product:oxycontin

‘Become My Mom Again’: What It’s Like to Grow Up Amid the Opioid Crisis - The New York Times
▻https://www.nytimes.com/2019/05/31/us/opioid-children-addiction.html

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More than 20 years after the introduction of OxyContin — and nearly 400,000 opioid overdose deaths later — a generation is growing up amid the throes of a historic epidemic. Call them Generation O: the children whose families are trapped in a relentless grip of addiction, rehab and prison. Here in Scioto County, a mix of verdant farmland and old mill towns on the southern edge of Ohio where everyone appears to know someone who has struggled with dependency, 51 people died of an overdose in 2017. At one school, administrators said, four kindergartners lost parents to drugs, and a fifth to a drug-related homicide.

Nearly two dozen young people across the county described chaotic home lives rife with neglect and abuse. They recounted begging their parents — who more often spent money on the next fix than on food — to stop using drugs. And they described finding relatives unconscious or frothing at the mouth after overdosing. The interviews were coordinated by social workers, educators and community activists, and for those younger than 18, church staff, their guardians or their parents gave them permission to speak, and were present in some cases.

Schools in Scioto County, educators said, have seen a surge in the number of children born addicted to opioids or suffering from neglect, many with severe learning disabilities, some barely able to speak. Teachers told of tantrums, at times violent, and of chairs thrown in classrooms.

In a nation where more than 130 people die every day from an opioid overdose — and in a region where the impact of addiction has taken a severe emotional toll on children — school is for many students a refuge; a place where they attend classes, but also have access to hot meals, hot showers and donated clean clothes. On Fridays, educators said, students can take home backpacks full of food so they won’t go hungry over the weekend.

Harrowing stories of living amid addiction spill out during play therapy sessions at school or in halting conversations with a sympathetic basketball coach. One recent afternoon, Christian Robinson, a lanky 18-year-old who plans to join the Marines after he graduates from high school, said his mom went to rehab when he was 11, but she relapsed last year on meth and heroin. She now lives in another city several hours away.

“Mom has said that even us kids are not a good enough reason to stay clean,” Christian said. One of his sisters was born addicted to crack, he said, and a brother was born addicted to Oxycodone.

“I’ve seen what drugs can do to a family and it’s not worth it to me,” he said.

Amid the tumult, many children said they faulted themselves for not saving their parents from addiction. Others said they were made to feel guilty.

#Opioides #Vie_d_enfer #Enfants

The Met Will Turn Down Sackler Money Amid Fury Over the Opioid Crisis - The New York Times
▻https://www.nytimes.com/2019/05/15/arts/design/met-museum-sackler-opioids.html

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The Metropolitan Museum of Art said on Wednesday that it would stop accepting gifts from members of the Sackler family linked to the maker of OxyContin, severing ties between one of the world’s most prestigious museums and one of its most prolific philanthropic dynasties.

The decision was months in the making, and followed steps by other museums, including the Tate Modern in London and the Solomon R. Guggenheim Museum in New York, to distance themselves from the family behind Purdue Pharma. On Wednesday, the American Museum of Natural History said that it, too, had ceased taking Sackler donations.

The moves reflect the growing outrage over the role the Sacklers may have played in the opioid crisis, as well as an energized activist movement that is starting to force museums to reckon with where some of their money comes from.

“The museum takes a position of gratitude and respect to those who support us, but on occasion, we feel it’s necessary to step away from gifts that are not in the public interest, or in our institution’s interest,” said Daniel H. Weiss, the president of the Met. “That is what we’re doing here.”

“There really aren’t that many people who are giving to art and giving to museums, in fact it’s a very small club,” said Tom Eccles, the executive director of the Center for Curatorial Studies at Bard College. “So we have to be a little careful what we wish for here.”

There is also the difficult question of where to draw a line. What sort of behavior is inexcusable?

“We are not a partisan organization, we are not a political organization, so we don’t have a litmus test for whom we take gifts from based on policies or politics,” said Mr. Weiss of the Met. “If there are people who want to support us, for the most part we are delighted.”

“We would only not accept gifts from people if it in some way challenges or is counter to the core mission of the institution, in exceptional cases,” he added. “The OxyContin crisis in this country is a legitimate and full-blown crisis.”

Three brothers, Arthur, Mortimer and Raymond Sackler, bought a small company called Purdue Frederick in 1952 and transformed it into the pharmaceutical giant it is today. In 1996, Purdue Pharma put the opioid painkiller OxyContin on the market, fundamentally altering the company’s fortunes.

The family’s role in the marketing of OxyContin, and in the opioid crisis, has come under increased scrutiny in recent years. Documents submitted this year as part of litigation by the attorney general of Massachusetts allege that members of the Sackler family directed the company’s efforts to mislead the public about the dangers of the highly addictive drug. The company has denied the allegations and said it “neither created nor caused the opioid epidemic.”

Nan Goldin, a photographer who overcame an OxyContin addiction, has led demonstrations at institutions that receive Sackler money; in March 2018, she and her supporters dumped empty pill bottles in the Sackler Wing’s reflecting pool.

“We commend the Met for making the ethical, moral decision to refuse future funding from the Sacklers,” a group started by Ms. Goldin, Prescription Addiction Intervention Now, or PAIN, said in a statement. “Fourteen months after staging our first protest there, we’re gratified to know that our voices have been heard.”

The group also called for the removal of the Sackler name from buildings the family has bankrolled. Mr. Weiss said that the museum would not take the more drastic step of taking the family’s name off the wing, saying that it was not in a position to make permanent changes while litigation against the family was pending and information was still coming to light.

The Met also said that its board had voted to codify how the museum accepts named gifts, formalizing a longstanding practice of circulating those proposals through a chain of departments. The decision on the Sacklers, Mr. Weiss said, was made by the Met leadership in consultation with the board.

#Opioides #Sackler #Musées

The Purdue Case Is One in a Wave of Opioid Lawsuits. What Should Their Outcome Be ? | The New Yorker
▻https://www.newyorker.com/news/daily-comment/the-purdue-case-is-one-in-a-wave-of-opioid-lawsuits-what-should-their-out

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Two years ago, when I was reporting on the opioid epidemic in one West Virginia county, the exorbitant cost of it—both socially and financially—perpetually astonished me. Narcan, the overdose-reversal drug, yanks people back from the edge of death to live another day and maybe, in time, conquer their addiction. Watching paramedics administer it was like witnessing a miracle over and over again. But Narcan is expensive—it cost Berkeley County, where I was reporting, fifty dollars a dose at the time, and consumed two-thirds of its annual budget for all emergency medications. Since then, the price of naloxone, its generic name, has risen to nearly a hundred and fifty dollars per dose, not because the formula has improved or become costlier to make—the drug has been around since 1961, and off patent since 1985—but because pharmaceutical manufacturers know a profitable market when they see one. According to the National Institute on Drug Abuse, an average of a hundred and thirty people fatally overdose on prescription or illicit opioids every day in the United States. The Centers for Disease Control and Prevention report that four hundred thousand Americans, a war’s worth of dead, died between 1999 and 2017.

In Berkeley County, though, as in so many places across the country, Narcan accounted for just one column on a staggering spreadsheet. Hospitals have had to care for babies born in withdrawal. Foster-care systems have been strained by an influx of children whose families had been turned upside down by addiction. In many communities, the rates of H.I.V. and hepatitis C have climbed, because, once OxyContin pills were reformulated to make them harder to abuse, in 2010, and changes in prescribing practices made them more difficult to obtain, people addicted to them began injecting heroin and fentanyl instead.

Under the Master Settlement Agreement, the tobacco companies also committed to pay the states two hundred billion dollars over twenty-five years, and to keep paying them sums tied to cigarette sales in each state in perpetuity. But nothing in the M.S.A. specified how that money was to be spent, and, though one might expect that the bulk of it would be dedicated to the goals of the lawsuits—reducing smoking and promoting public health—that has not generally been the case. In many states, much of the money has gone not to anti-smoking efforts, or even to general spending on health, but instead to closing budget shortfalls, lowering taxes, and funding infrastructure. States treated the agreement like what it felt like: a no-strings-attached gift.

Je ne suis pas vraiment convainc par la conclusion :

The Oklahoma settlement with Purdue is a reasonable stab at insuring that the money won in opioid lawsuits doesn’t follow a similar route. Yet some public-health advocates I spoke with said that, in the future, they hope more settlement money will go directly to the treatment of addiction. There’s good evidence, for example, that medication-assisted treatment using buprenorphine, naltrexone, or methadone works well for many people trying to get off opioids, but most states don’t have enough of it.

Diriger les amendes vers la lutte contre les opioides es tune bonne chose, parce qu’elle évite le pire (que l’amende serve à « baisser les impôts »)... mais cela ne peut pas être un projet dans le cadre des procès. Une fois la responsabilité établie, il faut démanteler ces entreprises et ramener les familles qui les possèdent à un niveau de vie normal, car les Sackler ont largement organisé la promotion d’OxyContin. Or les accords à l’amiable doivent être acceptés par les deux parties, et les construire comme une fin en soi, c’est déjà baisser les bras devant la puissance financière (et donc la qualité/quantité des avocats...). Surtout quand une partie de l’amende sera comme en Oklahoma payée « en nature » par des médicaments produits par Purdue Pharma !!!

#Opioides #Sackler #Procès

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

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
▻https://www.usnews.com/dims4/USNEWS/a731fff/2147483647/thumbnail/970x647/quality/85/?url=http%3A%2F%2Fcom-usnews-beam-media.s3.amazonaws.com%2F36%2F18d09dd2aa95

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

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

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

The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy
▻https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774

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Un article scientifique de 2009 sur le marketing d’Oxycontin.

OxyContin’s commercial success did not depend on the merits of the drug compared with other available opioid preparations. The Medical Letter on Drugs and Therapeutics concluded in 2001 that oxycodone offered no advantage over appropriate doses of other potent opioids.3 Randomized double-blind studies comparing OxyContin given every 12 hours with immediate-release oxycodone given 4 times daily showed comparable efficacy and safety for use with chronic back pain4 and cancer-related pain.5,6 Randomized double-blind studies that compared OxyContin with controlled-release morphine for cancer-related pain also found comparable efficacy and safety.7–9 The FDA’s medical review officer, in evaluating the efficacy of OxyContin in Purdue’s 1995 new drug

application, concluded that OxyContin had not been shown to have a significant advantage over conventional, immediate-release oxycodone taken 4 times daily other than a reduction in frequency of dosing.10 In a review of the medical literature, Chou et al. made similar conclusions.11

The promotion and marketing of OxyContin occurred during a recent trend in the liberalization of the use of opioids in the treatment of pain, particularly for chronic non–cancer-related pain. Purdue pursued an “aggressive” campaign to promote the use of opioids in general and OxyContin in particular.1,12–17 In 2001 alone, the company spent $200 million18 in an array of approaches to market and promote OxyContin.❞

From 1996 to 2001, Purdue conducted more than 40 national pain-management and speaker-training conferences at resorts in Florida, Arizona, and California. More than 5000 physicians, pharmacists, and nurses attended these all-expenses-paid symposia, where they were recruited and trained for Purdue’s national speaker bureau.19(p22)

In much of its promotional campaign—in literature and audiotapes for physicians, brochures and videotapes for patients, and its “Partners Against Pain” Web site—Purdue claimed that the risk of addiction from OxyContin was extremely small.43–49

Purdue trained its sales representatives to carry the message that the risk of addiction was “less than one percent.”50(p99)

In 1998, Purdue distributed 15 000 copies of an OxyContin video to physicians without submitting it to the FDA for review, an oversight later acknowledged by Purdue. In 2001, Purdue submitted to the FDA a second version of the video, which the FDA did not review until October 2002—after the General Accounting Office inquired about its content. After its review, the FDA concluded that the video minimized the risks from OxyContin and made unsubstantiated claims regarding its benefits to patients.19

When OxyContin entered the market in 1996, the FDA approved its original label, which stated that iatrogenic addiction was “very rare” if opioids were legitimately used in the management of pain. In July 2001, to reflect the available scientific evidence, the label was modified to state that data were not available for establishing the true incidence of addiction in chronic-pain patients. The 2001 labeling also deleted the original statement that the delayed absorption of OxyContin was believed to reduce the abuse liability of the drug.19 A more thorough review of the available scientific evidence prior to the original labeling might have prevented some of the need for the 2001 label revision.

#Opioides #Marketing #Purdue_Pharma

Opioid billionaire granted patent for addiction treatment | Financial Times
▻https://www.ft.com/content/a3a53ae8-b1e3-11e8-8d14-6f049d06439c
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Purdue owner Richard Sackler listed as inventor of drug to wean addicts off painkillers
Richard Sackler’s family owns Purdue Pharma, the company behind the opioid painkiller OxyContin © Reuters

David Crow in New York

A billionaire pharmaceuticals executive who has been blamed for spurring the US opioid crisis stands to profit from the epidemic after he patented a new treatment for drug addicts.

Richard Sackler, whose family owns Purdue Pharma, the company behind the notorious painkiller OxyContin, was granted a patent earlier this year for a reformulation of a drug used to wean addicts off opioids.

The invention is a novel form of buprenorphine, a mild opiate that controls drug cravings, which is often given as a substitute to people hooked on heroin or opioid painkillers such as OxyContin.

The new formulation as described in Dr Sackler’s patent could end up proving lucrative thanks to a steady increase in the number of addicts being treated with buprenorphine, which is seen as a better alternative to other opioid substitutes such as methadone.

Last year, the leading version of buprenorphine, which is sold under the brand name Suboxone, generated $877m in US sales for Indivior, the British pharmaceuticals group that makes it.

Before the opioid crisis, the Sackler family was primarily known for its philanthropy, emerging as one of the largest donors to arts institutions in the US and UK. But the rising number of addictions and deaths has highlighted the family’s ownership of Purdue, which some members have tried to shy away from.

It’s reprehensible what Purdue Pharma has done to our public health
Luke Nasta, director of Camelot

Dr Sackler’s patent, which was granted by the US Patent and Trademark Office in January, acknowledges the threat posed by the opioid crisis, which claimed more than 42,000 lives in 2016.

“While opioids have always been known to be useful in pain treatment, they also display an addictive potential,” the patent states. “Thus, if opioids are taken by healthy human subjects with a drug-seeking behaviour they may lead to psychological as well as physical dependence.”

It adds: “The constant pressures upon addicts to procure money for buying drugs and the concomitant criminal activities have been increasingly recognised as a major factor that counteracts efficient and long-lasting withdrawal and abstinence from drugs.”

However, the patent makes no mention of the fact that Purdue Pharma has been hit with more than a thousand lawsuits for allegedly fuelling the epidemic — allegations the company and the Sackler family deny.

“It’s reprehensible what Purdue Pharma has done to our public health,” said Luke Nasta, director of Camelot, an addiction treatment centre in Staten Island, New York. He said the Sackler family “shouldn’t be allowed to peddle any more synthetic opiates — and that includes opioid substitutes”.

Buprenorphine is prescribed to opioid addicts in tablets or thin film strips that dissolve under the tongue in less than seven minutes. These “sublingual” formulations are used to stop drug abusers from hoarding a stockpile of pills they can sell or use to get high at a later date.

The patent describes a new, improved form of buprenorphine that would come in a wafer that disintegrated more quickly than existing versions — perhaps in just a few seconds.

The original application was made by Purdue Pharma and Dr Sackler is listed as one of the inventors alongside five others, some of whom work or have worked for the Sackler’s group of drug companies.

“Drug addicts sometimes still try to divert these sublingual buprenorphine tablets by removing them from the mouth,” the patent application stated. “There remains a need for other . . . abuse-resistant dosage forms.”
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What next for the Sacklers? A pharma dynasty under siege

In June, the Massachusetts attorney-general filed a lawsuit against Dr Sackler and seven other members of the Sackler family, which accused them of engaging in a “deadly, deceptive scheme to sell opioids”.

Purdue and the family deny the allegations and Purdue said it intends to file a motion to dismiss. The company points out that OxyContin was, and still is, approved by the US Food and Drug Administration.

“We believe it is inappropriate for [Massachusetts] to substitute its judgment for the judgment of the regulatory, scientific and medical experts at FDA,” it said in a recent statement to the Financial Times.

Andrew Kolodny, a professor from Brandeis University who has been a vocal advocate for greater use of buprenorphine to battle the opioid crisis, said the idea Dr Sackler “could get richer” from the patent was “very disturbing”. He added: “Perhaps the profits off this patent should be used to pay any judgment or settlement down the line.”

Earlier this week, Purdue donated $3.4m to boost access to naloxone, an antidote given to people who have just overdosed on opioids.

#Opioides #Cynisme #Capitalisme_sauvage #Brevets #Sackler

Heroin and Opioids - Bloomberg
▻https://www.bloomberg.com/quicktake/heroin

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Everything about the massive surge in opioid abuse cuts across traditional boundaries of drug use in the U.S. It’s hit white residents in the countryside as well as minorities in cities. It involves long-banned substances like heroin, legally prescribed painkillers like OxyContin and, increasingly, street drugs that mimic powerful synthetic opioids like fentanyl. Their combined death toll now exceeds that of car crashes or firearms and opioid abuse is seen as a prime factor in declining American longevity. Behind the crisis is a tangle of issues from addiction to treatment to enforcement, regulatory policy involving drugmakers and diplomacy with nations where opioids are manufactured.

Officials of Purdue Pharma Inc., the maker of OxyContin, confirmed in November that they are in settlement talks with a group of state attorneys general and trying to come up with a global resolution of the government opioid claims. States and the federal government have made the opiate-antidote drug naloxone more readily available; it’s been credited with reversing more than 26,000 overdoses between 1996 and 2014. Still, in 2016 fatal drug overdoses jumped by 21 percent, and the rate of deaths from synthetic opioids like fentanyl doubled.

Extracts of the poppy plant have been a source of trouble since the 19th century Opium Wars. Heroin, first produced in 1898 by Bayer, the German pharmaceutical company, was marketed as a non-addictive substitute for morphine. By the early 1900s, widespread heroin use led states like New York to open addiction centers in hospitals. Heroin’s latest wave arose from changes in prescription opiate use. Opioid painkillers rose in popularity in the 1990s, partly in response to what was seen as widespread undertreatment of chronic pain. In 1996, Purdue Pharma Inc. introduced OxyContin as an alternative to stronger opioids reserved mainly for the dying. Its annual sales surged to $1 billion. In 2007 Purdue paid $600 million in fines and its executives pleaded guilty to federal criminal charges for misbranding the product as less addictive than other painkillers. In 2010, it released a reformulated version that was harder to crush for snorting. A May 2015 study found that while the new version reduced illicit use of the painkiller, it led more people to take up heroin, whose price was dropping. Nearly 90 percent of new heroin users in the U.S. are now white, compared with an equal mix of whites and nonwhites before 1980. Globally, poppy cultivation has reached its highest level since the 1930s.

#Opioides #Purdue_Pharma #Procès

OxyContin Manufacturer Says It Will Stop Promoting Opioid Painkiller To Doctors : NPR
▻https://www.npr.org/2018/02/12/585177743/oxycontin-manufacturer-says-it-will-stop-promoting-opioid-painkiller-to-doctors

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SHAPIRO: How much money has this drug made for Purdue Pharma over the years?

QUINONES: Well, it’s a private company. I’m not sure exactly. But estimates that I have read - between $35 and $40 billion in sales since the drug came out in 1996. It’s basically the reason why the Sackler family, which owns Purdue, is one of the wealthiest families in America. Forbes magazine pegged it as one of the wealthiest families in America due almost entirely to the sales of OxyContin.

#Opioides #Sackler

Opioid Makers, Blamed for Overdose Epidemic, Cut Back on… — ProPublica
▻https://www.propublica.org/article/opioid-makers-blamed-for-overdose-epidemic-cut-back-on-marketing-payment

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The past two years have been a time of reckoning for pharmaceutical manufacturers over their role in promoting opioid drugs that have fed a national epidemic.

Lawsuits and media reports have accused Purdue Pharma, the maker of OxyContin, of aggressively marketing the powerful narcotic even after it knew the drug was being misused. Prosecutors have charged the founder of Insys Therapeutics and several of the company’s sales representatives and executives for their roles in an alleged conspiracy to bribe doctors to use its fentanyl spray for unapproved uses. State and local governments have sued a host of drugmakers, alleging they deceptively marketed opioids and seeking to recoup what it costs to treat people addicted to the drugs.

But as public attention increases, the marketing tide may finally be retreating, a new ProPublica analysis shows. Pharmaceutical company payments to physicians related to opioid drugs decreased significantly in 2016 from the year before.

In 2016, drug makers spent $15.8 million to pay doctors for speaking, consulting, meals and travel related to opioid drugs. That was down 33 percent from $23.7 million in 2015 and is 21 percent less than the $19.9 million in spent in 2014. Companies are required to report the payments publicly under the Physician Payment Sunshine Act, a part of the 2010 Affordable Care Act.

A number of studies have shown a correlation between marketing of opioids and doctors’ prescribing of the drugs. Hadland and his colleagues reported in May that for every meal a physician received related to an opioid product in 2014, there was an increase in opioid claims by that doctor for Medicare patients the following year. And a report from the New York State Health Foundation published this month found that physicians who received payments from opioid makers prescribed more opioids to Medicare patients than doctors who didn’t receive the payments.

The sharp drop in marketing is more pronounced than the much slower reduction in the use of prescription opioids. The number of opioid prescriptions in Medicare, the public health program for seniors and the disabled, peaked at 81.7 million in 2014, and then dropped to 80.2 million in 2015 and 79.5 million in 2016, according to the Centers for Medicare and Medicaid Services. (Enrollment in Medicare’s prescription drug program continued to grow during that time, so the rate of opioid prescriptions per beneficiary dropped even more.)

Still, the toll of opioid overdoses continues to grow. Some 42,000 people died of opioid overdoses in 2016, the most recent year available, and about 40 percent of those involved a prescription opioid. The epidemic has shifted somewhat away from prescription drugs as more people die of heroin and synthetic opioids like fentanyl.

Purdue Pharma, which has received the most attention because of its one-time blockbuster OxyContin, has ratcheted back its spending on doctors, especially for programs in which doctors talk to their peers over lunch or dinner to help companies market their products. Purdue ended its speaker program for OxyContin at the end of 2016 and for Hysingla ER in November 2017. Earlier this year, it ended all direct promotion of its opioids to prescribers and last week, the company laid off its remaining sales representatives.

Purdue spokesman Robert Josephson said in an email that payments to doctors related to opioids have decreased since 2016 and that there would be very little such spending in 2018.

”Pharmaceutical manufacturers are legally permitted in the U.S. to promote all FDA-approved products to physicians in accordance with the subject product’s label,” Endo said in a statement. “This includes opioid products, which are safely used by millions of Americans to improve their quality of life.”

That said, Endo said it stopped promoting Opana ER in the United States in January 2017 before voluntarily withdrawing the drug in September. “Today, Endo does not promote any opioid products to U.S. physicians,” the company said in a statement.

#Opioides #Marketing #Pharmacie

New York City sues ’Big Pharma’ for $500m for fueling opioid epidemic | US news | The Guardian
▻https://www.theguardian.com/us-news/2018/jan/23/new-york-city-sues-big-pharma-for-500m-for-fueling-opioid-epidemic

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New York City on Tuesday sued the makers of prescription painkillers such as OxyContin, Percocet and fentanyl that have played a central role in the opioid crisis killing tens of thousands across the nation.

The mayor of New York, Bill de Blasio, and his wife Chirlane McCray, who leads the city’s efforts on mental health and drug addiction, announced a $500m lawsuit “to hold manufacturers and distributors to account”, filed in New York state supreme court.

“More New Yorkers have died from opioid overdoses than car crashes and homicides combined in recent years. ‘Big Pharma’ helped to fuel this epidemic by deceptively peddling these dangerous drugs and hooking millions,” De Blasio said. A record 1,000-plus people died in New York from opioid-related overdoses in 2016, the mayor reported.

New York City on Tuesday sued several companies, led by Purdue Pharma, the family-owned creator of OxyContin the original brand of slow-release, powerful prescription narcotics that ushered in the crisis 20 years ago with aggressive marketing campaigns and insufficient warnings about addiction and abuse.

Additional defendants include Endo, which makes the painkiller Percocet; Cephalon, which makes the fentanyl lollipop-type lozenge Actiq; Janssen, which makes fentanyl patches; and other opioid makers, including Johnson & Johnson, Watson, Teva and Allergan.

#Opioides #Procès

Rudy Giuliani won deal for OxyContin maker to continue sales of drug behind opioid deaths | US news | The Guardian
▻https://www.theguardian.com/us-news/2018/may/22/rudy-giuliani-opioid-epidemic-oxycontin-purdue-pharma?CMP=Share_Android

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The US government missed the opportunity to curb sales of the drug that kickstarted the opioid epidemic when it secured the only criminal conviction against the maker of OxyContin a decade ago.

Purdue Pharma hired Rudolph Giuliani, the former New York mayor and now Donald Trump’s lawyer, to head off a federal investigation in the mid-2000s into the company’s marketing of the powerful prescription painkiller at the centre of an epidemic estimated to have claimed at least 300,000 lives.
The Sackler family made billions from OxyContin. Why do top US colleges take money tainted by the opioid crisis?
Read more

While Giuliani was not able to prevent the criminal conviction over Purdue’s fraudulent claims for OxyContin’s safety and effectiveness, he was able to reach a deal to avoid a bar on Purdue doing business with the federal government which would have killed a large part of the multibillion-dollar market for the drug.

The former New York mayor also secured an agreement that greatly restricted further prosecution of the pharmaceutical company and kept its senior executives out of prison.

OxyContin became the go-to drug for people looking for an instant high by snorting or injecting.

“This was the magic pill, right? This was a long-acting pill that the addicts wouldn’t like and you couldn’t get dependent on, and that is the magic bullet. The reality is it just wasn’t true,” said Brownlee. “It was highly deceptive and then they trained their sales force to go out and to push that deception on physicians.”

Investigators waded through several million of Purdue’s internal memos, marketing documents and notes from sales representatives. Brownlee’s office discovered training videos in which reps acted out selling the drug using the false claims. “This was pushed by the company to be marketed in an illegal way, pushed from the highest levels of the company, that in my view made them a criminal enterprise that needed to be dealt with,” said Brownlee.

The US attorney had six meetings with Giuliani. They moved from how to interpret the evidence and questions around discovery to negotiations over the final settlement.

But Giuliani and his team seemed to be also working their Washington contacts. The Purdue lawyers complained to the office of the then deputy attorney general, James Comey, whose tenure as head of the FBI lay ahead of him, that Brownlee was exceeding his legal authority in pursuit of documents from the company.

“The defence lawyers contacted Mr Comey unbeknownst to us and said those guys down there are crazy,” said Brownlee. The US attorney went to Washington to explain to Comey in person. Purdue was not instantly recognizable as a pharmaceutical company to most people in DC. The name was easily mistaken for Perdue Farms, a regional chicken producer well known for its television ads featuring the owner, Frank Perdue. “Mr Comey said, why are you prosecuting the chicken guy?” said Brownlee.

Once that misunderstanding was cleared up, Comey signed off on Brownlee’s actions and Purdue was forced to hand over the documents. Brownlee set the drug maker a deadline in October 2006 to agree to the plea deal or face a trial. Hours before it expired, the federal prosecutor received a call at home from a senior justice department official, Michael Elston, chief of staff to the new deputy attorney general, Paul McNulty.

Elston asked why the case was being pushed along so rapidly and pressed for a delay. The prosecutor again saw the influence of Purdue’s lawyers at work and cut the call short.

Brownlee said he did not want to be responsible for taking OxyContin off the market and so agreed with Giuliani to target the prosecution at the parent company, Purdue Frederick. That left Purdue Pharma, cleaved out as a separate painkiller manufacturer in 1991, to continue selling the painkiller without restriction even though opioid deaths were escalating.

“I didn’t feel as a lawyer I could be in a position to bar anyone from getting OxyContin. Faced with that decision, I was just simply not prepared to take it off the market. I didn’t feel like that was my role. My role was to address prior criminal conduct. Hold them accountable. Fine them. Make sure the public knew what they did. ” said Brownlee.

Brownlee said he expected federal regulators, particularly the Food and Drug Administration, and other agencies to use the criminal conviction to look more closely at Purdue and its drug. But there was no follow-up and OxyContin went on being widely prescribed .

#Opioides #Purdue_Pharma

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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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.”

Arthur died eight years before OxyContin hit the marketplace. His widow, Jillian Sackler, and Elizabeth, who is Jillian’s stepdaughter, are represented by separate public-relations firms and have successfully won clarifications and corrections from media outlets for suggesting that sales of the potent opioid enriched Arthur Sackler or his family.

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.

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.

#Opioids #Sackler

The Secretive Family Making Billions From the Opioid Crisis
►https://www.esquire.com/news-politics/a12775932/sackler-family-oxycontin

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The Sackler Courtyard is the latest addition to an impressive portfolio. There’s the Sackler Wing at New York’s Metropolitan Museum of Art, which houses the majestic Temple of Dendur, a sandstone shrine from ancient Egypt; additional Sackler wings at the Louvre and the Royal Academy; stand-alone Sackler museums at Harvard and Peking Universities; and named Sackler galleries at the Smithsonian, the Serpentine, and Oxford’s Ashmolean. The Guggenheim in New York has a Sackler Center, and the American Museum of Natural History has a Sackler Educational Lab. Members of the family, legendary in museum circles for their pursuit of naming rights, have also underwritten projects of a more modest caliber—a Sackler Staircase at Berlin’s Jewish Museum; a Sackler Escalator at the Tate Modern; a Sackler Crossing in Kew Gardens. A popular species of pink rose is named after a Sackler. So is an asteroid.

The Sackler name is no less prominent among the emerald quads of higher education, where it’s possible to receive degrees from Sackler schools, participate in Sackler colloquiums, take courses from professors with endowed Sackler chairs, and attend annual Sackler lectures on topics such as theoretical astrophysics and human rights. The Sackler Institute for Nutrition Science supports research on obesity and micronutrient deficiencies. Meanwhile, the Sackler institutes at Cornell, Columbia, McGill, Edinburgh, Glasgow, Sussex, and King’s College London tackle psychobiology, with an emphasis on early childhood development.

The Sacklers’ philanthropy differs from that of civic populists like Andrew Carnegie, who built hundreds of libraries in small towns, and Bill Gates, whose foundation ministers to global masses. Instead, the family has donated its fortune to blue-chip brands, braiding the family name into the patronage network of the world’s most prestigious, well-endowed institutions. The Sackler name is everywhere, evoking automatic reverence; the Sacklers themselves, however, are rarely seen.

Even so, hardly anyone associates the Sackler name with their company’s lone blockbuster drug. “The Fords, Hewletts, Packards, Johnsons—all those families put their name on their product because they were proud,” said Keith Humphreys, a professor of psychiatry at Stanford University School of Medicine who has written extensively about the opioid crisis. “The Sacklers have hidden their connection to their product. They don’t call it ‘Sackler Pharma.’ They don’t call their pills ‘Sackler pills.’ And when they’re questioned, they say, ‘Well, it’s a privately held firm, we’re a family, we like to keep our privacy, you understand.’ ”

By any assessment, the family’s leaders have pulled off three of the great marketing triumphs of the modern era: The first is selling OxyContin; the second is promoting the Sackler name; and the third is ensuring that, as far as the public is aware, the first and the second have nothing to do with one another.

#Opioides #Sackler #Communication

Heir to OxyContin fortune buys $22.5M Bel Air mansion - Curbed LA
▻https://la.curbed.com/2018/3/8/17098042/oxycontin-david-sackler-bel-air-mansion-cash

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One of the heirs of Purdue Pharma, the makers of OxyContin, has just purchased a stylish 1980s estate in Bel Air for $22.5 million.

TMZ reports David Sackler, the grandson of one of the founders of Purdue, paid entirely in cash for the nearly 10,000-square-foot estate on about four acres.

The gated estate holds a two-story atrium, sweeping spiral staircase, and a master suite that occupies nearly the entire second story of the residence. The grounds hold a tennis court and pool, and large expanses of green lawn.

Sackler is the grandson of Raymond Sackler, one of the three brothers who together launched and ran Purdue Pharma. (By 1996, when the company introduced OxyContin, only two brothers and their families were still involved in the business.)

#Opioides #Sackler

Opioid Protest at Met Museum Targets Donors Connected to OxyContin - The New York Times
▻https://www.nytimes.com/2018/03/10/us/met-museum-sackler-protest.html

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Anti-opioid activists unfurled banners and scattered pill bottles on Saturday inside the Sackler Wing of the Metropolitan Museum of Art in New York, which is named for a family connected to the powerful painkilling drug OxyContin.

The protest, which was organized by a group started by the celebrated photographer Nan Goldin, started just after 4 p.m., when several dozen people converged at the Temple of Dendur inside the wing.

The wing is named after Arthur, Mortimer and Raymond Sackler, brothers who in the 1970s donated $3.5 million toward its construction. Their scientific and marketing skills also transformed a small business into what became Purdue Pharma, the company that developed OxyContin, which has been widely prescribed and abused. The drug is among the most common painkillers involved in prescription opioid overdose deaths, which have become an unrelenting crisis in the United States.

On Saturday the protesters called for cultural institutions to reject money from the Sackler family. They also demanded, among other things, that Purdue, which has been accused of using deceptive and aggressive tactics to market OxyContin, fund addiction treatment.

#Opioides #Sackler #Nan_Goldin

The Family That Built an Empire of Pain | The New Yorker
▻https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain?mbid=social_twitter

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While the Sacklers are interviewed regularly on the subject of their generosity, they almost never speak publicly about the family business, Purdue Pharma—a privately held company, based in Stamford, Connecticut, that developed the prescription painkiller OxyContin. Upon its release, in 1995, OxyContin was hailed as a medical breakthrough, a long-lasting narcotic that could help patients suffering from moderate to severe pain. The drug became a blockbuster, and has reportedly generated some thirty-five billion dollars in revenue for Purdue.

#opioids_epidemic ou quelque chose comme ça

Finding a Fix – Mother Jones
▻http://www.motherjones.com/crime-justice/2017/12/opioids-users-dealers-police-1

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Opioids started seeping into the surrounding counties in the mid-’90s, when Purdue Pharma introduced OxyContin and dramatically underplayed its addictive qualities. Thanks to pharmaceutical lobbying, years of liberal painkiller prescribing—the United States consumes more than 70 percent of the world’s opioid painkillers—planted the seeds for widespread addiction to both painkillers and heroin, which is chemically similar to the prescription pills but far cheaper and more potent.

As the demand for opioids grew in suburban areas, capillaries sprang up from the main drug trafficking artery of Interstate 95, which runs from Florida to Maine, bringing opioids to small towns like Bel Air and Aberdeen. But the turning point in Harford—and much of the country—came in 2015 after fentanyl, an opioid up to 50 times more powerful than heroin that is typically manufactured in illicit labs in China, started making its way into the heroin supply. Complicating matters is the fact that, by the time drugs get to Baltimore or Harford County, they have likely changed hands so many times—and mixed with fentanyl and other additives along the way—that dealers often don’t know what they are dealing. Indeed, the customary drug in Baltimore is “scramble”: an amalgamation of heroin and other drugs, sold in gel capsules. “We knew [fentanyl] was coming; we were trying to brace for it,” said Dunbar. He recruited officers to do nothing but heroin investigations, because “we knew we were gonna see this surge.”

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Of course, the epidemic is much bigger than Harford. In Ohio, coroners’ offices use refrigerated trucks to store bodies. In Connecticut, medical examiners’ autopsy caseloads have quadrupled in one year. In West Virginia, 1 in 20 infants are born in withdrawal from opioids. And in Maryland, two-thirds of people in jail have a diagnosed substance abuse disorder, according to a 2016 analysis by the governor’s office. Harford County Sheriff’s Office cops are no longer allowed to test seized drugs suspected to contain opioids on the spot, because of reports that interacting with some variants of fentanyl can be deadly. When the drugs are sent to DEA labs, “while one person is testing, another person is ready to treat them with [the overdose reversal drug] naloxone in case they fall while they’re testing,” says Hedrick, the DEA supervisor.

As the wave of fatal overdoses hit Harford in early 2015, county officials sprang into action. Police officers are now equipped with naloxone and trained that addiction is a disease. Cops on the Narcotics Task Force rarely charge users for drug possession in quantities that seem intended for personal use. After every overdose, cops give victims a “help card” with addiction treatment resources. “We’re not going to solve the problem by putting addicts in jail,” said Underhill. “If they’re not going to get effective treatment, it’s not going to change anything.”

Another part of Harford’s response is aggressively tracking down dealers. In 2016 alone, the county arrested and charged 240 people with felony drug offenses. As Dunbar sums up the strategy, “We need to lock up the bad guys—the dealers and traffickers putting out stuff on the street—but we also play a role in getting the victims help.”

It’s not that Harford cops don’t empathize with user-dealers. The guy who gets in a car accident is prescribed painkillers, becomes addicted, and then starts selling to support his own habit—“I’ve seen that story 150 times,” Underhill told me. But where do you draw the line? “They’re selling just enough to get theirs,” he said of user-dealers, “but they’re killing people with what they’re bringing back.” He gets most worked up when he talks about the kids: the toddlers strapped in car seats as he pulls parents over for drugs, the children he terrifies when breaking open front doors with Halligan bars in predawn raids, the teens who come home from school to find that cops have gone through their bedrooms looking for drugs.

When it comes to reforming user-dealers, evidence strongly suggests that prison time isn’t very effective. Instead, stable housing, support services, and employment have been shown to promote long-term recovery. Law Enforcement Assisted Diversion, a Seattle program that has been replicated in dozens of jurisdictions across the country, demonstrates the research in action: Rather than jailing people for low-level drug crimes, police divert them to programs offering treatment, housing, and job training. Participants are nearly 60 percent less likely to be rearrested.

#Opioides #USA

The Super Wealthy Oxycontin Family Supports School Privatization With Tactics Similar to Those That Fueled the Opioid Epidemic | Alternet
▻https://www.alternet.org/education/notorious-family-contributing-opioid-crisis-and-funding-elitist-charter-sc

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Keefe writes, “Purdue and other pharmaceutical companies have long funded ostensibly neutral nonprofit groups that advocate for pain patients.”

The same influence techniques Purdue used to promote painkillers are now being used by Jonathan Sackler to expand charter schools.

Jonathan Sackler, Arthur’s nephew, is a well-known name in the education reform movement. He founded the charter school advocacy group ConnCan, progenitor of the nationwide group 50CAN, of which he is a director. He is on the Board of Directors of the Achievement First charter school network. Until recently, Sackler served on the board of the New Schools Venture Fund, which invests in charter schools and advocates for their expansion. He was also on the board of the pro-charter advocacy group Students for Education Reform.

The GAO report went on to quote the DEA as saying the Purdue’s use of branded promotional items in the marketing of OxyContin was “was unprecedented among schedule II opioids, and was an indicator of Purdue’s aggressive and inappropriate marketing of OxyContin.”

The description of “lavish swag” will sound familiar to anyone who has witnessed one of the no-expenses-spared charter school rallies that are a specialty of Sackler-funded organizations like Families for Excellent schools. Then there is the dizzying array of astroturf front groups all created for the purpose of demanding more charter schools. Just in Connecticut, we’ve had the Coalition for Every Child, A Better Connecticut, Fight for Fairness CT, Excel Bridgeport, and the Real Reform Now Network. All of these groups ostensibly claim to be fighting for better public schools for all children. In reality, they have been lobbying to promote charter schools, often running afoul of ethics laws in the process.

#Education #Ecole_privée #Opioides

The Secretive Family Making Billions From the Opioid Crisis
►http://www.esquire.com/news-politics/a12775932/sackler-family-oxycontin

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You’re aware America is under siege, fighting an opioid crisis that has exploded into a public-health emergency. You’ve heard of OxyContin, the pain medication to which countless patients have become addicted. But do you know that the company that makes Oxy and reaps the billions of dollars in profits it generates is owned by one family?

les frères Sackler, la #pharma #drogue et le #profit qui provoque l’actuelle crise d’overdoses, et le #whitewashing à travers les donations aux #musées

A 1980 Letter on the Risk of Opioid Addiction — NEJM
▻http://www.nejm.org/doi/full/10.1056/NEJMc1700150

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We identified 608 citations of the index publication and noted a sizable increase after the introduction of OxyContin (a long-acting formulation of oxycodone) in 1995 (Figure 1FIGURE 1
Number and Type of Citations of the 1980 Letter, According to Year.). Of the articles that included a reference to the 1980 letter, the authors of 439 (72.2%) cited it as evidence that addiction was rare in patients treated with opioids. Of the 608 articles, the authors of 491 articles (80.8%) did not note that the patients who were described in the letter were hospitalized at the time they received the prescription, whereas some authors grossly misrepresented the conclusions of the letter

On a donc les noms de 608 auteurs (et plus) qui ont participé par la #désinformation médicale à la prolifération des #opiacés qui aboutit à la #crise_sanitaire actuelle.

#recherche #bibliométrie #médecine #drogues #États-Unis #pharma