Purdue Pharma launched two revolutions when it released OxyContin 20 years ago. The drug, a powerful opioid, changed pain management in America. But it was also a leader in fueling the rapid growth of prescription painkiller abuse and opioid addiction, now a nationwide public health crisis of unprecedented proportions. Questions still loom about exactly how complicit Purdue Pharma, the maker of OxyContin, has been in the abuse of the drug.
STAT, a sister publication of The Boston Globe, went to court in an effort to begin answering those questions. STAT last month asked a judge in Kentucky to unseal Purdue court records that could offer new insight into what the company and its owners knew about OxyContin’s real addiction risks and whether they sought continuously to minimize the danger in marketing the controversial painkiller. A hearing is set for Friday. It’s critical that the Kentucky judge releasethose sealed documents, since they could shed light and offer lessons in the opioid crisis, a scourge that has overwhelmed so many American families.
The secret records are part of a case the company settled with the Commonwealth of Kentucky last December for $24 million. They include a deposition of Dr. Richard Sackler, former Purdue president and current board member. This is believed to be the first time a member of the Sackler family, which owns the Connecticut-based company and is worth an estimated $14 billion, has been called to account for the company’s actions.
The original OxyContin pill released oxycodone, a powerful narcotic, over a period of 12 hours. Users soon found a way to abuse the painkiller by crushing the pill and snorting or injecting it, producing a heroin-like high. Yet Purdue Pharma kept selling that original pill for about 14 years before the company withdrew it from the market in 2010, replacing it with an improved, abuse-deterrent formulation.Finally recognizing the drug’s dangerousness, the FDA announced in 2013 that it wouldn’t approve generic versions of the original OxyContin pill.
Meanwhile, opioid addiction in the country continued to grow. A recent STAT-Harvard poll revealed that 1 in 3 Americans blame doctors for the opioid epidemic. But the overprescribing of opioid painkillers didn’t happen in a vacuum. Purdue’s aggressive marketing and promotion efforts essentially amounted to the creation of a market, as documented by variousresearch studies and mediareports. The company funded hundreds of thousands of educational programs for the medical community promoting a “more aggressive identification and treatment of pain,’’ an idea that soon picked up mainstream backing while the drug’s downsides received insufficient attention.
Indeed, three Purdue executives pleaded guilty in 2007 to charges of misbranding the original OxyContin and minimizing the drug’s risk of addiction. But the culpability at Purdue, and that of the Sacklers, hasn’t been fully explored. In that federal case, Purdue agreed to pay more than $600 million in fines and also settled with most states — including Massachusetts, which received nearly $1 million. But Kentucky refused to participate and filed its own suit, which concluded in the recent $24 million settlement.
Some believe that the 2007 case never really got to the heart of what Purdue had done to unleash the epidemic. “What they really did wasn’t so much the specific branding [of OxyContin] but the general way in which they promoted opioids as a class of drug that was not addictive in the long run,’’ says Dr. Andrew Kolodny, director of Physicians for Responsible Opioid Prescribing.
What’s important about Sackler’s testimony becoming public is that it promises to be useful for the cases against Purdue that are in the pipeline. The State of Mississippi and the City of Chicago have filed litigation against the company. Other states, including New Hampshire, are investigating whether to pursue their own cases against Purdue and other opioid makers.
Disclosing Sackler’s sealed depositionand all other documents from the casecould be key in understanding how a painkiller became part of a national epidemic. It is in the public’s best interest to learn what Kentucky investigators found out about the roots of the opioid crisis. It may very well be that Purdue did nothing untoward in the last two decades, but the public deserves to find out.
