David Sackler wants you to know that he and his family, which owns the company behind the blockbuster opioid OxyContin, are human — that’s one reason he gave for talking to Bethany McLean at Vanity Fair.
But they’re not human enough, apparently, to make serious mistakes. Throughout the interview with Vanity Fair, Sackler repeatedly insisted that his family and its company, Purdue Pharma, are not at all to blame for the opioid epidemic, and he reportedly got upset at suggestions that they’re culpable.
In the interview, Sackler told a story of his 4-year-old coming home and asking, “Why are my friends telling me that our family’s work is killing people?”
It sounds sad for a child who genuinely has nothing to do with the opioid crisis, but it’s apparently especially sad to Sackler because, in his view, his whole family had nothing to do with the epidemic. “Facts will show we didn’t cause the crisis,” he claimed, “but we want to help.”
This defies the widely accepted understanding of the opioid epidemic. In the 1990s, Purdue unveiled and heavily marketed OxyContin as a new, safe, effective kind of opioid. The company encouraged doctors, with a variety of marketing schemes, to prescribe far more of the drugs, with the promise that misuse, addiction, and overdose would be rare.
During this time, Sackler’s father, Richard, had a major marketing role in the company. David Sackler himself later served on Purdue’s board of directors from 2012 to 2018, after working for the company for a couple summers but otherwise working at different places and a family investment firm.
OxyContin uses an extended-release formula that releases a lot of the drug over time instead of all at once — which Purdue, with the approval of the Food and Drug Administration (FDA), argued made it less prone to misuse. In reality, it was more prone to misuse; the extended-release formula let Purdue include more opioids in each pill, and people found they could bypass the extended-release formula and absorb the opioids all at once by crushing and snorting or injecting the pills.
The result was the beginning of today’s opioid epidemic. Prescriptions skyrocketed, and the US continues leading the world — by far — in opioid prescriptions to this day. Between 1999 and 2017, nearly 200,000 overdose deaths were linked to painkillers, excluding synthetic opioids like fentanyl. Hundreds of thousands more have been linked to heroin, fentanyl, and other opioids. Much of that can be connected back to OxyContin and other legal opioid painkillers, with people who use even illicit opioids like heroin often tracing their initial opioid use — the thing that got them hooked — to the painkillers and, yes, Purdue and the Sacklers.
Sackler gave several reasons for why the opioid crisis is not his family’s fault
Sackler told Vanity Fair that it’s not his family’s or Purdue’s fault that things worked out this way. In his telling, Purdue was working with the best science it had at the time, even if that science turned out to be wrong.
For instance, Purdue relied on a five-sentence letter published in The New England Journal of Medicine in 1980 that seemed to suggest less than 1 percent of people who use opioids in a medical setting become addicted. Purdue interpreted that letter to claim that less than 1 percent of people who use OxyContin would become addicted.
In reality, the letter wasn’t intended to support such sweeping claims. And the letter’s author later told the Associated Press that he was “mortified that that letter to the editor was used as an excuse to do what these drug companies did.”
It doesn’t take an expert to devise that a five-sentence letter to the editor is not solid ground for sweeping claims about science or medicine. And while Sackler argued evidence other than the letter supported Purdue’s claims at the time, Vanity Fair noted that many of the other materials he pointed to are “sourced to the original letter from The New England Journal of Medicine.”
Beyond that, though, the fact of the matter is the addictive and otherwise dangerous traits of opioids have been well known for a long, long time. In fact, opioid epidemics caused by widespread medical use aren’t even new to the US — with a previous opioid crisis taking off after the Civil War when soldiers became addicted to morphine given to them to relieve pain from battlefield wounds. America had personally known about these risks for well over a century before OxyContin arrived.
Yet Sackler continues to insist that OxyContin isn’t that addictive, telling Vanity Fair that addiction rates are “between 2 and 3 percent” and only rise to nearly 5 percent when including more typical dependence and misuse. In reality, reviews of the research have estimated addiction rates at 8 percent and misuse rates as high as 26 percent.
Sackler also argued that OxyContin couldn’t be to blame for the opioid crisis, because it only makes up a small share of the opioid market — never more than 4 percent of opioid prescriptions. But as Andrew Kolodny, an opioid policy expert at Brandeis University, told Vanity Fair, this gravely misunderstands Purdue’s role: Since OxyContin is one of the more potent opioids, it was disproportionately prone to misuse and addiction. So it may make up only 4 percent, at most, of the prescription share, but it’s involved in a much higher percentage of all misuse and addiction cases.
Purdue also had a significant role beyond OxyContin. By marketing its new opioid as safe and effective, Purdue helped foster an environment in which opioids in general — not just OxyContin — were far more loosely prescribed. As Kolodny and other experts explained in the Annual Review of Public Health, Purdue’s advocacy through “education” campaigns and astroturfs was about how opioids in general are safe and effective — even helping spread the term “opiophobia,” which suggested that doctors were irrationally scared of prescribing opioids.
Sackler’s last point is that the real fault behind the opioid crisis falls on government agencies, like the FDA, that let opioids run amok: “You say, ‘Okay, first of all, it was known that those patients were going to exist.’ And the FDA approved this medication with that balance in mind. So like any medication that has unintended side effects, you knew that this was one. It was approved as one. Doctors understood it, right?
There is some truth to this. As I’ve explained before, regulatory agencies could have done far more to prevent the opioid crisis. The FDA itself agrees, telling Vanity Fair that “the scope of the epidemic reflects many past mistakes and many parties who missed opportunities to stem the crisis, including the FDA.”
But the company who sold one of the most misused drugs surely bears more responsibility than the regulators who failed to stop it.
But they’re not human enough, apparently, to make serious mistakes. Throughout the interview with Vanity Fair, Sackler repeatedly insisted that his family and its company, Purdue Pharma, are not at all to blame for the opioid epidemic, and he reportedly got upset at suggestions that they’re culpable.
In the interview, Sackler told a story of his 4-year-old coming home and asking, “Why are my friends telling me that our family’s work is killing people?”
It sounds sad for a child who genuinely has nothing to do with the opioid crisis, but it’s apparently especially sad to Sackler because, in his view, his whole family had nothing to do with the epidemic. “Facts will show we didn’t cause the crisis,” he claimed, “but we want to help.”
This defies the widely accepted understanding of the opioid epidemic. In the 1990s, Purdue unveiled and heavily marketed OxyContin as a new, safe, effective kind of opioid. The company encouraged doctors, with a variety of marketing schemes, to prescribe far more of the drugs, with the promise that misuse, addiction, and overdose would be rare.
During this time, Sackler’s father, Richard, had a major marketing role in the company. David Sackler himself later served on Purdue’s board of directors from 2012 to 2018, after working for the company for a couple summers but otherwise working at different places and a family investment firm.
OxyContin uses an extended-release formula that releases a lot of the drug over time instead of all at once — which Purdue, with the approval of the Food and Drug Administration (FDA), argued made it less prone to misuse. In reality, it was more prone to misuse; the extended-release formula let Purdue include more opioids in each pill, and people found they could bypass the extended-release formula and absorb the opioids all at once by crushing and snorting or injecting the pills.
The result was the beginning of today’s opioid epidemic. Prescriptions skyrocketed, and the US continues leading the world — by far — in opioid prescriptions to this day. Between 1999 and 2017, nearly 200,000 overdose deaths were linked to painkillers, excluding synthetic opioids like fentanyl. Hundreds of thousands more have been linked to heroin, fentanyl, and other opioids. Much of that can be connected back to OxyContin and other legal opioid painkillers, with people who use even illicit opioids like heroin often tracing their initial opioid use — the thing that got them hooked — to the painkillers and, yes, Purdue and the Sacklers.
Sackler gave several reasons for why the opioid crisis is not his family’s fault
Sackler told Vanity Fair that it’s not his family’s or Purdue’s fault that things worked out this way. In his telling, Purdue was working with the best science it had at the time, even if that science turned out to be wrong.
For instance, Purdue relied on a five-sentence letter published in The New England Journal of Medicine in 1980 that seemed to suggest less than 1 percent of people who use opioids in a medical setting become addicted. Purdue interpreted that letter to claim that less than 1 percent of people who use OxyContin would become addicted.
In reality, the letter wasn’t intended to support such sweeping claims. And the letter’s author later told the Associated Press that he was “mortified that that letter to the editor was used as an excuse to do what these drug companies did.”
It doesn’t take an expert to devise that a five-sentence letter to the editor is not solid ground for sweeping claims about science or medicine. And while Sackler argued evidence other than the letter supported Purdue’s claims at the time, Vanity Fair noted that many of the other materials he pointed to are “sourced to the original letter from The New England Journal of Medicine.”
Beyond that, though, the fact of the matter is the addictive and otherwise dangerous traits of opioids have been well known for a long, long time. In fact, opioid epidemics caused by widespread medical use aren’t even new to the US — with a previous opioid crisis taking off after the Civil War when soldiers became addicted to morphine given to them to relieve pain from battlefield wounds. America had personally known about these risks for well over a century before OxyContin arrived.
Yet Sackler continues to insist that OxyContin isn’t that addictive, telling Vanity Fair that addiction rates are “between 2 and 3 percent” and only rise to nearly 5 percent when including more typical dependence and misuse. In reality, reviews of the research have estimated addiction rates at 8 percent and misuse rates as high as 26 percent.
Sackler also argued that OxyContin couldn’t be to blame for the opioid crisis, because it only makes up a small share of the opioid market — never more than 4 percent of opioid prescriptions. But as Andrew Kolodny, an opioid policy expert at Brandeis University, told Vanity Fair, this gravely misunderstands Purdue’s role: Since OxyContin is one of the more potent opioids, it was disproportionately prone to misuse and addiction. So it may make up only 4 percent, at most, of the prescription share, but it’s involved in a much higher percentage of all misuse and addiction cases.
Purdue also had a significant role beyond OxyContin. By marketing its new opioid as safe and effective, Purdue helped foster an environment in which opioids in general — not just OxyContin — were far more loosely prescribed. As Kolodny and other experts explained in the Annual Review of Public Health, Purdue’s advocacy through “education” campaigns and astroturfs was about how opioids in general are safe and effective — even helping spread the term “opiophobia,” which suggested that doctors were irrationally scared of prescribing opioids.
Sackler’s last point is that the real fault behind the opioid crisis falls on government agencies, like the FDA, that let opioids run amok: “You say, ‘Okay, first of all, it was known that those patients were going to exist.’ And the FDA approved this medication with that balance in mind. So like any medication that has unintended side effects, you knew that this was one. It was approved as one. Doctors understood it, right?
There is some truth to this. As I’ve explained before, regulatory agencies could have done far more to prevent the opioid crisis. The FDA itself agrees, telling Vanity Fair that “the scope of the epidemic reflects many past mistakes and many parties who missed opportunities to stem the crisis, including the FDA.”
But the company who sold one of the most misused drugs surely bears more responsibility than the regulators who failed to stop it.
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