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OpEdNews Op Eds    H3'ed 1/25/18

Healthcare Plus Capitalism Equals Opioid Epidemic

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Ever heard of the Sackler family? If you have, it's probably because they mastered the art of branding and marketing while managing to sneak OxyContin into millions of homes. Theirs is a story of drugs, capitalism and what happens when you wear the right suit while you're mixing the two. Theirs is a truly American story.

A little over a decade ago, the Sackler family opioid empire was in trouble. However, if you pay attention to the info about opioid manufacturers that have faced government lawsuits , you wouldn't know it has anything to do with the Sacklers -- unless you know the Sacklers are behind Purdue Pharma. The Sacklers have done a lot to distance their name from their company. More on that soon.

In 2007, Purdue Pharma paid out an unprecedented $600 million settlement for misbranding OxyContin. The company used branding to controvert science, making it seem like OxyContin, a powerful opioid, is not addictive. In 2015, the state of Kentucky reached a $24 million settlement with Purdue, again for misbranding OxyContin. Misbranding is a practice that goes all the way back to Arthur Sackler, who co-founded Purdue Pharma with his brothers .

Arthur Sackler's first and most blatant instance of "misbranding" (legalese for lying) took the form of an ad for a Pfizer antibiotic called Sigmamycin. The ad featured a bunch of doctors' business cards next to the message, "More and more physicians find Sigmamycin the antibiotic therapy of choice." In 1959, an investigative reporter discovered that the business cards in the ad didn't belong to any real doctors.

Arthur was a marketer who first went to medical school. As a trained physician, he knew that when it comes to peddling drugs, it's important to market to doctors. It worked; by 1973 he had doctors writing more than a hundred million tranquilizer prescriptions per year because, according to Sackler's ad campaign, Valium was great for people with "no demonstrable pathology."

Fast forward to 1995. The FDA approved OxyContin, although, according to the New Yorker, Purdue hadn't conducted any studies as to whether the drug is addictive. Purdue's marketing campaign was about as pervasive as it gets. Even before Oxycontin's release, a reputable pain specialist named Russell Portenoy told the New York Times, "There is a growing literature showing that these drugs [opioids] can be used for a long time, with few side effects." Turns out Purdue had Portenoy on its payroll.

The FDA put an insert in the Oxycontin package that claimed it wasn't as addictive as other painkillers. Then, the examiner who approved OxyContin quit the FDA and started working for Purdue. Coincidence? Hardly. Purdue has plenty of cash with which to woo and poach employee prospects. Primarily through the sale of Oxycontin, which was falsely branded as non addictive and not prone to abuse, the Sackler family amassed a fortune of $13 billion, placing them among America's richest families .

Recently, artist Nan Goldin began campaigning against the Sackler family, and Arthur Sackler's daughter, Elizabeth Sackler, proclaimed her support . This falls in step with the side of the Sacklers plenty of people have heard about: the philanthropic side. They've contributed to the Metropolitan Museum of Art, Harvard, the Guggenheim, the Louvre, and plenty more. Elizabeth is responsible for the Elizabeth A. Sackler Center for Feminist Art. They make vastly important contributions to the arts.

The family makes their arts endowments well-known -- the Sackler name is on all their contributions, such as the Sackler Wing of the Met. Meanwhile, eight of the Sacklers who are on Purdue's board of directors aren't listed in that capacity on Purdue's website. This is a family whose brand is associated with the arts. To fund their continuing philanthropy and opulent lifestyles, they aggressively marketed one of the biggest opioids on the market through Purdue Pharma.

"If you look at the prescribing trends for all the different opioids, it's in 1996 that prescribing really takes off. It's not a coincidence. That was the year Purdue launched a multifaceted campaign that misinformed the medical community about the risks," says Andrew Kolodny, co-director of the Opioid Policy Research Collaborative. Basically, doctors wouldn't have started handing out opioids like candy if Purdue Pharma hadn't marketed them as harmless.

To be sure, opioid manufacturing is a huge industry, as is the healthcare industry mobilized to treat the victims of opioid abuse. Substance abuse nurses are in high demand; this year, there's an estimated shortage of about 200,000 nurses. The chain of supply and demand for this capitalist drug machine is clear. Big pharma manufactures and markets the drugs, doctors prescribe them, then nurses and doctors help treat the addicts, which is part of how they get paid. About four out of five heroin addicts start off on prescription opioids. In turn, that helps cartels who traffic heroin. All told, the manufacture and distribution of illicit drugs in America is a $249 billion industry.

An opioid epidemic is what you would expect in a system where drug manufacturers (read: suppliers) can legally work hand-in-hand with doctors (read: dealers) to distribute product and accumulate capital. They're wearing the right suits and they've got the Federal Drug Administration their side. Welcome to the machine.

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