#opioïdes

Lawsuits Lay Bare Sackler Family’s Role in Opioid Crisis - The New York Times
▻https://www.nytimes.com/2019/04/01/health/sacklers-oxycontin-lawsuits.html

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The Sacklers had a new plan.

It was 2014, and the company the family had controlled for two generations, Purdue Pharma, had been hit with years of investigations and lawsuits over its marketing of the highly addictive opioid painkiller OxyContin, at one point pleading guilty to a federal felony and paying more than $600 million in criminal and civil penalties.

But as the country’s addiction crisis worsened, the Sacklers spied another business opportunity. They could increase their profits by selling treatments for the very problem their company had helped to create: addiction to opioids.

The filings cite numerous records, emails and other documents showing that members of the family continued to push aggressively to expand the market for OxyContin and other opioids for years after the company admitted in a 2007 plea deal that it had misrepresented the drug’s addictive qualities and potential for abuse.

In addition to New York and Massachusetts, Connecticut, Rhode Island and Utah have filed suit against members of the family. Last month, a coalition of more than 500 counties, cities and Native American tribes named the Sacklers in a case in the Southern District of New York, bringing the family into a bundle of 1,600 opioids cases being overseen by a federal court judge in Cleveland.

In 2009, two years after the federal guilty plea, Mortimer D.A. Sackler, a board member, demanded to know why the company wasn’t selling more opioids, email traffic cited by Massachusetts prosecutors showed.

In 2011, as states looked for ways to curb opioid prescriptions, family members peppered the sales staff with questions about how to expand the market for the drugs. Mortimer asked if they could sell a generic version of OxyContin in order to “capture more cost sensitive patients,” according to one email. Kathe, his half sister, suggested studying patients who had switched to OxyContin to see if they could find patterns that could help them win new customers, according to court filings in Massachusetts.

The lawsuits brought by the attorneys general of New York and Massachusetts, Letitia James and Maura Healey, named eight Sackler family members: Kathe, Mortimer, Richard, Jonathan and Ilene Sackler Lefcourt — children of either Mortimer or Raymond Sackler — along with Theresa Sackler, the elder Mortimer’s widow; Beverly Sackler, Raymond’s widow; and David Sackler, a grandson of Raymond.

Purdue’s business was fundamentally changed after the F.D.A. approved OxyContin in 1995. The company marketed the drug as a long-acting painkiller that was less addictive than shorter-acting rivals like Percocet and Vicodin, a strategy aimed at reducing the stigma attached to opioids among doctors.

While the Sacklers “have reduced Purdue’s operations and size, Rhodes continues to grow and sell opioids for the benefit of the Sackler families,” the New York suit contends.

By 2016, Rhodes, though little known to the public, had a greater share of the American prescription opioid market than Purdue, according to a Financial Times analysis. Together, the companies ranked seventh in terms of the market share of opioids.

Purdue temporarily abandoned plans to pursue Project Tango in 2014, but revived the idea two years later, this time pursuing a plan to sell naloxone, an overdose-reversing drug, according to the Massachusetts filing. A few months later, in December 2016, Richard, Jonathan and Mortimer Sackler discussed buying a company that used implantable drug pumps to treat opioid addiction.

In recent years, the Sacklers and their companies have been developing products for opioid and overdose treatment on various tracks. Last year, Richard Sackler was awarded a patent for a version of buprenorphine, a drug that blocks opioid receptors, administered by mouth in a thin film. In March, the F.D.A. fast tracked the company’s application for an injectable drug for emergency treatment of overdoses.

Fait très rare, cet article comporte de nombreuses photos des membres de la famille Sackler

#Opioides #Sackler #Procès

Tate Galleries Will Refuse Sackler Money Because of Opioid Links - The New York Times
▻https://www.nytimes.com/2019/03/21/arts/design/tate-modern-sackler-britain-opioid-art.html

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“The Sackler family has given generously to Tate in the past, as they have to a large number of U.K. arts institutions,” a Tate statement said.

"We do not intend to remove references to this historic philanthropy. However, in the present circumstances we do not think it right to seek or accept further donations from the Sacklers.”

Si je comprends bien, cela veut dire qu’ils ne retireront pas le nom des Sackler des lieux déjà sponsorisés... futilités.

Tate’s statement came two days after Britain’s National Portrait Gallery said it would not accept a long-discussed $1.3 million donation from the London-based Sackler Trust, one of the family’s charitable foundations. It said the decision was taken jointly by the gallery and Trust.

But the Thursday announcement, affecting Tate Modern and Tate Britain in London, as well as Tate Liverpool and Tate St. Ives in Cornwall, could have a bigger impact in the art world. All these galleries are major tourist attractions as well as home to large, high-profile exhibitions.

In an email, a spokesman for the Mortimer and Raymond Sackler family said, “We deeply sympathise with all the communities, families and individuals affected by the addiction crisis in America. The allegations made against family members in relation to this are strongly denied and will be vigorously defended in court.” He did not comment on Tate’s decision.

Ne parlons pas du Valium, qui fut la première cause des richesse de la famille Sackler. Surtout pas. Une drogue à la fois, isn’t it ? Quinze ans plus tôt.

“The Sackler family has been connected with the Met for more than a half century,” Mr. Weiss’s statement said. “The family is a large extended group and their support of The Met began decades before the opioid crisis.”

#Opioides #Sackler #Philanthropie #Musées

Museums Cut Ties With Sacklers as Outrage Over Opioid Crisis Grows - The New York Times
▻https://www.nytimes.com/2019/03/25/arts/design/sackler-museums-donations-oxycontin.html

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In Paris, at the Louvre, lovers of Persian art knew there was only one place to go: the Sackler Wing of Oriental Antiquities. Want to find the long line for the Temple of Dendur at the Metropolitan Museum of Art? Head for the soaring, glass-walled Sackler Wing.

For decades, the Sackler family has generously supported museums worldwide, not to mention numerous medical and educational institutions including Columbia University, where there is a Sackler Institute, and Oxford, where there is a Sackler Library.

But now some favorite Sackler charities are reconsidering whether they want the money at all, and several have already rejected any future gifts, concluding that some family members’ ties to the opioid crisis outweighed the benefits of their six- and sometimes seven-figure checks.

In a remarkable rebuke to one of the world’s most prominent philanthropic dynasties, the prestigious Tate museums in London and the Solomon R. Guggenheim in New York, where a Sackler sat on the board for many years, decided in the last week that they would no longer accept gifts from their longtime Sackler benefactors. Britain’s National Portrait Gallery announced it had jointly decided with the Sackler Trust to cancel a planned $1.3 million donation, and an article in The Art Newspaper disclosed that a museum in South London had returned a family donation last year.

On Monday, as the embarrassment grew with every new announcement, a Sackler trust and a family foundation in Britain issued statements saying they would suspend further philanthropy for the moment.

“The current press attention that these legal cases in the United States is generating has created immense pressure on the scientific, medical, educational and arts institutions here in the U.K., large and small, that I am so proud to support,” Theresa Sackler, the chair of the Sackler Trust, said in a statement. “This attention is distracting them from the important work that they do.”

The Guggenheim’s move was perhaps the most surprising, and not just because it was the first American institution known to cut ties with its Sackler supporters.

Mortimer D.A. Sackler, a son of Mortimer Sackler, sat on the Guggenheim’s board for nearly 20 years and the family gave the museum $9 million between 1995 and 2015, including $7 million to establish and support the Sackler Center for Arts Education.

The Guggenheim and the Metropolitan Museum had been the scene of protests related to the Sacklers. One last month, led by the photographer Nan Goldin, who overcame an OxyContin addiction, involved dropping thousands of slips of white paper from the iconic gallery spiral into its rotunda, a reference to a court document that quoted Richard Sackler, who ran Purdue Pharma, heralding a “blizzard of prescriptions that will bury the competition.”

Last Thursday, the Guggenheim, like other American museums, stated simply that “no contributions from the Sackler family have been received since 2015 and no additional gifts are planned.”

But a day later, amid more articles about British museums rejecting Sackler money, the Guggenheim amended its statement: “The Guggenheim does not plan to accept any gifts.”

#Opioides #Sackler #Philanthropie #Musées

Sackler family money is now unwelcome at three major museums. Will others follow? - The Washington Post
▻https://www.washingtonpost.com/entertainment/museums/two-major-museums-are-turning-down-sackler-donations-will-others-follow/2019/03/22/20aa6368-4cb9-11e9-9663-00ac73f49662_story.html

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By Philip Kennicott
Art and architecture critic
March 23

When the National Portrait Gallery in London announced Tuesday that it was forgoing a grant from the Sackler family, observers could be forgiven for a certain degree of skepticism about the decision’s impact on the art world. The Sacklers, owners of the pharmaceutical behemoth Purdue Pharma, which makes OxyContin, had promised $1.3 million to support a public-engagement project. The money, no doubt, was welcome, but the amount involved was a relative pittance.

Now another British institution and a major U.S. museum, the Guggenheim, have said no to Sackler money, which has become synonymous with a deadly and addictive drug that boosted the family fortune by billions of dollars and caused immeasurable suffering. The Tate art galleries, which include the Tate Modern and the Tate Britain in London as well as outposts in Liverpool and Cornwall, announced Thursday that it will also not accept money from the family.

The Sacklers are mired in legal action, investigations and looming congressional inquiries about their role in marketing a drug blamed for a significant early role in an epidemic of overdose deaths that has claimed the lives of hundreds of thousands of Americans since 1997.

Is this a trend? These moves may affect immediate plans but won’t put much of a dent in the museums’ budgets. The impact on the Sackler family’s reputation, however, will force American arts institutions to pay attention.

The Sackler family, which includes branches with differing levels of culpability and involvement with the issue, has a long history of donating to cultural organizations. Arthur M. Sackler, who gave millions of dollars’ worth of art and $4 million for the opening of the Smithsonian’s Sackler Gallery in 1987, died long before the OxyContin scandal began. Members of the family involved with OxyContin vigorously contest the claims that Perdue Pharma was unscrupulous in the promotion of a drug, though company executives pleaded guilty to violations involving OxyContin in 2007 and the company paid more than $600 million in fines.

A million here or there is one thing. Having a whole building named for a family with blood on its hands is another, and seeking yet more money for new projects will become even more problematic. And every institution that bears the Sackler family name, including New York’s Metropolitan Museum of Art (which has a Sackler wing) and the University Art Museum at Princeton (which has a Sackler gallery) is now faced with the distasteful proposition of forever advertising the wealth of a family that is deeply implicated in suffering, death and social anomie.

Will any major U.S. institution that has benefited from Sackler largesse remove the family’s name?

The National Portrait Gallery in London. (Daniel Leal-Olivas/AFP/Getty Images)
The usual arguments against this are stretched to the breaking point. Like arguments about Koch family money, which has benefited cultural institutions but is, to many, inextricably linked to global warming and the impending collapse of the Anthropocene, the issues at stake seem, at first, to be consistency and pragmatism. The pragmatic argument is this: Cultural organizations need the money, and if they don’t take it, that money will go somewhere else. And this leads quickly to the argument from consistency. Almost all of our major cultural organizations were built up with money derived from family fortunes that are tainted — by the exploitation of workers, slavery and the lasting impacts of slavery, the depredations of colonialism and the destruction of the environment. So why should contemporary arts and cultural groups be required to set themselves a higher, or more puritanical, standard when it comes to corrupt money? And if consistency matters, should we now be parsing the morality of every dollar that built every opera house and museum a century ago?

Both arguments are cynical. Arts organizations that engage in moral money laundering cannot make a straight-faced claim to a higher moral purpose when they seek other kinds of funding, including donations and membership dollars from the general public and support from government and foundations. But the consistency argument — that the whole system is historically wrapped up in hypocrisy about money — needs particular reconsideration in the age of rapid information flows, which create sudden, digital moral crises and epiphanies.

[The Sacklers have donated millions to museums. But their connection to the opioid crisis is threatening that legacy.]

Moral (or social) hazard is a funny thing. For as long as cultural institutions are in the money-laundering business, companies such as Perdue Pharma will have an incentive to take greater risks. If the taint of public health disaster can be washed away, then other companies may choose to put profits over public safety. But this kind of hazard isn’t a finely calibrated tool. It involves a lot of chance and inconsistency in how it works. That has only increased in the age of viral Twitter campaigns and rapid conflagrations of public anger fueled by new social media tools.

Why is it that the Sackler family is in the crosshairs and not any of the other myriad wealthy people whose money was made through products that are killing us? Because it is. And that seeming randomness is built into the way we now police our billionaires. It seems haphazard, and sometimes unfair, and inefficient. Are there worse malefactors scrubbing their toxic reputations with a new hospital wing or kids literacy program? Surely. Maybe they will find their money unwelcome at some point in the future, and maybe not. The thing that matters is that the risk is there.

[Now would be a good time for museums to think about our gun plague]

The Arthur M. Sackler Gallery of Art in Washington. (Bill O’Leary/The Washington Post)
Much of the Sackler family money was made off a drug that deadens the mind and reduces the human capacity for thought and feeling. There is a nice alignment between that fact and what may now, finally, be the beginnings of a new distaste about using Sackler money to promote art and cultural endeavors, which must always increase our capacities for engagement with the world. It is immensely satisfying that the artist Nan Goldin, whose work has explored the misery of drug culture, is playing a leading role in the emerging resistance to Sackler family money. (Goldin, who was considering a retrospective of her work at the National Portrait Gallery, said to the Observer: “I have told them I would not do it if they take the Sackler money.”)

More artists should take a lead role in these conversations, to the point of usurping the usual prerogatives of boards and executive committees and ethical advisory groups to make decisions about corrupt money.

[‘Shame on Sackler’: Anti-opioid activists call out late Smithsonian donor at his namesake museum]

Ultimately, it is unlikely that any arts organization will manage to find a consistent policy or somehow finesse the challenge of saying all that money we accepted from gilded-age plutocrats a century ago is now clean. But we may think twice about taking money from people who are killing our planet and our people today. What matters is that sometimes lightning strikes, and there is hell to pay, and suddenly a name is blackened forever. That kind of justice may be terrifying and swift and inconsistent, but it sends a blunt message: When the world finally learns that what you have done is loathsome, it may not be possible to undo the damage through the miraculous scrubbing power of cultural detergent.

#Opioides #Sackler #Musées #Shame

Exclusive: OxyContin Maker Purdue Pharma Exploring Bankruptcy - Sources | Investing News | US News
▻https://money.usnews.com/investing/news/articles/2019-03-04/exclusive-oxycontin-maker-purdue-pharma-exploring-bankruptcy-sources
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By Mike Spector, Jessica DiNapoli and Nate Raymond

(Reuters) - OxyContin maker Purdue Pharma LP is exploring filing for bankruptcy to address potentially significant liabilities from roughly 2,000 lawsuits alleging the drugmaker contributed to the deadly opioid crisis sweeping the United States, people familiar with the matter said on Monday.

The potential move shows how Purdue and its wealthy owners, the Sackler family, are under pressure to respond to mounting litigation accusing the company of misleading doctors and patients about risks associated with prolonged use of its prescription opioids.

Purdue denies the allegations, arguing that the U.S. Food and Drug Administration-approved labels for its opioids carried warnings about the risk of abuse and misuse associated with the pain treatments.

Filing for Chapter 11 protection would halt the lawsuits and allow Purdue to negotiate legal claims with plaintiffs under the supervision of a U.S. bankruptcy judge, the sources said.

Shares of Endo International Plc and Insys Therapeutics Inc, two companies that like Purdue have been named in lawsuits related to the U.S. opioid epidemic, closed down 17 percent and more than 2 percent, respectively, on Monday.

More than 1,600 lawsuits accusing Purdue and other opioid manufacturers of using deceptive practices to push addictive drugs that led to fatal overdoses are consolidated in an Ohio federal court. Purdue has held discussions to resolve the litigation with plaintiffs’ lawyers, who have often compared the cases to widespread lawsuits against the tobacco industry that resulted in a $246 billion settlement in 1998.

“We will oppose any attempt to avoid our claims, and will continue to vigorously and aggressively pursue our claims against Purdue and the Sackler family,” Connecticut Attorney General William Tong said. Connecticut has a case against Purdue and the Sacklers.

BANKRUPTCY FILING NOT CERTAIN

A Purdue bankruptcy filing is not certain, the sources said. The Stamford, Connecticut-based company has not made any final decisions and could instead continue fighting the lawsuits, they said.

“As a privately-held company, it has been Purdue Pharma’s longstanding policy not to comment on our financial or legal strategy,” Purdue said in a statement.

“We are, however, committed to ensuring that our business remains strong and sustainable. We have ample liquidity and remain committed to meeting our obligations to the patients who benefit from our medicines, our suppliers and other business partners.”

Purdue faces a May trial in a case brought by Oklahoma’s attorney general that, like others, accuses the company of contributing to a wave of fatal overdoses by flooding the market with highly addictive opioids while falsely claiming the drugs were safe.

Last year, U.S. President Donald Trump also said he would like to sue drug companies over the nation’s opioid crisis.

Opioids, including prescription painkillers, heroin and fentanyl, were involved in 47,600 overdose deaths in 2017, a sixfold increase from 1999, according to the latest data from the U.S. Centers for Disease Control and Prevention.

Purdue hired law firm Davis Polk & Wardwell LLP for restructuring advice, Reuters reported in August, fueling concerns among litigants, including Oklahoma Attorney General Mike Hunter, that the company might seek bankruptcy protection before the trial.

Companies facing widespread lawsuits sometimes seek bankruptcy protection to address liabilities in one court even when their financial condition is not dire. California utility PG&E Corp filed for bankruptcy earlier this year after deadly wildfires raised the prospect of large legal bills even though its stock remained worth billions of dollars.

DECEPTIVE MARKETING

Massachusetts Attorney General Maura Healey in June became the first attorney general to sue not just Purdue but Sackler family members. Records in her case, which Purdue has asked a judge to dismiss, accused Sackler family members of directing deceptive marketing of opioids for years while enriching themselves to the tune of $4.2 billion.

Some other states have since also sued the Sacklers. The Sacklers are currently discussing creating a nonprofit backed by family financial contributions to combat addiction and drug abuse, a person familiar with their deliberations said.

The drugmaker downplayed the possibility of a bankruptcy filing in a Feb. 22 court filing in the Oklahoma case. “Purdue is still here - ready, willing and eager to prove in this Court that the State’s claims are baseless,” the company said in court papers.

Sales of OxyContin and other opioids have fallen amid public concern about their addictive nature, and as restrictions on opioid prescribing have been enacted. OxyContin generated $1.74 billion in sales in 2017, down from $2.6 billion five years earlier, according to the most recent data compiled by Symphony Health Solutions.

Purdue Chief Executive Officer Craig Landau has cut hundreds of jobs, stopped marketing opioids to physicians and moved the company toward developing medications for sleep disorders and cancer since taking the helm in 2017.

In July, Purdue appointed a new board chairman, Steve Miller, a restructuring veteran who previously held leadership positions at troubled companies including auto-parts giant Delphi and the once-teetering insurer American International Group Inc.

Mortimer D.A. Sackler no longer sits on Purdue’s board, according to a filing the company made with the Connecticut secretary of state late Monday.

The Oklahoma case and other lawsuits seek damages from Purdue and other pharmaceutical companies accused of fueling the opioid crisis. In addition to lawsuits consolidated in an Ohio federal court, more than 300 cases are pending in state courts, and dozens of state attorneys general have sued manufacturers, including Purdue.

Settlement discussions have not yet resulted in a deal.

Purdue and three executives in 2007 pleaded guilty to federal charges related to the misbranding of OxyContin and agreed to pay a total of $634.5 million in penalties, according to court records.

(Reporting by Mike Spector and Jessica DiNapoli in New York and Nate Raymond in Boston; Editing by Bill Berkrot)

Copyright 2019 Thomson Reuters.

#Opioides #Sackler #Bankruptcy

FDA takes fresh look at whether opioids are effective for chronic pain - The Washington Post
▻https://www.washingtonpost.com/national/health-science/fda-takes-fresh-look-at-whether-opioids-are-effective-for-chronic-pain/2019/02/25/227a5fe6-3917-11e9-a06c-3ec8ed509d15_story.html

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The Food and Drug Administration will require drug companies to study whether prescription opioids are effective in quelling chronic pain — another step in the government’s efforts to rein in use of the narcotics that spawned the drug epidemic.

Some studies already indicate that opioids are ineffective for pain beyond 12 weeks and many experts say long-term use can cause addiction, by prompting patients to build up tolerance to the drugs and seek higher doses. But conclusive, controlled research is scarce.

A finding of ineffectiveness in more rigorous studies supervised by the FDA could allow the agency to change the labeling on some opioids, impose special rules for prescribing, dispensing and taking them, and even prohibit their use in some cases, according to FDA Commissioner Scott Gottlieb.

But at least one longtime critic of the FDA’s response to the opioid crisis expressed frustration with the move. Andrew Kolodny, director of Physicians for Responsible Opioid Prescribing, said the FDA already has all the research it needs — and authority under existing law — to tighten restrictions on the use of opioids for chronic pain by changing instructions for how they should be prescribed.

“Here we go again,” Kolodny said in an interview. “That’s exactly what the FDA said to us in 2013. . . . Five years later, we don’t have the studies and another FDA commissioner says, ‘We’re going to do the studies.’ ”

In 2013, after Kolodny’s group complained that opioids should be labeled unsafe and ineffective for chronic pain, the FDA ordered similar research, including an attempt to determine whether painkillers cause hyperalgesia. Gottlieb said those studies were difficult to carry out because, at the time, the FDA had authority only to require post-market studies of safety, rather than effectiveness.

On Sunday, the CBS program “60 Minutes” explored the FDA’s decision in 2001 to allow long-term use of OxyContin despite the lack of research showing it was safe and effective. Gottlieb conceded that “it’s regrettable we didn’t do this many years ago.”

The vast majority of opioid prescriptions written in 2017 were for generic versions of the drugs. The research would be required only of companies that produce brand-name narcotics; generic producers would be required to adopt the same changes.

#Opioides #USA #FDA #Efficacité

Opioid crisis engulfs blockaded Gaza Strip
▻https://www.apnews.com/ff3cf542ded542d5b2e51ceb3fbe051c

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GAZA CITY, Gaza Strip (AP) — An opioid crisis has quietly spread in the Gaza Strip, trapping thousands in the hell of addiction and adding another layer of misery to the blockaded and impoverished coastal territory.

The scourge can be traced to the mass import of cheap opioid-based Tramadol pain pills through smuggling tunnels under Gaza’s border more than a decade ago. A more addictive black-market form of the drug called Tramal has since taken hold.

“I have seen the top elites taking it — university students, girls and respectful people,” said Dr. Fadel Ashour, who treats addicts in his dimly lit clinic.

Tramadol, a synthetic opioid analgesic, is considered a controlled substance by the U.S. Food and Drug Administration, in the same category as well-known medications like Valium and Xanax.

The WHO study cited the blockade, high unemployment among university graduates and never-ending conflict with Israel as factors associated with “widespread” Tramadol abuse.

It said users turned to the drug to “escape problems,” obtain a “feeling of relaxation,” to “not think” and to fall asleep.

Tramal, believed to be a more addictive black market form of Tramadol, arrived later, gaining popularity after the first war between Hamas and Israel in 2009.

Tramal was cheap, less than 50 cents a tablet, and people discovered its sedative effects at a time when they were “trying to overcome their anxiety because Gaza was a very traumatic environment,” said Dr. Ashour.

But in recent months, prices have shot up. A single pill can cost about $20, well beyond most people’s means.

Being a health worker himself, Abu Karim was able to get prescriptions to buy the milder Tramadol legally and more affordably.

“It was not as powerful as the smuggled Tramal, but with more pills, it does part of the job,” he said.

Today, he’s among the few patients at the Hope Center, the first and only rehab facility in Gaza. Since opening at Gaza’s only psychiatric hospital in 2017, it has treated 230 people, 90 percent of them tramadex users.

Nearly a year of border protests against the Israeli blockade have added a new element to the crisis. Hundreds of young men have been shot by the Israeli army, which says it is defending its border.

Mahmoud, a 29-year-old, said he became addicted to Lyrica after he was shot during a protest. Unemployed and unmarried, he is now being treated by Dr. Ashour.

“I don’t want to reach a level in which I lose my personality and dignity because of the drugs,” said Mahmoud, who would not give his family name because of the social stigma associated with addiction. “I want to stop.”

#Opioides #Gaza #Addiction

L’addiction, une garantie pour les profits | Entre les lignes entre les mots
▻https://entreleslignesentrelesmots.blog/2019/02/27/laddiction-une-garantie-pour-les-profits

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par Didier Epsztajn

Patrick Radden Keefe débute son texte par le Metropolitan Museum, l’« aile Sackler » du nom d’une « des plus grandes dynasties de philanthropes américains ». Il interroge l’origine de cette richesse, « aussi obscure que celle des barons voleurs », l’entreprise familiale Purdue Pharma.

Une entreprise privée, un antalgique, OxyContin, un opioïde et ses propriétés addictives, des campagnes marketing, le financement de médecins pour construire des « arguments »… « Depuis 1999, 300 000 à 500 000 Américains selon les évaluations, sont morts d’overdose liées à OxyContin ou d’autres opioïdes délivrés sur ordonnance ».

L’auteur analyse la place du commerce – et non de la pratique médicale – ayant fait la fortune des frères Sackler, les campagnes de séduction des médecins, la multiplication des ordonnances de tranquillisants, les vertus thérapeutique du pavot à opium et les risques addictifs, la commercialisation de « jumbo pills », les choix liés aux « impératifs » de rentabilité, les informations – véritables publicités – fournies aux médecins, « l’entreprise persuadait les médecins que le médicament était sans danger en s’appuyant sur des documents produits par des médecins payés ou fiancés par l’entreprise », la diffusion des comprimés sur le marché noir, le refus de reconnaître le caractère addictif du médicament, le rejet de la responsabilité sur les seul·es individu·es (une ritournelle du néolibéralisme), la sur-prescription et les énormes profits, les arrangements pour éviter les procès, le blocage de la concurrence des médicaments génériques, le lobbyisme…

Une mise en cause tant de la marchandisation de la santé, des mensonges et de la propagande des laboratoires pharmaceutiques, des addictions propagées par le capitalisme, des systèmes privatisés de soins et de la place des fondations – du cynisme de la philanthropie – sans oublier leur rôle dans l’évitement fiscal…

Une nouvelle collection interventions (« il s’agit de dévoiler les détournements, les enclosures et les accaparements ou d’évoquer des solutions ouvertes, originales et coopératives ») à suivre.

#Addiction_ordonnance #C&F_éditions #Sackler #Opioides #Patrick_Radden_Keefe

Des chercheurs français élaborent un #antidouleur qui pourrait ringardiser la morphine - Le Point
▻https://www.lepoint.fr/sante/des-chercheurs-francais-elaborent-un-antidouleur-qui-pourrait-ringardiser-la

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L’effet naturel de ce neurotransmetteur, libéré par des neurones lors d’une sensation douloureuse trop intense, était jusqu’alors trop fugace pour être utilisé par les médecins. « Malheureusement, après administration, ces molécules sont métabolisées en quelques minutes et sont dans l’incapacité de déclencher un effet analgésique », développe en effet l’Inserm dans un communiqué relayé par LCI. Mais tout change lorsque la molécule est combinée avec du squalène. Grâce à ce lipide, présent dans tous les organismes supérieurs, et précurseur commun des hormones stéroïdes et de quelques vitamines, comme les vitamines D, l’enképhaline se stabilise.

#opioïdes

Antalgiques : les chiffres inquiétants de l’addiction aux opiacés en France
►https://www.lemonde.fr/les-decodeurs/article/2019/02/22/antalgiques-les-chiffres-inquietants-de-l-addiction-aux-opiaces-en-france_54

https://img.lemde.fr/2019/02/22/188/0/3408/1704/1440/720/60/0/e919a34_BDbU_iq6fTKVvdaY0tbUmwXd.jpg

Dans un état des lieux publié mercredi 20 février, l’Agence nationale de sécurité du médicament et des produits de santé (ANSM) met en garde contre les risques de dépendance résultant d’une surconsommation des médicaments antidouleur contenant des opiacés ou des dérivés, qualifiée de « préoccupation majeure des autorités de santé ».

Le nombre d’hospitalisations liées à la consommation de ce type de médicaments a ainsi presque triplé (avec une hausse de 167 %) entre 2000 et 2017, tandis que le nombre de décès a augmenté de 146 % entre 2000 et 2015. D’après les données de l’Assurance-maladie, près de dix millions de Français ont eu une prescription de ce type d’antalgiques en 2015.

Avec un total estimé entre deux cents et huit cents décès chaque année (le haut de la fourchette inclut une consommation illégale de médicaments opiacés), les opioïdes constituent la première cause de morts par overdose en France. Par comparaison, l’héroïne a tué quatre-vingt-dix personnes en 2016, la méthadone cent quarante. Premiers responsables de cette mortalité : le tramadol, la morphine et la codéine.

Mais cette mortalité n’est pas seulement liée aux consommateurs habituels de drogues : dès la fin 2013, Jean-Pierre Couteron, alors président de la Fédération addiction, et Pierre Chappard, président de l’association PsychoActif, alertaient ainsi sur la codéine et le tramadol comme « l’héroïne de M. et Mme Tout-le-Monde » dans leur blog Psychoactif. Des pratiques qui « concernaient plutôt des personnes socialement insérées », insistaient-ils.

Selon l’ANSM, les consommateurs d’antalgiques sont majoritairement des femmes, que ce soit pour les opioïdes faibles ou forts (respectivement 57,7 % et 60,5 % en 2015), consultant pour une affection de longue durée (ALD) impliquant une douleur aiguë. Les prescripteurs sont à près de 90 % des médecins généralistes.

#Opioides #France

Watch: These drug company execs actually used rap video parody to push high-dose fentanyl sales – Alternet.org
▻https://www.alternet.org/2019/02/watch-these-drug-company-execs-actually-used-rap-video-parody-to-push-high

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Back in 2015, as the country was deep in the midst of the ongoing opioid crisis, at least one major pharmaceutical company thought its sales reps weren’t doing enough to push higher doses of its highly potent fentanyl product, so company executives produced a parody rap video to spur them on.

The video emerged last week during the trial in Boston of Insys Therapeutics Inc. founder John Kapoor and four of his former executives on charges they conspired to pay bribes and kickbacks to doctors to get them to prescribe the company’s fentanyl spray, which was designed to treat cancer patients with severe pain.

One of those executives was a former stripper hired as a regional sales manager even though prosecutors said she had no pharmaceutical experience. She was good at providing lap dances for doctors, though.

More than 900 people have died from Insys’ fentanyl spray since it was approved in 2012.

The video, “Great by Choice,” features suit-and-tie wearing sales reps rapping to the tune of an A$AP Rocky song, but with lyrics focused on getting doctors to gradually increase the doses of fentanyl spray they prescribed to patients, a process known as titration.

“I love titrations, yeah, that’s not a problem. I got new patients and I got a lot of ’em,” the sales reps rap. “Build relationships that are healthy. Got more docs than Janelle’s got selfies.”

And, of course, a shout-out to the boss:

“What we built here can’t be debated. Shout to Kapoor for what you’ve created,” they rap. “While the competition just making noise. We’re making history because we’re great by choice.”

The video also includes a cameo from former Insys vice-president of sales Alec Burlakoff. He pleaded guilty to racketeering conspiracy in November and is expected to testify against Kapoor in the current trial. He enters dressed up as a bottle of fentanyl spray before unveiling himself as the company’s hard-charging sales cheerleader.

The video is just the latest explosive revelation from the trial, which is expected to last for several more weeks, and, while not as titillating as the lap-dancing sales exec, does as much to demonstrate the craven corporate culture fostered by Kapoor in his bid to turn a profit off pain medications.

And now, Kapoor and his former top execs are turning on each other. Burlakoff and another key witness, former CEO Michael Babich, who pleaded guilty last month, are pointing fingers at Kapoor. Babich testified last week that Kapoor pushed sales reps to get doctors to put patients on higher doses, and Burlakoff is expected to echo that testimony.

Kapoor’s attorneys, though, are portraying Burlakoff and Babich as liars seeking reduced sentences and blaming Burlakoff for any criminal activity. Is there no honor among pharma execs?

#Opioides #Fentanyl #Insys

ENVOYE SPECIAL. « Ce sont des dealers de drogue légaux ! » : une victime d’un antidouleur à base d’opium raconte sa descente aux enfers
▻https://www.francetvinfo.fr/monde/usa/video-ce-sont-des-dealers-de-drogue-legaux-une-victime-de-l-addiction-a

https://www.francetvinfo.fr/image/75n9b5mlj-89ed/1500/843/17052031.jpg

Lauren Cambra, qui souffrait d’une sciatique, a été choisie à la fin des années 1990 par un laboratoire pharmaceutique pour incarner les vertus de l’OxyContin, un antidouleur à base d’opium. Sur une vidéo publicitaire où elle a accepté de figurer, à la demande de son médecin, on la voit, radieuse, nager avec ses petits-enfants dans sa piscine. Le Dr Spanos apparaît lui aussi dans le film, pour « réfuter la légende selon laquelle les opioïdes conduisent, à terme, à l’addiction et la passivité. »
Encouragé par les médecins

Ce film était diffusé dans la salle d’attente de nombreux médecins. Il a été financé intégralement par Purdue Pharma, le laboratoire qui produit l’OxyContin (il a été condamné en 2007 à 634 millions de dollars d’amende pour avoir « désinformé » les médecins). Après une campagne de communication massive, ces pilules ont inondé le marché américain. Présenté comme un médicament miracle, l’OxyContin est, avec d’autres opioïdes, à l’origine d’une des plus graves crises sanitaires qu’aient connues les Etats-Unis. Ce type de médicaments continue à tuer : 72 000 personnes sont mortes d’overdose en 2017.
Des vidéos financées par le laboratoire

« Ils se sont fait des dizaines de millions de dollars grâce à ces vidéos. Ils ont fait ça pour l’argent, par pure avidité ! dénonce Lauren aujourd’hui. Ce sont des dealers de drogue ! Des dealers légaux, mais des dealers. Si demain vous allez chez le médecin et qu’il vous prescrit de l’OxyContin, écoutez-moi : partez en courant ! »

Vingt ans plus tard, Lauren Cambra est la seule patiente apparaissant dans cette vidéo promotionnelle qui ait survécu et accepté d’en parler. Elle avait toujours refusé de se confier à des journalistes. L’histoire qu’elle raconte à « Envoyé spécial » est faite de douleur et de honte.

Au début, l’OxyContin soulage les douleurs dues à sa sciatique de manière miraculeuse. Mais très vite, les effets s’estompent, et il faut augmenter la dose. Cela provoque une somnolence, des absences. Lauren perd son emploi, son assurance, et ne peut plus se payer les pilules.
« J’étais pratiquement SDF »

« Et là, confie-t-elle, ç’a été le début de… oh, mon Dieu ! C’est là que j’ai compris à quel point cette pilule était addictive. Parce que j’ai arrêté de la prendre. Et là… Oh là là… j’ai tenu douze heures, quatorze heures, seize heures… et j’étais à l’agonie. Mon corps n’en pouvait plus. Je hurlais sur tout le monde, c’était horrible. Je n’ai même pas tenu une journée. »

Commence alors pour Lauren une véritable descente aux enfers. « J’ai pris l’argent prévu pour mon crédit voiture, et je suis allée m’acheter mes pilules. Ça, c’était le premier mois. Ensuite, j’ai pris l’argent prévu pour la voiture, pour le crédit de la maison, la nourriture… pour mes pilules. Et au final, j’ai tout perdu : ma voiture, ma maison… J’étais pratiquement SDF. »

Extrait de « Antidouleurs : l’Amérique dévastée », un reportage à voir dans « Envoyé spécial » le 21 février 2019.

#Opioides #Sackler #Reportage

« Antidouleurs : l’Amérique dévastée » : un scandale sanitaire hors du commun
▻https://www.lemonde.fr/culture/article/2019/02/21/antidouleurs-l-amerique-devastee-un-scandale-sanitaire-hors-du-commun_542610

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C’est une enquête menée à travers les Etats-Unis et qui fait froid dans le dos. Elle concerne des dizaines de milliers d’hommes, de femmes et d’enfants. Il y est question de douleurs physiques intolérables, de pilules prétendument magiques, d’accoutumance mortelle, de décès en masse et d’un scandale sanitaire hors du commun.

Des victimes issues de tous les milieux sociaux, n’ayant pas le profil habituel des toxicomanes mais qui, pour faire passer des douleurs diverses (arthrose, sciatique, douleurs abdominales…), se sont accoutumées à des médicaments antidouleur qui se sont révélés particulièrement dangereux.
Lire l’enquête : Les Etats-Unis tentent de réagir face à la crise des opioïdes

L’addiction aux opioïdes a causé la mort de près de 300 000 personnes en vingt ans aux Etats-Unis, dont 72 000 pour la seule année 2017.

Dans ce documentaire diffusé dans le cadre de l’émission « Envoyé spécial », plusieurs extraits font frémir : on y voit une mère de famille s’écroulant subitement au supermarché sous les yeux de son enfant. Ou un quadragénaire plongeant dans le coma au volant de son véhicule. Sans parler de la petite Emma, née quinze jours plus tôt dans une clinique du Tennessee et qui, sans ses huit doses de morphine par jour, succomberait de douleur. Le bébé souffre du syndrome d’abstinence néonatal, il est chimiquement accro aux antidouleur. La raison ? Sa mère prenait en masse des antalgiques dérivés de l’opium et a contaminé sa fille. D’autres images montrent des policiers munis d’un spray nasal spécial (Narcan) – antidote efficace aux opioïdes – sauvant des vies in extremis.
L’OxyContin dans le viseur

En première ligne sur la liste noire : l’OxyContin, médicament antidouleur à base d’opium – deux fois plus puissant que la morphine – fabriqué par l’influent laboratoire Purdue. Lancé en 1996 à grand renfort de publicité, l’OxyContin a rapidement envahi les pharmacies des particuliers. A l’époque, des médecins payés par Purdue assuraient, face caméra, que les opioïdes étaient non seulement très efficaces, mais surtout sans danger. Le succès commercial est gigantesque.
Lire l’enquête : L’inquiétant succès de l’OxyContin, puissant antalgique opiacé

Vingt ans plus tard, la plupart des anciens patients modèles choisis par Purdue pour incarner les vertus du médicament sont morts. Les auteurs du documentaire ont retrouvé, en Caroline du Nord, une survivante. En 1996, une sciatique la faisait souffrir. A force d’ingurgiter des doses de plus en plus importantes d’OxyContin, les douleurs s’estompent. Pour un temps, puisqu’il faut toujours augmenter les doses. Le cercle vicieux est sans fin.

En 2007, trois cadres de Purdue plaident coupable devant la justice, qui inflige une amende de 600 millions de dollars au laboratoire

Depuis plus de quinze ans, Purdue est dans le viseur des autorités. En décembre 2001, des sénateurs, inquiets des pratiques du laboratoire, avaient auditionné un responsable de l’entreprise. En 2007, trois cadres de Purdue ont plaidé coupable devant la justice, qui a infligé une amende de 600 millions de dollars au laboratoire. La fin du cauchemar ? Pas du tout. Le lobby pharmaceutique américain continue sa campagne en faveur des opioïdes.

Face caméra, une ancienne visiteuse médicale de Purdue, recrutée en 2008, raconte l’efficacité de ses visites aux médecins de famille. « Vos patients ont des douleurs ? J’ai le médicament qu’il vous faut pour les soulager… » Ses primes, conséquentes, augmentaient selon les dosages prescrits par les médecins. Avec la multiplication des morts par overdose, la très discrète et richissime famille Sackler, propriétaire de Purdue, risque cette fois de sérieux ennuis. Une centaine de villes et près de trois cents avocats ont engagé des centaines de procédures contre ses méthodes.

« Antidouleurs : l’Amérique dévastée », de Pierre Monégier, Brice Baubit et Emmanuel Lejeune (France, 2019, 55 min). Francetvinfo.fr/france-2/envoye-special

#Opioides #Sackler #OxyContin #Reportage

«ENVOYE SPECIAL». Etats-Unis : les médicaments antidouleur tuent plus que les armes à feu
▻https://www.francetvinfo.fr/monde/usa/video-mort-sur-ordonnance-aux-etats-unis-les-medicaments-antidouleur-tu

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Des Américains ordinaires qui s’écroulent en pleine rue, au supermarché, au volant de leur voiture… victimes d’overdose. Intoxiqués aux #opioïdes par des médicaments antidouleur prescrits et vendus en toute légalité. « Envoyé spécial » diffuse le 21 février un document exceptionnel sur ce qui est devenu une véritable épidémie aux Etats-Unis.

#Prince
Walt Dohrn, Vice, le 19 février 2019
▻https://www.vice.com/en_us/article/8xymv5/prince-todays-comics-by-walt-dohrn-1-comics

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#Musique #BD

Gifts Tied to Opioid Sales Invite a Question : Should Museums Vet Donors ? - The New York Times
▻https://www.nytimes.com/2017/12/01/arts/design/sackler-museum-donations-oxycontin-purdue-pharma.html

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The New York Times surveyed 21 cultural organizations listed on tax forms as having received significant sums from foundations run by two Sackler brothers who led Purdue. Several, including the Guggenheim, declined to comment; others, like the Brooklyn Museum, ignored questions. None indicated that they would return donations or refuse them in the future.

“We regularly assess our funding activities to ensure best practice,” wrote Zoë Franklin, a spokeswoman for the Victoria and Albert Museum, which was listed as receiving about $13.1 million from the Dr. Mortimer and Theresa Sackler Foundation in 2012. “The Sackler family continue to be an important and valuable donor to the V & A and we are grateful for their ongoing support.”

De l’usage de la philanthropie comme écran de fumée

Robert Josephson, a spokesman for the company, pointed to its efforts to stem the opioid epidemic — distributing prescription guidelines, developing abuse-deterrent painkillers and ensuring access to overdose-reversal medication — and noted that OxyContin has never had a large share of total opioid prescriptions. In an email, he added, “Many leading medical, scientific, cultural and educational institutions throughout the world have been beneficiaries of Sackler family philanthropy.”

#Sackler #Philanthropie #Opioides #Musées

Parution : Addiction sur ordonnance, La crise des antidouleurs, par Patrick Radden Keefe
►https://cfeditions.com/addiction

https://cfeditions.com/addiction/ressources/addiction-900.jpg

J’ai le plaisir de vous annoncer la parution de :

Addiction sur ordonnance
La crise des antidouleurs
par Patrick Radden Keefe

traduit de l’anglais (États-Unis) par Claire Richard
avec des contributions de :
Frédéric Autran, Cécile Brajeul et Hervé Le Crosnier

C&F éditions, 2019
16 €
ISBN 978-2-915825-90-9
►https://cfeditions.com/addiction

Ce premier livre de la collection interventions traite d’un sujet douloureux, la « crise des opioïdes » qui ronge les États-Unis de l’intérieur et qui s’étend dans le monde entier. 400000 décès par overdose dans la dernière décennie aux USA, dont 70000 l’an passé... pour une addiction qui a souvent débuté dans le cabinet d’un médecin ou un service d’hôpital ayant prescrit des antidouleurs sans prendre les précautions nécessaires pour éviter la dépendance aux opiacés.

Patrick Radden Keefe est remonté à la source en étudiant les stratégies marketing de la famille Sackler, et de sa petite entreprise de pharmacie du Connecticut, devenue une des plus riches du pays... au prix d’une crise de santé publique majeure.

L’article de Frédéric Autran montre la vie quotidienne des personnes dépendantes aux opiacés, et plus particulièrement aux opioïdes de synthèse vendus comme des médicaments.

Celui de Cécile Brajeul expose plus spécifiquement la situation en France.

Dans sa postface, Hervé Le Crosnier considère les trusts pharmaceutiques comme des acteurs de la « société de l’information », pour lesquels l’appât du gain et les mensonges marketing sont le moteur prioritaire. Il appelle à reconsidérer la dépendance des organismes publics (musées, universités...) aux financements privés et notamment au cynisme de la philanthropie.

On peut obtenir un extrait spécimen à :
▻https://cfeditions.com/addiction/ressources/addiction_SPECIMEN.pdf

Bonne lecture

#Addiction #Opioides #C&F_éditions #Sackler #Oxycontin

OxyContin Maker Explored Expansion Into “Attractive”… — ProPublica
▻https://www.propublica.org/article/oxycontin-purdue-pharma-massachusetts-lawsuit-anti-addiction-market

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Secret portions of a lawsuit allege that Purdue Pharma, controlled by the Sackler family, considered capitalizing on the addiction treatment boom — while going to extreme lengths to boost sales of its controversial opioid.

In internal correspondence beginning in 2014, Purdue Pharma executives discussed how the sale of opioids and the treatment of opioid addiction are “naturally linked” and that the company should expand across “the pain and addiction spectrum,” according to redacted sections of the lawsuit by the Massachusetts attorney general. A member of the billionaire Sackler family, which founded and controls the privately held company, joined in those discussions and urged staff in an email to give “immediate attention” to this business opportunity, the complaint alleges.

The sections of the complaint already made public contend that the Sacklers pushed for higher doses of OxyContin, guided efforts to mislead doctors and the public about the drug’s addictive capacity, and blamed misuse on patients.

Citing extensive emails and internal company documents, the redacted sections allege that Purdue and the Sackler family went to extreme lengths to boost OxyContin sales and burnish the drug’s reputation in the face of increased regulation and growing public awareness of its addictive nature. Concerns about doctors improperly prescribing the drug, and patients becoming addicted, were swept aside in an aggressive effort to drive OxyContin sales ever higher, the complaint alleges.

Among the allegations: Purdue paid two executives convicted of fraudulently marketing OxyContin millions of dollars to assure their loyalty, concealed information about doctors suspected of inappropriately prescribing the opioid, and was advised by global consulting firm McKinsey & Co. on strategies to boost the drug’s sales and burnish its image, including how to “counter the emotional messages” of mothers whose children overdosed. Since 2007, the Sackler family has received more than $4 billion in payouts from Purdue, according to a redacted paragraph in the complaint.

The redacted paragraphs leave little doubt about the dominant role of the Sackler family in Purdue’s management. The five Purdue directors who are not Sacklers always voted with the family, according to the complaint. The family-controlled board approves everything from the number of sales staff to be hired to details of their bonus incentives, which have been tied to sales volume, the complaint says. In May 2017, when longtime employee Craig Landau was seeking to become Purdue’s chief executive, he wrote that the board acted as “de-facto CEO.” He was named CEO a few weeks later.

After its 1996 launch, OxyContin rapidly became a top seller. But reports of patients abusing the drug soon followed. OxyContin contained more pain relief medication than older drugs, and crushing and snorting it was a simple way to get high fast. In 2007, Purdue pleaded guilty to federal charges of understating the risk of addiction and agreed to pay $600 million in fines and penalties. Still, the company argued publicly that OxyContin has “done far more good than harm,” and it sought to place responsibility for the bad acts on “certain of its supervisors and employees.”

Privately, the complaint suggests, the Sacklers were concerned about alienating two executives, then-CEO Michael Friedman and then-legal counsel Howard Udell. Friedman and Udell each pleaded guilty in 2007 in U.S. District Court in Abingdon, Virginia, to a misdemeanor charge of misbranding OxyContin, as did a former executive. The board signed off on the three executives’ decisions to plead guilty. No member of the Sackler family pleaded guilty.

Purdue paid $5 million to Udell in November 2008, and up to $1 million in November 2009, the complaint states. In February 2008, the company paid $3 million to Friedman. The complaint doesn’t mention any payments to the former executive.

“The Sacklers spent millions to keep the loyalty of people who knew the truth,” the complaint alleges.

Udell died in 2013. A person answering a phone number listed to Friedman declined comment.

When sales results disappointed, Sackler family members didn’t hesitate to intervene. In late 2010, Purdue told the family that sales of the highest dose and most profitable opioids were lower than expected, according to the complaint. That meant an expected quarter-end payout to the family of $320 million was at risk of being reduced to $260 million and would have to be made in two installments in December instead of one in November.

That news prompted a sharp email question from Mortimer D.A. Sackler, whose late father, also named Mortimer, was a Purdue co-founder. “Why are you BOTH reducing the amount of the distribution and delaying it and splitting it in two?” he asked. “Just a few weeks ago you agreed to distribute the full 320 [million dollars] in November.” The complaint doesn’t say how much was ultimately paid.

In September 2014, Purdue embarked on a secret project to join an industry that was booming thanks in part to OxyContin abuse: addiction treatment medication. Code-named Project Tango, it involved Purdue executives and staff as well as Dr. Kathe Sackler, a daughter of the company co-founder Mortimer Sackler and a defendant in the Massachusetts lawsuit. She participated in phone calls and told staff that the project required their “immediate attention,” according to the complaint.

Internally, Purdue touted the growth of an industry that its aggressive marketing had done so much to foster.

“It is an attractive market,” the team working on the project wrote in a presentation. “Large unmet need for vulnerable, underserved and stigmatized patient population suffering from substance abuse, dependence and addiction.”

While OxyContin sales were declining, the internal team at Purdue touted the fact that the addiction treatment marketplace was expanding.

“Opioid addiction (other than heroin) has grown by ~20%” annually from 2000 to 2010, the company noted. Although Richard Sackler had blamed OxyContin abuse in an email on “reckless criminals,” the Purdue staff exploring the new business opportunity described in far more sympathetic terms the patients whom it now planned to treat.

“This can happen to any-one – from a 50 year old woman with chronic lower back pain to a 18 year old boy with a sports injury, from the very wealthy to the very poor,” it said.

Company documents recommended becoming an “end-to-end pain provider.” Initially, Purdue intended to sell one such medication, Suboxone, which is commonly retailed as a film that melts in the mouth. When Kathe Sackler asked staff members to look into reports that children might be swallowing the film, they reassured her. They responded, according to the complaint, that youngsters were overdosing on pills, but not the films, “which is a positive for Tango.”

In 2015, Purdue turned its attention to another potential product, the overdose reversing agent known as Narcan, calling it a “strategic fit.” Purdue executives discussed how its sales force could promote Narcan to the same doctors who prescribed the most opioids. Purdue said in the statement Wednesday that it decided against acquiring the rights to sell Suboxone and Narcan.

While those initiatives appear to have stalled or ended, Richard Sackler received a patent last year for a drug to treat addiction, according to the complaint. The patent application states that opioids are addictive and refers to people who suffer from substance use disorders as “junkies.”

#Opioides #Sackler

Judge to rule next week on disclosing claims about Purdue Pharma - STAT
▻https://www.statnews.com/2019/01/25/judge-to-rule-on-disclosing-allegations-against-purdue

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BOSTON — A Massachusetts judge said Friday she would rule by early next week on a request from media organizations, including STAT and the Boston Globe, to make public redacted portions of a lawsuit brought by the Massachusetts attorney general’s office against Purdue Pharma, the maker of OxyContin and other opioid painkillers.

The Connecticut company’s aggressive and misleading marketing of OxyContin has been blamed by addiction experts for helping spawn the opioid addiction crisis. Outside the Boston courthouse Friday, families of people who became addicted to opioids after taking Purdue’s medications rallied, with some calling for criminal charges against the company.

“Every day that goes by where this document is substantially under seal is a day that the public does not have access to newsworthy and important information,” Jeffrey Pyle, a lawyer representing the media organizations, argued before Judge Janet Sanders in Suffolk County Superior Court.

Attorney General Maura Healey accused Purdue of misleading doctors and patients about the addiction and overdose risks of its medications in a lawsuit originally filed in June, which also named current and former Purdue executives and members of the Sackler family, which controls the privately held Purdue, as defendants.

An updated, 300-plus-page complaint from Healey’s office filed last week contained newly public portions that showed Purdue executives and the Sacklers demanding greater sales of their medications despite the risks and pressuring salespeople to push physicians to prescribe higher doses of their drugs for longer periods of time to more patients.

#Opioides #Procès

Opioid Lawsuits Are Headed to Trial. Here’s Why the Stakes Are Getting Uglier. - The New York Times
▻https://www.nytimes.com/2019/01/30/health/opioid-lawsuits-settlement-trial.html

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Uncontested: The devastation from prescription opioids has been deadly and inordinately expensive.

Contested: Who should foot the bill?

Just over a year ago, opioid lawsuits against makers and distributors of the painkillers were proliferating so rapidly that a judicial panel bundled all the federal cases under the stewardship of a single judge. On a January morning, Judge Dan Aaron Polster of the Northern District of Ohio made his opening remarks to lawyers for nearly 200 municipal governments gathered in his Cleveland courtroom. He wanted the national opioid crisis resolved with a meaningful settlement within a year, proclaiming, “We don’t need briefs and we don’t need trials.”

That year is up.

Far from being settled, the litigation has ballooned to 1,548 federal court cases, brought on behalf of cities and counties, 77 tribes, hospitals, union benefit funds, infants with neonatal abstinence syndrome and others — in total, millions of people. With a potential payday amounting to tens of billions of dollars, it has become one of the most complicated and gargantuan legal battles in American history.

With settlement talks sputtering, the judge has signed off on a parallel track involving, yes, briefs, focused on, yes, trial. He will preside over three consolidated Ohio lawsuits in what is known as a “bellwether,” or test case. The array of defendants include Purdue Pharma, Mallinckrodt PLC, CVS RX Services Inc. and Cardinal Health, Inc. That jury’s verdict could determine whether the parties will then negotiate in earnest or keep fighting.

The plaintiffs have long said that the companies deliberately looked the other way at the improbable quantities. But the lawyers did not have the hard numbers in hand to bolster their claims.

Now they do.

For the time being, the judge will not release the data to the public. But a passage from a congressional report gives a sense of the granular information in the data: during 10 months in 2007, one distributor, McKesson, shipped three million prescription opioids to a single pharmacy in a West Virginia town with 400 residents.

Typically, patients who sue for medical malpractice or product liability must turn over their own medical records as proof. They forfeit conventional privacy rights.

Here, the overwhelming majority of plaintiffs are government entities, not individuals. They are seeking to be reimbursed for the accumulated costs of drug addiction and its collateral damage. The defendants want them to produce precise evidence showing how those costs are calculated, including the chain of events — for example, from a drug’s development, to its delivery, to a pharmacy-filled prescription to, eventually, bills from hospitals and others.
What on Earth Is Going On?

That means the drug industry is asking for patients’ records and for every prescription the plaintiffs deemed medically “suspicious.” The plaintiffs are pushing back, saying that the depleted municipal budgets for health, social services and law enforcement paint a more telling picture.

Why drug companies could have an upper hand

Lawyers on both sides agree: This litigation presents a slew of novel legal issues.

If the bellwether ends in a victory for plaintiffs, appeals courts, increasingly filled with conservative judges, would be unlikely to uphold all of Judge Polster’s rulings on these untested legal questions, much less a whopping, emotional jury award. Complexity favors the defense.

And in settlement negotiations, the long game is the defense’s best friend: they can afford to drag this out. Typically, the longer it slogs on, the more the final tab gets driven down.

#Opioides #Procès

The Arthur Sackler Family’s Ties to OxyContin Money - The Atlantic
►https://www.theatlantic.com/health/archive/2018/04/sacklers-oxycontin-opioids/557525

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Much as the role of the addictive multibillion-dollar painkiller OxyContin in the opioid crisis has stirred controversy and rancor nationwide, so it has divided members of the wealthy and philanthropic Sackler family, some of whom own the company that makes the drug.

In recent months, as protesters have begun pressuring the Metropolitan Museum of Art in New York and other cultural institutions to spurn donations from the Sacklers, one branch of the family has moved aggressively to distance itself from OxyContin and its manufacturer, Purdue Pharma. The widow and one daughter of Arthur Sackler, who owned a related Purdue company with his two brothers, maintain that none of his heirs have profited from sales of the drug. The daughter, Elizabeth Sackler, told The New York Times in January that Purdue Pharma’s involvement in the opioid epidemic was “morally abhorrent to me.”

But an obscure court document sheds a different light on family history—and on the campaign by Arthur’s relatives to preserve their image and legacy. It shows that the Purdue family of companies made a nearly $20 million payment to the estate of Arthur Sackler in 1997—two year after OxyContin was approved, and just as the pill was becoming a big seller. As a result, though they do not profit from present-day sales, Arthur’s heirs appear to have benefited at least indirectly from OxyContin.

The 1997 payment to the estate of Arthur Sackler is disclosed in the combined, audited financial statements of Purdue and its associated companies and subsidiaries. Those documents were filed among hundreds of pages of exhibits in the U.S. District Court in Abingdon, Virginia, as part of a 2007 settlement in which a company associated with Purdue and three company executives pleaded guilty to charges that OxyContin was illegally marketed. The company paid $600 million in penalties while admitting it falsely promoted OxyContin as less addictive and less likely to be abused than other pain medications.

Arthur’s heirs include his widow and grandchildren. His children, including Elizabeth, do not inherit because they are not beneficiaries of a trust that was set up as part of a settlement of his estate, according to court records. Jillian receives an income from the trust. Elizabeth’s two children are heirs and would receive bequests upon Jillian’s death. A spokesman for Elizabeth Sackler declined to comment on the Purdue payment.

Long before OxyContin was introduced, the Sackler brothers already were notable philanthropists. Arthur was one of the world’s biggest art collectors and a generous benefactor to cultural and educational institutions across the world. There is the Arthur M. Sackler Gallery at the Smithsonian Institution, the Arthur M. Sackler Museum at Harvard, and the Jillian and Arthur M. Sackler Wing of Galleries at the Royal Academy of Arts in London.

His brothers were similarly generous. They joined with their older brother to fund the Sackler Wing at the Met, which features the Temple of Dendur exhibit. The Mortimer and Theresa Sackler Foundation was the principal donor of the Serpentine Sackler Gallery in London; the Sackler name is affiliated with prestigious colleges from Yale to the University of Oxford, as well as world-famous cultural organizations, including the Victoria and Albert Museum in London. There is even a Sackler Rose—so christened after Mortimer Sackler’s wife purchased the naming rights in her husband’s honor.

Now the goodwill gained from this philanthropy may be waning as the Sackler family has found itself in an uncomfortable spotlight over the past six months. Two national magazines recently examined the intersection of the family’s wealth from OxyContin and its philanthropy, as have other media outlets across the world. The family has also been targeted in a campaign by the photographer Nan Goldin to “hold the Sacklers accountable” for OxyContin’s role in the opioid crisis. Goldin, who says she became addicted to OxyContin after it was prescribed for surgical pain, led a protest last month at the Metropolitan Museum of Art, in which demonstrators tossed pill bottles labeled as OxyContin into the reflecting pool of its Sackler Wing.

While it doesn’t appear that any recipients of Sackler charitable contributions have returned gifts or pledged to reject future ones, pressure and scrutiny on many of those institutions is intensifying. In London, the National Portrait Gallery said it is reviewing a current pledge from the Sackler Trust.

#Opioides #Sackler

How Do You Recover After Millions Have Watched You Overdose? - The New York Times
▻https://www.nytimes.com/2018/12/11/us/overdoses-youtube-opioids-drugs.html

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The first time Kelmae Hemphill watched herself overdose, she sobbed. There she was in a shaky video filmed by her own heroin dealer, sprawled out on a New Jersey road while a stranger pounded on her chest. “Come on, girl,” someone pleaded.

Ms. Hemphill’s 11-year drug addiction, her criminal record, her struggles as a mother — they were now everybody’s business, splashed across the news and social media with a new genre of American horror film: the overdose video.

As opioid deaths have soared in recent years, police departments and strangers with cameras have started posting raw, uncensored images of drug users passed out with needles in their arms and babies in the back seats of their cars. The videos rack up millions of views and unleash avalanches of outrage. Then some other viral moment comes along, and the country clicks away.

But life is never the same for the people whose bleakest, most humiliating moments now live online forever. In interviews with The New York Times, they talked — some for the very first time — about the versions of themselves captured in the videos.

“Why bother saving her?” asked one YouTube commenter. “I would’ve let her die,” said another. Angry Facebook messages arrived months, even years, later, when strangers stumbled across the videos.

Addiction experts say the videos are doing little else than publicly shaming drug users, and the blunt horror of the images may actually increase the stigma against them. Users themselves disagree on whether the humiliation helped them clean up their lives.

“We’re showing you this video of them at the worst, most humiliating moment of their life,” said Daniel Raymond, deputy director of policy and planning at the Harm Reduction Coalition, an advocacy group. “The intent is not to help these people. The intent is to use them as an object lesson by scapegoating them.”

Mandy McGowan, 38, knows that. She was the mother unconscious in that video, the woman who became known as the “Dollar Store Junkie.” But she said the video showed only a few terrible frames of a complicated life.

As a child, she said, she was sexually molested. She survived relationships with men who beat her. She barely graduated from high school.

She said her addiction to opioids began after she had neck surgery in 2006 for a condition that causes spasms and intense pain. Her neurologist prescribed a menu of strong painkillers including OxyContin, Percocet and fentanyl patches.

As a teenager, Ms. McGowan had smoked marijuana and taken mushrooms and ecstasy. But she always steered clear of heroin, she said, thinking it was for junkies, for people living in alleys. But her friends were using it, and over the last decade, she sometimes joined them.

She tried to break her habit by buying Suboxone — a medication used to treat addiction — on the street. But the Suboxone often ran out, and she turned to heroin to tide her over.

On Sept. 18, 2016, a friend came to Ms. McGowan’s house in Salem, N.H., and offered her a hit of fentanyl, a deadly synthetic painkiller 50 times more potent than heroin. They sniffed a line and drove to the Family Dollar across the state line in Lawrence, where Ms. McGowan collapsed with her daughter beside her. At least two people in the store recorded the scene on their cellphones.

Medics revived her and took her to the hospital, where child welfare officials took custody of her daughter, and the police charged Ms. McGowan with child neglect and endangerment. (She eventually pleaded guilty to both and was sentenced to probation.) Two days later, the video of her overdose was published by The Eagle-Tribune and was also released by the Lawrence police.

The video played in a loop on the local news, and vaulted onto CNN and Fox News, ricocheting across the web.

“For someone already dealing with her own demons, she now has to deal with public opinion, too,” said Matt Ganem, the executive director of the Banyan Treatment Center, about 15 miles north of Boston, which gave Ms. McGowan six months of free treatment after being contacted by intermediaries. “You’re a spectacle. Everyone is watching.”

Ms. McGowan had only seen snippets of the video on the news. But two months later, she watched the whole thing. She felt sick with regret.

“I see it, and I’m like, I was a piece of freaking [expletive],” she said. “That was me in active use. It’s not who I am today.”

But she also wondered: Why didn’t anyone help her daughter? She was furious that bystanders seemed to feel they had license to gawk and record instead of comforting her screaming child.

She writes letters to her two teenage sons, who live with her former husband in New Hampshire. Her daughter, now 4, lives with the girl’s uncle. Ms. McGowan knows she will probably not regain custody, but hopes to develop a relationship with her and supplant the image embedded in her own mind of the sobbing girl in the pink pajamas.

“I know if I do the right thing, I can be involved in her life,” Ms. McGowan said. “It’s going to be a long road for me. You don’t just get clean and your life is suddenly all put back together.”

Still, the video lives on, popping up online almost constantly.

Ms. McGowan is bracing herself for the day when her daughter sees it, when her daughter lashes out at her for it, when she throws it back in her mother’s face when Ms. McGowan tries to warn her not to use drugs.

“That video is PTSD for my children,” she said. “The questions are going to come as my daughter gets older. And I have to be prepared for it. I did this. And it cost me my children.”

#Opioides #Vidéos #Médias_sociaux #Addiction #Traitements

‘The Numbers Are So Staggering.’ Overdose Deaths Set a Record Last Year. - The New York Times
▻https://www.nytimes.com/interactive/2018/11/29/upshot/fentanyl-drug-overdose-deaths.html

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The recent increases in drug overdose deaths have been so steep that they have contributed to reductions in the country’s life expectancy over the last three years, a pattern unprecedented since World War II. Life expectancy at birth has fallen by nearly four months, and drug overdoses are the leading cause of death for adults under 55.

“The idea that a developed wealthy nation like ours has declining life expectancy just doesn’t seem right,” said Robert Anderson, the chief of mortality statistics at the C.D.C., who helped prepare the reports. “If you look at the other wealthy countries of the world, they’re not seeing the same thing.”

#opioides #opiacés

Opioid Nation | by #Marcia_Angell | The New York Review of Books
▻https://www.nybooks.com/articles/2018/12/06/opioid-nation

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As long as this country tolerates the chasm between the rich and the poor, and fails even to pretend to provide for the most basic needs of our citizens, such as health care, education, and child care, some people will want to use drugs to escape. This increasingly seems to me not a legal or medical problem, nor even a public health problem. It’s a political problem. We need a government dedicated to policies that will narrow the gap between the rich and the poor and ensure basic services for everyone. To end the epidemic of deaths of despair, we need to target the sources of the despair.

#politique #opiacés #opioides #etats-unis

Alcohol Is Killing More People Per Year Than The Opioid Crisis, And Most Deaths Are Young Women
▻https://www.newsweek.com/alcohol-killing-more-people-year-opioid-crisis-and-most-deaths-are-young-1

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lcohol is killing more adults in the U.S. than the opioid epidemic according to the Institute for Health Metrics and Evaluation at the University of Washington. The opioid epidemic kills an average of 72,000 people per year, while alcohol kills 88,000. In those 88,000 deaths are 2.5 million years of potential life lost, according to the Center for Disease Control and Prevention.

The surge of alcohol related deaths is new. In ten years, the number of deaths by alcohol have increased 35 percent according the new report shared by USA Today on Friday. The statistics are based on findings from 2007 to 2017.

Most affected by the rising alcohol epidemic are young women. Among women, deaths rose 67 percent, while for men, the percentage rose only 27 percent.

Women are more susceptible to alcohol-related risks because they typically weigh less than men, and can feel the effects of alcohol faster, according to the National Institute on Alcohol and Abuse and Alcoholism. The complications that most affect women who drink excessively are Liver Damage, Heart Disease, Breast Cancer and complications with pregnancy.

#Addiction #Opioides #Alcool