This story is a collaboration between STAT and ProPublica.
In May 1997, the year after Purdue Pharma launched OxyContin, its head of sales and marketing sought input on a key decision from Dr. Richard Sackler, a member of the billionaire family that founded and controls the company. Michael Friedman told Sackler that he didn’t want to correct the false impression among doctors that OxyContin was weaker than morphine, because the myth was boosting prescriptions — and sales.
“It would be extremely dangerous at this early stage in the life of the product,” Friedman wrote to Sackler, “to make physicians think the drug is stronger or equal to morphine. … We are well aware of the view held by many physicians that oxycodone [the active ingredient in OxyContin] is weaker than morphine. I do not plan to do anything about that.”
“I agree with you,” Sackler responded. “Is there a general agreement, or are there some holdouts?”
Ten years later, Purdue pleaded guilty in federal court to understating the risk of addiction to OxyContin, including failing to alert doctors that it was a stronger painkiller than morphine, and agreed to pay $600 million in fines and penalties. But Sackler’s support of the decision to conceal OxyContin’s strength from doctors — in email exchanges both with Friedman and another company executive — was not made public.
The email threads were divulged in a sealed court document that ProPublica has obtained: an Aug. 28, 2015, deposition of Richard Sackler. Taken as part of a lawsuit by the state of Kentucky against Purdue, the deposition is believed to be the only time a member of the Sackler family has been questioned under oath about the illegal marketing of OxyContin and what family members knew about it. Purdue has fought a three-year legal battle to keep the deposition and hundreds of other documents secret, in a case brought by STAT; the matter is currently before the Kentucky Supreme Court.
Meanwhile, interest in the deposition’s contents has intensified, as hundreds of cities, counties, states and tribes have sued Purdue and other opioid manufacturers and distributors. A House committee requested the document from Purdue last summer as part of an investigation of drug company marketing practices.
In a statement, Purdue stood behind Sackler’s testimony in the deposition. Sackler, it said, “supports that the company accurately disclosed the potency of OxyContin to healthcare providers.” He “takes great care to explain” that the drug’s label “made clear that OxyContin is twice as potent as morphine,” Purdue said.
Still, Purdue acknowledged, it had made a “determination to avoid emphasizing OxyContin as a powerful cancer pain drug,” out of “a concern that non-cancer patients would be reluctant to take a cancer drug.”
The company, which said it was also speaking on behalf of Sackler, deplored what it called the “intentional leak of the deposition” to ProPublica, calling it “a clear violation of the court’s order” and “regrettable.”
Much of the questioning of Sackler in the 337-page deposition focused on Purdue’s marketing of OxyContin, especially in the first five years after the drug’s 1996 launch. Aggressive marketing of OxyContin is blamed by some analysts for fostering a national crisis that has resulted in 200,000 overdose deaths related to prescription opioids since 1999.
Taken together with a Massachusetts complaint made public last month against Purdue and eight Sacklers, including Richard, the deposition underscores the pivotal role of the Sackler family in developing the business strategy for OxyContin and directing the hiring of an expanded sales force to implement a plan to sell the drug at ever-higher doses. Documents show that Richard Sackler was especially involved in the company’s efforts to market the drug, and that he pushed staff to pursue OxyContin’s deregulation in Germany. The son of a Purdue co-founder, he began working at Purdue in 1971 and has been at various times the company’s president and co-chairman of its board.
In a 1996 email introduced during the deposition, Sackler expressed delight at the early success of OxyContin. “Clearly this strategy has outperformed our expectations, market research and fondest dreams,” he wrote. Three years later, he wrote to a Purdue executive, “You won’t believe how committed I am to make OxyContin a huge success. It is almost that I dedicated my life to it. After the initial launch phase, I will have to catch up with my private life again.”
During his deposition, Sackler defended the company’s marketing strategies — including some Purdue had previously acknowledged were improper — and offered benign interpretations of emails that appeared to show Purdue executives or sales representatives minimizing the risks of OxyContin and its euphoric effects. He denied that there was any effort to deceive doctors about the potency of OxyContin and argued that lawyers for Kentucky were misconstruing words such as “stronger” and “weaker” used in email threads.
The term “stronger” in Friedman’s email, Sackler said, “meant more threatening, more frightening. There is no way that this intended or had the effect of causing physicians to overlook the fact that it was twice as potent.”
Emails introduced in the deposition show Sackler’s hidden role in key aspects of the 2007 federal case in which Purdue pleaded guilty. A 19-page statement of facts that Purdue admitted to as part of the plea deal, and which prosecutors said contained the “main violations of law revealed by the government’s criminal investigation,” referred to Friedman’s May 1997 email to Sackler about letting the doctors’ misimpression stand. It did not identify either man by name, attributing the statements to “certain Purdue supervisors and employees.”
Friedman, who by then had risen to chief executive officer, was one of three Purdue executives who pleaded guilty to a misdemeanor of “misbranding” OxyContin. No members of the Sackler family were charged or named as part of the plea agreement. The Massachusetts lawsuit alleges that the Sackler-controlled Purdue board voted that the three executives, but no family members, should plead guilty as individuals. After the case concluded, the Sacklers were concerned about maintaining the allegiance of Friedman and another of the executives, according to the Massachusetts lawsuit. To protect the family, Purdue paid the two executives at least $8 million, that lawsuit alleges.
“The Sacklers spent millions to keep the loyalty of people who knew the truth,” the complaint filed by the Massachusetts attorney general alleges.
The Kentucky deposition’s contents will likely fuel the growing protests against the Sacklers, including pressure to strip the family’s name from cultural and educational institutions to which it has donated. The family has been active in philanthropy for decades, giving away hundreds of millions of dollars. But the source of its wealth received little attention until recent years, in part due to a lack of public information about what the family knew about Purdue’s improper marketing of OxyContin and false claims about the drug’s addictive nature.
Although Purdue has been sued hundreds of times over OxyContin’s marketing, the company has settled many of these cases, and almost never gone to trial. As a condition of settlement, Purdue has often required a confidentiality agreement, shielding millions of records from public view.
That is what happened in Kentucky. In December 2015, the state settled its lawsuit against Purdue, alleging that the company created a “public nuisance” by improperly marketing OxyContin, for $24 million. The settlement required the state attorney general to “completely destroy” documents in its possession from Purdue. But that condition did not apply to records sealed in the circuit court where the case was filed.
In March 2016, STAT filed a motion to make those documents public, including Sackler’s deposition. The Kentucky Court of Appeals last year upheld a lower court ruling ordering the deposition and other sealed documents be made public. Purdue asked the state Supreme Court to review the decision, and both sides recently filed briefs. Protesters outside Kentucky’s Capitol last week waved placards urging the court to release the deposition.
Sackler family members have long constituted the majority of Purdue’s board, and company profits flow to trusts that benefit the extended family. During his deposition, which took place over 11 hours in a law office in Louisville, Ky., Richard Sackler said “I don’t know” more than 100 times, including when he was asked how much his family had made from OxyContin sales. He acknowledged it was more than $1 billion, but when asked if they had made more than $5 billion, he said, “I don’t know.” Asked if it was more than $10 billion, he replied, “I don’t think so.”
By 2006, OxyContin’s “profit contribution” to Purdue was $4.7 billion, according to a document read at the deposition. From 2007 to 2018, the Sackler family received more than $4 billion in payouts from Purdue, according to the Massachusetts lawsuit.
During the deposition, Sackler was confronted with his email exchanges with company executives about Purdue’s decision not to correct the misperception among many doctors that OxyContin was weaker than morphine. The company viewed this as good news because the softer image of the drug was helping drive sales in the lucrative market for treating conditions like back pain and arthritis, records produced at the deposition show.
Designed to gradually release medicine into the bloodstream, OxyContin allows patients to take fewer pills than they would with other, quicker-acting pain medicines, and its effect lasts longer. But to accomplish these goals, more narcotic is packed into an OxyContin pill than competing products. Abusers quickly figured out how to crush the pills and extract the large amount of narcotic. They would typically snort it or dissolve it into liquid form to inject.
The pending Massachusetts lawsuit against Purdue accuses Sackler and other company executives of determining that “doctors had the crucial misconception that OxyContin was weaker than morphine, which led them to prescribe OxyContin much more often.” It also says that Sackler “directed Purdue staff not to tell doctors the truth,” for fear of reducing sales. But it doesn’t reveal the contents of the email exchange with Friedman, the link between that conversation and the 2007 plea agreement, and the back-and-forth in the deposition.
A few days after the email exchange with Friedman in 1997, Sackler had an email conversation with another company official, Michael Cullen, according to the deposition. “Since oxycodone is perceived as being a weaker opioid than morphine, it has resulted in OxyContin being used much earlier for non-cancer pain,” Cullen wrote to Sackler. “Physicians are positioning this product where Percocet, hydrocodone and Tylenol with codeine have been traditionally used.” Cullen then added, “It is important that we be careful not to change the perception of physicians toward oxycodone when developing promotional pieces, symposia, review articles, studies, et cetera.”
“I think that you have this issue well in hand,” Sackler responded.
Friedman and Cullen could not be reached for comment.
Asked at his deposition about the exchanges with Friedman and Cullen, Sackler didn’t dispute the authenticity of the emails. He said the company was concerned that OxyContin would be stigmatized like morphine, which he said was viewed only as an “end of life” drug that was frightening to people.
“Within this time it appears that people had fallen into a habit of signifying less frightening, less threatening, more patient acceptable as under the rubric of weaker or more frightening, more — less acceptable and less desirable under the rubric or word ‘stronger,’” Sackler said at his deposition. “But we knew that the word ‘weaker’ did not mean less potent. We knew that the word ‘stronger’ did not mean more potent.” He called the use of those words “very unfortunate.” He said Purdue didn’t want OxyContin “to be polluted by all of the bad associations that patients and healthcare givers had with morphine.”
In his deposition, Sackler also defended sales representatives who, according to the statement of facts in the 2007 plea agreement, falsely told doctors during the 1996-2001 period that OxyContin did not cause euphoria or that it was less likely to do so than other opioids. This euphoric effect experienced by some patients is part of what can make OxyContin addictive. Yet, asked about a 1998 note written by a Purdue salesman, who indicated that he “talked of less euphoria” when promoting OxyContin to a doctor, Sackler argued it wasn’t necessarily improper.
“This was 1998, long before there was an Agreed Statement of Facts,” he said.
The lawyer for the state asked Sackler: “What difference does that make? If it’s improper in 2007, wouldn’t it be improper in 1998?”
“Not necessarily,” Sackler replied.
Shown another sales memo, in which a Purdue representative reported telling a doctor that “there may be less euphoria” with OxyContin, Sackler responded, “We really don’t know what was said.” After further questioning, Sackler said the claim that there may be less euphoria “could be true, and I don’t see the harm.”
The same issue came up regarding a note written by a Purdue sales representative about one doctor: “Got to convince him to counsel patients that they won’t get buzzed as they will with short-acting” opioid painkillers. Sackler defended these comments as well. “Well, what it says here is that they won’t get a buzz. And I don’t think that telling a patient ‘I don’t think you’ll get a buzz’ is harmful,” he said.
Sackler added that the comments from the representative to the doctor “actually could be helpful, because many patients won’t get a buzz, and if he would like to know if they do, he might have had a good medical reason for wanting to know that.”
Sackler said he didn’t believe any of the company sales people working in Kentucky engaged in the improper conduct described in the federal plea deal. “I don’t have any facts to inform me otherwise,” he said.
Purdue said that Sackler’s statements in his deposition “fully acknowledge the wrongful actions taken by some of Purdue’s employees prior to 2002,” as laid out in the 2007 plea agreement. Both the company and Sackler “fully agree” with the facts laid out in that case, Purdue said.
The deposition also reveals that Sackler pushed company officials to find out if German officials could be persuaded to loosen restrictions on the selling of OxyContin. In most countries, narcotic pain relievers are regulated as “controlled” substances because of the potential for abuse. Sackler and other Purdue executives discussed the possibility of persuading German officials to classify OxyContin as an uncontrolled drug, which would likely allow doctors to prescribe the drug more readily — for instance, without seeing a patient. Fewer rules were expected to translate into more sales, according to company documents disclosed at the deposition.
One Purdue official warned Sackler and others that it was a bad idea. Robert Kaiko, who developed OxyContin for Purdue, wrote to Sackler, “If OxyContin is uncontrolled in Germany, it is highly likely that it will eventually be abused there and then controlled.”
Nevertheless, Sackler asked a Purdue executive in Germany for projections of sales with and without controls. He also wondered whether, if one country in the European Union relaxed controls on the drug, others might do the same. When finally informed that German officials had decided the drug would be controlled like other narcotics, Sackler asked in an email if the company could appeal. Told that wasn’t possible, he wrote back to an executive in Germany, “When we are next together we should talk about how this idea was raised and why it failed to be realized. I thought that it was a good idea if it could be done.”
Asked at the deposition about that comment, Sackler responded, “That’s what I said, but I didn’t mean it. I just wanted to be encouraging.” He said he really “was not in favor of” loosening OxyContin regulation and was simply being “polite” and “solicitous” of his own employee.
Near the end of the deposition — after showing Sackler dozens of emails, memos and other records regarding the marketing of OxyContin — a lawyer for Kentucky posed a fundamental question.
“Sitting here today, after all you’ve come to learn as a witness, do you believe Purdue’s conduct in marketing and promoting OxyContin in Kentucky caused any of the prescription drug addiction problems now plaguing the Commonwealth?” he asked.
Sackler replied, “I don’t believe so.”
David Armstrong is a senior reporter for ProPublica and was formerly STAT’s senior enterprise reporter.
ALL Nursing Homes recently got this letter below. All Nursing Home nurses will ever read is the first page or two; which means all they’ll get out of this letter is NO MORE Opioids for elderly patients (no matter how close to death) & use Naloxone??? THE CDC HAS GONE INSANE! If anyone is addicted to opioids at Nursing Homes IT’S THE NURSES! Yet they are not mentioned in this letter??? ———————————————-
QUANTUM REHABILITATION AND NURSING
63 OAKCREST AVE
MIDDLE ISLAND NY 11953-1415
JKA02152019
Dear Health Care Provider:
IT
Thank you for your participation in Medicare and the services you and your colleagues provide to more than 55 million people with Medicare. You are integral to our work at the Centers for Medicare & Medicaid Services (CMS) to combat the opioid epidemic.
We recently published an opioids roadmap at https://www.cms.gov/About-CMS/Agency Information/Emergency/Downloads/Opioid-epidemic-roadmap.pdf outlining our efforts to address this issue of national concern. In this roadmap, we detail our three-pronged approach, focusing in on preventing new cases of opioid use disorder, treating patients who have opioid use disorders, and using data from across the country to target prevention and treatment activities.
CMS is working with the U.S. Department of Health and Human Services (HHS) to encourage health care providers to co-prescribe naloxone to certain at-risk patients who use opioids. We are also strengthening Medicare drug plan policies to promote care coordination and safe use of prescription opioids, and encouraging health care providers to promote a range of safe and effective pain treatments, including courses of action other than opioids.
Co-prescribing Naloxone
HHS issued guidance at https://www.hhs.gov/opioids/sites/default/files/2018-12/naloxone coprescribing-guidance.pdf and recommended a set of indications for naloxone prescriptions. As a provider, you can have important conversations with your patients about pain management, and opioid safety. You can help expand naloxone access and awareness by co-prescribing naloxone for certain patients who get opioids for pain management and who may be at-risk for an opioid overdose. In concert with standing pharmacy orders, pharmacist prescriptive authority, and other naloxone laws, regulations and policies, your action can help ensure your high-risk patients have naloxone more readily available to them, and, when needed, to their families and caregivers.
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New Medicare Part D Opioid Policies
:
CMS recently finalized new policies for Medicare drug plans, effective January 1, 2019. The policies broaden our partnership with providers to address the opioid crisis while maintaining access to needed medications. It’s very important you understand the new policies to minimize additional burden on you and your patients. It is also critical in avoiding adverse and unintended impacts on your patients’ access to prescribed opioids.
Our approach centers on increasing communication tools to improve safety, especially as we process opioid prescriptions. The new policies include improved safety alerts (pharmacy claim edits) when a patient fills an opioid prescription at a pharmacy, and drug management programs to help coordinate care for patients with high-risk opioid use, such as those receiving high levels of opioids from multiple prescribers and/or pharmacies.
Detailed training materials about these new policies are available:
A Prescriber’s Guide to the New Medicare Part D Opioid Overutilization Policies for 2019: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network MLN/MLNMatters Articles/downloads/SE18016.pdf.
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Information for Prescribers, such as slide deck and tip sheet: https://www.cms.gov/Medicare/Prescription-Drug Coverage/Prescription Drug CovContra/RxUtilization.html
Starting January 1, 2019, Medicare drug plans will employ the following safety alerts at the pharmacy:
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7 day supply limit for opioid naïve patients: This is a policy to limit an initial opioid prescription supply to 7 days or less until the pharmacy gets an override from the plan for Medicare patients who have not recently filled an opioid prescription (e.g., within 60 days). The pharmacist can fill part of the initial prescription (e.g., a 7 day supply) per state and federal regulations. If a prescriber writes another prescription for the remainder of the days-supply, or any subsequent prescriptions, those prescriptions are not subject to the 7 day supply limit because the patient is no longer considered opioid naïve. However, if a prescriber believes that an opioid naïve patient will initially need more than a 7-day supply initially, the prescriber can contact the plan to request a coverage determination on behalf of the patient attesting to the medical need for a supply greater than 7 days. The prescriber can also request an expedited or standard coverage determination in advance of prescribing an opioid.
Opioid care coordination alert: This is an alert for pharmacists to review when the patient’s cumulative morphine milligram equivalents (MME) reaches 90 mg or greater per day across all. opioid prescriptions. Some plans use this alert only when the patient uses multiple opioid prescribers and/or opioid dispensing pharmacies.
This 90 MME threshold identifies potentially high risk patients who may benefit from closer monitoring and care coordination. It is cited in the Centers for Disease Control and Prevention (CDC) Guideline (https://www.cdc.gov/drugoverdose/prescribing guideline.html) as the level above which primary care prescribers should generally avoid. This is not a prescribing limit. In reviewing the alert, the pharmacist may contact the prescriber to confirm medical need for the higher MME. The pharmacist may talk with the prescriber about other opioid prescribers or increasing level (MME) of opioids. After that discussion to confirm intént, the pharmacist can fill the prescription.
The prescriber who writes the prescription will trigger the alert and a pharmacist will contact the prescriber even if that prescription itself is below the 90 MME threshold. Once a pharmacist consults with a prescriber on a patient’s prescription for a plan year, the prescriber will not be contacted on every opioid prescription written for the same patient after that unless the plan implements further restrictions.
The new CMS policies also include drug management programs to encourage care coordination and safe use of opioids as required by the Comprehensive Addiction and Recovery Act of 2016. Starting in 2019, for patients who could potentially abuse or misuse prescription drugs – including opioids and benzodiazepines – a Medicare drug plan will contact prescribers through case management to review patients’ total utilization pattern of frequently abused drugs and discuss the following.coverage:
Requiring the patient to get these medications from a specified prescriber and/or pharmacy, or Implementing an individualized point of sale edit that limits the amount the drug plan covers for these medications.
Medicare drug plans identify potential at-risk patients by their opioid use which involve multiple doctors
and pharmacies. After the plan conducts case management with prescribers and before implementing any coverage limitation tools, the Medicare plan will notify your patients in writing. Plans must make reasonable efforts to send the prescriber a copy of the letter.
Prescribers and patients can respond to the notice within 30 days. After this 30 day time period, if the plan determines based on its review that the patient is at-risk and implements a limitation, the plan must send the patient a second written notice confirming the specific limitation and its duration.
If the plan decides to limit coverage under a drug management program, the patient and their prescriber have the right to appeal the plan’s decision. The patient or prescriber should contact the plan for additional information on how to appeal.
Promoting a range of safe and effective pain treatments
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Opioids are one tool to help your patients with chronic pain. You may also want to consider other treatments when you discuss options with your patients. Medicare covers a variety of services to treat pain. Medicare covers some services across the country, including physical therapy, individual and group therapy, behavioral health integration services, psychiatric collaborative care services and electrical nerve stimulation. Local coverage of additional services may vary somewhat by jurisdiction; you can find detailed information, related coding information, and any restrictions on our website at https://www.cms.gov/medicare-coverage-database/indexes/national-and-local-indexes.aspx along with a searchable database https://www.cms.gov/medicare-coverage-database/overview-and-quick search.aspx
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Medicare also covers care management services to give patients medical care and care coordination services that can help manage their medical condition(s). Information about Chronic Care Management, Behavioral Health Integration, and Transitional. Care Management at: https://www.cms.gov/Medicare/Medicare-Fee-for-Service Payment/PhysicianFeeSched/Care-Management.html. Medicare’s Initial Preventive Physical Exam and subsequent Annual Wellness Visits give you other opportunities to discuss your patients’ general health issues including pain, and review and promote options for pain treatment. See more information about coverage of these services at https://www.cms.gov/Outreach-and-Education/Medicare-Learning Network-MLN/MLNMattersArticies/downloads/SE18004.pdf. There are community programs to help your Medicare patients manage their pain and other chronic conditions. Find out how to access these programs through Area Agencies on Aging and other community-based organizations at: https://eldercare.acl.gov/Public/Index.aspx. CMS has dedicated quality improvement contractors to work with you and community organizations to improve health care safety and reduce opioid related adverse events in every state with the Quality Innovation Network Quality improvement Organizations (QIN-QIOS https://gioprogram.org/locate-your-gio), and the Hospital Improvement and innovation Network (HIIN)
https://partnershipforpatients.cms.gov/wherepartnershipsareinaction/wherepartnershipsarein action.html#HIIN).
CMS is committed to exploring and offering viable options to address the opioid crisis, sharing information on the data we collect with other agencies and organizations, and protecting our beneficiaries and communities affected by the crisis. Together, we can make progress in addressing. many aspects of the opioid epidemic. For questions on CMS opioid policies, please see our available resources at: https://www.cms.gov/about-cms/story-page/opioid-misuse-resources.html#provider.
For ALL:
http://nationalpainreport.com/what-is-largest-chronic-pain-patient-survey-showing-8838943.html
Which states. Sackler ios just the tip of the iceberg who is ruining our lives
What is Largest Chronic Pain Patient Survey Showing?
by Terri A Lewis, PhD.
For the last several months, The National Pain Report has been promoting the efforts of Terri Lewis’ to calculate the impact of changes in chronic pain treatment on the patient population. Nearly 4,000 people have filled out the survey. If you haven’t you can do by clicking here.:https://www.surveymonkey.com or put in browser addy line. PLEASE FILL OUT THIS SURVEY !!!/r/Y8YXRJ9
Here’s more on what the survey is showing:
Seventy percent (70%) report that their health care has either worsened or they have lost support entirely. Twenty-five (25%) of individuals have lost access to a primary care provider. Forty percent (40%) lack access to specialty care for disease management. Of those who have lost access to care management, 63% report that the burden of self-managing their illness has increased, reliance on over the counter medications has increased with little effect, feelings of hopelessness have increased, and family relations are excessively strained. Many express concern about the long term use of over the counter analgesics and the apparent disregard of potential risks by their physicians.
Forty percent (40%) are unhappy with their insurance carrier for reasons that are unique, complex, and reflect the various differences in plan implementation across the states. This, together with comments about integration with financial resources and public benefits programs requires close scrutiny – I am still working to understand the influence of external factors on this area of responses. It appears that the loss of economic basis imposed by the onset of chronic disease imposes significant limitations on resources to manage care. Roughly 70% of respondents are living at or near poverty levels. This limitations on choices and increases dependence on systems of care that are not operating consistently or optimally across the states.
Suicidal ideation and action are ever present in the pain community. Two hundred sixty-seven (267) persons thoughtfully reflect upon their suicide stories; 89 persons shared the story of a friend or family member who ended their life, while the balance of respondents describe the conditions under which they will take action to end their life. I have not yet teased out the factors that correlate to respondent characteristics. Many comments reflect loss of care support, concern for burden on care partners, and running out of energy and personal resources for this difficult race.
Thirty-five (35%) of respondents have changed pharmacies one or more times in the last two years – either because of pharmacy plan changes to formularies, out of stock issues, errors, or because the pharmacy stopped stocked necessary medications. Limitations of mobility, transportation, and impact of disability require reliance on friends or family to handle filling of scripts. The pharmacy crawl causes extra stressors as many report feeling like they are treated like criminals upon presentation of a legitimate prescription.
Follow on Twitter:
@NatPainReport
They are still lying to the public. Read any mass media article, or statement by a politician. Every single one of them conflates Oxycontin with oxycodone, an opiate that has been prescribed for more than 60 years. This was part of the deception started by Perdue. Illegal Fentanyl is being used in pills, and sold as any random brand name they think will sell, people are dying. Kolodny was a safe choice for Perdue, since he was peddling a lot of misinformation, which took atttention awsy from the marketing tactics of Perdue. Their tactic of going after physicians and pain patients was also part of the distraction. They knew that as the population of older retired overworked Americans, would need future pain management. They targeted Veterans, older Americans, the disabled, and sick people, and portrayed them all as addicts. They deliberaely confalted addiction and dependance for a reason, they had to malign sick people, and the ones the healthcare system could not cure. There was also a significant number of people who had undergone surgery, and were left with intractable chronic pain. Portraying all of these groups as mindless drug addicts, was designeod to protect our broken healthcare system.
The Fact that industry rgualtions and profit generating proceedures, such as filling a prescription for 30 days, becuse often patients were unable to see their physicans for months was not adressed. With insurance paying for the medications, and protecting the profit generating healthcare system, it was simpler to fill for a 30 day supply. This left unused medications in people’s homes. When Kolodny or the other propagandists made claims about prescription drugs, they meant drugs stolen from patients. There was a significant amount of theft from the supply chain too, millions of doses, that went tot he balck market. The industry chose to avoid that topic, it was bad for PR, and they interfered with DEA investigations. All of this was not covered by mass media, as the deaths increased. These big corporations are above the Law.
Oxycontin was profitable, and when the pharma industry did away with the Laws, that controlled pharmaceutical and health advertising, none of this was illegal anymore. The so called opaite epidemic has been profiable for people like Kolodny, who could profit from treatment providors, while appearing to be stemmming the epidemic he created.
The US is the only only developed nation that is seeing this kind of epidemic. Of course none of the underlying social and economic problems that led to this, are being examined. When they turned addiction into a reality show, and people died, no one paid attention. Publicizing the so called opaite epidemic is have the reverse effect creating more users. They lined childen up, with corporate publicists, to teach them about opiates. Children that would never be exposed to opaites, were now educated about getting high. Kids who did not know that the stuff in grandmas medicine chest was woth money or could get them high, were bringing them to school, and sharing with their friends. The propganda told them that opiates could kill, but they rarely saw proof, and kids are lied to all of the time.
Koldny and the Perdue family and every one else that profited, turned a health crisis inot a marketing and misinformation extravaganza. They even justified peddling quackery as a benefit to public health. Previously discredited unscintific cures, were suddenly legiamate, because the were better thant the horrers of opiate addiction.
Even the psychologists got in on the action, equating their profession with medical doctors. They rewrote the DSMV to broaden the definitions of addiction, and to descibe people with inadequate medical care, as mentally ill. They left out chronic pain for a reason, it was just more profitble. They even made up words, like “Catastrophization” and “Opiod Unduced Hyperalgia” to further stigmatize people left with chronic pain.
The mass media presented spuedo scince as if it were factual. They ran articles to misinform, confuse and frighten the public. The Internet was full of deceptive advertising, Content Marketing, Patient Testimonials, and lies.
The Patient Groups, were funded by pharma interests and the effect of the lies and content marketing could be measured in real time. Vulnerable patients were Gas Lighted, and sold Mindfullness, useless creams, dangerous steroid injections, and unproven implants. Quack Doctors, psychologists, and psychiatrists launched Television marketing careers and made millions. Of course the deaths could be counted in real time, but those were only reported in fear based marketing. The costs and adverse outcomes from all of this profit generating marketing, lies and misinformation is incalculable.
The US is experincing the effect of 20years of lies and advertising, and even as the death toll rises, they are told to demonize pain patients, while the only “treatment” for people with addiction is a faith based church program. The media has been complicit, they advertised the few available treatments as if they were adequate. They lied about how the sytem responded, it failed. 20 years out, and they are looking at Perdues marketing. All of this was made possible by corrupt politicians, in bed with the industries that profited.
This is just one element of “Market Based” healthcare, no one is looking at how they undermined the laws that were supposed to protect us. The criminal actions of the Sakler family are just the tip of the iceberg. Funny we should have a Reality Show response to all of this as the lies and deception continue!
Mavis,
That’s why I never watch the mass media anymore, the “FAKE/DUMB NEWS” won’t get my limited use eyes.
Legal Fentanyl hidden with different names are still VERY EXPENSIVE, which is why the CDC/DEA won’t pull that from the market, but kids are making their own Heroin/Fentanyl mixes to get a better high; causing many of the overdoses (not to mention all the kids smoking or snorting it)! But that’s ignored for now by the US Government because of all the money they are making off of Fentanyl.
Today at my pain manage t doctor’s office there was a guy there (first time patient) who had been REFUSED to be seen a (14) other pain clinics/doctors before he tried mine. So I vetted him myself; he had a torn stomach/abdominal muscle that no doctor will operate on, plus he have severe knee problems and a herniated disc that was operated on 5-years ago, helped for 2-years then the pain came back twice as bad. He volunteered that all he wants is around (150) oxycodone 5mg pills so that he can make it through each day in the month. Otherwise he’s bedridden in excruciating pain. He also volunteered that he doesn’t care if my doctor lowers what he was on to (120) pills a month (until his hospital refused to see him anymore for pain). THESE ARE NOT THINGS ADDICTS SAY! Yet my doctor made him wait 2-full hours just to tell him “I can’t treat you!” and sent him home after the guy tried to explain his medical problems and my doctor just shut him down. THIS IS INSANE WHAT’S GOING ON!
I told him to go to a big Manhattan Hospital and collapse on the street in from of the ER entrance. At least this way they have to see him in the ER, have to find our his medical history, and have to give him a referral to see Pain Management at least ONCE (the specific hospital is how I got to see the doctor I’m dealing with now, so I know it worked in early 2012).
I’m on board with the things you say. But I have to start working on CHANGING THIS as soon as I’m physically able.
I’ve made huge changes to things everyone told me “You’ll never get done”, or “Don’t waste your time.”. Once I put my mind to something it gets fixed.. and there is no OR or BUT! I copied your post to read slower when I can see better.
Thanks for knowing the real truth…