells. “We have so much empathy,” he says of his family. “I’m sorry we didn’t start with that. We feel absolutely terrible. Facts will show we didn’t cause the crisis, but we want to help.”
But Purdue went all-out to sell OxyContin, which consisted of a pure concentration of oxycodone, to doctors and consumers: In its first six years on the market, according to the General Accounting Office, Purdue spent up to 12 times more promoting OxyContin than it had MS Contin. “It was like a perfect storm,” says Robert Marder, M.D., a longtime consultant to medical staffs.
The second claim—that less than 1 percent of patients taking OxyContin would become addicted—was based not on a peer-reviewed study, but on a five- sentence letter topublished in January 1980. The doctor who wrote the letter has since expressed regret that drug companies misrepresented it in their marketing campaigns pushing opioids as non-addictive.
Purdue’s critics scoff at such assertions. Andrew Kolodny, M.D., cofounder of Physicians for Responsible Opioid Prescribing, says the British article was only a review of other studies, none of which was explicitly designed to measure addiction in patients taking opioids for months and years at time—the very shift in treatment that Purdue pushed to bring about.
In September 2017, according to the Massachusetts complaint, Purdue’s CEO jotted down a note summarizing some of the roots of the opioid crisis. It reads:For conditions that often don’t require themSackler insists that the company did all it could in response to the crisis. “You can be as cynical as you want and say we should have moved faster,” he says. “But there was imperfect information in an incredibly complex market. Building a plan was not that simple.
Such bluntness, Sackler adds, comes across even harsher in writing. “For a person like that,” he says, “email is about the worst medium possible to communicate in, because there is no other cue. And so he’s saying things that sound incredibly strident and sound incredibly unsympathetic, and that’s not the person that he is.
Sackler also points to the company’s decision, in 2010, to launch a new form of OxyContin—one that was supposed to be an “abuse deterrent” because it couldn’t be broken down and snorted or injected. “We made a tremendously honest and ethical effort to fix a problem,” he says. “That’s all. To fix a problem.” The reformulated OxyContin, he adds, cost more than $1 billion to develop.
In retrospect, it seems inconceivable that the Sacklers didn’t see that their family’s reputation—and perhaps their fortune—was going to be demolished by the opioid crisis. But David says the maelstrom took him by surprise. “I don’t think any of us had a sense of what a problem this was going to become. You’ve just had the federal government complete a monitoring program; you’ve settled with the states.
In 2016, the Centers for Disease Control and Prevention finally stepped in to curb the epidemic of pain medication, issuing new guidelines that discourage twice-a-day prescriptions of Purdue’s three most profitable doses of OxyContin. “We know of no other medication,” the CDC observed, “that’s routinely used for a nonfatal condition that kills patients so frequently.”
By one measure, that’s true: OxyContin’s share was never more than 4 percent of all opioid prescriptions, which include such everyday medicines as Tylenol 3, and is less than 2 percent today. But Kolodny, the Purdue critic, argues that prescriptions are a “misleading” definition of market share. Because OxyContin is far more potent than many other opioids, he says, its true market share was “way, way more.
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