Medication-Assisted Treatment for Opioid Use Disorders
Medication can be an important and beneficial part of any treatment plan for opioid addiction. Learn more about how medication can support recovery.
An estimated 130 people die every day from overdosing on opioids. This includes prescription pain relievers, synthetic opioids like fentanyl, and heroin. Of people who use heroin, 80% first misused a prescription opioid, such as OxyContin or Vicodin. In fact, the 3 most common drugs involved in prescription overdose deaths are Methadone, Oxycodone (OxyContin), and Hydrocodone (Vicodin). In 2017 alone, over 191 million opioid prescriptions were dispensed to Americans with pain. About 21 to 29% of patients who receive an opioid prescription for chronic pain misuse them, and between 8 and 12% of them develop an opioid use disorder. The opioid epidemic has been ongoing for the last 20 years, taking thousands of lives by death or addiction. To understand how this happened, you have to look back to the late 1990s, and you will likely see Purdue Pharma and the Sackler Family right in the center of it all.
Purdue Pharma was founded in the 1990s by Richard Sackler and the company planned to unveil the pain pill OxyContin in 1996. Purdue Pharma’s marketing strategy aimed to target the drug to all patients with chronic pain, not just cancer patients. In a 1994 email from sales and marketing executive Michael Friedman to 3 members of the Sackler family, Friedman said, “Our current MS Contin business has created ‘a franchise’ with certain physicians who routinely write prescriptions for the drug,” Friedman continued saying that these physicians, “may be the bridge that we can use to expand the use of OxyContin beyond Cancer patients to chronic non-malignant pain.” This idea of incorporating physicians to promote OxyContin worked, growing sales from $48 million in 1996 to almost $1.1 billion in 2000.
Before the 1990s, many physicians hesitated to prescribe patients opioids for pain because of the risk of developing an addiction. However, as Purdue Pharma and other major pharmaceutical companies developed relationships with leading physicians and researchers, the spread of misinformation began stating that opioids are safe and effective. Purdue hosted dinner programs and weekend meetings to speak to doctors about OxyContin. In a 1996 email from Richard Sackler, he stated, “Physicians who attended the dinner programs or the weekend meetings wrote more than double the number of new Rxs for OxyContin compared to the control group. Weekend meetings had the greatest impact, increasing new prescriptions for OxyContin by a factor between 2.16 and 2.62.”
One example of this is neurologist and pain specialist Russell Portenoy, MD whose pain center received millions of dollars of funding from Purdue and other pharmaceutical companies. He contradicted earlier statements about the dangers of opioids, stating that, “the risks of addiction to opioids were minimal and that not treating pain was cruel and even amounted to medical negligence.” Portenoy admitted to having financial relationships with over a dozen companies that produced opioid pain killers. However, this was after the research had been published in medical journals that lacked credibility. As some doctors began voicing their concerns about opioid addiction, Sackler sent an email to Purdue’s medical director, Dr. Paul Goldenheim, stating, “Why don’t you guys plan a presentation about addiction, give a convincing presentation that [controlled-release] products are less prone to addiction potential, abuse or diversion than [immediate-release] products.” A memo to Purdue’s sales team said, “Your priority is to Sell, Sell, Sell OxyContin.”
As years went by and the opioid epidemic unfolded, Purdue Pharma came under fire for deception about the safety of OxyContin. In 2007, Purdue pleaded guilty to misleading the public about OxyContin’s risk of addiction and paid $600 million. The lawsuits did not stop, and the company received thousands more over the years. In early 2019 they reached a deal for the Sackler family to pay $3 billion and give up ownership of the company. In September 2019, Purdue Pharma filed for bankruptcy, which would temporarily stay the litigation against the company until bankruptcy proceedings are complete.
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The Sackler family is one of the richest families in America, with an estimated $13 billion fortune. Once thought of as a philanthropic family, the reputation of the Sackler’s has been impacted since the majority of their wealth has come from OxyContin sales. Some family members have distanced themselves from Purdue Pharma, while others are still very much involved. In the past, lawsuits have arisen against the company but not at the individual family members. As of late 2019, the lawsuits are now being aimed at the family as well as Purdue Pharma. Many are now accusing the family of trying to move and protect their assets.
In September 2019, the New York attorney general’s office stated that it had tracked $1 billion in wire transfers by the Sackler’s and this suggested that, “the family tried to shield wealth as it faced a raft of litigation over its role in the opioid crisis,” according to the New York Times. Many of the transfers are through Swiss bank accounts. Banks based in Switzerland are notorious for their secrecy and high levels of privacy that Swiss law mandates. Stat News reports that the Sackler family has been investigated by the FBI many times over a quarter century. There is also suspicion that the Food and Drug Administration (FDA) may have been involved after refusing to place dispensing restrictions on OxyContin after requests from the Drug Enforcement Administration (DEA).
Today, Americans are becoming more aware of the dangers of opioids but there is still a fight against the greed and corruption that many pharmaceutical companies are founded on. Shifting the blame to the addict has been a tactic, despite the fact that anyone can become addicted to the powerful effects of opioids. A famous 2001 email from Richard Sackler stated, “We have to hammer on the abusers in every way possible. They are the culprits and the problem. They are reckless criminals.”
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