In the U.S. legal system, some say money - good, cold cash - talks far louder than the court judges or the prosecuting district attorneys can manage, and it appears this form of “justice” has been applied to the villainous criminals of the U.S. opioid epidemic - the Sackler family, proud owners of Purdue Pharma and the even prouder creators of OxyContin - who can now look forward to a future of unabandoned liberty and unreal, vast sums of personal wealth.On July 8th, an additional 15 U.S. states, including those attorney generals who had been the most vociferous in their previous rejections, like Massachusetts and New York, agreed to Purdue Pharma’s revised opioid crisis settlement proposal in a bid to access the promised funds as soon as possible.The newly revised proposal includes a new business model for the company, the release of tens of millions of internal documents, and (yes, you’ve guessed it) a further $1.5 billion of that good, cold cash. Additionally, if the plan is certified by Judge Robert Drain as expected, both the family and the company would be shielded from further opioid-related lawsuits.Let’s repeat that. “Shielded from further opioid-related lawsuits.” Money does indeed talk - and loudly, too.Among those who reneged on their previous promises to the families of opioid drug overdose victims (sadly, yes, they have) is the once-vocal Massachusetts AG, Maura Healey, who was the first to sue individual members of the Sackler family.She stated, “While I know this resolution does not bring back loved ones or undo the evil of what the Sacklers did, forcing them to turn over their secrets by providing all the documents, forcing them to repay billions, forcing the Sacklers out of the opioid business, and shutting down Purdue will help stop anything like this from ever happening again.”If you didn’t know, only four months ago, that’s the same lady who once said (on WBUR’s Morning Edition, Boston’s NPR radio news show), “There are many things that I don't like about this plan. It's not enough money. It's also a plan that doesn't provide what our families deserve, which is transparency and accountability. So this is not the end, and this deal is nowhere near acceptable.”Only last month, Healey again stated her disdain for Purdue’s plan in an interview, “The Sacklers are not offering to pay anything near what they should for the harm and devastation caused to families and communities around this country.”Well... apparently, now, they are paying enough and the deal is acceptable - certainly to the Massachusetts’ AG, at least.The Sacklers’ True Legacy: Over Half a Million U.S. DeathsOxyContin, and many other prescription opioids like it, have resulted in a man-made, yet totally needless national public health crisis and epidemic in the U.S. (and beyond, for that matter) that will continue for generations to come.Opioid-related drug overdoses are now the leading cause of accidental death in the U.S., overshadowing deaths by motor vehicle accidents and even gunshot wounds. In fact, more Americans have died from opioid overdoses than those lives lost in every war since World War II.And OxyContin? Well, that one little pill - “Oxy,” for short - did make the Sackler family a sizable amount - a colossal $35 billion, thanks to the huge criminal deception that fooled doctors, the law courts, and the unsuspecting U.S. public for way too long.Their own personal wealth? Much of that good, cold cash is now sitting happily, both earning interest or being used to purchase even more global real estate, in various off-shore bank accounts in paradisiacal locations such as the Cayman Islands. How? The Sacklers quickly made siphoning company profits an art form as soon as they realized the proverbial stuff was about to hit the fan.Over Half a Million Families: Mothers, Father, Sisters, BrothersAsk any parent who loses their child - through the clear and criminal fault of someone else - what they really want, and they’ll reply “justice.” Among other things, like the “5-minutes-in-a-locked-room” scenario… But always justice, too.As the U.S. opioid epidemic continues to claim too many lives every single day in the U.S., and turn good, hard-working people into backstreet heroin users, many will be wondering, as I certainly am:“Why didn’t they legally nail this family to the wall?”“No jail time, and not even an admission of their guilt?”“How have they legally kept all of their criminally-gotten gains?”Here’s the proof, according to the American Society of Addiction Medicine (ASAM) and The Centers for Disease Control and Prevention (CDC), of the damage opioid prescriptions have done to the U.S.:A massive 80% of the world’s opioids are consumed in the U.S.The #1 cause of accidental death in the U.S. is overdoseFurthermore:21-29% of patients prescribed opioids for chronic pain will misuse them8-12% will go on to develop an opioid use disorder (OUD)4-6% who misuse such opioids will transition to heroinFatal opioid overdoses among females have risen by a staggering 450% in the last 10 yearsThe CDC estimates that the "economic burden" endured in the U.S. from the misuse of prescription opioids stands at around $78.5 billion a yearLet’s look at more of the publicly available evidence. Firstly, what is the drug at the very heart of all this?What is OxyContin?Purdue Pharma’s OxyContin is the brand name of controlled-release oxycodone, a powerful, morphine-like opioid painkiller available only by prescription. It is primarily used for the relief of severe pain that is unresponsive to less potent pain-relief medicines (analgesics).Oxycodone binds to the brain’s mu opioid receptor, although it can bind to other opioid receptors at higher dosages. It is known as a “full agonist,” and belongs to the group of drugs known as opioids or opioid analgesics. Oxycontin can also be called a narcotic analgesic.Purdue began selling OxyContin just over 25 years ago, encouraging doctors to forget their reservations about opioids, and focus fully on easing the pain of patients. Court documents have shown that company officials continued to push to maintain sales even after it became clear to all concerned that the drug was highly addictive, and, furthermore, was actively being abused.The facts (and they are facts) speak for themselves...Purdue Pharma’s Fraudulent Activity Marketing OxyContinPurdue Pharma knew that OxyContin was more powerful than morphine - a highly addictive opioid drug used medically in cases of severe chronic pain, and with a wide range of strict warnings even about its directed use. However, they actively exploited the fact that medical doctors, such as family physicians, thought the reverse was actually true. In fact, a Purdue Pharma official once advised the company, “It is important that we be careful not to change the perception of physicians.”Purdue Pharma claimed OxyContin posed little risk of addiction, even though they had carried out no tests - zero - to that effect at all.Purdue Pharma knew they were relying on only a small amount of ambiguous medical literature (such as a short letter to an editor by a couple of doctors at Boston University) to reassure physicians about the safety of OxyContin, and not a peer-reviewed study, as such claims normally require.Purdue Pharma knew that OxyContin could actually be effectively injected into a recreational user’s body in the form of a solution, but they never made it public.Purdue Pharma argued that OxyContin’s slow-release mechanism was a barrier to possible abuse. However, at the same time as they (continually) made this statement, they also owned another company that made immediate-release oxycodone - the primary ingredient of OxyContin tablets.Purdue Pharma found that, by scrutinizing their sales data, they could find, locate and then maintain a secret list of doctors who regularly over-prescribed OxyContin. They did little to alert the relevant authorities to these “pill mills,” as they are legally required to do. Instead, Purdue Pharma were content to grow rich off the proceeds.These numerous criminal (and, at the very least, completely unethical) deceptions devised by the Sackler family and their company, were extremely successful, and Purdue Pharma subsequently earned at least $35bn from the sales of OxyContin.The Sacklers: Currently Guilty of NothingHowever, it came at a tragic, huge cost to the U.S. and the families who had to endure the loss of a loved one. To date, more than 500,000 Americans have now died from overdoses of both prescription and illegal opioids. The Sacklers? The family continues to refuse to accept the pivotal role they have master-minded in this horrendous crime, and, so far, they have been found guilty of nothing.For people in the business of supposedly alleviating pain, they continue to be the root cause of an unspeakable amount of it...“Those members of the Sackler family who were involved have endured nothing more distressing than a social downfall. Only in a deranged world can the erasure of their names from museum galleries be considered punishment enough for OxyContin.”- from Empire of Pain review by Patrick Radden Keefe – the dynasty behind an opioid crisis (The Guardian, May 13th, 2021)Knowing that the sales of OxyContin earned the Sacklers $35 billion makes their settlement proposal figure of $4.5 billion a little on the lean side, don’t you think? In fact, it’s about an eighth - 12.85%, to be exact - of the profits from their most profitable drug. Of course, the Purdue Pharma medicine cabinet is packed full of other types of opioid tablets, too.No Strangers to the U.S. Courts: The 2007 Plea AgreementPurdue Pharma, steered and guided by the Sacklers, are no strangers to criminal charges or litigation. Back in 2007, they were faced with both criminal and civil charges for “misbranding” their prescription drug OxyContin. Purdue were allowed and subsequently accepted a plea agreement - they, their parent company, and three top executives were fined a total of $600 million.A mere matter of months after the 2007 plea agreement took place, Mortimer Sackler wrote an email to cousins which stated, "While things are looking better now, I would not count out the possibility that times will get much more difficult again in the future, and probably much sooner than we expect."Kathe Sackler: The Deposition - Spring, 2019In the interests of fairness, it is only right that we share some of the legally sworn comments made by at least one member of the Sackler family.The beginning of O'Keefe's book, Empire of Pain, describes the scene in a packed conference room of the New York headquarters of legal firm Debevoise & Plimpton. With around 20 lawyers in attendance, the conference room would witness the deposition of reclusive billionaire, Kathe Sackler - her sworn, out-of-court testimony, a part of the discovery process in thousands of lawsuits involving herself, her family, and her company, Purdue Pharma.Asking the questions was one of the plaintiffs’ lawyers, Paul Hanley. It didn’t take long for Hanley to start asking the tough questions:Hanley: “Dr. Sackler, does Purdue bear any responsibility for the opioid crisis?”[Immediate shouts of “Objection!” from her lawyers]Sackler: “I don’t believe Purdue has a legal responsibility.”Hanley: “That’s not what I asked. What I want to know is whether Purdue’s conduct was a cause of the opioid epidemic?”[Further shouts of “Objection!” from her lawyers]Sackler: “I think it’s a very complex set of factors and confluence of different circumstances and societal issues and problems and medical issues and regulatory gaps in different states across the country. I mean, it’s very, very, very complex.”During the course of the deposition, Sackler continued to insist that the family had nothing to be ashamed of or even to apologize for, because they believed that there was nothing wrong with OxyContin.Sackler: “It’s a very good medicine, and it’s a very safe and effective medicine.” If that were really the case, would we really have so many deaths attributable to the opioid crisis? Remember, as O’Keefe himself comments, “Before the introduction of OxyContin, America did not have an opioid crisis. After the introduction of OxyContin, it did.”Oh, the Sacklers’ deception gets worse, by the way…The Story of the Fast-Tracked Approval for OxyContinAccording to author Patrick O'Keefe, one significant aspect of OxyContin’s approval by the Food and Drug Administration (FDA) looks decidedly questionable, to say the very least. The actual FDA official who granted OxyContin its various approvals in 1995 did so in an astonishingly short time - just 11 months.However, here’s the real kicker:The same “helpful” official promptly quit the FDA soon afterwards, and, within a year, was found to be working… (yes, you guessed it again) at Purdue Pharma, earning a remarkably improved salary, too. Around $400,000 a year.Furthermore, Oxycontin’s rapid approval was based on it being “safe and effective” when used only in the "short-term." However, six years later, in 2001, the FDA, under more pressure from “Big Pharma” (the entire U.S. pharmaceutical industry, in other words), took the ill-perceived decision to widen the use of Oxycontin to just about anyone, such as those with chronic arthritis and back pain.The FDA did this by simply changing a few words on the label - the “label” being the small, folded piece of paper full of the drug’s small print accompanying the pill bottle. The label change proudly stated these morphine-like pain pills were now effective for "daily, around-the-clock, long-term… treatment." Unfortunately, this meant any drug company could now market the similar drugs differently, and even allow them to sell more and more pills at higher and higher doses.In a 2016 interview with mainstream media, Dr. David Kessler, who was in charge of the FDA from 1990 to 1997, when asked about the opioid crisis, stated, "FDA has responsibility, pharmaceutical companies have responsibility, physicians have responsibility. We didn't see these drugs for what they truly are."When Dr. Kessler was asked about his own responsibility as the head of the FDA, he said the crisis began after he left the agency in 1997; however, he does admit he should have pushed for stricter prescription practices when he was still in charge.The rest, as they say, is history...“While some progress has been made - especially around the public document depository - this plan is far from justice. Purdue and the Sacklers have misused this bankruptcy to protect their vast wealth, and evade consequences for their callous misconduct. This deal alarmingly allows the Sacklers to still walk away with their personal wealth intact.”- William Tong, Attorney General of ConnecticutOnce Purdue had approval for OxyContin, in 1996, a company head salesman told company sales reps in Tennessee to now convince doctors to prescribe stronger OxyContin doses to pain sufferers. These are the words he used: “It’s bonus time in the neighbourhood.”However, as soon as the legal authorities eventually started taking a closer and more detailed look at the “bonus time” sales and information practices of Purdue Pharma, the end result was their court case appearance and plea agreement in 2007. For the Sacklers, it meant one thing only - move their money, and quickly.Oregon’s current lawsuit sums it up; it alleges, “Between 2008 and 2018, they directed Purdue to make nearly $11 billion in total distributions (including tax distributions) to partnered companies, foreign entities, and ultimately to trusts established for the benefit of the Sackler families.’’And the U.S. Opioid Crisis Goes On...All in all, the whole story of how the Sacklers’ strove to build their very real empire of pain should have resulted in very real justice for the victims, justice for their families and their loved ones, justice for the communities so badly affected by the opioid epidemic, and justice for the U.S. as a nation.However, as we said at the beginning of this article - money talks. It now appears to be speaking as loudly to the various state attorney generals spread across this nation of ours as it has always done to the Sackler family.Let’s give the last word to plaintiffs’ attorney Paul Hanly - the man with the tough questions that still remain unanswered. He believes the states who have now agreed to the revised settlement plan simply considered it the better option. The alternative?He referred to that as “probably a decade or more in the bankruptcy court, at the end of which will probably be a ham sandwich left over for our clients, the communities that are suffering.”
