Purdue Pharma’s Use of Hospital, Academic Ties Helped Fuel Opioid Crisis

Purdue Pharma headquarters in Stamford, CT. Photo: John9474/CC BY-SA 4.0 (Wikimedia)

In 1996, Purdue Pharma—a privately held pharmaceutical company owned by members of the Sackler family—released a new prescription painkiller called OxyContin. The drug, which uses a controlled-release mechanism to deliver large doses of oxycodone (a chemical cousin of heroin), was promoted as “smooth and sustained pain control” since patients would only have to take one pill every 12 hours.

Over the next two decades, Purdue aggressively pushed sales of OxyContin, using every trick in the playbook to sell its product even as stories of prescription opioid addiction grew. During this period, the Sacklers made billions from this one pill. Meanwhile, the opioid epidemic, the origin of which has largely been attributed to the increase in opioid prescriptions in the 1990s, swept across America. From 1999 to 2017, almost 400,000 people died from opioid overdoses.

Purdue’s marketing campaign included promoting false claims to doctors—such as instructing sales representatives to tell doctors that fewer than one percent of patients became addicted to OxyContin—as well as using doctors with ties to the company to promote the drug. In 2007, the company and three executives plead guilty to criminal charges that they deceived doctors, patients, and regulators about the addictiveness and abuse potential of OxyContin.

Additionally, when faced with claims that OxyContin doesn’t last a full 12 hours—an issue the company had known about for decades—Purdue instructed prescribers to simply increase the dose, even though higher doses are more dangerous and leaving gaps in effects of narcotics can lead to addiction. Purdue was also the most prominent of several drug companies to pay third-party advocacy groups to fight against opioid-limiting laws and guidelines. More broadly, between 2006 and 2015, the pharmaceutical industry spent almost $900 million on lobbying and campaign contributions.

In their use of “The Screen,” Purdue and the Sacklers hid behind medical schools and hospitals in order to boost their credibility. In 2002, Purdue launched the Massachusetts General Hospital Purdue Pain Program. As alleged by a 2018 lawsuit filed by the Massachusetts Attorney General, the Sacklers chose to start the program “after due diligence, including a review of OxyContin sales data, led staff to conclude that it would help Purdue sell more opioids in Massachusetts.”

The lawsuit additionally alleges that staff told the Sacklers the program “gave Purdue name recognition among medical students, residents, and the public, as well as political protection against the efforts to address the opioid crisis.” One staffer specifically told the Sacklers that, in response to state legislators considering a ban on OxyContin, “I fear that a termination of support [for the program] might fuel the efforts of those already hostile to us, or reduce the willingness of those who have supported our positions to continue to do so.”

The Sacklers also gave money to Tufts University for similar reasons. In 1999, the Sacklers established the Tufts Masters of Science program in Pain Research, Education, and Policy. Among the benefits that came with this generous gift, Purdue got access to doctors at multiple hospitals; got to control research on pain treatment; and Purdue employees regularly taught a seminar in the program about opioids in Massachusetts. In 2011, Tufts also promoted a Purdue employee to Adjunct Associate Professor.

 The claims revealed in the lawsuit caused concern among medical school faculty. Michelle Mello, a professor at Stanford’s medical and law schools, told Stat News that “It’s clear that at this very highest level of the company, they wanted to not just cultivate relationships with Tufts and MGH, but to use their brands.” An assistant professor of medicine, medical ethics, and health policy at the University of Pennsylvania added that “my first reaction was kind of ‘yikes,’” and that, with regard to the hiring of the Purdue employee, “The university should ask exactly what expertise a drug company can offer that the fine faculty at Tufts cannot.”

Since the 1990s, prescription opioids have relieved chronic pain for many. But decades of their reckless sale (which has only recently begun to come under control) has also fueled an opioid epidemic that has led to significant loss of life both from the prescription opioids themselves, and by leading addicted persons to heroin and illicitly manufactured fentanyl. Heroin deaths began rising in 2010, and deaths involving synthetic opioids, most prominently fentanyl, began to climb dramatically in 2013.

By keeping the science away from patients and doctors and hiding behind the credibility of institutions, Purdue helped fuel an ongoing public health crisis of epic proportions.

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