The masters of persuasion and deception, the Sackler family, with their army of well paid force of “drug dealers” were able to convince enough uninformed, physicians and dentists to prescribe opioids to their patients and thus unleashed the worst public health disaster in American history. In the past two decades, the actions by Purdue, the drug company privately owned by the family, has made billions pushing prescription pills with predatory marketing techniques, contributing to the death of more than 400,000 American of opioid related overdoses and millions are dependent on opioids and suffer from opioid use disorder. The products manufactured and marketed by the company, violated “the state’s public nuisance law, creating a substantial health harm”, and as such the company and its owners should be found responsible for the damaged product and be held to pay for the abatement of the devastation it had caused in the various states.
In this narrative physicians and dentists were succumbed to a highly effective campaign, utilizing the weapons of modern advertising and marketing genius that included pens, lunches, speakers fees, well placed articles in scientific journals, captured medical thought leaders and organizations, conferences, fake pain patient groups and other strategies to prescribe Oxycontin. This sophisticated marketing campaign, developed by Dr. Arthur Sackler, a psychoanalytically trained psychiatrist, and executed by Dr. Richard Sackler, set out to change the culture regarding the use opioids by clinicians. Building on the recognized under treatment of pain, Purdue was able to convince clinicians to prescribe Oxycontin, a “miracle” product, for unproven indications. It directed its sales force to claim that Oxycontin was more effective, due to its unique mechanism lasted longer in the patients blood, thus requiring less frequent doses, and most importantly didn’t lead to dependence or addiction at the same rate as previously available opioids. Furthermore, shortly after Oxycontin was introduced in 1995, the company was aware of the addiction potential and misuse of their products and failed to report it to the proper governmental authorities, thus providing the “Jet fuel” that ignited and sustained the opioid epidemic during the past two decades. This narrative, has in the past few years gained prominence in the media as tens of thousands of Americans continue to die of opioid related overdoses.
Increasingly, but not surprisingly, the narrative has been promoted as the avalanche of legal actions against Purdue and its owners as well as many other companies along the supply chain, are unfolding in jurisdictions across the US.
If the lawsuits prove successful, prosecutors on behalf of the citizenry “can procure some measure of justice from the wealthy family for the hundreds of thousands of Americans caught up in the surge of addiction wrought by prescription painkillers”. Funds needed for programs to address the various aspects of the epidemic will be made available to localities and states to more effectively address the opioid scourge. Furthermore, a victory in court would provide some reassurance that the system works, justice will prevail, and all will be well once the real culprits pay for their transgression; the lawyers, who stand to earn over $60,000,000 in just one of the cases, government officials eager to use the funds for a multitude of projects, and other stakeholders who stand to make billions of dollars in damages from currently hundreds of court cases in Ohio, Massachusetts, Oklahoma, PA and hundreds of other localities would like us to believe, in this narrative.
In order to be most likely to succeed in the court system, it has been recognized that the Sackler’s and Purdue must be “convicted” in the court of public opinion. As part of the legal and media strategy it has become common and necessary to vilify the privately held company and its owners who have created and profited from the epidemic to the tune of 35 billion dollars. The Sackler’s, a secretive multigenerational family, has become one of the wealthiest families in the world. In the public court they are further accused that rather than acknowledging and assuming responsibility for the devastation their product has brought, or helping victims of their actions fight their addiction they use “blood money" to funded multiple art, cultural, and medical institution. Until recently, the company owners have not made their “case” in the media.
The legal and public campaign appears to be succeeding. Well orchestrated media campaign, with TV segments, multiple articles, rallies, demonstrations, public shaming of cultural institutions who received Sackler support has been able to elevate the Sacklers and the Purdue Pharmaceutical company to the heights of villain-hood, passing El Chapo, South American Cartels and Mexican drug dealers. Late night TV hosts including John Oliver, Trevor Noah, Samantha Bee, Stephen Colbert have also taken up the cause with sarcastic accuracy. In the past few months, JP Morgan Chase, the companies banker and Consulting giant McKinsey and Co. dropped Purdue as a client. One needs only to read comments in articles reporting on the role of Purdue to recognize that many in the public have bought this narrative. The campaign to shame organizations who benefited from Sackler family donations have been increasingly successful. Politicians have jumped on the bandwagon as well. Medical organizations such as The American Pain Society have considered bankruptcy, concerned about the mounting legal costs, after being named as culprits for the opioid epidemic as a front group.
The blame, shame and collect campaign as well as the likely multi billion verdict and or settlements, unfortunately divert our attention to truly understand and learn from this public health disaster about the corruption of the institutions that are meant to protect us, the social and economic forces that lead to increasing number of Americans to feel alienated and marginalized and communities adrift. Focus on the winners and losers of the main stage of the legal battle will deprive us of developing and implementing an informed “treatment plan” to mitigate the underlying social, economic and political causes that provide breeding ground for substance use.
Without a more comprehensive understanding of the nature of the complex factors that fermented and now maintain this epidemic, the billions of dollars that localities and states stand to “win” and promise to help “fight” the epidemic, will have similar outcomes to all the billions in taxpayer dollars that has been “spent” over the past 2 decades, during which the US opioid related overdose deaths went from 400 overdoses deaths in 2001 to 42,000 this past year. Furthermore, it will divert our attention from the devastating and deadly unintended consequences of governmental policies and enforcement action. Perhaps just as importantly, it deprives the US public from an opportunity to better understand the challenges and dysfunction in our body politic and to try out a different approach for addressing the many aspects and stakeholders associated with the complexity of the opioid crisis
What is most urgently needed is to reframe the question at the heart of the opioid crisis from who is to blame and how much money can we make (for the injured individuals and families, legal teams, localities, states, and other stakeholders) to ask additional questions:
How is it that we, from elected officials, public servants throughout local, state and federal government, the medical profession, the media, the law profession, criminal justice, and citizens have been aware for two decades of all the information being utilized in the above narrative to bring the culprits to justice, and yet we have continued to witness the devastation of the epidemic?
Answering this question requires a more nuanced, complex yet comprehensive narrative. A narrative that explores the various stakeholders, processes and dynamics that led and maintained the devastation for the past two decades. Building on this narrative from available material in the public domain, can provide a clearer picture of the path to the current opioid related carnage. A deep dive into decisions made will expose the mechanism of corruption in our governing institutions. Furthermore, an action plan can emerge that will have a greater probability to achieve citizen based positive outcomes for individuals, communities and enhance the health of our body politic.
Elsewhere I describe my interest and “political agenda” that focuses on the role of the citizen and the opioid epidemic as a case study and framework for better understanding and engaging with the body politic.