Sackler Family Threatens Media After Opioid Settlement

[Brenda Archer]

 

[Eunoli]

I just want to say that they /do/ have their place. I took them after my surgery and it helped me through what I am pretty sure would have been almost unbearable otherwise. Its almost a shame that they can help so much when appropriate, because it makes this issue more complicated and messy.

 

[Brenda Archer]

The gist of what I’m getting from the thread:

1) States and large medical organizations created guidelines even stricter than the CDC in some cases.

2) The DEA has access to the prescribing database and investigates doctors who go over the arbitrary guidelines, even though CDC claims it was not trying to remove doctor discretion or have the guidelines applied to all types of patients.

3) Doctors have been arrested. They are at risk of loss of license. There is patient abandonment.

4) Patients being denied adequate pain care included cancer, palliative end-of-life care, severely injured, post-surgery and rare diseases. The removal of treatment to long term pain patients is causing disability and suicide.

There are suspicious tweets saying the patients are being diverted into lucrative suboxone treatment, which, if true, would fit the corruption pattern we’ve been seeing from this Administration. At the very least, it’s quite clear they are trying to whittle away at care for the disabled with policies that remove access to care, piece by piece, such as Medicaid work requirements for younger people. In every case the Republicans claim there are supposed to be safety guide rails and then act surprised when patients are kicked out of care they didn’t “mean to” harm.

 

[Katheryne Helendale]

I can quite see suing particular doctors and clinics for their irresponsible prescribing practices. I'm just less clear about why it is argued the Sackler family (whether all adult living family members or particular individuals) should be held responsible for what sounds like the prescribing doctors' malpractice.

I'm a little muddy with regards to the situation as well, but this is what I understand of it: While it's true that various pharmacies and doctors were abusing the drugs and violating all sorts of laws and regulations regarding prescriptions, Purdue Pharma did not do due diligence in reporting the unusual volume of orders for the drug - instead, they encouraged it. Further, Purdue misled prescribing physicians about the drug's addictive qualities, leading to further over-prescriptions. So there's a lot of blame to go around, but I think it was Purdue's reckless irresponsible quest for profit that is at the root of it.

 

[Essence Lumin]

I sure haven't followed all the specifics of everything here. My understanding is Big pharma way over prescribed opioids and painkillers. And now my friend who has gone through major surgery and is in excruciating pain actually needs pain pills and can't get them. She screams in her apartment from the pain. But there is nothing she can do

 

[Brenda Archer]

I sure haven't followed all the specifics of everything here. My understanding is Big pharma way over prescribed opioids and painkillers. And now my friend who has gone through major surgery and is in excruciating pain actually needs pain pills and can't get them. She screams in her apartment from the pain. But there is nothing she can do

This is horrible and I don’t have words, I wish she could get help. This country has become a nightmare.

 

[Imnotgoing Sideways]

Money talks. (^_^)

 

[Beebo Brink]

Money talks. (^_^)

Isn't he in prison now?

 

[Innula Zenovka]

There's clearly so much going on here -- opioid addiction in the USA seems entwined with so many issues, ranging from health care provision to the difference in response to opioids vs the earlier "crack epidemic" to pharmaceutical companies, tort and compensation issues and even hostility and suspicion towards China.

I guess the two issues that really worry me are partly my fear that, in all this concern -- much of it wholly justified, of course -- there's a risk of losing sight of the fact that, at least when properly administered and used, powerful opioid painkillers like fentanyl are extremely valuable medicines.

I very much doubt I could have made it through radiotherapy without it, and I get scared when I see politicians trying to use the criminal law to micromanage prescribing it -- I'm sorry, but I am not taking medical advice on anything serious from anyone but a qualified doctor, and neither would any lawmaker in his or her right mind, and I just worry about the unforeseen consequences of hasty legislation and sloppy legal draughtsmanship leaving patients in agony.

My other concern is that a complex public health scandal like this has so many strands, and I am really not sure that the courts are the right place to try to untangle them all.

By this I mean that there's a whole range of public policy issues involved, including how to help people who've become addicted to drugs generally, which requires multiple answers, and their communities, how to disrupt the illicit supply and to reduce demand for it, and how to ensure that what looks to me like a massive breakdown of scrutiny and oversight by multiple professional and regulatory bodies.

It's all very well complaining about the manufacturers but what on earth were the FDA and the various professional and regulatory bodies doing while this building up?

Even I know that if something is a powerful painkiller it's likely also to be pretty habit-forming, to say the least, so while Purdue may have lied about this (I don't know) what about all these independent peer-reviewed, evidence-based clinical trials that are supposed to be part of the approval procedure? Surely doctors must have realised that, whatever the product information leaflets said should and shouldn't happen, their patients seemed to become dependent on these drugs pretty quickly? What were their professional bodies saying?

Seems to me that, while the courts can help resolve, at least, the issue of whether particular organisations or individuals are to blame, whether to the criminal or the civil standard, they can't do much to resolve the question, in many ways more important, of what happened and what can be learned from it to stop it happening again.

That's because, in a confrontational forum like a civil or criminal court, it's always a question of P vs D, with P alleging that D did or didn't do something. D, therefore, will always want to challenge P to demonstrate -- to the civil or criminal standard -- that, in fact, the cause of the mischief was not, or could not have been, x, y or z rather than whatever P alleges it was.

A court isn't so good at looking at the wider picture, which in this case seems to be one of general regulatory and professional failure.

I'm worried, I think, that by concentrating on the wrongdoings of particular individuals or companies we risk losing sight of the structural problems that allowed their wrongdoings to go unreported and unchecked for so long.

When the system of medical care and regulation allows this kind of thing to happen, the problem is wider than simply unscrupulous, or even criminal, individuals. There's also something wrong with the health care system that allows it to happen.

 

[Beebo Brink]

When the system of medical care and regulation allows this kind of thing to happen, the problem is wider than simply unscrupulous, or even criminal, individuals. There's also something wrong with the health care system that allows it to happen.

Well, yes. And this isn't even the worst thing wrong with our health care system.

USA! USA! USA!

 

[Clara D.]

Doctors are going back to Tylenol 3/4 (with codeine) -- according to this site prescriptions for T#4 have gone up over 1000% (which is what I'm now on because Tramadol was meh.)

Change in prescription habits after federal rescheduling of hydrocodone combination products
...
Statistical analysis of the number of prescriptions received for each medication illustrated a 17% increase in tramadol, 597% increase in Tylenol #3, and 1056% increase in Tylenol #4 after federal rescheduling of hydrocodone combination products.
...
With the significant rise in alternative prescriptions, there was only a slight change in the quantity of morphine equivalents prescribed before and after the federal rescheduling.

Change in prescription habits after federal rescheduling of hydrocodone combination products

Nationally, health care providers wrote 259 million prescriptions for narcotic analgesics in 2012, or roughly one bottle of narcotics per US adult (). In an effort to combat this ever-growing problem, the Drug Enforcement Administration changed the schedule ...

www.ncbi.nlm.nih.gov

 

[Brenda Archer]

Doctors are going back to Tylenol 3/4 (with codeine) -- according to this site prescriptions for T#4 have gone up over 1000% (which is what I'm now on because Tramadol was meh.)

Change in prescription habits after federal rescheduling of hydrocodone combination products

Nationally, health care providers wrote 259 million prescriptions for narcotic analgesics in 2012, or roughly one bottle of narcotics per US adult (). In an effort to combat this ever-growing problem, the Drug Enforcement Administration changed the schedule ...

www.ncbi.nlm.nih.gov

I have to wonder at this, it looks like transferring money from one product to another.

I had hydrocodone after surgery and I hated it. It certainly didn’t make me high (as some say it does to them). But I had Tylenol with codeine (T3) during a particularly awful ear infection and got higher than a kite (and I’ve heard others say the same). So I’m not sure what the Puritans hope to accomplish by moving people from hydrocodone to codeine.
And Tylenol is not the safest.

 

[Clara D.]

I have to wonder at this, it looks like transferring money from one product to another.

I had hydrocodone after surgery and I hated it. It certainly didn’t make me high (as some say it does to them). But I had Tylenol with codeine (T3) during a particularly awful ear infection and got higher than a kite (and I’ve heard others say the same). So I’m not sure what the Puritans hope to accomplish by moving people from hydrocodone to codeine.
And Tylenol is not the safest.

The rescheduling didn't really change much overall. "...there was only a slight change in the quantity of morphine equivalents prescribed before and after the federal rescheduling. "

Oddly, T4 doesn't mess with me at all, unlike Vicodin (sleepy) or Percoset (loopy). It just works.

 

[Beebo Brink]

So the ire against pharmaceutical companies is mounting. Good article on their culpability.

Internal drug company emails show indifference to opioid epidemic

Just a few examples from a long article:

The Controlled Substances Act requires drug companies to control against diversion, and to design and operate systems to identify “suspicious orders,” defined as “orders of unusual size, orders deviating substantially from a normal pattern, and orders of unusual frequency.” The companies are supposed to report such orders to the DEA and refrain from shipping them unless they can determine the drugs are unlikely to be diverted to the black market. The plaintiffs, in the filing, allege that the companies ignored red flags and failed at every level.

At Cardinal Health, one of the nation’s largest drug distributors, then-CEO Kerry Clark in January 2008 wrote in an email to Cardinal senior officials that the company’s “results-oriented culture” was perhaps “leading to ill-advised or shortsighted decisions,” the filing contends.

On Aug. 31, 2011, McKesson Corp.’s then-director of regulatory affairs, David B. Gustin, told his colleagues he was concerned about the “number of accounts we have that have large gaps between the amount of Oxy or Hydro they are allowed to buy (their threshold) and the amount they really need,” according to the filing, which cites Gustin’s statements. “This increases the ‘opportunity’ for diversion by exposing more product for introduction into the pipeline than may be being used for legitimate purposes.”

According to the filing, he had earlier noted to his colleagues that they “need to get out visiting more customers and away from our laptops or the company is going to end up paying the price . . . big time.”

The Post has previously reported that Kristine Atwell, who managed distribution of controlled substances for the company’s warehouse in Jupiter, Fla., sent an email on Jan. 10, 2011, to corporate headquarters urging that some of the stores be required to justify their large quantity of orders.

“I ran a query to see how many bottles we have sent to store #3836 and we have shipped them 3271 bottles between 12/1/10 and 1/10/11,” Atwell wrote. “I don’t know how they can even house this many bottle to be honest. How do we go about checking the validity of these orders?”

A bottle sent by a wholesaler generally contains 100 pills.

Walgreens never checked, the DEA said. Between April 2010 and February 2012, the Jupiter distribution center sent 13.7 million oxycodone doses to six Florida stores, records show, many times the norm, the DEA said.

 

[Cristiano]

The Weekly | A Secret Opioid Memo That Could Have Slowed an Epidemic (Published 2019)

Details in a confidential government document were kept in the dark for years.

www.nytimes.com

 

[Cristiano]

They seem nice:

New York Accuses Purdue Pharma Family Of Secretly Siphoning Off Fortune

The Sacklers, the family behind OxyContin, allegedly wired around a billion dollars to their own bank accounts while defending their role in the opioid crisis.

www.huffpost.com

 

[Sean Gorham]

They think they're better than everyone else because they have obscene amounts of money. The only real punishment for these vultures is to take away ALL their money and put them in the poor house. It's all they understand. Put them out on the street!

 

[Jolene Benoir]

They seem nice:

New York Accuses Purdue Pharma Family Of Secretly Siphoning Off Fortune

The Sacklers, the family behind OxyContin, allegedly wired around a billion dollars to their own bank accounts while defending their role in the opioid crisis.

www.huffpost.com

Any bets that they will receive a fine (if any) which is a mere pittance of what they sacked away in offshore accounts? They also will claim bankruptcy to avoid any other means of fines/punishments. This is what I was talking about in another post when I mentioned how businesses are able to avoid the same penalties as individuals.

They simply squirrel away whatever ill-gotten gains they have received, as the Panama Papers showed us, while committing crimes and/or endangering the public, yet largely go unpunished. If anything they gain large rewards.

 

[GoblinCampFollower]

I'm glad they're not letting themselves be silenced.

Related to this, I was wondering the other day how common it is for billionaires to overestimate their ability to intimidate millionaires. If you have no resources to fight a big lawsuit, you are very vulnerable in America. But once you have a certain critical mass of money, having LOTS AND LOTS of extra cash may not help you very much if you are obviously in the wrong on a lawsuit. The Sackler family is getting desperate, because they know on some level that their enemies are right.

 

[Cristiano]

Sackler Family Members Fight Removal of Name at Tufts, Calling It a ‘Breach’ (Published 2019)

After Tufts took the Sackler name off one of its buildings over the family’s role in the opioid crisis, some family members are crying foul.

www.nytimes.com