Deaths from heroin and opioids increased again in Connecticut last year, and suddenly everyone’s talking about it. Press releases on the topic went out last week from five of Connecticut’s seven Congressional delegates (Sens. Chris Murphy and Richard Blumenthal and Reps. John Larson, Rosa DeLauro, and Joe Courtney).
But it’s not a new problem. I attended the Citizen’s Police Academy here in Greenwich back in 2003. The night of my ridealong with an officer, one call was for a person overdosing a block from Greenwich Avenue. Fortunately, Narcan was available, so the person didn’t die — that time. Sadly, with addiction, there’s too often a next time, and the story often ends differently.
But did we read about such things in the hometown paper of record? Perish the thought! And we still don’t, for that matter, even when people from all walks of life, including from the town’s most prominent families, die of an overdose. Just move along up the coast, thank you very much. Everything is perfect behind these manicured lawns.
As I always say to anyone who will listen, denial is our worst enemy on so many important issues. We’ve been in denial for far too long about the role of prescription painkillers in the cycle of heroin addiction and death. According to a 2013 study from the Center for Behavioral Health Statistics and Quality, nearly four out of five people who had started using heroin admitted using prescription painkillers first.
This is no accident.
In 2009, Dr. Art Van Zee published a peer-reviewed paper in the American Journal of Public Health titled, The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy. Van Zee detailed how the aggressive promotion and marketing of OxyContin by manufacturer Purdue Pharma grew sales from $48 million after its introduction in 1996 to almost $1.1 billion in 2000.
By 2004, OxyContin had become a leading drug of abuse in the United States.
Van Zee points out that OxyContin’s commercial success was not based on the merits of the drug compared to its competitors. “The Medical Letter on Drugs and Therapeutics concluded in 2001 that oxycodone offered no advantage over appropriate doses of other potent opioids,” Van Zee wrote.
According to Van Zee, the company used data-driven techniques to target the physicians who were the highest prescribers of opioids, and a lucrative bonus system encouraged sales reps to increase sales of OxyContin in those territories.
But the most egregious part of the Purdue marketing strategy was a systemic effort to misrepresent and minimize the risk of addiction.
Sales reps were trained to promote the message that the risk of addiction was “less than one percent,” Van Zee wrote. But, according to federal prosecutors in Virginia, “Purdue’s own testing in 1995 had demonstrated that 68% of the oxycodone could be extracted from an OxyContin tablet when crushed.”
Essentially, by crushing the tablets, addicts could defeat their slow-release design and get the fast high they were seeking.
In 2007, Purdue Frederick (one of Purdue Pharma’s divisions) and three of its top executives pleaded guilty and admitted they “fraudulently marketed OxyContin by falsely claiming that OxyContin was less addictive, less subject to abuse, and less likely to cause withdrawal symptoms than other pain medications when there was no medical research to support these claims and without Food and Drug Administration approval of these claims.”
The company settled with U.S. District Attorney John Brownlee as to the Virginia charges, agreeing to pay $634.5 million in fines, forfeitures, and fraud control payments.
The verdict goes on to list the costs resulting from this fraud — not just addiction and death, but higher crime rates in communities as well.
“Purdue put its desire to sell OxyContin over the interests of the public,” Virginia Assistant Attorney General Peter D. Keisler wrote.
Last December, Purdue settled another lawsuit with the State of Kentucky for $24 million, after offering a mere $500,000 in 2007.
Here in Connecticut we are bearing the costs, both emotional and financial, of this unethical drive for profits over people at a time of budgetary crisis when drug treatment funds are drying up. But will we see a similar lawsuit, demanding financial justice from the company that clearly contributed to the crisis?
In his previous role as Connecticut’s Attorney General, Sen. Richard Blumenthal filed a citizen petition with the FDA in January 2004, requesting that the agency require Purdue to revise OxyContin’s labeling with additional warnings. Then in 2008, Blumenthal filed a lawsuit against the FDA to compel the agency to respond to the 2004 petition.
But the State of Connecticut, unlike many other jurisdictions, hasn’t filed a claim against the company itself.
Why? Call me cynical, but maybe it has something to do with the campaign contributions the Connecticut State Democratic Party has received to both their state and federal accounts from the Sackler family, Purdue Pharma’s founders. Not to mention their donations over the years to the state’s Congressional delegates, although notably not to Blumenthal, Larson, DeLauro or Courtney.
While none of the Sacklers were directly implicated in the marketing fraud, they have clearly received a massive financial benefit from it.
Indeed, their entry into the Forbes 2015 list of the richest U.S. families calls them “The OxyContin Clan” and attributes their accumulation of the 16th largest fortune in the country — “a stunning $14 billion” — to “making the most popular and controversial opioid of the 21st century.”
And for those of you who are keeping score, here’s one more awkward overlap: Purdue Pharma heir Jonathan Sackler founded the charter school advocacy groups ConnCAN and 50Can, and is a board member of the Achievement First charter school network. His wife, Mary Corson, also is a donor.
Either way, it’s hard to see the party biting the hands that feed it.
Sarah Darer Littman is an award-winning columnist and novelist of books for teens. A former securities analyst, she’s now an adjunct in the MFA program at WCSU, and enjoys helping young people discover the power of finding their voice as an instructor at the Writopia Lab.
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