#sac

Purdue Pharma Cuts Rest of Its Sales Force in Opioids Pullback - Bloomberg
▻https://www.bloomberg.com/news/articles/2018-06-20/purdue-pharma-cuts-rest-of-its-sales-force-in-opioids-pullback

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Oxycontin-maker Purdue Pharma LP cut the remainder of its sales force this week, the latest move by the company to distance itself from opioids as it faces accusations that it contributed to the nation’s addiction crisis.

The Stamford, Connecticut-based drugmaker said it will retain about 550 employees after chopping around 350 positions, including about 250 employees focused on promoting the treatment for opioid-induced constipation, Symproic. That product launched last year in partnership with Japan-based Shionogi & Co. The other employees worked in the company’s headquarters.

#Opioides #Purdue_Pharma #Sackler

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

Enquête. OxyContin, un antidouleur addictif à la conquête du monde | Courrier international
►https://www.courrierinternational.com/article/enquete-oxycontin-un-antidouleur-addictif-la-conquete-du-mond

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Face à l’épidémie d’addiction aux opioïdes analgésiques qui a déjà causé 200 000 morts dans le pays, l’establishment médical américain commence à prendre ses distances avec les antalgiques. Les plus hauts responsables de la santé incitent les généralistes à ne plus les prescrire en cas de douleur chronique, expliquant que rien ne prouve leur efficacité sur le long terme et que de nombreux indices montrent qu’ils mettent en danger les patients.

Les prescriptions d’OxyContin ont baissé d’environ 40 % depuis 2010, ce qui se traduit par plusieurs milliards de manque à gagner pour son fabricant, basé dans le Connecticut, Purdue Pharma.

La famille Sackler, propriétaire du laboratoire, a donc décidé d’adopter une nouvelle stratégie : faire adopter l’oxycodone, l’analgésique qui a déclenché la crise des opioïdes aux États-Unis, dans les cabinets médicaux du reste du monde.
Best-seller pharmaceutique

Un réseau d’entreprises internationales détenues par la famille est en train de s’implanter en Amérique latine, en Asie, au Moyen-Orient, en Afrique et dans d’autres régions, et d’encourager le recours généralisé aux antalgiques dans des endroits très mal outillés pour faire face aux ravages de l’abus d’opioïdes et de la dépendance qu’ils induisent.

Pour mener à bien cette expansion mondiale, ces entreprises, regroupées sous le nom collectif de Mundipharma, utilisent quelques-unes des méthodes controversées de marketing qui ont fait de l’OxyContin un best-seller pharmaceutique aux États-Unis. Au Brésil, en Chine et ailleurs, les sociétés mettent en place des séminaires de formation dans lesquels on encourage les médecins à surmonter leur “opiophobie” et à prescrire des antalgiques. Elles sponsorisent des campagnes de sensibilisation qui poussent les gens à solliciter un traitement médical de leurs douleurs chroniques. Elles vont même jusqu’à proposer des ristournes aux patients afin de rendre plus abordables les opioïdes sur ordonnance.
Les leçons de l’expérience américaine

Le directeur américain de la santé publique [surgeon general], Vivek H. Murthy, a déclaré qu’il conseillerait à ses homologues étrangers d’être “très prudents” avec les médicaments opiacés, et de tirer les leçons des “erreurs” américaines. “Je voudrais les exhorter à envisager avec une extrême prudence la commercialisation de ces médicaments”, a-t-il déclaré dans une interview.

Aujourd’hui, avec le recul, nous nous rendons compte que pour nombre d’entre eux les bénéfices ne compensaient pas les risques.”

L’ancien commissaire de l’agence des produits alimentaires et des médicaments [Food and Drug Administration] David A. Kessler a estimé que l’aveuglement face aux dangers des antalgiques constitue l’une des plus grosses erreurs de la médecine moderne. Évoquant l’entrée de Mundipharma sur les marchés étrangers, il a déclaré que la démarche était “exactement la même que celle des grands fabricants de cigarettes. Alors que les États-Unis prennent des mesures pour limiter les ventes sur leur territoire, l’entreprise se développe à l’international.”
Un marketing agressif

Des représentants de Mundipharma et certains de ses matériels promotionnels s’emploient à minorer les risques d’addiction des patients aux opioïdes. Ces affirmations rappellent la première campagne de commercialisation de l’OxyContin aux États-Unis à la fin des années 1990, dans laquelle Purdue avait trompé les médecins au sujet de la nature addictive du médicament.

En 2007, Purdue et trois hauts responsables de l’entreprise ont plaidé coupable face aux accusations fédérales de publicité mensongère sur leurs médicaments. Ils ont été condamnés à une amende de 635 millions de dollars. L’agence fédérale de lutte contre la drogue [Drug Enforcement Administration] a estimé en 2003 que le marketing “agressif, excessif et inapproprié” de l’entreprise avait “aggravé de manière très importante” l’usage abusif et le trafic illégal de l’OxyContin.

Purdue était une petite firme pharmaceutique new-yorkaise lorsque les frères Mortimer et Raymond Sackler, tous deux

[...]
Harriet RyanLisa Girion et Scott Glover

#Mundipharma #Sackler #Opioides

3 000 documents attendent les fans de chanson sur le musée virtuel de la Sacem.
▻http://www.telerama.fr/musique/3-000-documents-attendent-les-fans-de-chanson-sur-le-musee-virtuel-de-la-sa
▻https://musee.sacem.fr/index.php/Browse/objects/view/images
#sacem #archives

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The #Opioid Timebomb: The #Sackler family and how their painkiller fortune helps bankroll London arts | London Evening Standard
▻https://www.standard.co.uk/news/health/the-opioid-timebomb-the-sackler-family-and-how-their-painkiller-fortune-

We sent all 33 non-profits the same key questions including: will they rename their public space (as some organisations have done when issues arose regarding former benefactors)? And will they accept future Sackler philanthropy?

About half the respondents, including the Royal Opera House and the National Gallery, where Dame Theresa Sackler is respectively an honorary director and a patron, declined to answer either question.

Of the rest, none said it planned to erase the Sackler name from its public space. The organisations’ positions were more guarded on future donations.

Only the V&A, Oxford University, the Royal Court Theatre and the National Maritime Museum said outright that they were open to future Sackler grants.

The V&A said: “The Sackler family continue to be a valuable donor to the V&A and we are grateful for their ongoing support.”

Millions for London: Where Sackler money has gone
MUSEUMS AND GALLERIES

Serpentine Galleries

Grants received/pledged: £5,500,000
Used to fund (among other things): Serpentine Sackler Gallery
Will you accept future Sackler grants? Won’t say

Tate

Grants received/pledged: £4,650,000
Used to fund (among other things): Sackler Gallery, Sackler Escalators, Sackler Octagon
Will you accept future Sackler grants? Won’t say

Dulwich Picture Gallery

Grants received/pledged: £3,491,000
Used to fund (among other things): Sackler Centre for Arts Education
Will you accept future Sackler grants? Won’t say

V&A Museum

Grants received/pledged: £2,500,000
Used to fund (among other things): Sackler Courtyard
Will you accept future Sackler grants? Yes

The Design Museum

Grants received/pledged: £1,500,000
Used to fund (among other things): Sackler Library and Archive
Will you accept future Sackler grants? No reply

Natural History Museum

Grants received/pledged: £1,255,000
Used to fund (among other things): Sackler Biodiversity Imaging Laboratory
Will you accept future Sackler grants? Subject to vetting that typically takes into account “reputational risk” and “all relevant new information about the donor in the public domain”

National Gallery

Grants received/pledged: £1,050,000
Used to fund (among other things): Sackler Room (Room 34)
Will you accept future Sackler grants? Won’t say

National Portrait Gallery

Grants received/pledged: £1,000,000
Used to fund (among other things): Pledged grant still being vetted
Will you accept future Sackler grants? Being vetted. Subject to vetting that typically takes into account “reputational risk” and “all relevant new information about the donor in the public domain”

The Garden Museum

Grants received/pledged: £850,000
Used to fund (among other things): Sackler Garden
Will you accept future Sackler grants? No reply

National Maritime Museum

Grants received/pledged: £230,000
Used to fund (among other things): Sackler Research Fellowships
Will you accept future Sackler grants? Yes

Museum of London

Grants received/pledged: Refused to disclose grants received
Used to fund (among other things): Sackler Hall
Will you accept future Sackler grants? Subject to vetting that typically takes into account “reputational risk” and “all relevant new information about the donor in the public domain”

Royal Academy of Arts

Grants received/pledged: Refused to disclose grants received
Used to fund (among other things): Sackler Wing, Sackler Sculpture Gallery
Will you accept future Sackler grants? Subject to vetting that typically takes into account “reputational risk” and “all relevant new information about the donor in the public domain”

THE PERFORMING ARTS

Old Vic

Grants received/pledged: £2,817,000
Used to fund (among other things): Productions and projects
Will you accept future Sackler grants? Won’t say

Royal Opera House

Grants received/pledged: £2,500,000
Used to fund (among other things): Won’t say
Will you accept future Sackler grants? Won’t say

National Theatre

Grants received/pledged: £2,000,000
Used to fund (among other things): Sackler Pavilion
Will you accept future Sackler grants? Won’t say

Shakespeare’s Globe

Grants received/pledged: £1,660,000
Used to fund (among other things): Sackler Studios
Will you accept future Sackler grants? Won’t say

Royal Court Theatre

Grants received/pledged: £360,000
Used to fund (among other things): Sackler Trust Trainee Scheme
Will you accept future Sackler grants? Yes

UNIVERSITIES/RESEARCH

University of Oxford

Grants received/pledged: £11,000,000
Used to fund (among other things): Bodleian Sackler Library, Keeper of Antiquities
Will you accept future Sackler grants? Yes

University of Sussex

Grants received/pledged: £8,400,000
Used to fund (among other things): Sackler Centre for Consciousness Science
Will you accept future Sackler grants? Won’t say

King’s College, London

Grants received/pledged: £6,950,000
Used to fund (among other things): Sackler Institute for Translational Neurodevelopment
Will you accept future Sackler grants? Subject to vetting that typically takes into account “reputational risk” and “all relevant new information about the donor in the public domain”

The Francis Crick Institute

Grants received/pledged: £5,000,000
Used to fund (among other things): One-off funds raised via CRUK to help build the Crick
Will you accept future Sackler grants? N/A

UCL

Grants received/pledged: £2,654,000
Used to fund (among other things): Sackler Institute for Musculo-Skeletal Research
Will you accept future Sackler grants? Subject to vetting that typically takes into account “reputational risk” and “all relevant new information about the donor in the public domain”

Royal College of Art

Grants received/pledged: £2,500,000
Used to fund (among other things): Sackler Building
Will you accept future Sackler grants? Subject to vetting that typically takes into account “reputational risk” and “all relevant new information about the donor in the public domain”

The Courtauld Institute of Art

Grants received/pledged: £1,170,000
Used to fund (among other things): Sackler Research Fellowship, Sackler Lecture Series
Will you accept future Sackler grants? Won’t say

Royal Ballet School

Grants received/pledged: £1,000,000
Used to fund (among other things): Won’t say
Will you accept future Sackler grants? Won’t say

Imperial College London

Grants received/pledged: £618,000
Used to fund (among other things): Knee research
Will you accept future Sackler grants? Subject to vetting that typically takes into account “reputational risk” and “all relevant new information about the donor in the public domain”

Old Royal Naval College

Grants received/pledged: £500,000
Used to fund (among other things): Sackler Gallery
Will you accept future Sackler grants? Won’t say

OTHER

Royal Botanic Gardens, Kew

Grants received/pledged: £3,100,000
Used to fund (among other things): Sackler Crossing footbridge
Will you accept future Sackler grants? Subject to vetting that typically takes into account “reputational risk” and “all relevant new information about the donor in the public domain”

Moorfields Eye Hospital

Grants received/pledged: £3,000,000
Used to fund (among other things): New eye centre (pledged only)
Will you accept future Sackler grants? Won’t say

The London Library

Grants received/pledged: £1,000,000
Used to fund (among other things): The Sackler Study
Will you accept future Sackler grants? Won’t say

The Prince’s Trust

Grants received/pledged: £775,000
Used to fund (among other things): Programmes for disadvantaged youth
Will you accept future Sackler grants? Subject to vetting that typically takes into account “reputational risk” and “all relevant new information about the donor in the public domain”

Westminster Abbey

Grants received/pledged: £500,000
Used to fund (among other things): Restoration of Henry VII Chapel
Will you accept future Sackler grants? Won’t say

Royal Hospital for Neurodisability

Grants received/pledged: £350,000
Used to fund (among other things): Won’t say
Will you accept future Sackler grants? No reply

cc @hlc

La plus grande #grotte #sous-marine du #monde #découverte au #Mexique
▻https://www.futura-sciences.com/planete/actualites/geologie-plus-grande-grotte-sous-marine-monde-decouverte-mexique-69

https://fr.cdn.v5.futura-sciences.com/buildsv6/images/wide1920/9/5/c/95c6535f9f_118741_grotte-sous-marine.jpg

Cet #article de #Xavier_Demeersman a été publié le #19_janvier #2018 sur #futura_sciences. Il traite de la #découverte d’un #passage entre les #réseaux de grottes sous-marines de #Sac_Actun et #Dos_Ojos dans le #Yucatán. Ces #cénotes, #puits d’#eau douce provenant des eaux de pluie ayant percé le plafond d’une #grotte #karstique, sont les points de #départ de #réseaux #souterrains que les scientifiques n’ont pas fini d’ #explorer...

C’est dans les eaux du #gouffre de 43 mètres de profondeur de #Hoyo_Negro (en français « trou noir »), dans le réseau de #Sac_Actun, qu’a été trouvé le #squelette de #Naia en #2007. Comme certains animaux de l’#âge_de_glace, la jeune fille qui vivait dans la région il y a environ 13.000 ans est malheureusement tombée dans ce trou. Bien des siècles et des millénaires plus tard, les descendants de la civilisation #maya considéreront ces #cénotes (dérivé du maya dz’onot signifiant « puits sacrés ») comme des bouches à travers lesquelles ils pouvaient communiquer avec les #dieux des mondes #souterrains. De nombreux objets de leur #culture y ont été pêchés.

Tiro al bersaglio senza pietà : ucciso #Sacko_Soumaila, 29 anni

A #San_Calogero, in provincia di Vibo Valentia, nel pomeriggio di sabato 2 giugno, intorno alle sei, ignoti hanno ucciso un uomo di 29 anni originario del Mali con una fucilata alla tempia. Sacko Soumaila è morto dopo essere stato soccorso da un’ambulanza e trasportato prima all’ospedale di Polistena, e poi nel reparto di neurochirurgia dell’ospedale di Reggio Calabria.

Il giovane, titolare di un regolare permesso di soggiorno (cosa che la stampa mainstream tiene a sottolineare come un mantra, ndr), viveva nella vicina #tendopoli di #San_Ferdinando (sulle condizioni di vita dei braccianti all’interno di questo “#ghetto” si veda il recente rapporto MEDU) e lavorava come bracciante nei campi della piana di #Gioia_Tauro per pochi euro al giorno ed era sindacalista dell’#Unione_Sindacale_di_Base.

Lo scorso 27 gennaio nella baraccopoli c’era stato un devastante incendio in cui era morta una giovane donna di origini nigeriane, Becky Moses. Dopo quell’episodio, i migranti avevano iniziato a utilizzare le lamiere per ricostruire le baracche al posto di altri materiali di recupero più facilmente infiammabili (cartoni, teli di plastica, aste di legno e così via).

Sacko Soumalia, insieme a due suoi connazionali, Drame Madiheri, 39 anni, e Madoufoune Fofana, 27 anni, stava cercando proprio delle lamiere per costruire altri ripari nella tendopoli. I tre si trovavano in una ex fabbrica di mattoni, la Fornace, in contrada Calimera di San Calogero, lungo la Statale 18, vicino Rosarno, al confine tra la provincia di Vibo quella di Reggio Calabria, chiusa ormai da dieci anni, e in completo abbandono, per disposizione della magistratura perché ci avevano trovato «oltre 135mila tonnellate di rifiuti pericolosi e tossici, inclusi fanghi altamente inquinanti» (precisa il quotidiano La Repubblica).

Stando al racconto di uno dei due sopravvissuti, a sparare sarebbe stato un uomo piuttosto anziano, di carnagione chiara, sceso da una Panda bianca che ha preso la mira da oltre 60 metri e ha sparato, senza alcuna esitazione, numerosi colpi di fucile. Come spesso è successo in casi analoghi, la notizia dell’omicidio è stata proposta in modo fuorviante. La “storia” dei migranti che “rubano” e poi muoiono barbaramente “giustiziati”, ci fa risalire alla memoria il lontano 2008, quando un giovane italiano, Abdul William Guibre detto Abba, 19 anni, originario del Burkina Faso, veniva ucciso da due italiani, padre e figlio, a sprangate per il presunto furto di una piccola scatola di biscotti a Milano (vedi nel primo libro bianco sul razzismo in Italia, G. Faso, L’uccisione di Abdul Guibre, pag. 72). O la più recente morte di Mamoudou Sare, 37enne del Burkina Faso, ucciso a colpi di fucile nelle campagne di Lucera, nell’estate 2015, sempre da padre e figlio, per un presunto furto di meloni marci (vedi nel quarto libro bianco sul razzismo in Italia, P. Andrisani, La vita per un melone marcio. L’assurdo omicidio
di Sare Mamadou a Lucera, pag. 165).

Oggi, qualcuno ha ucciso con un obiettivo preciso per quattro pezzi di lamiera abbandonata. Fra i tanti giornali calabresi online, i primi a diffondere la notizia dell’omicidio del migrante, StrettoWeb la correda di una foto che allude ai furti in appartamento (un ladro che scavalca un balcone per svaligiare un appartamento) con il titolo “Far West in Calabria, immigrati tentano un furto ma uno finisce ucciso a colpi di fucile”. Ovviamente questo ha inevitabilmente scatenato centinaia di commenti razzisti irripetibili, distillando un concentrato d’odio devastante. Molti commenti al post con cui è stato diffuso l’articolo esaltano la possibilità di “farsi giustizia da soli” e incitano ad “ammazzarli tutti”. Triste e sconfortante constatare che nei commenti (o non-commenti) all’accaduto, da una parte, c’è il silenzio assordante della politica e del Governo, e dall’altra, vi è un gran numero di commenti che giustificano l’accaduto dicendo che “stavano rubando”.

Ricordiamo che esattamente un anno fa, la Camera ha completato l’esame della proposta di legge sulla riforma della cosiddetta “legittima difesa”, approvando alcune modifiche alla legge vigente. La proposta di legge iniziale riguardava solo l’articolo 59 del codice penale (quindi non quello sulla legittima difesa, ma quello sulle circostanze del reato), aumentando la tutela per chi si difenda da un’aggressione in casa con un’arma legittimamente posseduta, eliminando la colpa di “chi si difende in modo eccessivo”, se si trova in uno stato di “grave turbamento psichico causato dalla persona contro la quale è diretta la reazione”. Il fatto è che, nella zona, si sono già verificati diversi episodi di violenza, anche brutale, contro i migranti, per cui lo scorso ottobre i carabinieri avevano arrestato quattro ragazzi italiani per aggressioni «con l’aggravante di aver commesso il fatto per finalità di discriminazione e odio razziale» (si sporgevano dai finestrini della loro auto, colpendo con delle mazzate i migranti in bicicletta, “come dei birilli”). Una ragione in più per presidiare. Una ragione in più per porre maggiore attenzione ad un problema che purtroppo, va ben al di là della morte terribile del giovane bracciante maliano.

Oggi, lunedì 4 giugno, il sindacato di cui faceva parte Soumaila, l’USB, ha indetto uno sciopero generale (condiviso anche in altri luoghi simbolo dello sfruttamento dei braccianti stranieri, come a Foggia e dintorni, e a Lecce) e un’assemblea per decidere il da farsi.

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▻http://www.cronachediordinariorazzismo.org/tiro-al-bersaglio-senza-pieta-ucciso-sacko-soumaila-29-
#racisme #xénophobie #Italie #assassinat #meurtre #travail #bracciante #braccianti #exploitation #tomates #Soumaila_Sacko #Sacko

Raymond SACKLER Officier of the Legion of Honor - France in the United States / Embassy of France in Washington, D.C.
▻https://fr.franceintheus.org/spip.php?article5052

Dear Dr. Sackler,
Dear Mrs. Sackler
Distinguished guests,
American and French friends,

It is a great pleasure and honor for me to be here with you today on this very special occasion and I would like to express my warmest thanks to Raymond Sackler, whom we are honoring today, for welcoming us to this beautiful location.

We are gathered here this afternoon to honor one of the most remarkable medical doctors in the field of Psychiatry and a very successful businessmanwho is also a great friend of France and an exceptional individual, Raymond Sackler.

I would like to thank Mr. Sackler’s family and friends who have joined us here this afternoon to show their support and admiration, with a special word of appreciation to his wife Beverly, to whom I also want to pay tribute.

Before proceeding with the ceremony, I would like to say a few words about the award I will bestow upon Mr. Sackler. The Legion of Honor was created by Napoleon Bonaparte in 1802 to reward extraordinary accomplishments and outstanding services rendered to France.
It is France’s highest distinction and one of the most coveted in the world. And the rank of officier that I will bestow upon Raymond Sackler is truly exceptional.

Dear Dr. Sackler,

You have accomplished so much that it is difficult to briefly sum up all of your outstanding achievements.

Already at a very young age, you were interested in France and French culture. You first visited France in 1939, and since then, have come to France very often, becoming a true Francophile, as evidenced throughout your professional life and philanthropic activities.

Together with your brother Mortimer, also a medical doctor, you created a pharmaceutical laboratory in France that was and still is a great success story. Being aware of the caliber of French research in medical and pharmaceutical sciences, you chose France for their first industrial investment, co-funding Les Laboratoires SARGET (today MEDA-PHARMA). You developed this company by creating or acquiring several subsidiaries in France, Italy, Spain, the Netherlands and Portugal.

You were incredibly successful, bringing the “Laboratoires SARGET” from a staff of a few hundred people in 1961, when it was created, to more than two thousand in 1987, when it was sold. With your brother and family, you later created another pharmaceutical company, MUNDIPHARMA, which is still growing, creating many jobs in France, and thus significantly contributing to the rise of the pharmaceutical industry in our country.

At the same time, you and your wife, Beverly, became patrons of a number of worthy causes: many scientific institutions, universities, and museums such as the Louvre and the Musée d’Art Contemporain de Bordeaux have benefited from your generosity. You also expressed a special interest in IHES, the Institut des Hautes Etudes Scientifiques, that is very well represented this afternoon.

I’d like to recognize the new Chairman of the Friends of IHES, Prof. Michael Douglas, the new Director of IHES Emmanuel Ullmo and its former director Jean-Pierre Bourguignon.

If IHES is what it is today, a worldclass scientific center that is second to none, it is to a large extend thanks to you mon cher Jean-Pierre, to your talent, dedication and commitment to the Institute.

It is also thanks to the support of many of you, Luc Hardy, and Raymond and Beverly Sackler in particular.

Cher Raymond,

Since 1990, you have made 3 donations to IHES, leading to the creation of 2 permanent endowments to host 2 scientists every year. You also supported the agreement between IHES and the Raymond and Beverly Sackler School of Mathematical Sciences at Tel Aviv University. You encouraged IHES to diversify its scientific activities by making an additional donation in 2012 to create a Chair in Physics and Cosmology.

Your long friendship and tremendous generosity toward French arts and science mirror your exceptional qualities as human beings. Your professional and social success go hand in hand with a unwavering intellectual curiosity and a strong commitment to future generations.

You were originally named Chevalier of the Legion of Honor by President Mitterrand. Your name had been proposed by the Minister of Foreign Affairs and Benoît d’Abboville, then French Consul in New York, who presented you with the award here in New York in 1990.

Today, in recognition of your continued dedication and commitment to French-American cultural and scientific cooperation, the President of the French Republic has promoted you to the rank of Officier dans l’Ordre national de la Légion d’Honneur.

It is my great pleasure and privilege to award you this distinction. I will now proceed in French:

Raymond SACKLER,

Au nom du Président de la République, je vous fais Officier dans l’Ordre de la Légion d’Honneur.

#Opioides #Sackler #Légion_honneur

Yale donor linked to opioid crisis
▻https://yaledailynews.com/blog/2017/11/13/yale-donor-linked-to-opioid-crisis

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By 2008, when Raymond and Beverly Sackler endowed Yale with funds for an Institute for Biological, Physical and Engineering Sciences, Purdue Pharma’s misrepresentation of the drug was commonly known — the company had already settled multiple suits.

“These are gifts that different family members made as individual family gifts. These were not gifts from the company — these were individual family gifts, so in that sense, these individuals have wealth that they gave to us, so it’s no more complicated than that when they made these gifts a number of years ago,” said Vice President for Development Joan O’Neill. “We have no reason that we wouldn’t have been excited by the generosity that they provided to Yale and that they’ve provided to institutions around the world.”

In 2009, Richard and Jonathan Sackler endowed the Richard Sackler and Jonathan Sackler Professorship, to be held by the Yale Cancer Center director, with a $3 million gift. Mark Lemmon, the co-director of the Yale Cancer Biology Institute at Yale’s West Campus, currently holds the David A. Sackler Professorship of Pharmacology. According to Dean of the School of Medicine Robert Alpern, the Sacklers have given many gifts over the years to research and lectureship at Yale.

As of July 2014, Richard S. Sackler, former co-chairman and president of Purdue Pharma, was a member of the School of Medicine dean’s council and the Yale Cancer Center director’s advisory board. That year, Alpern called Sackler a “steadfast friend of the medical school.”

In March 2014, Sackler and his children established the Richard Sackler Family Endowment in Medicine, funded by a gift of stock donated by Sackler in 2009, to support three professorships. Raymond and Beverly Sackler have given to Yale to support archaeological excavation work and the establishment of the Raymond and Beverly Sackler Visiting Professor/Lecturer at the School of Medicine.

Asked whether Yale considered the source of the Sackler family’s wealth a factor in deciding whether to accept their donations and why the University ultimately accepted them, Alpern responded that the Sackler family had been “incredibly generous” to the University as well as other organizations. He added that members of the family have always been professional and never asked for anything in return.

#Opioides #Sackler #Yale

University of Glasgow :: Story :: Biography of Mortimer Sackler
▻https://www.universitystory.gla.ac.uk/biography/?id=WH27277&type=P

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Dr Mortimer Sackler (1916-2010) was an American physician and entrepreneur. He was Chairman and co-Chief Executive of Purdue Pharma, a leading American pharmaceuticals company. Alongside his brothers Arthur and Raymond, he used his fortune from the pharmaceutical industry to become a prominent philanthropist and he greatly supported the University of Glasgow.

Sackler was born on 7th December 1916 in Brooklyn to Isaac and Sophie (nee Greenberg), Polish Jewish immigrant Brooklyn grocers. After attending Erasmus Hall High School, Sackler sailed to the UK in 1937 and, with the help of Glasgow’s Jewish community, enrolled at Anderson’s College of Medicine, an institution that became part of the University of Glasgow in 1947. He attended the College between 1937-1939. His brothers Arthur and Raymond also studied at Anderson’s College in the years 1937-39 and 1938-40 respectively. Mortimer Sackler was prevented from finishing his degree at the University by the outbreak of the Second World War and finished his MD degree in Massachusetts. Dr Mortimer Sackler and his brothers bought the New York pharmaceuticals company Purdue Frederick Co in 1952. All three were research psychiatrists.

Mortimer Sackler received an honorary degree from the University of Glasgow in 2001 for his support of the University. He funded the Sackler Institute of Psychobiological Research, a research unit at the Southern General Hospital which investigates neuro-psychiatric disorders in association with the Sackler Institute at the University of Edinburgh. The Institute was opened in 2004.

Dr Mortimer Sackler died on 24th March 2010.

#Opioides #Sackler #Mortimer_Sackler

The OxyContin Clan: The $14 Billion Newcomer to Forbes 2015 List of Richest U.S. Families
▻https://www.forbes.com/sites/alexmorrell/2015/07/01/the-oxycontin-clan-the-14-billion-newcomer-to-forbes-2015-list-of-richest-u-s-families/#33de89e275e0

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The richest newcomer to Forbes 2015 list of America’s Richest Families comes in at a stunning $14 billion. The Sackler family, which owns Stamford, Conn.-based Purdue Pharma, flew under the radar when Forbes launched its initial list of wealthiest families in July 2014, but this year they crack the top-20, edging out storied families like the Busches, Mellons and Rockefellers.

How did the Sacklers build the 16th-largest fortune in the country? The short answer: making the most popular and controversial opioid of the 21st century — OxyContin.

The Sacklers’ OxyContin score came long after the family initially got into the pharmaceutical business. Brothers Arthur, Mortimer and Raymond Sackler — each practicing psychiatrists — bought a small, struggling drug manufacturer in New York City in 1952, which would eventually become Purdue Pharma. The brothers initially sold small-time products like laxative and earwax remover.

Arthur, simultaneously, was a standout in the field of medical advertising. He helped Pfizer PFE -0.08% establish itself in the prescription drug arena, and he is credited with writing scientific papers that contributed to Valium becoming the first $100 million drug, according to his listing in the Medical Advertising Hall of Fame.

By the time Arthur died in 1987 at age 73, brothers Mortimer and Raymond had Purdue Pharma dabbling in pain medications. They eventually took generic painkiller oxycodone — invented in World War I-era Germany — and installed a timed-release mechanism, which promised to stymie abuse by spreading the drug’s effects over half-day period. This enabled them to market it beyond the traditional target audience for powerful opioids — cancer patients — and not long after OxyContin’s launch in 1995, primary-care doctors were prescribing it for an array of painful symptoms. Sales hit $1.5 billion by 2002.

#Opioides #Sackler

In the Discussion About the Sacklers and Oxycontin, It’s Important to Get the Facts Right | artnet News
▻https://news.artnet.com/opinion/discussion-sacklers-oxycontin-facts-elizabeth-a-sackler-1203458

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Some of the many media articles about the family, such as Christopher Glazek’s piece in Esquire, have drawn the correct distinction between Elizabeth Sackler and her father Arthur M. Sackler—who have never been involved in nor benefited from the sale of Oxycontin—and other branches of the Sackler family, who have been involved in and benefited directly from this harmful drug through their company Purdue Pharma.

Se foutre de la gueule du monde : Et la publicité Valium et la crise de dépendance qui s’en est suivie ? C’est par Arthur peut-être ? Et MS Contin ?

#Opioides #Sackler

Avec la mort de Raymond Sackler, le monde des arts perd un immense philanthrope par Le Quotidien de l’Art
▻https://www.lequotidiendelart.com/articles/11134-avec-la-mort-de-raymond-sackler-le-monde-des-arts-perd-un-i

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Scientifique de renom, connu pour avoir commercialisé l’OxyContin, un puissant analgésique, aussi bien que pour son activité de mécénat, Raymond Sackler est décédé le 17 juillet 2017 à l’âge de 97 ans. Avec son épouse Beverly Sackler, il a été un grand bienfaiteur du Metropolitan Museum of Art de New York. En témoignent la Raymond and Beverly Sackler Gallery du département d’art assyrien et, plus encore, l’aile baptisée Sackler, regroupant les centres de recherche sur l’histoire des arts chinois et japonais et abritant les vestiges du temple d’Isis de Dendour. Donateurs également du British Museum de Londres, une aile du musée porte leur nom, au sein du département du Proche-Orient et de l’Égypte ancienne. Leurs dons ont par ailleurs permis la restauration de la stèle de victoire du roi Narâm-Sîn du Louvre, une pièce majeure du département des Antiquités orientales. Il a également laissé son empreinte à la Smithsonian Institution de Washington avec la Freer et Sackler Gallery. Honoré de plusieurs distinctions comme celle de Chevalier de l’Ordre de l’Empire britannique, il avait été fait en France Chevalier de la Légion d’honneur puis, en 2013, Officier de la Légion d’honneur.

#Opiides #Sackler #Raymond_Sackler

Benzodiazépines : Valium, Tranxen, Lexomil, Xanax...
▻https://www.passeportsante.net/fr/Actualites/Dossiers/DossierComplexe.aspx?doc=que-penser-des-benzodiazepines-les-benzodia

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L’ensemble des risques généraux liés à l’usage des benzodiazépines est bien connu et figure dans le Résumé des Caractéristiques du Produit (AMM) de chacune d’elle1. Ainsi, leur usage peut entraîner :

Une amnésie antérograde (perte de la mémoire des faits récents) qui augmente proportionnellement avec la dose.
Une altération des fonctions psychomotrices pouvant survenir dans les heures suivant la prise.
Un syndrome associant, à des degrés divers, des troubles du comportement et une altération de l’état de conscience. Peuvent être ainsi observés les effets suivants : aggravation de l’insomnie, cauchemars, agitation, nervosité, idées délirantes, hallucinations, état confuso-onirique, symptômes de type psychotique, désinhibition avec impulsivité, euphorie, irritabilité, amnésie antérograde et suggestibilité.
Une tolérance caractérisée par une diminution progressive de l’effet thérapeutique pour une même dose administrée pendant plusieurs semaines. La tolérance peut conduire à une augmentation des doses pour obtenir l’effet recherché.

Ces effets secondaires ne sont pas fréquents et s’estompent rapidement après la prise. En réalité, le principal problème des benzodiazépines est la très forte dépendance qu’elles induisent, aussi bien sur le plan psychique que physique.
Une dépendance psychologique et physique fortes

Au début, la dépendance n’est que psychologique, mais peu à peu, la tolérance s’installe, nécessitant une augmentation de la dose pour obtenir l’effet initial. « Quand on prend des benzodiazépines pendant plus d’un mois, on a des signes de dépendance physique qui se manifestent notamment par les “effets rebonds”, c’est-à-dire qu’au moment où on arrête, pendant quelques temps, on va plus mal qu’avant. » explique le Docteur Mallaret, praticien hospitalier. Les symptômes qui apparaissent alors sont des manifestations du sevrage. Ils peuvent être extrêmement différents en fonction des individus, de la durée de consommation et du produit ingéré :

Anxiété
Tremblements et agitation
Convulsions et attaques d’apoplexie
Paranoïa, hallucinations et délire

Ces symptômes ne sont pas anodins et il est indispensable d’être sous surveillance médicale en cas d’arrêt du traitement. Celui-ci doit être progressif : les doses absorbées doivent être diminuées petit à petit pour éviter des effets secondaires sévères, et une éventuelle rechute.

C’est ce risque de dépendance qui est à l’origine des durées de prescription, fixées à 12 semaines. Malheureusement, celles-ci ne sont que trop peu respectées… L’ANSM révèle que le temps de traitement médian est de 7 mois pour une benzodiazépine anxiolytique et hypnotique. Toujours selon elle, environ la moitié des sujets traités par ces médicaments le sont plus de 2 ans (avec ou sans interruption de traitement). Cette dépendance s’accompagne également d’un surdosage : environ 18% des patients ont une posologie journalière estimée supérieure à celle recommandée par l’autorisation de mise sur le marché. Une addiction que beaucoup vivent comme un enfer : « Au départ c’est un simple traitement de trois semaines, mais en fait, vous n’arrivez jamais à vous en débarrasser. J’ai mis dix ans pour m’en sortir… » témoigne une ancienne consommatrice. Un cas extrême qui rappelle toutefois que les recommandations ne sont pas à prendre à la légère. Malheureusement, il n’est pas jamais évident de savoir qu’on devient dépendant, car comme toute substance, ses effets sont différents sur chacun…

Les risques présentés par les benzodiazépines sont d’autant plus inquiétants que leur consommation s’est dangereusement banalisée. En France, elle bat même des records en Europe : 3,8 millions en consomment régulièrement, soit deux fois plus qu’en Espagne et cinq fois plus qu’en Allemagne1. L’ANSM (Agence nationale de sécurité du médicament et des produits de santé) note que plus de 25 millions de personnes ont été exposées à ces médicaments entre 2006 et 2011. Un chiffre qui n’a pas manqué de faire réagir La Haute Autorité de Santé, auteur récent d’une campagne d’information sur le sujet2.

…ou penser à d’autres alternatives
Pour le professeur Edouard Zarifian , psychiatre et auteur de l’ouvrage "La Force de guérir", la réponse est évidente : « Je ne critique pas le médicament, mais son utilisation systématique et abusive. Il faut revenir à la clinique. Il s’agit d’un homme ou d’une femme dont la plainte en matière de sommeil ne doit pas être prise au premier degré. C’est une erreur de commencer à prescrire un médicament avant même d’aller plus loin. On n’a qu’une chance sur cent de se trouver devant un vrai trouble du sommeil. Ce qu’il faut, c’est découvrir à quoi correspond cette plainte. » Outre ce travail relationnel relatif aux professionnels de soin, il existe aussi des moyens pour diminuer son anxiété sans passer par la case « médicaments ». En Angleterre et en Allemagne, où la consommation de benzodiazépines est moindre, la phytothérapie est très utilisée, tout comme la psychothérapie. Nombreux sont les professionnels de soins à déplorer d’ailleurs le non-remboursement de cette pratique en France.

#Opioides #Benzodiazépines #Valium #Lexomil #Sackler

Valium: It’s more addictive than heroin, with horrifying side-effects, so why is it still given to millions? | Daily Mail Online
▻http://www.dailymail.co.uk/femail/article-2289311/Valium-Its-addictive-heroin-horrifying-effects-given-millions.html

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One of the first - and most infamous - of the ‘benzos’ was Valium. Launched in the 1960s it quickly became the pill for every ill, dished out in profligate quantities to anyone struggling with the travails of daily life. Sixty per cent of users were women and Valium was soon dubbed ’mother’s little helper’.

But Valium and the other benzos are derived from chemical compounds which make some of them more addictive even than heroin.

And their legacy is a vast group of people suffering appalling withdrawal symptoms so severe they are unfit for work, relationships or even independent living. Some have also been left with permanent effects, including memory loss.

Increasingly worried about what the drug might be doing to her after six years on it, Baylissa started researching clonazepam-type drugs on the internet and was shocked by what she read. People reported memory loss, dementia, paranoia, hallucinations and excruciating pain, either as a result of being on the drug or coming off it.

Valium’s pernicious legacy has touched everyone from schoolgirls and poverty stricken single mothers to middle-class divorcees and wealthy socialites. In some cases, distraught addicts resort to suicide: Department of Health figures show the drug is implicated in 300-500 deaths a year in this country.

But the scale of the problem has been largely ignored. Despite guidelines dating back to 1988, which warn doctors to limit the prescribing of this potent and controversial drug, clinicians have found it an effective way to handle many hard-to-diagnose, hard-to-treat patients.

There are now 183 different formulations of Valium-derived medications. Doctors in Britain issue almost 18 million prescriptions a year for benzodiazepiones, and every GP has at least 180 long-term users on their books.

Despite being highly addictive and having alarming side-effects, Valium had become one of the world’s best-selling drugs by the mid-Seventies. It was originally manufactured by Hoffmann La Roche, but the company lost its patent protection in 1985. Some 500 different versions of the drug were subsequently marketed by different companies worldwide.

It was on a holiday to France in April 2011 that Fiona made the life-changing decision to stop taking Valium. ’I didn’t take enough with me — I don’t know if that was on purpose or not — and we were sitting in a cafe one day when I had a panic attack, mewling like a puppy.

’People were staring and it was awful, but it took about three weeks for the real withdrawal symptoms to appear. By then I was whimpering and shaking the whole time, I couldn’t sleep, I was depressed and just exhausted.’

Back home, with no further help from her GP, Fiona sought information about Valium withdrawal on the internet and tackled her long-term dependency by gradually reducing her dose to zero over five months.

’It was absolute hell,’ she says. ’I felt sick, I had long periods of shaking uncontrollably, excruciating muscle cramps, and all the symptoms of severe flu. I couldn’t go out, leave the house at all, or do anything at all.’

#Opioides #Sackler #Valium

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

L’Hippocrate - projet de #patriarche
Je met ici mes document pour mon prochain patriarche sur la crise des #opioïdes - Fentanyl, oxycodone ...

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J’avais raté la sucette au Fentanyl ; Actiq du labo Cephalon

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Les anti-overdose au naloxone

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The B.C. government announced Wednesday that pharmacies will now offer free naloxone kits at pharmacies. Naloxone can reverse a drug overdose by helping restore a person’s breathing. Photo Dan Toulgoet

#mad_meg #iconographie

How Advertising Shaped the First Opioid Epidemic | Science | Smithsonian
▻https://www.smithsonianmag.com/science-nature/how-advertising-shaped-first-opioid-epidemic-180968444

hen historians trace back the roots of today’s opioid epidemic, they often find themselves returning to the wave of addiction that swept the U.S. in the late 19th century. That was when physicians first got their hands on morphine: a truly effective treatment for pain, delivered first by tablet and then by the newly invented hypodermic syringe. With no criminal regulations on morphine, opium or heroin, many of these drugs became the “secret ingredient” in readily available, dubiously effective medicines.

In the 19th century, after all, there was no Food and Drug Administration (FDA) to regulate the advertising claims of health products. In such a climate, a popular so-called “patent medicine” market flourished. Manufacturers of these nostrums often made misleading claims and kept their full ingredients list and formulas proprietary, though we now know they often contained cocaine, opium, morphine, alcohol and other intoxicants or toxins.

Products like heroin cough drops and cocaine-laced toothache medicine were sold openly and freely over the counter, using colorful advertisements that can be downright shocking to modern eyes. Take this 1885 print ad for Mrs. Winslow’s Soothing Syrup for Teething Children, for instance, showing a mother and her two children looking suspiciously beatific. The morphine content may have helped.

Taiwan Announces Ban on All Plastic Bags, Straws, and Utensils

Ordering take-out, picking up groceries, buying a soft drink — these are all activities that will change over the next decade in Taiwan when the island nation imposes a blanket ban on single-use plastic bags, straws, and cups, according to the Hong Kong Free Press.

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The Opioid that Made a Fortune for Its Maker — and for Its Prescribers - The New York Times
▻https://www.nytimes.com/interactive/2018/05/02/magazine/100000005878055.app.html

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For Insys, Chun was just the right kind of doctor to pursue. In the late 1990s, sales of prescription opioids began a steep climb. But by the time Subsys came to market in 2012, mounting regulatory scrutiny and changing medical opinion were thinning the ranks of prolific opioid prescribers. Chun was one of the holdouts, a true believer in treating pain with narcotics. He operated a busy practice, and 95 percent of the Medicare patients he saw in 2015 had at least one opioid script filled. Chun was also a top prescriber of a small class of painkillers whose active ingredient is fentanyl, which is 50 to 100 times as powerful as morphine. Burlakoff’s product was a new entry to that class. On a “target list,” derived from industry data that circulated internally at Insys, Chun was placed at No. 3. The word inside the company for a doctor like Chun was a “whale.”

In the few months since Subsys was introduced, demand was not meeting expectations. Some of the sales staff had already been fired. If Burlakoff and Krane could persuade Chun to become a Subsys loyalist, it would be a coup for them and for the entire company. The drug was so expensive that a single clinic, led by a motivated doctor, could generate millions of dollars in revenue.

Speaker programs are a widely used marketing tool in the pharmaceutical business. Drug makers enlist doctors to give paid talks about the benefits of a product to other potential prescribers, at a clinic or over dinner in a private room at a restaurant. But Krane and some fellow rookie reps were already getting a clear message from Burlakoff, she said, that his idea of a speaker program was something else, and they were concerned: It sounded a lot like a bribery scheme.

But the new reps were right to be worried. The Insys speaker program was central to Insys’ rapid rise as a Wall Street darling, and it was also central to the onslaught of legal troubles that now surround the company. Most notable, seven former top executives, including Burlakoff and the billionaire founder of Insys, John Kapoor, now await trial on racketeering charges in federal court in Boston. The company itself, remarkably, is still operating.

The reporting for this article involved interviews with, among other sources, seven former Insys employees, among them sales managers, sales reps and an insurance-authorization employee, some of whom have testified before a grand jury about what they witnessed. This account also draws on filings from a galaxy of Insys-related litigation: civil suits filed by state attorneys general, whistle-blower and shareholder suits and federal criminal cases. Some are pending, while others have led to settlements, plea deals and guilty verdicts.

The opioid crisis, now the deadliest drug epidemic in American history, has evolved significantly over the course of the last two decades. What began as a sharp rise in prescription-drug overdoses has been eclipsed by a terrifying spike in deaths driven primarily by illicitly manufactured synthetic opioids and heroin, with overall opioid deaths climbing to 42,249 in 2016 from 33,091 in 2015. But prescription drugs and the marketing programs that fuel their sales remain an important contributor to the larger crisis. Heroin accounted for roughly 15,000 of the opioid deaths in 2016, for instance, but as many as four out of five heroin users started out by misusing prescription opioids.

By the time Subsys arrived in 2012, the pharmaceutical industry had been battling authorities for years over its role in promoting the spread of addictive painkillers. The authorities were trying to confine opioids to a select population of pain patients who desperately needed them, but manufacturers were pushing legal boundaries — sometimes to the breaking point — to get their products out to a wider market.

Even as legal penalties accrued, the industry thrived. In 2007, three senior executives of Purdue Pharma pleaded guilty in connection with a marketing effort that relied on misrepresenting the dangers of OxyContin, and the company agreed to pay a $600 million settlement. But Purdue continued booking more than $1 billion in annual sales on the drug. In 2008, Cephalon likewise entered a criminal plea and agreed to pay $425 million for promoting an opioid called Actiq and two other drugs “off-label” — that is, for unapproved uses. That did not stop Cephalon from being acquired three years later, for $6.8 billion.

Subsys and Actiq belong to a class of fentanyl products called TIRF drugs. They are approved exclusively for the treatment of “breakthrough” cancer pain — flares of pain that break through the effects of the longer-acting opioids the cancer patient is already taking around the clock. TIRFs are niche products, but the niche can be lucrative because the drugs command such a high price. A single patient can produce six figures of revenue.

Fentanyl is extremely powerful — illicitly manufactured variations, often spiked into heroin or pressed into counterfeit pills, have become the leading killers in the opioid crisis — and regulators have made special efforts to restrict prescription fentanyl products. In 2008, for instance, the F.D.A. rebuffed Cephalon’s application to expand the approved use for a TIRF called Fentora; in the company’s clinical trials, the subjects who did not have cancer demonstrated much more addictive behavior and propensity to substance abuse, which are “rarely seen in clinical trials,” F.D.A. officials concluded. An F.D.A. advisory committee reported that, during the trials, some of the Fentora was stolen. The agency later developed a special protocol for all TIRF drugs that required practitioners to undergo online training and certify that they understood the narrow approved use and the risks.

Despite these government efforts, TIRF drugs were being widely prescribed to patients without cancer. Pain doctors, not oncologists, were the dominant players. This was common knowledge in the industry. Although it is illegal for a manufacturer to promote drugs for off-label use, it is perfectly legal for doctors to prescribe any drug off-label, on their own judgment. This allows drug makers like Insys to use a narrow F.D.A. approval as a “crowbar,” as a former employee put it, to reach a much broader group of people.

That points to a major vulnerability in policing the opioid crisis: Doctors have a great deal of power. The F.D.A. regulates drug makers but not practitioners, who enjoy a wide latitude in prescribing that pharmaceutical companies can easily exploit. A respected doctor who advocates eloquently for wider prescribing can quickly become a “key opinion leader”; invited out on the lucrative lecture circuit. And any doctor who exercises a free hand with opioids can attract a flood of pain patients and income. Fellow doctors rarely blow the whistle, and some state medical boards exercise timid oversight, allowing unethical doctors to continue to operate. An assistant district attorney coping with opioids in upstate New York told me that it’s easy to identify a pill-mill doctor, but “it can take five years to get to that guy.” In the meantime, drug manufacturers are still seeing revenue, and that doctor is still seeing patients, one after another, day after day.

Kapoor believed that he had the best product in its class. All the TIRF drugs — for transmucosal immediate-release fentanyl — deliver fentanyl through the mucous membranes lining the mouth or nose, but the specific method differs from product to product. Actiq, the first TIRF drug, is a lozenge on a stick. Cephalon’s follow-up, Fentora — the branded market leader when Subsys arrived — is a tablet meant to be held in the cheek as it dissolves. Subsys is a spray that the patient applies under the tongue. Spraying a fine mist at the permeable mouth floor makes for a rapid onset of action, trials showed.

Once the F.D.A. gave final approval to Subsys in early 2012, the fate of Insys Therapeutics rested on selling it in the field. The industry still relies heavily on the old-fashioned way of making sales; drug manufacturers blanket the country with representatives who call on prescribers face to face, often coming to develop personal relationships with them over time.

The speaker events themselves were often a sham, as top prescribers and reps have admitted in court. Frequently, they consisted of a nice dinner with the sales rep and perhaps the doctor’s support staff and friends, but no other licensed prescriber in attendance to learn about the drug. One doctor did cocaine in the bathroom of a New York City restaurant at his own event, according to a federal indictment. Some prescribers were paid four figures to “speak” to an audience of zero.

One star rep in Florida, later promoted to upper management, told another rep that when she went in search of potential speakers, she didn’t restrict herself to the top names, because, after all, any doctor can write scripts, and “the company does not give a [expletive] where they come from.” (Some dentists and podiatrists prescribed Subsys.) She looked for people, she said, “that are just going through divorce, or doctors opening up a new clinic, doctors who are procedure-heavy. All those guys are money hungry.” If you float the idea of becoming a paid speaker “and there is a light in their eyes that goes off, you know that’s your guy,” she said. (These remarks, recorded by the rep on the other end of the line, emerged in a later investigation.)

As a result of Insys’s approach to targeting doctors, its potent opioid was prescribed to patients it was never approved to treat — not occasionally, but tens of thousands of times. It is impossible to determine how many Subsys patients, under Kapoor, actually suffered from breakthrough cancer pain, but most estimates in court filings have put the number at roughly 20 percent. According to Iqvia data through September 2016, only 4 percent of all Subsys prescriptions were written by oncologists.

Insys became the year’s best-performing initial public offering, on a gain of over 400 percent. That December, the company disclosed that it had received a subpoena from the Office of the Inspector General at Health and Human Services, an ominous sign. But a CNBC interviewer made no mention of it when he interviewed Babich a few weeks later. Instead he said, “Tell us what it is about Insys that has investors so excited.”

In 2014, the doctors each averaged one prescription for a controlled substance roughly every four minutes, figuring on a 40-hour week. A typical pill mill makes its money from patients paying in cash for their appointments, but Ruan and Couch had a different model: A majority of their scripts were filled at a pharmacy adjacent to their clinic called C&R — for Couch and Ruan — where they took home most of the profits. The pharmacy sold more than $570,000 of Subsys in a single month, according to Perhacs’s criminal plea. Together the two men amassed a collection of 23 luxury cars.

Over dinner, according to the Boston indictment, Kapoor and Babich struck a remarkable agreement with the pharmacists and the doctors, who were operating a clinic rife with opioid addiction among the staff: Insys would ship Subsys directly to C&R Pharmacy. An arrangement like this is “highly unusual” and a “red flag,” according to testimony from a D.E.A. investigator in a related trial. As part of the terms of the deal, the pharmacy would make more money on selling the drug, with no distributor in the loop. And there would be another anticipated benefit for all involved: Everyone could sell more Subsys without triggering an alert to the D.E.A.

The local medical community felt the impact of the raid. Because refills are generally not allowed on controlled substances, patients typically visited the clinic every month. For days, dozens of them lined up outside in the morning, fruitlessly trying to get prescriptions from the remaining staff or at least retrieve their medical records to take elsewhere. But other providers were either booked up or would not take these patients. “Nobody was willing to give the amount of drugs they were on,” a nurse in the city said. Melissa Costello, who heads the emergency room at Mobile Infirmary, said her staff saw a surge of patients from the clinic in the ensuing weeks, at least a hundred, who were going through agonizing withdrawal.

Two months after the raid in Mobile, Insys’ stock reached an all-time high.

Insys itself is still producing Subsys, though sales have fallen considerably. (Overall demand for TIRFs has declined industrywide.) The company is now marketing what it calls the “first and only F.D.A.-approved liquid dronabinol,” a synthetic cannabinoid, and is developing several other new drugs. Some analysts like the look of the company’s pipeline of new drugs and rate the stock a “buy.” In a statement, the company said its new management team consists of “responsible and ethical business leaders” committed to effective compliance. Most of its more than 300 employees are new to the company since 2015, and its sales force is focused on physicians “whose prescribing patterns support our products’ approved indications,” the company said. Insys has ended its speaker program for Subsys.

#Opioides #Pharmacie #Bande_de_salopards

The Top 5 Sacrifices Entrepreneurs Make
▻https://hackernoon.com/the-top-5-sacrifices-entrepreneurs-make-d61d064f2fc6?source=rss----3a814

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By Todd Belveal, Founder and CEO at Washlava (2015-present). Originally published on Quora.There’s a lot to love about doing a startup.I value freedom above all else in life, and startups are really freeing. Your time is your own, its spent on inherently creative pursuits, and you don’t have to waste any of it listening to business-speak or jargon in endless meetings.You can be yourself, be fearless, and get paid to do it.I enjoyed working in the corporate world, met great people and had good experiences. But there’s a real feeling of flexibility and control with startups you don’t get with a traditional job.Don’t be fooled — it’s work to run a company. You still wake up on the wrong side of the bed and don’t want to go to work. But in the end, it’s easy to get motivated because you’re (...)

#entrepreneur #entrepreneurs-make #sacrifice #quora-partnership #entrepreneurship

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

https://cdn.theatlantic.com/assets/media/img/mt/2018/04/Sacklers3/facebook.jpg?1523312653

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

Ranoumé : l’extravagante vie d’une danseuse créole - 7 Lames la Mer
▻http://7lameslamer.net/ranoume-l-extravagante-vie-d-une-2157.html

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D’origine réunionnaise et élevée à #Madagascar, la #danseuse #Ranoumé a brillé quelques années dans les nuits parisiennes. Son histoire rocambolesque commence par une « nocturne #cérémonie du #sacrifice »... selon la #légende.

Bezirksamt Tempelhof-Schöneberg: Beteiligung der Öffentlichkeit an der Bauleitplanung - FOCUS Online
▻https://www.focus.de/regional/berlin/bezirksamt-tempelhof-schoeneberg-beteiligung-der-oeffentlichkeit-an-der-baulei

Mittwoch, 28.03.2018, 17:17
gem. § 3 Abs. 2 Baugesetzbuch zum Bebauungsplan 7-75.

Der Entwurf des Bebauungsplans 7-75 für das Gebiet zwischen #Tempelhofer_Weg, #Hedwig-Dohm-Straße, #Sachsendamm und #Gotenstraße mit Ausnahme von Teilflächen der Grundstücke Sachsendamm 64, Gotenstraße 44-49, Gotenstraße 50-51, Tempelhofer Weg 27 und Tempelhofer Weg 28 im Bezirk Tempelhof-Schöneberg, Ortsteil Schöneberg liegt mit Begründung und Umweltbericht sowie den wesentlichen umweltbezogenen Stellungnahmen gemäß § 3 Absatz 2 des Baugesetzbuchs öffentlich aus. Beachten Sie bitte auch die formell verbindliche Veröffentlichung im Amtsblatt für Berlin vom 23. März 2018, insbesondere hinsichtlich der Arten vorliegender umweltbezogener Informationen.

Ziel des Bebauungsplanes ist die Entwicklung des oben genannten weitestgehend brachliegenden Geländes zu einem Wohnstandort mit Kita sowie zum Kerngebiet für Handel und Dienstleistungen.

Sie haben die Möglichkeit, sich an der Planung zu beteiligen. Während der Auslegungsfrist können Stellungnahmen abgegeben werden. Diese sind in die anschließende Abwägung der öffentlichen und privaten Belange gegeneinander und untereinander einzubeziehen. Nicht fristgerecht abgegebene Stellungnahmen können unberücksichtigt bleiben.

Termin:

4. April 2018 bis einschließlich 4. Mai 2018

Montag bis Mittwoch von 8 bis 15.30 Uhr, Donnerstag von 7.30 bis 18 Uhr, Freitag von 8 bis 14.30 Uhr sowie nach telefonischer Vereinbarung auch außerhalb dieser Sprechzeiten.

Ort:

Bezirksamt #Tempelhof-Schöneberg von Berlin

Abteilung Stadtentwicklung und Bauen, Fachbereich Stadtplanung

Rathaus Schöneberg, John-F.-Kennedy-Platz, Zimmer 3047

Tel.: (030) 90277-7819

(Postanschrift: Bezirksamt Tempelhof-Schöneberg von Berlin, Abt. Stadtentwicklung und Bauen, Fachbereich Stadtplanung, 10820 Berlin)

#Berlin #Stadtentwicklung

La passion et l’obstination… ou l’art de la création

En juin 2012, Mario Gonzalez proposait à Philippe Pillavoine de créer ensemble un spectacle : Laurenzaccio, une adaptation des œuvres Lorenzaccio d’Alfred de Musset et Une conspiration en 1537 de George Sand, produite par la Compagnie Le Bateau Ivre… Bien des écueils se seront présentés sur le chemin de la création, mais lorsque la passion rime avec obstination, l’art l’emporte toujours !

Après 3 représentations à Allonnes (72) au Théâtre de Chaoué Port Belle Eau puis grâce à l’invitation de Christian Sterne de la compagnie Les fous de Bassan ! à Beaugency (45) au Théâtre le Puits-Manu, Laurenzaccio foulera pour la première fois les planches de la région parisienne, le vendredi 4 mai 2018 à 20h30 au Théâtre Blanche de Castille à Poissy (78).

De plus, en préambule à cette représentation exceptionnelle, Laurenzaccio sera également à la fête le mercredi 2 mai de 16h30 à 18h à la Maison des Auteurs de la SACD à l’occasion de la publication du texte aux Éditions Les Cygnes. Vraiment, vive le joli mois de mai !... ▻https://www.relations-publiques.pro/91120/la-passion-et-lobstination-ou-lart-de-la-creation.html

#mai-2018 #2018 #spectacle #théâtre #représentation #livre #éditions_les_cygnes #les_cygnes #paris #sacd #poissy #blanche_de_castille #théâtre_blanche_de_castille #le_bateau_ivre

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