When Purdue Pharma started selling its prescription opioid painkiller OxyContin in 1996, Dr. Richard Sackler asked people gathered for the launch party to envision natural disasters like an earthquake, a hurricane, or a blizzard. The debut of OxyContin, said Sackler — a member of the family that started and controls the company and then a company executive — “will be followed by a blizzard of prescriptions that will bury the competition.”
Five years later, as questions were raised about the risk of addiction and overdoses that came with taking OxyContin and opioid medications, Sackler outlined a strategy that critics have long accused the company of unleashing: divert the blame onto others, particularly the people who became addicted to opioids themselves.
“We have to hammer on the abusers in every way possible,” Sackler wrote in an email in February 2001. “They are the culprits and the problem. They are reckless criminals.”
Sackler’s comments at the party and his email are contained in newly public portions of a lawsuit filed by the state of Massachusetts against Purdue that alleges that the company, the Sackler family, and company executives misled prescribers and patients as they aimed to blanket the country with prescriptions for their addictive medications.
“By their misconduct, the Sacklers have hammered Massachusetts families in every way possible,” the state’s complaint says, noting that since 2007, Purdue has sold more than 70 million doses of opioids in Massachusetts for more than $500 million. “And the stigma they used as a weapon made the crisis worse.”
The new filing also reveals how Purdue aggressively pursued tight relationships with Tufts University’s Health Sciences Campus and Massachusetts General Hospital — two of the state’s premier academic medical centers — to expand prescribing by physicians, generate goodwill toward opioid painkillers among medical students and doctors in training, and combat negative reports about opioid addiction.
Lawsuit filed by the state of Massachusetts against Purdue Pharma
Under an agreement with Mass. General, Purdue has paid the hospital $3 million since 2009 and was allowed to propose “areas where education in the field of pain is needed” and “curriculum which might meet such needs,” the court document shows. Tufts made a Purdue employee an adjunct associate professor in 2011, Purdue-written materials were approved for teaching to Tufts students in 2014, and the company sent staff to Tufts as recently as 2017, the complaint says. Purdue’s New England staff was congratulated for “penetrating this account.”
A Tufts spokesman declined to comment, citing the ongoing legal process. Mass. General did not immediately comment.
In a statement Tuesday, Purdue criticized the Massachusetts Attorney General Maura Healey’s office, which is spearheading the lawsuit, and said the complaint was “a rush to vilify” Purdue. It noted that its medications were approved by the Food and Drug Administration and regulated by the government, and that the company promoted the medications “to licensed physicians who have the training and responsibility to ensure that medications are properly prescribed.”
“Massachusetts’ amended complaint irresponsibly and counterproductively casts every prescription of OxyContin as dangerous and illegitimate, substituting its lawyers’ sensational allegations for the expert scientific determinations of the [FDA] and completely ignoring the millions of patients who are prescribed Purdue Pharma’s medicines for the management of their severe chronic pain,” the company said.
It also said the state attorney general’s office omitted information about the steps Purdue has taken in the past decade to promote safe and appropriate use of opioid medicines.
“To distract from these omissions of fact and the other numerous deficiencies of its claims, the Attorney General has cherry-picked from among tens of millions of emails and other business documents produced by Purdue,” the company said. “The complaint is littered with biased and inaccurate characterizations of these documents and individual defendants, often highlighting potential courses of action that were ultimately rejected by the company.”
Healey’s office sued Purdue, current and former executives, and members of the Sackler family in June. In December, it filed an amended complaint that was nearly 200 pages longer than the June filing, with more allegations spelled out against the individual defendants. Many of the details were redacted; a portion of them were made public in an updated document filed Tuesday in state court, though much of the complaint is still blacked out.
The state’s suit focuses on Purdue’s actions since 2007, when the company and three current and former executives pleaded guilty in federal court to fraudulently marketing OxyContin and the company agreed to pay $600 million in fines. The case is separate from litigation being waged by STAT to obtain sealed Purdue documents in Kentucky, including the only known deposition of Richard Sackler, about the company’s marketing practices in earlier years, which have been blamed for seeding the current opioid addiction crisis.
The Massachusetts complaint sketches an image of the Sacklers, as board members, exercising tight control over the company, overseeing the deployment of a phalanx of sales representatives who were pushed to get Purdue medications into more hands, at higher doses, and for longer periods of time. The Sacklers, the complaint states, reaped “billion of dollars,” even as the company blurred the risks of addiction and overdose that came with the drugs.
Richard Sackler, who was named president of the company in 1999 before becoming co-chairman in 2003, is singled out in the complaint as particularly domineering as he demanded greater sales. In 2011, he decided to shadow sales reps for a week “to make sure his orders were followed,” the complaint states.
Russell Gasdia, then the company’s vice president of sales and marketing, who is also a defendant in the Massachusetts lawsuit, went to Purdue’s chief compliance officer to warn that if Sackler directly promoted opioids, it was “a potential compliance risk.”
“LOL,” the compliance officer replied, according to the complaint. Other staff raised concerns, but they ultimately said that “Richard needs to be mum and anonymous” when he went into the field.
After the visits to doctors, Richard Sackler claimed that Purdue’s drugs shouldn’t need a legally mandated warning. He wrote in an email cited in the complaint that the warning “implies a danger of untoward reactions and hazards that simply aren’t there.”
The following year, Sackler’s pressure on the staff grew so intense that Gasdia asked the CEO to intervene: “Anything you can do to reduce the direct contacts of Richard into the organization is appreciated,” Gasdia wrote in an email cited by the complaint.
It apparently didn’t work: The next week, Richard Sackler emailed sales managers to say that U.S. sales were “among the worst” in the world.
Sales managers were badgered on nights, weekends, and holidays, according to the filing. The marketing campaigns focused on high-volume doctors, who were visited repeatedly by salespeople, and pushed doctors to prescribe high doses. The demands on sales managers created such a stressful environment that, in 2012, they threatened to fire all sales representatives in the Boston area because of lackluster numbers.
The complaint also accuses Purdue of rarely reporting allegedly illegal activity, such as improper prescribing, to government officials when it learned about it. In one 2009 case, a Purdue sales manager wrote to a company official that Purdue was promoting opioids to an illegal pill mill.
“I feel very certain this is an organized drug ring,” the employee wrote, adding “Shouldn’t the DEA be contacted about this?” Purdue did nothing for two years, according to the complaint.
In addition to relying on its sales force, Purdue cultivated ties with academic hospitals, which both treat patients and train the next generation of prescribers.
In 2002, the company started the Massachusetts General Hospital Purdue Pharma Pain Program after a Purdue employee reported that access to the hospital’s doctors “is great … they come to us with any questions, and allow us to see them when we need to.” The hospital, the staffer added, “has significant influence through most of New England, simply because they are MGH.”
As part of the program, Purdue gained influence over training programs and organized a symposium in the hospital’s famed “Ether Dome” — the site of the first public surgery with anesthetic.
The Sacklers renewed the deal with Mass. General in 2009 and agreed to contribute $3 million to fund the program, the lawsuit says.
Purdue’s funding, however, didn’t stop researchers at Mass. General from raising concerns about its products. The complaint cites a July 2011 email from Purdue’s then-chief medical officer Craig Landau — who is now the CEO and is a defendant in the lawsuit — flagging a study questioning the use of opioid painkillers for chronic pain that was conducted by Mass. General researchers with Purdue funding. Landau wanted to make sure that any Purdue-funded study supported the use of its medicines.
Purdue’s ties to Tufts date back even further, according to the lawsuit. In 1980, three Sacklers donated funding to launch the Sackler School of Graduate Biomedical Sciences. In 1999, the Sacklers gave money to help start the Tufts Masters of Science in Pain Research, Education, and Policy. Through the program, “Purdue got to control research on the treatment of pain coming out of a prominent and respected institution of learning,” the filing states. Purdue employees even taught a Tufts seminar about opioids, and Tufts and its teaching hospital collaborated with Purdue on a publication for patients called “Taking Control of Your Pain.”
Purdue also allegedly used Tufts’s ties in Maine as reports about addiction emerged in the state. Tufts ran a residency program in the state, the complaint says, and in 2000 “agreed to help Purdue find doctors to attend an event where Purdue could defend its reputation.”
The bulk of the documents cited in the Massachusetts complaint were filed by Purdue in federal court in Ohio as part of a consolidated case involving hundreds of lawsuits filed by states, cities, counties, and tribes against Purdue, other opioid manufacturers, and others in the pharmaceutical industry.
Purdue says it produced 45 million pages of documents for the federal court case — known as a multidistrict litigation. In a motion filed last month and in an emergency hearing before the federal judge in Ohio overseeing the MDL, Purdue argued that the details in Massachusetts’s amended complaint were largely drawn from about 500 Purdue documents it had filed on a confidential basis in the federal court. The company’s lawyers argued the rules of confidentiality established in the federal court should apply to Massachusetts’ filing in state court, while state officials say the issue of what should be made public should be decided in state court.
Among the records Purdue said last month should remain confidential are those involving the company’s board of directors. Making them public, the company argued, would have a “chilling effect” on corporate governance.
The effort to protect the disclosure of board-related documents serves another purpose not cited by the company: It protects the Sackler family, whose members have long constituted the majority of board members.
In its filing last month, Purdue also said one company official, whom it did not name, was concerned for his safety because his home address was listed in the complaint along with “numerous irrelevant, incendiary, and misleading comments about his career at Purdue.”
Purdue’s attorneys contend the Massachusetts amended complaint is a “concerted effort by the Commonwealth to use confidential documents in an attempt to publicly embarrass Purdue and its officers, directors and employees.” They claim the information selected was “cherry-picked” to “bolster a series of inflammatory and misleading allegations against Purdue.”
In September 2017, Landau, by that time Purdue’s CEO, jotted down a note summarizing some of the roots of the opioid crisis. It reads:
Too many Rxs being written
Too high a dose
For too long
For conditions that often don’t require them
By doctors who lack the requisite training in how
to use them appropriately.”
The state’s lawsuit concludes: “The opioid epidemic is not a mystery to the people who started it. The defendants knew what they were doing.”
This story has been updated.
Since 1999-2019 Isa ( my Wife ) had 7 different Surgeries, from Brain Tumors, Failed (3Spinal) ,Nasal,Foot,Back Treatments,Pain Management, And Patrick (self) has had, Rotator cuff surgery,Cervical Discetomy, Fusion(neck), Discectomy Lumbar & S-1, Fusion,L3-4 Repair Fusion,Removal of hardware L-3-S-1,& Fusion,L-3,4, Fusion, Microfusio. From 2003-2018. We were given 30 mg OxyContin for chronic back pain and 15 mg for accute Pain, doctors changed to new stronger Oxymoriphorphone all which has kept us relying on it for about 14 years, and it has been very difficult reducing,and trying to get off,I even Flatlined in Doctors Office and Hospital as well. Please pray for us.
How do i become a participant in the lawsuit? Oxycontin ruined my life. I lost myself…my family…and my children. To this day i still struggle because of my oxycontin addiction. Half of my family is dead because of oxycontin. Please help me claim my retribution. Thank you
I may sound like an idiot to most of you, but I don’t blame the Sackler Family at all. I now, granted years later, I place the blame on Charlie Baker. If all these Politicians didn’t think that they knew everything, the issue would have nothing to do with Fackler. I am living proof. I felt lmk 5 stories in 2007, at 25 years old and I was prescribed Oxycontin 80mg Instant Release due to unbearable pain in which I still suffer from. If there wasn’t a change from an instant release Form to an extended release Form, this topic would be mute. On May 20, 2011, I first received a prescription for extended release Tablets, and they didn’t work at all and I mean an aleve was better. That led me to sell them to Junkies, to buy Heroin which instantly cured my pain. Upon Baker’s appointment, 1st on his utterly clueless agenda was to fix the opioid epidemic in MA, well a day late and a dollar short, better yet and the most important thing is that he is wrong about Drs, and opioid addiction. If Purdue was allowed to prescribe the IR Oxycontin tablets the epidemic would be maybe 10% compared to what it is. He is so clueless that he puts a statute in stating that a Dr can only give a patient a weeks worth, Hellk Charlie, take a look at the % of Overdose Deaths from May 2011-present day, and compare it to the overdose rate when Oxycontin IR were allowed, hint go by a roll of Scott’s. A good %age after 2011 were suicides, because they couldn’t get Heroin or ODs from Heroin. But you, want to legalize State Gambling, hell of an idea, especially when suicide is the #1 cause of Death in the U.S, and 85% of Suicides stem from Gambling Addiction. So it kind of tells me that, A, you, by saying that a person who had 4 wisdom teeth removed doesn’t deserve 10 Vicodin, means to me that a so called Govenor, who we all know has endless amounts of the State’s money and power will never be put into a situation like us 90% blue collar people trying to get by, I have learned that the harder you personally Fight for State gambling, the more addicted to gambling you are, so it begs the differ, what’s the difference between you and me?
Yeah with lack of real information about addiction you do sound like an idiot….
I used OxyContin from 2008 until 2019 had 3 flatline experiences, I believe that I should be compensated, Inhad reduction from 30mg to 10mg.Your company Purdue Sent me prescriptions also. I would still continue to use OxyContin OxyContin and Oxycodone10mg because of Failed (3:spinal surgeries to andantes microfusion spinal surgery and have chronic pain and am addicted.
My daughter had a addiction to heroin. She died 4/25/2017. There was no heroin in her system, 7 times the lethal limit of fentanyl 40 times the lethal , limit of morphine, NO HEROIN. She was poisoned. She used Oxcyconyin, “hillbilly heroin”. Because of incompetant Doctors writing too many scripts the DEA cut back the scripts, the drug dealers cut back the prices of heroin and the epidemic exploaded. The DEA cut the scripts and the Doctors walked free. I talked to the police Lt. in charge of criminal cases, nothing, I talked to the District Atty, nothing, I talked to the vice squad, nothing. Drugs change a receptor in your brain which makes this an illness. who’s to blame, The DEA, drug dealers or all of the above, but ya know what my daughters is still dead
Not absurd Pam it is well documented that opiodes alter the brain. This is very problomatic with young males. 18-27 as the part of the brain for reasoning is not completely developed. Addiction is not a choice and the drug companies knew how highly addictive the pain meds were. Doctors also should have been made more aware and had some thought as to does one really need such powerful pain medication for minor surgery. You cannot be personally responsible for a drug that is so highly addictive you become dependent. See the word does not have a huge difference. Educate yourself please. Ignorance is not bliss.
You became addicted or dependent?? There’s a huge difference. Before labeling yourself an addict, you should research and learn the difference ! Blaming a manufacturing company because of your actions is absurd! Personal Responsibility!!!
The difference is purely semantic. Yes – I am all for personal responsibility – the Purdue’s need to accept theirs and cough – loud and long!
When I hear how this pharmaceutical company was able to manipulate doctors into prescribing their drugs, I kinda get where the anti-vaxers are coming from.
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