opioid crisis
October 5, 2019

It's becoming a little clearer just how much cash the Sackler family raked in from their ownership of Purdue Pharma, the pharmaceutical giant known for making OxyContin and allegedly playing a major role in the opioid epidemic plaguing the United States.

Bankruptcy court filings revealed that Purdue reportedly sent $12 billion or $13 billion in profits to the Sacklers, The Wall Street Journal reports, though it's not clear what years the distribution covered.

The figure is relevant as some states, cities, and tribes are looking to settle lawsuits with Purdue, which has been accused of fueling the opioid crisis through its marketing of OxyContin, while others argue the Sacklers should contribute more than they have agreed to so far. Purdue and the Sacklers deny the allegations about their role in the crisis, but they tentatively struck a deal with some states and local governments, in which the Sacklers would contribute $3 billion toward a potentially $12 billion total settlement.

The recent revelations are likely to "bolster resistance" to the settlement, however, the Journal reports. "The Sackler family is trying to take advantage of the fact that they've extracted nearly all the money out of Purdue and pushed the carcass of the company into bankruptcy," North Carolina Attorney General Josh Stein said Friday. "That's unacceptable." Read more at The Wall Street Journal. Tim O'Donnell

September 16, 2019

Purdue Pharma, the drugmaker accused of playing a major role in the opioid epidemic, filed for Chapter 11 bankruptcy protection in New York on Sunday. The move was expected after the company and its owners, the Sackler family, reached a tentative settlement with 24 states and thousands of local governments last week. Under the settlement, the Sacklers would wash their hands of Purdue, putting up $3 billion of the family's estimated $13 billion fortune and turning Purdue into a trust, with profits from OxyContin and other drugs going to the plaintiffs.

This isn't the end of the road for Purdue yet, though, as The Associated Press explains.

The thousands of plaintiffs who have not yet signed on to the settlement, including about half of U.S. states, will likely object to the settlement in bankruptcy court, and there are open questions about whether the proposed settlement is really worth $12 billion and how the money would be distributed. Purdue and the lawyers representing the parties that agreed to the settlement argue that nobody is served by long, costly litigation.

Recent court filings suggest much of the Sackler wealth has been stashed offshore since 2008, making it likely out of reach of U.S. plaintiffs, especially if the company dissolves without admitting wrongdoing or being found guilty in court. "The Sacklers are going to be left with plenty of money after this,'' Adam J. Levitin, a bankruptcy expert at Georgetown Law, tells The Washington Post. "There is a desire that the Sacklers pay some blood money, but it's never going to be enough to make everyone happy.''

OxyContin accounts for only a slice of the opioid drugs sold in the U.S., but Purdue's aggressive and misleading marketing is blamed for helping spark the opioid addiction crisis. Since 1999, more than 200,000 people have died from overdoses of prescription opioids. Peter Weber

September 14, 2019

The New York attorney general's office in a court filing Friday said it uncovered about $1 billion in wire transfers by the Sackler family, the owners of pharmaceutical giant Purdue Pharma.

The discovery comes after thousands of municipal governments and 23 states tentatively reached a settlement with the Sacklers and Purdue, which manufactures OxyContin, over the company's alleged role in the opioid crisis plaguing the United States. The transfers have raised speculation that the Sacklers could have been trying to hide assets while facing litigation.

The attorney general's office only presented initial findings, and its major discovery was from 2009, long before the lawsuits began. But the filing said they identified "previously unknown shell companies" that Mortimer Sackler used to move Purdue money through international accounts before concealing it in real estate investments. A spokesman for Mortimer Sackler said there was nothing "newsworthy" about the "decade-old" transfers.

While it would reportedly be difficult to unveil the family's true international wealth, some legal experts do think the findings could spell bad news for the Sacklers. "The bigger question is how this is going to affect what many cities have already agreed to," Adam Zimmerman, an expert in complex litigation at Loyola Law School, Los Angeles, said, referring to the tentative settlement. "We might see, with these allegations, more state [attorneys general] saying they are opposed to it, and maybe even some cities."

Elizabeth Burch, a professor at the University of Georgia Law School, told The New York Times the findings should give those states objecting to the settlement "more wiggle room" to argue for more disclosure, which "could lead to criminal exposure for the Sacklers." Read more at The New York Times and NBC News. Tim O'Donnell

September 11, 2019

Members of the Sackler family, who own Purdue Pharma, have reportedly tentatively reached a settlement with lawyers representing thousands of local governments, states, and tribes across the United States in lawsuits over the drug manufacturer's alleged role in creating the country's opioid crisis. The deal is similar to one the company proposed in August and will eventually result in Purdue, which is expected to soon file for bankruptcy, paying up to $12 billion.

Two people involved in the negotiations told The New York Times that the settlement requires Purdue's dissolution as a company and the formation of a new company that the Sacklers will not control, but that will continue to sell OxyContin — Purdue's signature opioid. The proceeds, however, will reportedly go to a public beneficiary company that will pay the plaintiffs. Purdue will also reportedly donate "rescue" drugs for addiction treatment and overdose reversal. The settlement reportedly does not include a statement of wrongdoing from Purdue or the Sackler family.

If formalized, the agreement would reportedly end most cases against Purdue, but some states' attorneys general will reportedly continue to pursue the Sacklers independently. Read more at The New York Times. Tim O'Donnell

August 21, 2019

The heads of the National Institute of Drug Abuse (NIDA) and National Institutes of Health (NIH) correctly identified the nascent opioid abuse epidemic in March 2006 and nearly convinced then-Surgeon General Richard Carmona to issue an official call to action, the most potent tool the surgeon general has to alert the public, Politico reported Wednesday. But for reasons that aren't fully clear, "the effort didn't lead to any real action, and the toll of death and addiction climbed."

"Why it then didn’t happen is still a mystery to me," Geoffrey Laredo, a former senior NIDA adviser who worked closely on the call to action, tells Politico. "We were facing what we believed was a public health crisis that needed to be addressed and we had what we thought was an agreement with the surgeon general to do a thing. We produced that thing ... and then it never saw the light of day."

Carmona told Politico he held a number of meetings about the call to action with Health and Human Services Department officials and the George W. Bush White House Domestic Policy Council, but his office was dealing with other big crises, like obesity and bioterrorism. "The [opioid] crisis was in its infancy," he said. "It wasn't like we dropped the ball." His term ended a few months after NIDA Director Nora Volkow pressed him for urgent action, and when an acting surgeon general took over, "what little momentum had built for a public warning evaporated," Politico says.

"Had the call to action succeeded it would have been the first major attempt by the federal government to counteract the aggressive marketing of pharmaceutical companies that had led doctors to liberally — too liberally, in retrospect — prescribe the painkillers," Politico reports. Instead, "more than 133,000 people have died from prescription opioids since then — and hundreds of thousands more from street drugs including heroin and illicit fentanyl." Read more about the failed warnings at Politico. Peter Weber

June 26, 2019

For the first time in three decades, deaths from drug overdose look like they're going to fall instead of rise.

Back in 1990, drug overdoses claimed 8,400 lives in the U.S.; and for every year afterward, the number of deaths has risen, especially in recent years, as the epidemic of opioid addiction takes a heavy toll on parts of the country. While the official total for overdose deaths in 2018 hasn't been confirmed yet, provisional data from the Centers of Disease Control and Prevention suggests that we might finally be in for a change. The CDC's data from Nov. 2017 to Nov. 2018 counted about 69,100 deaths from drug overdose, compared to 72,300 from Nov. 2016 to Nov. 2017.

But this isn't a sign that the worst is over, The Wall Street Journal explained. While health officials are eager to see any evidence that progress is being made in the fight against overdose deaths, "we shouldn't say oh, we've won," said Robert Anderson, a CDC official.

"The opioid crisis is in early remission, yet at high risk of relapse," said Jim Hall, an epidemiologist at Nova Southeastern University in Florida. But even if this doesn't mean we're out of the worst of the opioid epidemic, these numbers could be a sign that some of our methods for combating overdose deaths are working. In large part, broadened access to naloxone, a drug that can reverse the worse effects of overdose, has been shown to save lives that would otherwise be lost to drug overdose.

The picture is still bleak — overdose deaths are still much higher than "in the peak of the crack-cocaine crisis decades ago," The Wall Street Journal reports. But it's possible that our current methods will help to turn the tide. Shivani Ishwar

June 5, 2019

Researchers have discovered a troubling trend while looking into why so many addicts go without treatment in America.

As part of a study that covered the areas of the U.S. with the highest rates of overdose-related deaths, scientists discovered that about 40 percent of providers were unable or unwilling to provide an appointment to seek treatment. Even more concerning, the number of denied appointments was higher for people who were on Medicaid, which applies to "nearly 4 in 10" adults with an opioid addiction in the U.S., The Associated Press reported.

To conduct their research, two callers posed as adult heroin users, calling over 500 clinics in Maryland, Massachusetts, New Hampshire, Ohio, West Virginia, and the District of Columbia. The study, published on Monday in the Annals of Internal Medicine, paints a dire picture for opioid addicts who are trying to get help.

As for the difference between being uninsured and relying on Medicaid, while 38 percent of the calls were denied for people paying in cash, 46 percent were denied for Medicaid patients. It may be that "doctors have room in their schedules, but are shunning Medicaid because it pays less than other insurance," AP explained.

"I found it surprising how many calls I had to make before being offered an appointment," said Tamara Beetham, one of the researchers who conducted the calls. The number of calls and the frequency of being turned away can be a deterrent to people seeking addiction treatment, which makes this study a troubling revelation for people struggling with addiction across the country. Read more at The Associated Press. Shivani Ishwar

May 29, 2019

The marketing tactics that allegedly helped spur the current opioid crisis in the United States also played a role in at least one foreign market, a report from The Associated Press reveals.

Hundreds of pages of investigative files reviewed by AP show that a well-known Italian doctor, Guido Fanelli, was receiving "kickbacks" from pharmaceutical executives as incentive to increase sales of opioid painkillers in Italy. The executives include managers of Mundipharma, the international wing of Purdue Pharma, the American pharmaceutical giant which is facing more than 2,000 lawsuits stateside because of its role in the opioid crisis. Two Mundipharma managers reportedly accepted plea bargains in January after allegations that they paid Fanelli to push drug sales, though they did not admit guilt.

AP reports this is the first known instance outside the U.S. in which employees of the Sackler family-owned pharmaceutical empire have been implicated in criminal activity. It is worth noting, however, that while Mundipharma and Purdue are both owned by a share of trusts that benefit the Sacklers, a spokesman for Mundipharma's European branch said the two companies have different managers and portfolios and do not share strategies.

That said, the way opioids were sold in Italy mirror the tactics used in the United States in the eyes of some observers. "They're using the same playbook that worked in the United States, despite knowing that it led to a public health catastrophe" Andrew Kolodny, the executive director of Physicians for Responsible Opioid Prescribing, told AP. Read more at The Associated Press. Tim O'Donnell

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