American Oligarchy by Ron Formisano

Author:Ron Formisano
Language: eng
Format: epub
Publisher: University of Illinois Press

Copyright Ed Gamble. Reprinted with permission.

Part of the Virginia settlement went to reimburse state Medicaid programs, but Kentucky refused an offer to settle for $500,000 and filed its own lawsuit in Pike Circuit Court. Purdue succeeded in having the suit transferred out of Pike County, where a jury might have levied an enormous penalty. With the case back in federal court in December 2015, the company agreed to pay the state $24 million for misleading doctors and patients in its marketing of OxyContin, but admitted no wrongdoing.69

In 2012, with the prescription drug abuse epidemic still raging, the Kentucky legislature placed new restrictions on pain clinics and on the prescribing of controlled substances. Known as the “pill mill bill,” it mandated a tracking system for all such prescriptions, KASPER (Kentucky All Schedule Prescription Electronic Reporting). After the legislature revised it to accommodate hospitals, long-term care facilities, and approved researchers, one study showed that by 2015 the new system was having effect. At the same time, however, the scourge of heroin was on the rise in both eastern and northern Kentucky.70

The Making of an Epidemic

“The richest newcomer to the Forbes 2015 list of America's Richest Families comes in at a stunning $14 billion. The Sackler family, which owns the Stamford, Conn.–based Purdue Pharma, flew under the radar when Forbes launched its initial list of wealthiest families in July 2014, but this year they crack the top-20, edging out storied families like the Busches, Mellons and Rockefellers.

“How did the Sacklers build the 16th-largest fortune in the country? The short answer: making the most popular and controversial opioid of the 21st century—OxyContin.”71

Alex Morrell, “The OxyContin Clan”

The ravaging of regions of rural America by OxyContin abuse from Maine to Mississippi—and especially Appalachian Kentucky, West Virginia, Ohio, Maine, and Virginia—did not happen by accident. The Sacklers and Purdue Pharma targeted them.

Three brothers created OxyContin, Arthur, Mortimer, and Raymond Sackler, born to European immigrants who ran a grocery store. They all became psychiatrists, and at a small mental hospital in Queens they produced important research in the biology of mental illness that opened the door to drug treatments. In 1952 they bought a small drug factory in New York City and eventually branched out from producing laxatives to more profitable painkillers. They first took an old drug for cancer pain, morphine sulphate, added a time-release formula, and sold it as MS Contin; in the next decade sales rose to $475 million. Next they took oxycodone, invented in Germany in World War I to send exhausted soldiers back into battle, and added a time-release mechanism that they claimed would prevent its abuse.

Earlier, the elder brother, Arthur, a “brilliant polymath” working for a small advertising firm, became a pioneer of medical advertising and promoted Valium into the first $100 million drug. He was the first to cultivate relationships with doctors, courting them with expensive dinners and junkets and lucrative speaking fees, “an approach so effective that the entire industry adopted it.” (ProPublica's “Dollars for Doctors” database now tracks the flow of industry money to physicians, including those with disciplinary records.

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