Hello! And welcome to another edition of Inside The Newsroom. Today’s guest is David Armstrong, senior healthcare reporter at ProPublica. David has covered the pharma industry for more than a decade, and is an expert on the current opioid crisis in the U.S. We discussed a ton, and below is my post-game analysis on everything we covered. Enjoy!
How Did the Opioid Crisis Even Start?
The U.S. opioid crisis is one of its worst-ever drug epidemics. Almost 1,000 people die each week from opioid-related overdoses, and some experts say the death toll could be another 500,000 in the next decade. The problem started when doctors overprescribed legal painkillers for years and years, such as oxycodone, and was made worse by the influx of cheap substitutes supplied by foreign drug cartels, such as fentanyl. In 2017, it was estimated that 1.7 million Americans suffered from an opioid overdose.
Pain, Meet OxyContin
The most well-known painkiller on the market, and thus the drug attracting the most attention is OxyContin, produced and sold by Purdue Pharma. Purdue’s original best-seller was a drug called MS Contin, which is a slow-release morphine pill that dissolves over several hours into the bloodstream allowing many patients to sleep through the night. Just before the patent for MS Contin expired, Purdue developed a new, more potent painkiller derived from pure oxycodone and about 50 per cent stronger than morphine. This began the opioid crisis.
Thanks to Dan Keating and Samuel Granados from the Washington Post for visualizing just how strong the drugs are that people are taking legally and illegally.
Is the Crisis Nearing an End?
Latest data from the CDC shows that the number of drug overdose deaths fell five percent, the first decline since 1990. Some experts point to the fall being directly linked to the reduction in opioid overprescription, but we’re not of the woods yet. Other experts say that the overdose deaths from illegal painkillers sold by drug dealers are still on the rise.
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Who Are the Sackler family?
Brothers Mortimer and Raymond Sackler bought Purdue Pharma in 1952, which has been controlled by the wider Sackler family since their deaths in 2010 and 2017, respectively. The Sackler family were once known around the world for their generous philanthropic donations to some of the world’s leading institutions, from Yale University to the Guggenheim Museum in the US and the Serpentine Gallery to the Royal Academy in Britain. That’s all changed in the past few years.
The Danger (but Effectiveness) of Purdue’s Marketing
Purdue Pharma first released OxyContin in 1996 and has made billions of dollars from the drug. It did so by concealing the truth about the risk of addiction in its marketing. Purdue knew it would receive criticism, and in 2001, Richard Sackler, the company’s former president and co-chairman and son of the late Raymond Sackler, wrote this in an email with the aim of pinning the blame on the users of his company’s drug: “We have to hammer on the abusers in every way possible. They are the culprits and the problem. They are reckless criminals.”
Why Did Purdue Just Declare Bankruptcy?
Earlier this month, Purdue Pharma filed for Chapter 11 bankruptcy, as part of a deal to settle more than 2,000 lawsuits against the company (my guest David Armstrong said this number is now nearer 3,000). Don’t be fooled though. Purdue and the Sackler family have certainly not run out of money. Such a process is meant to ensure that Purdue can preserve its value while it gets more time to negotiate with every entity it’s being sued by.
Who Are the Other Opioid Companies Involved?
It’s not just Purdue under fire. Thousands of lawsuits have been filed against other drug companies including Teva and Johnson & Johnson, who were recently ordered to pay a whopping $572million for its part in fuelling the crisis in Oklahoma alone. But it’s not just drug producers that are in hot water. Pharmacies such as CVS, Rite Aid and Walgreens, who distribute the opioids to patients are being sued as well.
While the opioid crisis should unite Democrats and Republicans against Purdue and the other companies involved, diverging strategies may have started to emerge. Most of the 24 suing states that rejected Purdue’s settlement bill are Democratic, who “are aiming to send a broader message about corporate accountability, not just to Purdue, but to the large collection of even more powerful companies still tied up in opioid litigation,” according to Politico. Meanwhile the GOP are “going for a more pragmatic approach that may also reflect the party’s traditionally closer relationship with industry.”
As per usual, Trump has claimed credit for the decline in opioid overdose deaths. Like with most things in life, it’s not that simple, and work from previous administrations to tackle the opioid crisis may be part-responsible. More nuanced, the decline in fatalities doesn’t necessarily mean that fewer people are overdosing; it may mean that the campaign to make antidotes widely available is saving their lives, though not necessarily getting people treatment to end their addiction.
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