Opioid Litigation Media Report 10/24/17

Fulton County

1. Fulton County files suit against opioid manufacturers, distributors

   Oct 23, 2017 | Atlanta Journal-Constitution

   By Arielle Kass
   
   
   Fulton officials on Monday filed suit against more than two dozen drug manufacturers, distributors and doctors, accusing them of causing an ongoing opioid crisis that has killed hundreds of people in that county alone.
2. Fulton County filing lawsuit against companies that make, distribute opioids

   Oct 23, 2017 | Fox 5 Atlanta (GA)

   Georgia's largest county is filing a lawsuit against companies that make and distribute opioids.
3. Fulton County suing opioid companies over drug abuse epidemic (VIDEO)

   Oct 23, 2017 | 11 Alive.com NBC (GA)

   By Deborah Tuff, Kristen Reed
   
   
   They are household names like hydrocodone, methadone and oxycodone and are accounting for a quadruple in deaths since 1997.
4. Fulton County To Sue Drug Companies Over Opioid Distribution

   Oct 23, 2017 | WABE.org (GA)

   By Susanna Capelouto
   
   
   Fulton announced it will be the first Georgia county to file a lawsuit against companies that make and distribute opioids. Officials say the drugs have been responsible for the addiction and death of hundreds of citizens and takes up millions of public dollars and resources.

Other Litigation Coverage

5. Sheboygan County may go after pharmaceutical companies in opioid lawsuit

   Oct 23, 2017 | Sheboygan Press (USA Today Network - Wisconsin)

   By McLean Bennett
   
   
   A burgeoning drug epidemic is costing local government agencies “millions” of dollars, according to Sheboygan County estimates. Now, in an effort to recoup some of those costs, county leaders are mulling whether to press for a lawsuit against pharmaceutical companies they believe helped cause the problem.
6. St. Lawrence County Joins Lawsuit Against Opioid Drug Companies (VIDEO)

   Oct 24, 2017 | WWNY (NY)

   St. Lawrence County will join a class-action lawsuit that targets drug companies making prescription opioids, pills that fuel a drug epidemic across the country.
7. St. Lawrence County legislators vote 10-3 to join class action lawsuit against drug companies

   Oct 24, 2017 | Watertown Daily Times (PA)

   By Susan Mende
   
   
   Over the objections of three legislators, St. Lawrence County lawmakers voted 10-3 Monday night in favor of joining a class-action lawsuit against the major manufacturers of opioid drugs.
8. County intends to sue pharmaceutical companies

   Oct 24, 2017 | Superior Telegram (WI)

   By Shelley Nelson
   
   
   Douglas County is among a growing number of Wisconsin counties taking on pharmaceutical companies over the opioid epidemic.
9. Saratoga County to sue drug companies over opioids

   Oct 23, 2017 | Daily Gazette (NY)

   By Kassie Parisi
   
   
   In an effort to curb the opioid crisis in local municipalities, the county will pursue a lawsuit “against companies and potentially physicians responsible for careless practices related to the manufacturing, distribution and prescriptions of opioid pharmaceuticals.”
10. Jacksonville City Council to vote on suing makers, distributors of prescription painkillers (VIDEO)

    Oct 24, 2017 | Firstcoast News (FL)

    By Christopher Long
    
    
    The City Council plans to vote on legislation Tuesday to direct city attorneys to find an outside law firm to sue several companies that manufacture and distribute prescription painkillers.
11. Law firm asks if EP County is interested in joining litigation against opioid manufacturers

    Oct 23, 2017 | KVIA (TX)

    By Mauricio Casillas
    
    
    El Paso Commissioners Court is discussing whether to join a lawsuit against several pharmaceutical companies over opioid addiction costs.

Other Coverage

12. White House to host opioid 'event' Thursday

    Oct 23, 2017 | The Hill

    By Rachel Rouebein
    
    
    The White House will hold an event on the opioid epidemic Thursday afternoon, according to an email obtained by The Hill that suggests President Trump will make his announcement about a national emergency this week.
13. The Family That Built an Empire of Pain

    Oct 23, 2017 | New Yorker

    By Patrick Radden Keefe
    
    
    The north wing of the Metropolitan Museum of Art is a vast, airy enclosure featuring a banked wall of glass and the Temple of Dendur, a sandstone monument that was constructed beside the Nile two millennia ago and transported to the Met, brick by brick, as a gift from the Egyptian government. The space, which opened in 1978 and is known as the Sackler Wing, is also itself a monument, to one of America’s great philanthropic dynasties. The Brooklyn-born brothers Arthur, Mortimer, and Raymond Sackler, all physicians, donated lavishly during their lifetimes to an astounding range of institutions, many of which today bear the family name: the Sackler Gallery, in Washington; the Sackler Museum, at Harvard; the Sackler Center for Arts Education, at the Guggenheim; the Sackler Wing at the Louvre; and Sackler institutes and facilities at Columbia, Oxford, and a dozen other universities. The Sacklers have endowed professorships and underwritten medical research. The art scholar Thomas Lawton once likened the eldest brother, Arthur, to “a modern Medici.” Before Arthur’s death, in 1987, he advised his children, “Leave the world a better place than when you entered it.”
14. FDA chief supports opioid prescription limits, regrets agency's prior inaction

    Oct 23, 2017 | USA Today

    By Jayne O'Donnell
    
    
    The Food and Drug Administration's new chief says he doesn't want to repeat the mistakes made when he was at the agency in the 2000s and the government failed to regulate opioids more.
15. Another View: Drug companies did not have best interest in mind (OPINION)

    Oct 23, 2017 | Delco Daily Times (DE)

    By Tricia Soutch
    
    
    CBS aired a very important “60 Minutes Whistleblower” on Sunday, Oct. 15. Joe Rannazzisi, who ran the Drug Enforcement Agency’s (DEA) Diversion Control that investigates the pharmaceutical industry had a very important message we all needed to hear. Did you see it? Maybe not as it ran during Sunday night football.

Broadcast Media Coverage

16. Good Morning El Paso

    Oct 24, 2017 | KVIA ABC El Paso, TX

    View clip here: https://app.criticalmention.com/app/#clip/view/30236349?token=2a2ea22f-adc5-48f8-9fb7-9b50dc18a4ea

Fulton County

1. Fulton County files suit against opioid manufacturers, distributors

   Oct 23, 2017 | Atlanta Journal-Constitution

   By Arielle Kass

   Fulton officials on Monday filed suit against more than two dozen drug manufacturers, distributors and doctors, accusing them of causing an ongoing opioid crisis that has killed hundreds of people in that county alone.

   It’s the first such lawsuit in Georgia, though more than 100 others have been filed by cities, counties and state governments nationwide. The United States is in the grip of what the federal government described as an epidemic, with 91 Americans dying every day from an opioid overdose in 2015, according to the Centers for Disease Control and Prevention.

   Fulton County has had more opioid deaths than any other county in the state. So far this year, 61 people have died. There were 154 deaths last year, and 104 in 2015. District Attorney Paul Howard said Narcan, a drug that can reverse the effects of an overdose, has been administered 340 times in the last 12 months.

   Paul Napoli, an attorney representing the county, said the suit took on manufacturers, distributors and doctors so no one could pass the blame. The breadth of the suit, he said, gives the county a better chance of success.

   “It’s like whack-a-mole,” he said. “You really have to hit it at all angles.”

   The lawsuit is reminiscent of the tack local governments took against tobacco companies. The county accuses the drug manufacturers, distributors and others of being a public nuisance, as in the tobacco cases. The suit also accused them of fraud for marketing opioids as solutions to chronic pain, and of negligence in not reporting suspicious orders. Since 2007, no distributor refused to ship opioids to any Fulton County pharmacy, even as there was “an alarming and suspicious rise in the ordering of opioid pain medications by retailers throughout Fulton County.”

   Dick Anderson, the Fulton County manager, said the suit would help with the “mounting pressure” needed to get drug companies to curtail their practices. If the county does get money from the case, it can use it to help residents through recovery, he said.

   “We want to be responsive to this,” Anderson said.

   Napoli Shkolnik, the New York firm representing Fulton, has filed suits in 40 other cities and counties, and is working on other suits in metro Atlanta.

   The lawsuit does not specify a dollar amount, but asks that Fulton County be reimbursed for expenses related to the crisis. The county asserts that it “has been forced to expend exorbitant amounts of money” because of corporate greed.

   “Fulton County has experienced economic costs directly related to the opioid epidemic, including Medicaid costs, law enforcement, judicial, foster care, Narcan costs, loss of productivity and various other costs directly caused by the actions of the defendants,” the suit said. The county has spent “millions of dollars each year in its efforts to combat the public nuisance created by Defendants’ deceptive marketing campaign.”

   Napoli said the CDC estimated opioids cost Georgia $450 million in 2007. Since then, that number has only grown.

   “The only way you can affect change is their wallet,” said Shayna Sacks, an attorney with Napoli Shkolnik.

   The county will not spend any money on the case. Bob Ellis, the vice chairman of the county commission, said he thinks the county’s case is strong and it is time industry officials are “held accountable for their actions.”

   “I don’t think we’re going to lose this lawsuit,” he said.

   Ellis and County Commissioner Liz Hausmann said the lawsuit is necessary in order for something to change.

   “We want people to stop dying,” Hausmann said.

   There are 31 parties named in the suit, including drug manufacturers like Purdue, which makes OxyContin, and distributors like McKesson. When parent companies and subsidiaries are taken into account, the county has effectively sued 20 different groups it says are responsible for creating the opioid crisis.

   The drug manufacturers, distributors and others knew that opioids were addictive and subject to abuse, especially when prescribed for chronic pain, but set out to convince doctors they were not, and to encourage an increase in prescriptions, the suit said.

   In 2012, the suit said, the drugs generated $8 billion in revenue as health care workers wrote 259 million prescriptions for opioid painkillers.

   Roderick Edmond, a doctor and an attorney on the case, said people who received painkiller prescriptions after getting their wisdom teeth pulled were ending up shooting heroin in the Bluff, a notorious area where residents often go for drugs.

   “We’re at a tipping point with this epidemic,” Ellis said, saying police, jails, morgues and medical examiners’ offices have been taxed nationwide.

   Filing in Fulton County State Court, Napoli and Edmond said, will allow them to have locally elected judges and jurors who live in the area decide the case. Edmond said the process would take years.

   “We don’t control when they say uncle, but we’re in it 100 percent to the end,” he said.

   Fulton County has sued a number of companies and individuals they say are responsible for creating the opioid crisis. They are:

   Purdue Pharma

   Teva Pharmaceuticals

   Cephalon

   Johnson & Johnson

   Janssen Pharmaceuticals

   Endo Pharmaceuticals

   Allergan

   Actavis

   Watson Laboratories

   Insys Therapeutics

   McKesson Corporation

   Cardinal Health

   AmerisourceBergen Corporation

   Russell Portenoy

   Perry Fine

   Scott Fishman

   Lynn Webster

   Medicine Center Pharmacy

   Amrac Medical Clinic

   J.M. Smith Corporation

   Vaxserve

   PSS World Medical

   Attain Med

   Bloodworth Wholesale Drugs

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2. Fulton County filing lawsuit against companies that make, distribute opioids

   Oct 23, 2017 | Fox 5 Atlanta (GA)

   Georgia's largest county is filing a lawsuit against companies that make and distribute opioids.

   The Vice Chairman of the Fulton County Commission announced a lawsuit against more than a dozen manufacturers as well as scores of distributors.

   Fulton County's death rate from opioid abuse is twice the national average. More than 150 opioid-related deaths took place in Fulton County last year alone.

   In fact, from 2008 to 2014, Georgia led the nation for the number of patient encounters related to opioids, according to a healthcare consulting firm.

   Health experts believe along with northern states, the Southeast has the highest opioid use in the United States.

   Fulton county wants to hold drug companies responsible for costs to the government associated with public funded treatments for problems associated with opioids.

   Commissioner Bob Ellis said millions in costs are being incurred annually due to the overuse of opioids. Where the county sees mounting expenses includes emergency room visits, rehabilitation services and even the expenditure of portable detox equipment issued to first responders in the event they are called to an overdose situation.

   Fulton is the first county in the state to take this step toward legal action.

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3. Fulton County suing opioid companies over drug abuse epidemic (VIDEO)

   Oct 23, 2017 | 11 Alive.com NBC (GA)

   By Deborah Tuff, Kristen Reed

   They are household names like hydrocodone, methadone and oxycodone and are accounting for a quadruple in deaths since 1997.

   The data is out there – and it’s not pretty, 91 people die every day from opioids. Opioids' stronghold on two million Americans seems to be getting stronger. Abuse claims continue to skyrocket, along with the death tolls. That’s all according to the CDC.

   Fulton County has had its fair share of frustrations over the drugs and now plans to tackle it head-on. Now, the county is planning to sue the pharmaceutical companies behind the drugs claiming they are complicit in a rising epidemic - the first county to do so.

   President Donald Trump commented on the national epidemic in August saying, "We're going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis."

   In October, he took that comment a step further saying he would declare a national emergency.

   Locally, Fulton County is making their move with the lawsuit as the abuse crisis reaches a fever-pitch. 11Alive investigators have been bringing stories about how opioids are impacting the lives of people in Georgia. In 2016, the Atticus investigation team identified an area now called The Triangle where a high number of opioid-related deaths are concentrated. Now, that triangle has expanded.

   Statistics from 2015 showed that 60 percent of all overdose deaths were from opiates and that 199 accidental deaths in the county involved their use.

   Those are alarming numbers only made more concerning when combined with the fact that hospitalizations related to opioid use and dependence in Georgia skyrocketed from 302 in 2002 to over half a million (520,000) in 2012.

   A statewide task force was formed in September to fight what Georgia leaders called an epidemic. In the past 6 years, the number of heroin-related deaths has gone up by 3,844 percent in Fulton, DeKalb, Cobb, and Gwinnett counties alone.

   These dangerous drugs have also become the leading cause of death for Americans under the age of 50 according to the Centers for Disease Control and Prevention.

   In September, the Atticus team showed how one pill can lead to heroin addiction. In fact, that pill can be found in anyone's medicine cabinet.

   Statistics show nationwide that every 3 months the number of people dying equals the number of lives lost during the Sept. 11, 2001, terror attacks. But voices online are arguing that users who abuse the pills are in the wrong and it's about personal responsibility to prevent deaths, not on pharmaceutical companies.

   11Alive's Ryan Kruger spoke to one former addict who was in the same position of abusing opiates, but was able to turn her life around to help others with addiction.

   Lindsey Sizemore, now a counselor, said her addiction to opioids came on fast and strong. Within months, she said she found corrupt doctors to write phony prescriptions.

   "The pharmaceutical companies have spent many years pushing these pills far and wide," Sizemore said. "they have misrepresented the fact that these are very addictive. They have withheld harmful information."

   Sizemore argues that if pharmaceutical companies are held partially responsible for the current situation, "Why not have then play a helping role in getting people the treatment that they need?"

   Despite the large numbers, Fulton County says the lawsuit is one small step to tackle this critical issue.

   View clip here: http://www.11alive.com/article/news/fulton-county-suing-opioid-companies-over-drug-abuse-epidemic/485373965

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4. Fulton County To Sue Drug Companies Over Opioid Distribution

   Oct 23, 2017 | WABE.org (GA)

   By Susanna Capelouto

   Fulton announced it will be the first Georgia county to file a lawsuit against companies that make and distribute opioids.

   Officials say the drugs have been responsible for the addiction and death of hundreds of citizens and takes up millions of public dollars and resources.

   Counties in at least five other states have filed similar lawsuits against drug companies.

   A recent investigation by “60 Minutes” and the Washington Post showed how Congress had passed a law that limited the powers of the Drug Enforcement Agency in 2016 to go after pharmacies suspected of moving large amounts of opioids illegally.

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Other Litigation Coverage

5. Sheboygan County may go after pharmaceutical companies in opioid lawsuit

   Oct 23, 2017 | Sheboygan Press (USA Today Network - Wisconsin)

   By McLean Bennett

   A burgeoning drug epidemic is costing local government agencies “millions” of dollars, according to Sheboygan County estimates. Now, in an effort to recoup some of those costs, county leaders are mulling whether to press for a lawsuit against pharmaceutical companies they believe helped cause the problem.

   The county board could agree Oct. 24 to team up with several law firms in pursuing a potential suit targeting multiple national drug manufacturers. The move would put Sheboygan County alongside other counties around the state also considering similar legal action. Several counties in central Wisconsin have already OK'd the move.

   “If you look at just Sheboygan County alone, our health and human services department has spent upwards of $1 million or more … addressing individuals who are suffering from this substance abuse,” Sheboygan County Administrator Adam Payne said Monday. Other county departments, including the sheriff’s office, district attorney and medical examiner, he said, have also seen their budgets grow.

   The Wisconsin Counties Association is pushing for local governments around the state to join the pending lawsuit against drug makers “whose marketing practices may be responsible for much of the” opioid epidemic, county board chairman Tom Wegner wrote in a recent letter to other board members urging them to get behind the litigation attempt.

   “We hope this effort will help stop this improper activity and allow us to potentially recoup some of the expenses incurred in response to this crisis,” Wegner added in his letter, which notes the county has spent "millions" of dollars in response to local opioid drug-related issues.

   The National Institute on Drug Abuse lists opioids among a family of drugs that includes both prescription painkillers and heroin. Painkillers "are generally safe" when prescribed by a doctor and taken for a short period of time, the drug institute says on its website, but they can also lead to dependence and overdoses.

   Governments around the nation have been increasingly grappling with opioid abuse for the past several years, and Payne said the issue has dominated conversations he's had with other county leaders around the U.S.

   Sheboygan County's resolution would allow it to engage with several law firms already working with other counties across the state to investigate and possibly prosecute claims against drug manufacturers.

   Payne on Monday said he suspects more counties will eventually join the initiative, which first gained statewide attention about a month ago during the Wisconsin Counties Association's annual conference.

   According to a handout document available on the counties association's website, other states and counties are also considering lawsuits against major pharmaceutical companies to hold them "financially responsible" for opioid-related problems and to push them to change their drug marketing tactics.

   It wasn't clear Monday when a potential lawsuit might be filed. Payne said a suit could examine whether companies withheld information about their drugs.

   “I think that’s the type of approach that’s in play here, that they’re going to be really drilling into and evaluating these companies that have been selling these drugs and how they’ve been marketing them,” Payne said. “And had they been holding, withholding, any information, that as a result of withholding it people perhaps were taking more drugs or utilizing opioids more than what was in their best interest. And if anything like that comes out, that will be strong grounds for the lawsuit to be successful.”

   Litigation-related costs to Sheboygan County, including attorneys’ fees, would depend on the outcome of a potential lawsuit, according to a document included in the county board’s meeting agenda and that lays out terms of the agreement with the law firms.

   “Costs incurred during this litigation are contingent to a successful outcome to the lawsuit and are limited only to the sum of the settlement that would be received by the County,” says a fiscal note attached to the county's resolution authorizing the legal move.

   “At this point we see it as no cost to the county,” Wegner told a reporter Monday morning.

   "Every county is dealing with this crisis," Payne said. "It's growing in significance, and it's requiring a lot of taxpayer resources to try to address the problem."

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6. St. Lawrence County Joins Lawsuit Against Opioid Drug Companies (VIDEO)

   Oct 24, 2017 | WWNY (NY)

   St. Lawrence County will join a class-action lawsuit that targets drug companies making prescription opioids, pills that fuel a drug epidemic across the country. 

   “To recover some of the past costs that the counties have endured as of a result of having to provide treatment,” said county attorney Stephen Button.

   And what's to come in the future for treating those addicted to opioids like Oxycontin, fentanyl, and other prescription drugs.

   That's the idea behind the lawsuit county lawmakers voted to join Monday night.

   “It's an opportunity to get back some of that money," Legislator Joseph Lightfoot said. "It's an opportunity to use some of that money to provide additional treatment going down the road for these same people.”

   According to county documents, there were at least 31 deaths between 2010 and 2014 related to opioids, but there's no way to tell how many were because of heroin.

   Button says St. Lawrence is one of around 15 counties that have joined up with law firm Simmons, Hanly, and Conroy to sue the companies that make the drugs.

   Button says the law firm has had similar success before..

   “As we represent the people of St. Lawrence County, it is natural that this entity, St. Lawrence County government, would be the one to bring the suit on behalf of the harm that is alleged to have been suffered by our own citizenry," Button said.

   Three lawmakers voted against taking on the lawsuit. One thought was the problem comes down to personal responsibility, also that the money won from the drug companies would eventually come from the taxpayers pockets..

   SOT- Kevin Acres, R – District 8 legislator - :15 “It will show up in our health care costs," Legislator Kevin Acres said, "whether it's doctor liability, insurance liability, lack of innovation in drugs, or even delay in actually doing the research to produce new drugs.”

   The law firm handling the case says it won't cost the county anything to join in on the lawsuit unless they win the case.

   Even though lawmakers voted yes to join the lawsuit, this was a technically committee meeting, so they'll have to vote one more time at their next scheduled full board meeting. 

   View clip here: http://www.wwnytv.com/story/36666335/st-lawrence-county-joins-lawsuit-against-opioid-drug-companies

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7. St. Lawrence County legislators vote 10-3 to join class action lawsuit against drug companies

   Oct 24, 2017 | Watertown Daily Times (PA)

   By Susan Mende

   Over the objections of three legislators, St. Lawrence County lawmakers voted 10-3 Monday night in favor of joining a class-action lawsuit against the major manufacturers of opioid drugs.

   Lawmakers spent about 30 minutes during their Services Committee meeting debating whether to sign a contract with the law firm Simmons, Hanly, Conroy P.C. The board will have a final vote at the Nov. 6 full board meeting.

   The firm won’t charge the county any money unless the lawsuit results in a financial settlement from the companies.

   “I don’t want to be any part of this,” said Legislature Chairman Kevin D. Acres, R-Madrid. “The fact that we’re signing on, just because it’s free, I find absurd.”

   Joining Mr. Acres in voting no were Legislators Joe A. Timmerman, R-Potsdam, and Chad E. Colbert, R-Potsdam.

   Mr. Acres argued that class-action lawsuits have already increased the cost of medical malpractice insurance and health care expenses by 10 percent. He said another result is less funding for medical research to develop new drugs.

   “The drugs are all legal and regulated by the federal government,” Mr. Acres said. “Trying to bring litigation against these companies that are all legal is going to be very difficult.”

   He said he believes the majority of the reported 31 opioid-related deaths in St. Lawrence County between 2010 and 2014 were heroin overdoses, rather than related to opioid prescription use.

   “Here in St. Lawrence County, no one has told me we have an opioid problem. We have a heroin problem,” Mr. Acres said.

   He said he doubted that towns in St. Lawrence County felt strongly enough about the issue to put money toward the lawsuit, but support it because it doesn’t cost anything.

   Larry D. Denesha, R-DeKalb, said he originally opposed joining the class-action lawsuit because he thought the law firm was just looking to make money, but changed his mind after getting feedback from the town boards in his district and from his constituents.

   “The majority are in favor of it. I will be supporting it,” Mr. Denesha said.

   Supporters argued that if the lawsuit is successful the county will essentially be getting reimbursed for expenses related to the opioid epidemic, including hospital care, addiction treatment prosecuting cases, incarceration of defendants and other expenses.

   Legislator John H. Burke, R-Norfolk, said, “Our constituents have had to pay additional funds through Medicaid, through worker’s comp, due to the opioid crises. Should we not try to get some of that money back?”

   He argued that scientific research shows that using the painkiller Oxycontin is a gateway drug into more extensive use of opioids, including heroin and other deadly drugs. He said the drug companies misled physicians about the addictive nature of the opioid pain killers.

   Legislator David W. Forsythe, R-Lisbon, said the county would be “crazy” not to join a class action lawsuit that could bring a financial windfall to the county.

   Legislator Rick Perkins, D-Parishville, said the drug companies need to be held accountable for their role in the opioid epidemic.

   “These companies did things unscrupulously. They did things for the money. They didn’t care about the people,” Mr. Perkins said. “We’ve got to hold these companies accountable. Otherwise they’re going to keep doing it and we’re going to pay the price.”

   But Mr. Timmerman said he was opposed to joining the lawsuit for a “huge” number of reasons.

   “Everybody loves to get in on these lawsuits, especially the attorneys,” he said. “They see the dollar signs.”

   He said there are many addictive drugs and substances on the market that are legal, including nicotine and alcohol.

   “I can’t support something that helps drive up medical costs, and this is a major thing that drives up medical costs.” Mr. Timmerman said. “If we’re not happy with something in this country we sue for it. Drug abuse is a terrible thing. Suing drug manufacturers isn’t going to solve those problems.”

   Also, during the past four years, drug-related hospital stays in St. Lawrence County have risen more than 60 percent, according to state health officials.

   Statewide, statistics from the Centers for Disease Control and Prevention show there were 28,647 opioid overdose deaths nationwide in 2014, which translates into 78 people per day and a 14 percent increase in one year.

   According to the county’s resolution, “The litigation would be premised on a theory that opioid drug manufacturers worked collectively to widely circulate marketing materials declaring opioids safe, despite contrary medical statistics and medical studies, and as such, these manufacturers have played a significant role in the current drug epidemic that is devastating counties across New York state and the rest of the country.”

   Voting for the resolution were Anthony J. Arquiett, D-Helena; Mr. Burke; Henry J. Leader, R-Gouverneur; Mr. Forsythe; Joel L. LaPierre, R-Fowler; Mr. Lightfoot; Mr. Perkins; Daniel G. Fay, D-Canton; Lisa Bell, D-Louisville; and Mr. Denesha. Legislators Donald J. Hooper, R-Ogdensburg, and Gregory M. Paquin, D-Massena, were absent.

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8. County intends to sue pharmaceutical companies

   Oct 24, 2017 | Superior Telegram (WI)

   By Shelley Nelson

   Douglas County is among a growing number of Wisconsin counties taking on pharmaceutical companies over the opioid epidemic.

   The County Board on Thursday night approved signing a letter of engagement with counsel in relation to claims against opioid manufacturers because of the rapid rise in problems stemming from the use, abuse and overuse of opioid medications. The motion was amended to record the decision had the support of the full board.

   The county plans to sign an engagement letter with von Briesen & Roper, s.c. and Crueger Dickinson LLC, together with Simmons Hanly Conroy LLC.

   Societal costs of opioid abuse are about $75 billion annually, according to the Centers for Disease Control and Prevention. Since 1999, the number of overdose deaths has quadrupled.

   The idea was pushed by the Wisconsin Counties Association during a conference in late September, Douglas County Board Chairman Mark Liebaert said. After the conference, county officials asked corporate counselor Carolyn Pierce to take a look at it to determine whether the county should participate, Liebaert said.

   Pierce drafted a list of pros, cons and unknowns the county would face if it proceeds with legal action. She cautiously recommended that it is something the county would have to sign onto if it's going to recover any costs from the lawsuit.

   "A lot of it is unknown at this point," Pierce said. "They can't really tell us how much we're looking at in terms of recovery. We're really at the investigation point where the county is going to have to come up with damages."

   Among the risks is that the lawyers for the pharmaceutical companies could bury the county in paperwork, which would increase staffing costs, Liebaert said.

   "At some point, the sheriff's office, health and human services, or some other agencies, will have to put in a lot of work to prove our claim," Liebaert said.

   Pierce said attorneys involved in the lawsuit would assist with the discovery process. They would be paid on a contingency basis.

   "Whether or not there is going to be a big pot of gold at the end remains to be seen," Pierce said. But, she said, the county has no chance to recover its costs if it doesn't participate.

   Several Wisconsin counties, including Eau Claire, Sauk, Marathon, Columbia and Grant, have already approved joining the lawsuit, according to news reports. The Wisconsin Counties Association hopes 60 to 70 of Wisconsin's 72 counties join in the lawsuit.

   Liebaert likened the potential lawsuit to the one states won against tobacco companies about two decades ago. Then, the settlement received by the state wasn't shared with counties. Wisconsin's share of the settlement was largely used to patch holes in the state budget.

   "This is obviously not a sure thing, but we do have costs from this opioid addiction," Liebaert said.

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9. Saratoga County to sue drug companies over opioids

   Oct 23, 2017 | Daily Gazette (NY)

   By Kassie Parisi

   In an effort to curb the opioid crisis in local municipalities, the county will pursue a lawsuit “against companies and potentially physicians responsible for careless practices related to the manufacturing, distribution and prescriptions of opioid pharmaceuticals.”

   The Saratoga County Board of Supervisors  has authorized plans to pursue a lawsuit that will be filed in state Supreme Court in Suffolk County. Napoli Shkolnik PLLC, a firm headquartered in New York City that deals with pharmaceutical litigation, among other areas, will represent the county.

   The firm has been retained by other municipalities across the country, including Nassau County and Dayton, Ohio, to deal with similar cases.

   Saratoga is not the first county to turn to legal action as a means to keep addictive prescription drugs off the streets. In June, Schenectady County filed a state Supreme Court lawsuit against more than a dozen major pharmacy companies, alleging much of today’s epidemic can be blamed on drug companies’ policies pushing the sale of prescription painkillers. It was estimated that the crisis costs Schenectady County millions of dollars each year.

   The goal of the lawsuits is to recover the massive sums of money that are spent by counties to deal with the opioid crisis, costs which include proper training for police departments and recovery services provided by county health groups.

   Spencer Hellwig, Saratoga County administrator, described opioid addiction as a “public health issue” that has become so large and affected so many county departments that the Board of Supervisors decided to take action.

   The process started, he said, with discussions among the board and first responders, law enforcement officials, mental health officials and other departments to gauge exactly how much is spent dealing with the opioid epidemic locally, and what can be done to get that money back.

   “This is a step in that direction,” Hellwig said.

   Hellwig said that while the county does have a sense of exactly how much goes toward dealing with the opioid crisis in different departments, exact numbers will be included in the lawsuit. The lawsuit will present no cost to taxpayers. Lawyers will only be paid if they win a settlement.

   “It’s substantial enough that we’re taking this action,” Hellwig said. The county will be conducting in-depth audits of different departments, he said, to determine those exact dollar amounts.

   “Like most areas of the state, opioid abuse has become an epidemic in Saratoga County,” said Ed Kinowski, chairman of the Board of Supervisors, in a news release. “The ease of access, and over-prescription of these dangerous drugs, has led to the death of too many of our friends and neighbors. The misrepresentation of the nature of these drugs has led to an alarming rise in addiction and overdoses.”

   The lawsuit will target not only drug manufacturers, but potentially doctors who over-prescribe drugs such as morphine, hydrocodone and oxycodone to deal with pain. Hellwig claimed that drug companies often use reckless, aggressive and deceptive marketing campaigns to push the narcotics.

   Many doctors, he added, prescribe the medication to patients with not enough emphasis on the drugs’ addictive nature, or a failure altogether to give patients information about possible side effects.

   Saratoga County Sheriff Michael Zurlo said that the litigation is a good idea because it sends a message to the pharmaceutical companies that they are where the problem starts.

   “I think it sends a message,” Zurlo said. “It’s a start. Will it go away? I don’t know. But we need to send a message.”

   Zurlo added that his narcotic units are out on the streets constantly dealing with the ramifications of opioid overdoses. While he couldn’t say exactly how much the department commits annually in terms of resources to deal with the opioid epidemic, he said that he expected those numbers to come out with the lawsuit.

   The opioid crisis spans across the nation. Drug overdose deaths in 2016 most likely exceeded 59,000, according to The New York Times, and drug overdoses are now the leading cause of death among Americans younger than 50. Many states, including West Virginia and California, have pursued similar lawsuits against pharmaceutical companies. President Donald Trump has pledged to tackle the epidemic, and said that he is considering declaring the crisis a national emergency next week.

   Smaller efforts are being made to curb opioid addiction too. On Oct. 26, the towns of Halfmoon, Clifton Park, Stillwater, Ballston, Malta and Waterford will host a joint educational forum on understanding heroin and opioid use at Shenendehowa High School at 6 p.m.

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10. Jacksonville City Council to vote on suing makers, distributors of prescription painkillers (VIDEO)

    Oct 24, 2017 | Firstcoast News (FL)

    By Christopher Long

    The City Council plans to vote on legislation Tuesday to direct city attorneys to find an outside law firm to sue several companies that manufacture and distribute prescription painkillers.

    Cities across the country have struggled in recent years to contain opioid overdoses, which health officials say have reached epidemic levels.

    Jacksonville hasn’t been spared from the crisis.

    City officials say they’ve responded to 1,000 more drug overdose calls in 2016 than the previous year and expect to administer three times as much of a drug that reverses opioid overdoses in 2017 compared to 2015.

    The cost of transporting overdose patients is expected to cost the city $4 million this year. The city has also committed $1.5 million to an experimental addiction treatment program.

    Attorneys from a national law firm told council members in August they believe local governments have standing for a lawsuit and were preparing to file a complaint against six drug makers and two distributors. The firm has already been retained by the City of Delray Beach.

    The attorneys didn’t elaborate on specific details of their case but said drug companies fraudulently marketed prescription opioids as a safe treatment for a wide variety of pain conditions and underplayed their highly addictive properties.

    “The saddest part of the whole thing … these people, so many of them who are addicted, it’s a matter of them following doctors’ directions,” said Councilman Bill Gulliford, who proposed the lawsuit. “Here I am, trusting in both the company and medical professionals, and low and behold before you know it, I’m addicted to an opioid.”

    Instead of the city filing the lawsuit itself, city attorneys will search for an outside law firm to file a complaint on its behalf.

    The city will choose the firm based on several criteria, which includes the willingness to not charge the city any money upfront and receive payment only if the city wins a settlement.

    Gulliford said he expects any potential lawsuit would last years but that he hopes the city will walk away with something.

    “What I would hope, whatever we might recover might be utilized for the problem,” Gulliford said. “Part of it to reimburse what we know we’ve spent and will spend in the future, and maybe some money to put forward for better programs to address the problem.”

    View clip here: http://www.firstcoastnews.com/news/jacksonville-city-council-to-vote-on-suing-makers-distributors-of-prescription-painkillers/485538576

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11. Law firm asks if EP County is interested in joining litigation against opioid manufacturers

    Oct 23, 2017 | KVIA (TX)

    By Mauricio Casillas

    El Paso Commissioners Court is discussing whether to join a lawsuit against several pharmaceutical companies over opioid addiction costs.

    Representatives with the Houston-based Gallagher Law Firm gave county commissioners a presentation Monday about how the opioid epidemic is affecting the state.

    The law firm is reaching out to several municipalities across the state to find out who is interested in litigation.

    "It could affect our hospital district, our sheriff's office - you name it," said County Judge Ruben Vogt, "It could affect multiple areas that impact the county and the taxpayer, which is a reason why we should be concerned."

    The firm's presentation was initially placed on the regular agenda, but later moved to executive session where the public could not follow discussions. 

    Commissioners discussed the presentation in private and ultimately decided not to take any action - for now.

    In a power point presentation later provided by the Gallagher firm - and available on the county's website - the Gallagher firm accuses six pharmaceutical companies of creating and benefiting from an opioid epidemic.

    The firms listed are:Purdue Pharma EntitiesTeva PharmaceuticalsCephalon Inc.Johnson and JohnsonJanssen Pharmaceutical EntitiesEndo Pharmaceutical Entities

    ABC-7 reached out to the Gallagher law firm to see how many other municipalities - if any - have hired them. The firm did not immediately respond.

    The New Mexico Attorney General's Office recently filed a lawsuit accusing major manufacturers and distributors of prescription opioids of fueling the opiod epidemic.

    The state's drug overdose death rate is far above the national average and the lawsuit accuses opioid manufacturers of aggressively pushing highly addictive and dangerous drugs.

    The suit also accuses distributors of failing to monitor, investigate and report suspicious orders of prescription opiates.

    View clip here: http://www.kvia.com/lifestyle/health/law-firm-asks-if-ep-county-is-interested-in-joining-litigation-against-opioid-manufacturers/644015767

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Other Coverage

12. White House to host opioid 'event' Thursday

    Oct 23, 2017 | The Hill

    By Rachel Rouebein

    The White House will hold an event on the opioid epidemic Thursday afternoon, according to an email obtained by The Hill that suggests President Trump will make his announcement about a national emergency this week.

    The email, from the White House Office of National Drug Control Policy, is an invitation and a call to RSVP to an event at the White House on the “nationwide opioid crisis” at 2 p.m. Thursday.

    It’s not clear exactly what the event will be, but President Trump said he planned to declare the epidemic a national emergency this week. The White House did not immediately respond to a request for comment.

    Emergency declarations are typically used to provide short-term help, so there are not any guidelines for what one would look like for the opioid epidemic. Axios reported Monday morning that Trump will officially declare the opioid epidemic a national public health emergency this week and discuss combating the crisis on Thursday.

    Trump will “sign an executive document” that directs agencies to take all actions to combat the crisis, according to Axios.  

    Typically, the HHS secretary declares a public health emergency, which is usually reserved for infectious diseases. The president could declare a national emergency under the Stafford Act, which is typically used for natural disasters or terrorist attacks.

    There’s been confusion over the national emergency declaration since there’s never before been one for a drug epidemic. For one, there are questions over how long it would last and what the parameters would be for ending the emergency.

    Some advocates and lawmakers say any declaration must come with new funding to make it effective. The public health emergency fund has only $57,000 left, according to an HHS official.  Congress could provide a supplemental appropriation but while that means more money, it wouldn't necessarily happen quickly.

    There’s been some frustration over the length of time it’s been since Trump said his administration was drafting the emergency declaration paperwork over two months ago. This prompted a bipartisan letter from Sens. Lisa Murkowski (R-Alaska) and Elizabeth Warren (D-Mass.), who both hail from states whose governors had declared the opioid epidemic a statewide public health emergency or disaster.

    “We applaud your stated commitment to addressing opioid addiction and agree with you that the crisis is a ‘serious problem’ deserving of increased federal resources,” Warren and Murkowski wrote in an Oct 12 letter to Trump, referring to comments he made on Aug. 10.

    “However, we are extremely concerned that 63 days after your statement, you have yet to take the necessary steps to declare a national emergency on opioids, nor have you made any proposals to significantly increase funding to combat the epidemic,” the senators continued.

    On Aug. 10, Trump said his administration was drafting paperwork to declare the opioid epidemic a national emergency, which served as the“first and most urgent” recommendation in an interim report from the president’s commission to address the opioid crisis.

    When a reporter asked about the declaration at a press conference last week, Trump said “we are going to be doing that next week. By the way, you know that’s a big step,” saying it had been “time-consuming work.”

    The nationwide opioid crisis has caused the number of overdose deaths from prescription painkillers and heroin to quadruple since 1999, according to the Centers for Disease Control and Prevention.

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13. The Family That Built an Empire of Pain

    Oct 23, 2017 | New Yorker

    By Patrick Radden Keefe

    The north wing of the Metropolitan Museum of Art is a vast, airy enclosure featuring a banked wall of glass and the Temple of Dendur, a sandstone monument that was constructed beside the Nile two millennia ago and transported to the Met, brick by brick, as a gift from the Egyptian government. The space, which opened in 1978 and is known as the Sackler Wing, is also itself a monument, to one of America’s great philanthropic dynasties. The Brooklyn-born brothers Arthur, Mortimer, and Raymond Sackler, all physicians, donated lavishly during their lifetimes to an astounding range of institutions, many of which today bear the family name: the Sackler Gallery, in Washington; the Sackler Museum, at Harvard; the Sackler Center for Arts Education, at the Guggenheim; the Sackler Wing at the Louvre; and Sackler institutes and facilities at Columbia, Oxford, and a dozen other universities. The Sacklers have endowed professorships and underwritten medical research. The art scholar Thomas Lawton once likened the eldest brother, Arthur, to “a modern Medici.” Before Arthur’s death, in 1987, he advised his children, “Leave the world a better place than when you entered it.”
    

    Mortimer died in 2010, and Raymond died earlier this year. The brothers bequeathed to their heirs a laudable tradition of benevolence, and an immense fortune with which to indulge it. Arthur’s daughter Elizabeth is on the board of the Brooklyn Museum, where she endowed the Elizabeth A. Sackler Center for Feminist Art. Raymond’s sons, Richard and Jonathan, established a professorship at Yale Cancer Center. “My father raised Jon and me to believe that philanthropy is an important part of how we should fill our lives,” Richard has said. Marissa Sackler, the thirty-six-year-old daughter of Mortimer and his third wife, Theresa Rowling, founded Beespace, a nonprofit “incubator” that supports organizations like the Malala Fund. Sackler recently told W that she finds the word “philanthropy” old-fashioned. She considers herself a “social entrepreneur.”

    
    

    When the Met was originally built, in 1880, one of its trustees, the lawyer Joseph Choate, gave a speech to Gilded Age industrialists who had gathered to celebrate its dedication, and, in a bid for their support, offered the sly observation that what philanthropy really buys is immortality: “Think of it, ye millionaires of many markets, what glory may yet be yours, if you only listen to our advice, to convert pork into porcelain, grain and produce into priceless pottery, the rude ores of commerce into sculptured marble.” Through such transubstantiation, many fortunes have passed into enduring civic institutions. Over time, the origins of a clan’s largesse are largely forgotten, and we recall only the philanthropic legacy, prompted by the name on the building. According to Forbes, the Sacklers are now one of America’s richest families, with a collective net worth of thirteen billion dollars—more than the Rockefellers or the Mellons. The bulk of the Sacklers’ fortune has been accumulated only in recent decades, yet the source of their wealth is to most people as obscure as that of the robber barons. While the Sacklers are interviewed regularly on the subject of their generosity, they almost never speak publicly about the family business, Purdue Pharma—a privately held company, based in Stamford, Connecticut, that developed the prescription painkiller OxyContin. Upon its release, in 1995, OxyContin was hailed as a medical breakthrough, a long-lasting narcotic that could help patients suffering from moderate to severe pain. The drug became a blockbuster, and has reportedly generated some thirty-five billion dollars in revenue for Purdue.

    But OxyContin is a controversial drug. Its sole active ingredient is oxycodone, a chemical cousin of heroin which is up to twice as powerful as morphine. In the past, doctors had been reluctant to prescribe strong opioids—as synthetic drugs derived from opium are known—except for acute cancer pain and end-of-life palliative care, because of a long-standing, and well-founded, fear about the addictive properties of these drugs. “Few drugs are as dangerous as the opioids,” David Kessler, the former commissioner of the Food and Drug Administration, told me.

    Purdue launched OxyContin with a marketing campaign that attempted to counter this attitude and change the prescribing habits of doctors. The company funded research and paid doctors to make the case that concerns about opioid addiction were overblown, and that OxyContin could safely treat an ever-wider range of maladies. Sales representatives marketed OxyContin as a product “to start with and to stay with.” Millions of patients found the drug to be a vital salve for excruciating pain. But many others grew so hooked on it that, between doses, they experienced debilitating withdrawal.

    Since 1999, two hundred thousand Americans have died from overdoses related to OxyContin and other prescription opioids. Many addicts, finding prescription painkillers too expensive or too difficult to obtain, have turned to heroin. According to the American Society of Addiction Medicine, four out of five people who try heroin today started with prescription painkillers. The most recent figures from the Centers for Disease Control and Prevention suggest that a hundred and forty-five Americans now die every day from opioid overdoses.

    Andrew Kolodny, the co-director of the Opioid Policy Research Collaborative, at Brandeis University, has worked with hundreds of patients addicted to opioids. He told me that, though many fatal overdoses have resulted from opioids other than OxyContin, the crisis was initially precipitated by a shift in the culture of prescribing—a shift carefully engineered by Purdue. “If you look at the prescribing trends for all the different opioids, it’s in 1996 that prescribing really takes off,” Kolodny said. “It’s not a coincidence. That was the year Purdue launched a multifaceted campaign that misinformed the medical community about the risks.” When I asked Kolodny how much of the blame Purdue bears for the current public-health crisis, he responded, “The lion’s share.”

    Although the Sackler name can be found on dozens of buildings, Purdue’s Web site scarcely mentions the family, and a list of the company’s board of directors fails to include eight family members, from three generations, who serve in that capacity. “I don’t know how many rooms in different parts of the world I’ve given talks in that were named after the Sacklers,” Allen Frances, the former chair of psychiatry at Duke University School of Medicine, told me. “Their name has been pushed forward as the epitome of good works and of the fruits of the capitalist system. But, when it comes down to it, they’ve earned this fortune at the expense of millions of people who are addicted. It’s shocking how they have gotten away with it.”

    Dr. Sackler considered himself and was considered to be the patriarch of the Sackler family,” a lawyer representing Arthur Sackler’s children once observed. Arthur was a gap-toothed, commanding polymath who trained under the Dutch psychoanalyst Johan H. W. van Ophuijsen, whom Sackler proudly described as “Freud’s favorite disciple.” Arthur and his brothers, the children of Jewish immigrants from Galicia and Poland, grew up in Brooklyn during the Depression. All three attended medical school, and worked together at the Creedmoor Psychiatric Center, in Queens, collectively publishing some hundred and fifty scholarly papers. Arthur became fascinated, he later explained, by the ways that “nature and disease can reveal their secrets.” The Sacklers were especially interested in the biological aspects of psychiatric disorders, and in pharmaceutical alternatives to mid-century methods such as electroshock therapy and psychoanalysis.

    But the brothers made their fortunes in commerce, rather than from medical practice. They shared an entrepreneurial bent. As a teen-ager, Mortimer became the advertising manager of his high-school newspaper, and after persuading Chesterfield to place a cigarette ad he got a five-dollar commission—a lot of money at a time when, he later said, “even doctors were selling apples in the streets.” In 1942, Arthur helped pay his medical-school tuition by taking a copywriting job at William Douglas McAdams, a small ad agency that specialized in the medical field. He proved so adept at this work that he eventually bought the agency—and revolutionized the industry. Until then, pharmaceutical companies had not availed themselves of Madison Avenue pizzazz and trickery. As both a doctor and an adman, Arthur displayed a Don Draper-style intuition for the alchemy of marketing. He recognized that selling new drugs requires a seduction of not just the patient but the doctor who writes the prescription.

    Sackler saw doctors as unimpeachable stewards of public health. “I would rather place myself and my family at the judgment and mercy of a fellow-physician than that of the state,” he liked to say. So in selling new drugs he devised campaigns that appealed directly to clinicians, placing splashy ads in medical journals and distributing literature to doctors’ offices. Seeing that physicians were most heavily influenced by their own peers, he enlisted prominent ones to endorse his products, and cited scientific studies (which were often underwritten by the pharmaceutical companies themselves). John Kallir, who worked under Sackler for ten years at McAdams, recalled, “Sackler’s ads had a very serious, clinical look—a physician talking to a physician. But it was advertising.” In 1997, Arthur was posthumously inducted into the Medical Advertising Hall of Fame, and a citation praised his achievement in “bringing the full power of advertising and promotion to pharmaceutical marketing.” Allen Frances put it differently: “Most of the questionable practices that propelled the pharmaceutical industry into the scourge it is today can be attributed to Arthur Sackler.”

    Advertising has always entailed some degree of persuasive license, and Arthur’s techniques were sometimes blatantly deceptive. In the nineteen-fifties, he produced an ad for a new Pfizer antibiotic, Sigmamycin: an array of doctors’ business cards, alongside the words “More and more physicians find Sigmamycin the antibiotic therapy of choice.” It was the medical equivalent of putting Mickey Mantle on a box of Wheaties. In 1959, an investigative reporter for The Saturday Review tried to contact some of the doctors whose names were on the cards. They did not exist.

    During the sixties, Arthur got rich marketing the tranquillizers Librium and Valium. One Librium ad depicted a young woman carrying an armload of books, and suggested that even the quotidian anxiety a college freshman feels upon leaving home might be best handled with tranquillizers. Such students “may be afflicted by a sense of lost identity,” the copy read, adding that university life presented “a whole new world . . . of anxiety.” The ad ran in a medical journal. Sackler promoted Valium for such a wide range of uses that, in 1965, a physician writing in the journal Psychosomatics asked, “When do we notuse this drug?” One campaign encouraged doctors to prescribe Valium to people with no psychiatric symptoms whatsoever: “For this kind of patient—with no demonstrable pathology—consider the usefulness of Valium.” Roche, the maker of Valium, had conducted no studies of its addictive potential. Win Gerson, who worked with Sackler at the agency, told the journalist Sam Quinones years later that the Valium campaign was a great success, in part because the drug was so effective. “It kind of made junkies of people, but that drug worked,” Gerson said. By 1973, American doctors were writing more than a hundred million tranquillizer prescriptions a year, and countless patients became hooked. The Senate held hearings on what Edward Kennedy called “a nightmare of dependence and addiction.”

    While running his advertising company, Arthur Sackler became a publisher, starting a biweekly newspaper, the Medical Tribune, which eventually reached six hundred thousand physicians. He scoffed at suggestions that there was a conflict of interest between his roles as the head of a pharmaceutical-advertising company and the publisher of a periodical for doctors. But in 1959 it emerged that a company he owned, MD Publications, had paid the chief of the antibiotics division of the F.D.A., Henry Welch, nearly three hundred thousand dollars in exchange for Welch’s help in promoting certain drugs. Sometimes, when Welch was giving a speech, he inserted a drug’s advertising slogan into his remarks. (After the payments were discovered, he resigned.) When I asked John Kallir about the Welch scandal, he chuckled, and said, “He got co-opted by Artie.”

    In 1952, the Sackler brothers bought a small patent-medicine company, Purdue Frederick, which was based in Greenwich Village and made such unglamorous staples as laxatives and earwax remover. According to court documents, each brother would control a third of the company, but Arthur, who was occupied with his publishing and advertising ventures, would play a passive role. The journalist Barry Meier, in his 2003 book, “Pain Killer: A ‘Wonder’ Drug’s Trail of Addiction and Death,” remarks that Arthur treated his brothers “not as siblings but more like his progeny and understudies.” Now Raymond and Mortimer, who became joint C.E.O.s, had a company of their own.

    In the early sixties, Estes Kefauver, a Tennessee senator, chaired a subcommittee that looked into the pharmaceutical industry, which was growing rapidly. Kefauver, who had previously investigated the Mafia, was especially intrigued by the Sackler brothers. A memo prepared by Kefauver’s staff noted, “The Sackler empire is a completely integrated operation in that it can devise a new drug in its drug development enterprise, have the drug clinically tested and secure favorable reports on the drug from the various hospitals with which they have connections, conceive the advertising approach and prepare the actual advertising copy with which to promote the drug, have the clinical articles as well as advertising copy published in their own medical journals, [and] prepare and plant articles in newspapers and magazines.” In January, 1962, Arthur travelled to Washington to testify before Kefauver’s subcommittee. A panel of senators assailed him with pointed questions, but he was a formidable interlocutor—slippery, aloof, and impeccably prepared—and no senator landed a blow. At one point, Sackler caught Kefauver in an error and said, “If you personally had taken the training that a physician requires to get a degree, you would never have made that mistake.” Quizzed about his promotion of a cholesterol drug that had many side effects, including hair loss, Sackler deadpanned, “I would prefer to have thin hair to thick coronaries.”

    As the Sacklers grew wealthy, they became patrons of the arts. In 1974, the brothers gave the Met three and a half million dollars, enabling the construction of the wing housing the Temple of Dendur. Mortimer used the space for a lavish birthday party. The cake was in the shape of the Great Sphinx, but its face had been replaced with Mortimer’s.

    In April, 1987, when Arthur Sackler was seventy-three, he demanded that his third wife, Gillian, account for all their household expenditures. He dictated a terse memo: “I am determined to take command of all situations for which I personally and my estate bear the ultimate obligation.” A month later, he had a heart attack, and died. The family gathered for a fond memorial service at the Met, but Arthur’s children fought bitterly with Gillian, and sparred with Mortimer and Raymond, over the estate. They accused Gillian of trying to steal their inheritance, and of being “inspired variously by greed, malice, or vindictiveness toward her stepchildren.” According to the minutes of a family meeting, Arthur’s daughter Elizabeth suggested that he had hidden the true worth of some family investments, “because he didn’t want Morty and Ray to think they were more valuable.” A family lawyer told the children, “There were no absolutely white lilies here on either side.”

    Arthur’s descendants still owned a third of Purdue Frederick, and Mortimer and Raymond were interested in buying the stake. The company, which had moved to Connecticut and would eventually change its name to Purdue Pharma, had made a great deal of money under their stewardship. But such riches were about to seem paltry. By the time the brothers made their bid, Purdue was already developing a new drug: OxyContin.

    Humans have cultivated the opium poppy for five thousand years. The father of medicine, Hippocrates, recognized the therapeutic properties of the plant. But even in the ancient world people understood that the benevolent powers of this narcotic were offset by the perils of addiction. In his 1996 book, “Opium: A History,” Martin Booth notes that, for the Romans, the poppy was a symbol of both sleep and death. During the nineteen-eighties, Raymond and Mortimer Sackler had a great success at Purdue with an innovative painkiller called MS Contin, a morphine pill with a patented “controlled release” formula: the drug dissolved gradually into the bloodstream over several hours. (“Contin” was short for “continuous.”) MS Contin became the biggest seller in Purdue’s history. But, by the late eighties, its patent was about to expire, and Purdue executives started looking for a drug to replace it.

    One executive who was centrally involved in this effort was Raymond’s son Richard, an enigmatic, slightly awkward man who, in the family tradition, had trained as a doctor. Richard had joined Purdue in 1971 as an assistant to his father, and worked his way up. His name appears on numerous medical patents. In the summer of 1990, a Purdue scientist sent a memo to Richard and several other colleagues, pointing out that MS Contin could “face such serious generic competition that other controlled-release opioids must be considered.” The memo described ongoing efforts to create a product containing oxycodone, an opioid that had been developed by German scientists in 1916.

    Oxycodone, which was inexpensive to produce, was already used in other drugs, such as Percodan (in which it is blended with aspirin) and Percocet (in which it is blended with Tylenol). Purdue developed a pill of pure oxycodone, with a time-release formula similar to that of MS Contin. The company decided to produce doses as low as ten milligrams, but also jumbo pills—eighty milligrams and a hundred and sixty milligrams—whose potency far exceeded that of any prescription opioid on the market. As Barry Meier writes, in “Pain Killer,” “In terms of narcotic firepower, OxyContin was a nuclear weapon.”

    Before releasing OxyContin, Purdue conducted focus groups with doctors and learned that the “biggest negative” that might prevent widespread use of the drug was ingrained concern regarding the “abuse potential” of opioids. But, fortuitously, while the company was developing OxyContin, some physicians began arguing that American medicine should reëxamine this bias. Highly regarded doctors, like Russell Portenoy, then a pain specialist at Memorial Sloan Kettering Cancer Center, in New York, spoke out about the problem of untreated chronic pain—and the wisdom of using opioids to treat it. “There is a growing literature showing that these drugs can be used for a long time, with few side effects,” Portenoy told the Times, in 1993. Describing opioids as a “gift from nature,” he said that they needed to be destigmatized. Portenoy, who received funding from Purdue, decried the reticence among clinicians to administer such narcotics for chronic pain, claiming that it was indicative of “opiophobia,” and suggesting that concerns about addiction and abuse amounted to a “medical myth.” In 1997, the American Academy of Pain Medicine and the American Pain Society published a statement regarding the use of opioids to treat chronic pain. The statement was written by a committee chaired by Dr. J. David Haddox, a paid speaker for Purdue.

    Richard Sackler worked tirelessly to make OxyContin a blockbuster, telling colleagues how devoted he was to the drug’s success. The F.D.A. approved OxyContin in 1995, for use in treating moderate to severe pain. Purdue had conducted no clinical studies on how addictive or prone to abuse the drug might be. But the F.D.A., in an unusual step, approved a package insert for OxyContin which announced that the drug was safer than rival painkillers, because the patented delayed-absorption mechanism “is believed to reduce the abuse liability.” David Kessler, who ran the F.D.A. at the time, told me that he was “not involved in the approval.” The F.D.A. examiner who oversaw the process, Dr. Curtis Wright, left the agency shortly afterward. Within two years, he had taken a job at Purdue.

     

    Mortimer, Raymond, and Richard Sackler launched OxyContin with one of the biggest pharmaceutical marketing campaigns in history, deploying many persuasive techniques pioneered by Arthur. Steven May, who joined Purdue as an OxyContin sales representative in 1999, recalled, “At the time, we felt like we were doing a righteous thing.” He used to tell himself, “There’s millions of people in pain, and we have the solution.” (May is no longer working for Purdue.) The company assembled a sales force of as many as a thousand representatives and armed them with charts showing OxyContin’s benefits. May attended a three-week training session at Purdue’s headquarters. At a celebratory dinner following the training, he was seated at a table with Richard Sackler. “I was blown away,” he recalled. “My first impression of him was ‘This is the dude that made it happen. He has a company that his family owns. I want to be him one day.’ ”

    A major thrust of the sales campaign was that OxyContin should be prescribed not merely for the kind of severe short-term pain associated with surgery or cancer but also for less acute, longer-lasting pain: arthritis, back pain, sports injuries, fibromyalgia. The number of conditions that OxyContin could treat seemed almost unlimited. According to internal documents, Purdue officials discovered that many doctors wrongly assumed that oxycodone was less potent than morphine—a misconception that the company exploited.

    A 1995 memo sent to the launch team emphasized that the company did “not want to niche” OxyContin just for cancer pain. A primary objective in Purdue’s 2002 budget plan was to “broaden” the use of OxyContin for pain management. As May put it, “What Purdue did really well was target physicians, like general practitioners, who were not pain specialists.” In its internal literature, Purdue similarly spoke of reaching patients who were “opioid naïve.” Because OxyContin was so powerful and potentially addictive, David Kessler told me, from a public-health standpoint “the goal should have been to sell the least dose of the drug to the smallest number of patients.” But this approach was at odds with the competitive imperatives of a pharmaceutical company, he continued. So Purdue set out to do exactly the opposite.

    Sales reps, May told me, received training in “overcoming objections” from clinicians. If a doctor inquired about addiction, May had a talking point ready. “ ‘The delivery system is believed to reduce the abuse liability of the drug,’ ” he recited to me, with a rueful laugh. “Those were the specific words. I can still remember, all these years later.” He went on, “I found out pretty fast that it wasn’t true.” In 2002, a sales manager from the company, William Gergely, told a state investigator in Florida that Purdue executives “told us to say things like it is ‘virtually’ non-addicting.”

    May didn’t ask doctors simply to take his word on OxyContin; he presented them with studies and literature provided by other physicians. Purdue had a speakers’ bureau, and it paid several thousand clinicians to attend medical conferences and deliver presentations about the merits of the drug. Doctors were offered all-expenses-paid trips to pain-management seminars in places like Boca Raton. Such spending was worth the investment: internal Purdue records indicate that doctors who attended these seminars in 1996 wrote OxyContin prescriptions more than twice as often as those who didn’t. The company advertised in medical journals, sponsored Web sites about chronic pain, and distributed a dizzying variety of OxyContin swag: fishing hats, plush toys, luggage tags. Purdue also produced promotional videos featuring satisfied patients—like a construction worker who talked about how OxyContin had eased his chronic back pain, allowing him to return to work. The videos, which also included testimonials from pain specialists, were sent to tens of thousands of doctors. The marketing of OxyContin relied on an empirical circularity: the company convinced doctors of the drug’s safety with literature that had been produced by doctors who were paid, or funded, by the company.

    David Juurlink, who runs the division of clinical pharmacology and toxicology at the University of Toronto, told me that OxyContin’s success can be attributed partly to the fact that so many doctors wanted to believe in the therapeutic benefits of opioids. “The primary goal of medical practice is the relief of suffering, and one of the most common types that doctors see is pain,” he said. “You’ve got a patient in pain, you’ve got a doctor who genuinely wants to help, and now suddenly you have an intervention that—we are told—is safe and effective.”

    Keith Humphreys, a professor of psychiatry at Stanford, who served as a drug-policy adviser to the Obama Administration, said, “That’s the real Greek tragedy of this—that so many well-meaning doctors got co-opted. The level of influence is just mind-boggling. Purdue gave money to continuing medical education, to state medical boards, to faux grassroots organizations.” According to training materials, Purdue instructed sales representatives to assure doctors—repeatedly and without evidence—that “fewer than one per cent” of patients who took OxyContin became addicted. (In 1999, a Purdue-funded study of patients who used OxyContin for headaches found that the addiction rate was thirteen per cent.)

    Within five years of its introduction, OxyContin was generating a billion dollars a year. “There is no sign of it slowing down,” Richard Sackler told a team of company representatives in 2000. The sales force was heavily incentivized to push the drug. In a memo, a sales manager in Tennessee wrote, “$$$$$$$$$$$$$ It’s Bonus Time in the Neighborhood!” May, who was assigned to the Virginia area, was astonished to learn that especially skillful colleagues were earning hundreds of thousands of dollars in commissions. One year, May’s own sales were so brisk that Purdue rewarded him with a trip to Hawaii. As prescriptions multiplied, Purdue executives—and the Sackler family members on the company’s board—appeared happy to fund such blandishments. Internal budget plans described the company’s sales force as its “most valuable resource.” In 2001, Purdue Pharma paid forty million dollars in bonuses.

    One day, May drove with a colleague to Lewisburg, a small city in West Virginia. They were there to visit a doctor who had been one of May’s top prescribers. When they arrived, the doctor was ashen. A relative had just died, she explained. The girl had overdosed on OxyContin.

    Arthur and Mortimer Sackler each married three times, and Raymond married once. There are fifteen Sackler children in the second generation, most of whom have children of their own. The Sackler clan has pursued a variety of causes and interests. In 2011, Mortimer’s widow, Theresa, who sits on the board of Purdue, was awarded the Prince of Wales Medal for Art Philanthropy. When the medal was conferred, Ian Dejardin, the Sackler Director of the Dulwich Picture Gallery, remarked, “It’s going to be difficult not to make her sound utterly saintly.” Theresa’s daughter, Sophie, is married to the English cricket player Jamie Dalrymple, and lives in a forty-million-dollar house in London. Raymond’s thirty-seven-year-old grandson, David Sackler, runs a family investment fund, and is the only member of the third generation who sits on Purdue’s board. The fact that Purdue is privately held is a major reason that the Sacklers’ connection to OxyContin has remained obscure. A publicly traded company makes periodic disclosures to its shareholders. But Purdue, Barry Meier writes, “was the Sackler family’s private domain.”

    On occasion, press accounts about OxyContin note that profits from the drug flow to the Sacklers, but these stories tend to depict the family as a monolith. As with any large clan, however, there are fissures of discord. In the eighties, Mortimer sued his ex-wife Gertraud, claiming that she had illegally taken possession of an apartment that he owned on Fifth Avenue and had loaned it out to a contingent of models and photographers. None of Arthur’s descendants sit on the company’s board. At a courthouse in Long Island, in files stemming from the family fight over Arthur’s fortune, I came across a document indicating that, after a “protracted negotiation,” Arthur’s estate “sold its one third interest in Purdue” to Raymond and Mortimer.

    “I have never owned any shares in Purdue,” Michael Sackler-Berner, a Brooklyn-based singer-songwriter who is a grandson of Arthur Sackler, told me, in an e-mail. “None of the descendants of Arthur M. Sackler have ever had anything to do with, or benefited from, the sale of OxyContin.” Sackler-Berner made no mention of Librium, Valium, or MS Contin, but he added, “Given the current controversy surrounding OxyContin, I appreciate your clarifying the matter.”

    Even though Mortimer Sackler had a large stake in the company, he was only an occasional presence at the Connecticut headquarters. He renounced his U.S. citizenship in 1974, reportedly for tax reasons, and lived a flamboyant life in Europe, shuttling among residences in England, the Swiss Alps, and Cap d’Antibes. (In 1999, Queen Elizabeth conferred an honorary knighthood on him, in recognition of his philanthropy.) Raymond Sackler, who lived in Connecticut, had a more modest temperament and came to his office at Purdue—where he was respectfully known as Dr. Raymond—every day. John Kallir, Arthur’s former advertising colleague, recalled, “Ray was quiet, reasonably honest, always married to the same woman. The least interesting of the three brothers.”

    Almost immediately after OxyContin’s release, there were signs that people were abusing it in rural areas like Maine and Appalachia. If you ground the pills up and snorted them, or dissolved them in liquid and injected them, you could override the time-release mechanism and deliver a huge narcotic payload all at once. Perversely, users could learn about such methods by reading a warning label that came with each prescription, which said, “Taking broken, chewed or crushed OxyContin tablets could lead to the rapid release and absorption of a potentially toxic dose.” As more and more doctors prescribed OxyContin for an ever-greater range of symptoms, some patients began selling their pills on the black market, where the street price was a dollar a milligram. Doctors who were easily manipulated by their patients—or corrupted by the money in play—set up so-called pill mills, pain clinics that thrived on a wholesale business of issuing OxyContin prescriptions.

    The company did not pull the drug from shelves, however, or acknowledge that it was addictive. Instead, Purdue insisted that the only problem was that recreational drug users were not taking OxyContin as directed. “Their rap has always been that a bunch of junkies ruined their product,” Keith Humphreys, the Stanford professor, said. In 2001, Michael Friedman, Purdue’s executive vice-president, testified before a congressional hearing convened to look into the alarming increase in opioid abuse. The marketing of OxyContin had been “conservative by any standard,” he maintained. “Virtually all of these reports involve people who are abusing the medication, not patients with legitimate medical needs.”

    In 2002, a twenty-nine-year-old woman from New Jersey, Jill Skolek, was prescribed OxyContin for a back injury. One night, after four months on the drug, she died in her sleep, from respiratory arrest, leaving behind a six-year-old son. Her mother, Marianne Skolek Perez, was a nurse. Distraught and bewildered, she became convinced that OxyContin was dangerous. Perez wrote to F.D.A. officials, urging them to append to OxyContin packaging a warning about the risk of addiction.

    The following year, Perez attended a conference on addiction at Columbia University. A sandy-haired man named Robin Hogen, wearing a pin-striped suit and a bow tie, was there, too. He was a communications specialist for Purdue, and had launched a vigorous campaign to defend the drug, warning newspapers to be careful about their coverage. “We’re going to be watching them,” he had promised. He had also enlisted Rudolph Giuliani, the former mayor of New York, and his associate Bernard Kerik to preëmpt any government crackdown. “We have to be politically Machiavellian, often, to win the day,” Hogen once said. At the Columbia event, he was asked about Perez’s daughter. He cautioned that one should not read into the tragedy any liability on Purdue’s part. The real problem, he said, was Jill Skolek: “We think she abused drugs.” (Hogen subsequently apologized for his remark. He no longer works for Purdue.)

    Another speaker at the event was Purdue’s senior medical adviser, J. David Haddox, who insisted that OxyContin was not addictive. He once likened the drug to a vegetable, saying, “If I gave you a stalk of celery and you ate that, it would be healthy. But if you put it in a blender and tried to shoot it into your veins, it would not be good.” When Haddox was walking out of the event, Perez, who is petite and rail thin, deliberately bumped into him. Caught off guard, Haddox staggered backward and fell, with a clatter, into a row of folding chairs. “It was one of those Kodak moments,” Perez recalled. “It was probably the wrong thing to do. But I loved it.”

    Arthur Sackler once wrote that “all health problems devolve upon the individual,” and it was Purdue’s position that OxyContin overdoses were a matter of individual responsibility, rather than the drug’s addictive properties. In addition to people like Hogen and Haddox, the company put forward several top executives to mount a defense, including Howard Udell, Purdue’s general counsel, who had been a longtime legal adviser to the Sacklers. Udell “was like Tom Hagen in ‘The Godfather,’ ” an attorney who dealt with him told me. “Very loyal to the family.” Udell was clearly aware, however, of the abuse potential of OxyContin. According to court documents, his own secretary became addicted to the drug, and was subsequently fired by Purdue.

    By 2003, the Drug Enforcement Administration had found that Purdue’s “aggressive methods” had “very much exacerbated OxyContin’s widespread abuse.” Rogelio Guevara, a senior official at the D.E.A., concluded that Purdue had “deliberately minimized” the risks associated with the drug. But the company continued shifting the blame to drug abusers, creating a public-service announcement that showed a teen-ager raiding his parents’ medicine cabinet.

    In a phone interview, Hogen told me that, for Purdue and the Sacklers, “there was a sense almost of betrayal—how could people put the availability of that product in jeopardy by abusing it for pleasure?” Hogen said that the company received many letters from grateful pain patients, thanking Purdue for “giving them their lives back.” Asked about his reticence to acknowledge that OxyContin might be addictive, Hogen said, “Today, addiction is broadly seen as a disease. Then, it was not. I think our understanding of addiction has grown enormously in the last fifteen years.”

    People have known for thousands of years that opium derivatives are addictive, I said.

    “You really need to talk to a clinician,” Hogen replied. “I’m not a doctor.”

    J. David Haddox is a doctor. In 2001, he told an Associated Press reporter, “A lot of these people say, ‘Well, I was taking the medicine like my doctor told me to,’ and then they start taking more and more and more.” He added, “I don’t see where that’s my problem.” (Haddox, who still works for Purdue, declined to comment.)

    The truth was that the dangers of OxyContin were intrinsic to the drug—and Purdue knew it. The time-release formula meant that, in principle, patients could safely ingest one giant dose every twelve hours. They could sleep through the night—a crucial improvement over conventional painkillers, such as morphine, which require more frequent dosing. One of Purdue’s initial advertising campaigns featured a photograph of two little dosage cups, one marked “8 a.m.” and the other “8 p.m.,” and the words “Remember, Effective Relief Just Takes Two.” But internal Purdue documents, which have emerged through litigation, show that even before the company received F.D.A. approval it was aware that not all patients who took OxyContin were achieving twelve-hour relief. A recent exposé by the Los Angeles Times revealed that the first patients to use OxyContin, in a study conducted by Purdue, were ninety women recovering from surgery in Puerto Rico. Roughly half the women required more medication before the twelve-hour mark. The study was never published. For Purdue, the business reason for obscuring such results was clear: the claim of twelve-hour relief was an invaluable marketing tool. But prescribing a pill on a twelve-hour schedule when, for many patients, it works for only eight is a recipe for withdrawal, addiction, and abuse. Notwithstanding Purdue’s claims, many people who were not drug abusers—and who took OxyContin exactly as their doctors instructed—began experiencing withdrawal symptoms between doses. In March, 2001, a Purdue employee e-mailed a supervisor, describing some internal data on withdrawal and wondering whether or not to write up the results, even though doing so would only “add to the current negative press.” The supervisor responded, “I would not write it up at this point.”

    Doctors who prescribed OxyContin were beginning to report that patients were coming to them with symptoms of withdrawal (itching, nausea, the shakes) and asking for more medication. Haddox had an answer. In a 1989 paper, he had coined the term “pseudo-addiction.” As a pain-management pamphlet distributed by Purdue explained, pseudo-addiction “seems similar to addiction, but is due to unrelieved pain.” The pamphlet continued, “Misunderstanding of this phenomenon may lead the clinician to inappropriately stigmatize the patient with the label ‘addict.’ ” Pseudo-addiction generally stopped once the pain was relieved—“often through an increase in opioid dose.”

    “When you promote these very massive doses of opioids, the more of it that is out there the more abuse there will be,” David Kessler said. “It’s almost linear.” U.S. sales of OxyContin soon exceeded those of Viagra. Everywhere the drug spread, addiction followed. To Steven May, the sales representative in Virginia, it seemed as if the problems associated with OxyContin were metastasizing, “like a cancer.”

    According to Robin Hogen, the members of the Sackler family “were unified in their shock that this was happening to a product they were very proud of.” The Sacklers did not have an arm’s-length relationship with Purdue, Hogen said: “This was an active family and an active board.” In 1999, Richard Sackler became Purdue’s president. As the head of a privately held company, however, he felt no pressure to be the public face of the business, and he never appeared at forums where people like Haddox defended Purdue. Indeed, though Sackler presided over the tremendously successful launch of OxyContin, he has never given an on-the-record interview about the drug. “I’ve had a lot of experience with Purdue over the years, in different settings, but I’ve never even seen Richard Sackler,” the addiction specialist Andrew Kolodny, who is a frequent Purdue critic, told me. “I don’t think I’d know him if he was standing in front of me.”

    Even after it became clear that OxyContin was being widely abused, Purdue refused to concede that it posed risks. Company leaders worried mainly that attempts to stem overdoses might deprive pain patients of access to the drug. “They said, ‘We need to make sure that these products are available for patients,’ ” Hogen said. “That was their sole focus.” According to Steven May, the sales force was instructed to ride out the controversy, ignore abuse reports, and “sell through it.” As late as 2003, the F.D.A. sent Purdue a warning letter about ads that “grossly overstate the safety profile of OxyContin by not referring in the body of the advertisements to serious, potentially fatal risks.”

    In his congressional testimony, Michael Friedman, Richard Sackler’s deputy, said that Purdue first became aware of problems with OxyContin only in April, 2000, after a series of press reports about people abusing it recreationally in Maine. But Purdue didn’t need the media’s help to know that something was seriously off with the distribution of OxyContin. For years, it had maintained a contract with I.M.S., a little-known company, co-founded by Arthur Sackler, that furnished its clients with fine-grained information about the prescribing habits of individual doctors. Purdue’s sales representatives used the data to figure out which doctors to target.

    Such data could also be used to track patterns of abuse. “They know exactly what people are prescribing,” Kolodny said. “They know when a doctor is running a pill mill.” At the 2001 hearing, James Greenwood, a Pennsylvania congressman, asked Friedman whether Purdue would take any action if, say, I.M.S. data revealed that a rural osteopath was writing thousands of prescriptions.

    Friedman replied that it was not up to Purdue to assess “how well a physician practices medicine.”

    “Why do you want that information, then?” Greenwood pressed, before answering his own question: “To see how successful your marketing techniques are.”

    Greenwood then observed that, in a recent case involving a Pennsylvania doctor, Richard Paolino, who was wantonly overprescribing OxyContin, a local pharmacist had alerted the authorities. “He looked at this data and he said, ‘Holy God, there is some guy in Bensalem called Paolino, and he’s writing prescriptions out the wazoo,’ ” Greenwood said. “Now, he had that data and he blew the whistle. And you had that data. What did you do?”

    Purdue had not alerted the authorities. Clinicians like Paolino were breaking the law—he was sentenced to a minimum of thirty years in prison. But overprescribing generated tremendous revenue for the company. According to four people I spoke with, at Purdue such prescribers were given a name that Las Vegas casinos reserve for their most prized gamblers: whales.

    In July, 2001, Richard Blumenthal, who was then the attorney general of Connecticut, wrote to Richard Sackler. “I have been increasingly dismayed and alarmed about the problems and escalating abuse of OxyContin,” he began, citing overdose deaths, addiction, pharmacy robberies, and “the astonishing growth in state funding” that was being used to pay for OxyContin prescriptions through Medicaid and Medicare. Blumenthal acknowledged that other prescription drugs were also abused. “But OxyContin is different,” he wrote. “It is more powerful, more addictive, more widely sold, more illicitly available, and more publicized.” He urged Purdue to “overhaul and reform” its marketing of OxyContin.

    The Sacklers disregarded his recommendation, and so in 2004 Blumenthal filed a complaint against Purdue, on behalf of the State of Connecticut. It cited data indicating that a fifth of OxyContin prescriptions were now for dosing intervals shorter than twelve hours. In fact, Blumenthal obtained Purdue records indicating that company officials knew by 1998 that prescriptions for eight-hour intervals were becoming more and more frequent. In one document, a Purdue employee called the numbers “very scary.”

    Such alarm over off-label dosing may have been prompted less by concern about public health than by considerations of profit. If OxyContin was being widely prescribed at intervals of fewer than twelve hours, the company might lose its “two pills a day” marketplace advantage against cheaper alternatives, like generic morphine, and insurers could start refusing to cover the costs. As early as 1997, some benefit plans had begun citing abuse of OxyContin as an excuse not to pay. In a 1997 e-mail, Richard Sackler urged colleagues to counter this resistance, warning that, for insurance companies, “ ‘addiction’ may be a convenient way to just say ‘NO.’ ”

    Purdue has been sued thousands of times over OxyContin since its release. (Steven May, the sales rep, initiated a whistle-blower suit years after leaving the company; it was dismissed, on procedural grounds.) In 2002, Howard Udell said that the firm would defend itself “to the hilt.” The next year, a New York trial lawyer named Paul Hanly assembled a lawsuit, signing up five thousand patients who said that they’d become addicted to OxyContin after receiving a doctor’s prescription. In discovery, Hanly obtained thousands of documents. “They demonstrated that this company had set out to perpetrate a fraud on the entire medical community,” he told me. “These pronouncements about how safe the drug was emanated from the marketing department, not the scientific department. It was pretty shocking. They just made this stuff up.”

    In 2006, Purdue settled with Hanly’s clients, for seventy-five million dollars. Shortly afterward, the company pleaded guilty, in a case brought by federal prosecutors in Virginia, to criminal charges of misbranding, and acknowledged that Purdue had marketed OxyContin “with the intent to defraud or mislead.” (Rudolph Giuliani had tried, on Purdue’s behalf, to get the lead prosecutor to scuttle the case.) Michael Friedman, the executive vice-president, pleaded guilty to a criminal misdemeanor, as did Howard Udell and the company’s chief medical officer, Paul Goldenheim.

    Marianne Perez attended the sentencing, in Virginia. “I was on cloud nine,” she recalled. She had been working with the prosecution, and doing everything she could to inform the public about the dangers of OxyContin. Before the sentence was handed down, Perez delivered a victim-impact statement. “I want to know why the Sackler brothers have not been held accountable,” she said. (Richard Sackler, despite his leadership role at Purdue, had not been charged.)

    During a break in the proceedings, Perez looked over at Friedman, Goldenheim, and Udell, and told herself, “I could reach over, at ninety-eight pounds, and smack one of them.” This time, she restrained herself. Instead, she told them, “You are sheer evil. You are bastards.” The executives reddened, but said nothing. They all received probation, and were ordered, collectively, to pay nearly thirty-five million dollars in fines. Purdue agreed to pay an additional six hundred million. Given the billions of dollars that the Sacklers and Purdue had reaped from OxyContin, some observers felt that the company had got off easy. Arlen Specter, the Republican senator from Pennsylvania, remarked that such fines amounted to “expensive licenses for criminal misconduct.”

    Athur Sackler wrote a regular column for the Medical Tribune, and one of his fixations was the unethical behavior of tobacco companies. In 1979, he critiqued the “weasel-worded warning” on cigarette packages as insufficient, arguing that the “hazard to health should be more specific.” He also condemned newspapers and magazines for accepting “misleading” advertising about cigarettes, and contended that the publishers must “square with their own consciences their contribution to our national mortality.”

    In 1998, the tobacco industry, which had been sued by dozens of states, entered into the largest civil-litigation settlement in history, agreeing to pay two hundred and forty-six billion dollars. Tobacco and opioids are different in significant ways. The F.D.A. approved OxyContin as a medicine, and, whereas tobacco can kill you even when used as directed, Purdue would argue that this isn’t the case with OxyContin. Mike Moore, who, as Mississippi’s attorney general, played a key role in the tobacco litigation, noted another difference: the tobacco companies had more money to spare than Purdue does. “To resolve the opioid problem, you’re going to need billions,” he said. “Treatment alone could be fifty billion dollars or more. And you need prevention and education programs on top of that.”

    Moore is now working with Paul Hanly and other attorneys to bring a fresh wave of lawsuits against Purdue and other pharmaceutical companies. Ten states have filed suits, and private attorneys are working in partnership with dozens of cities and counties to bring others. Many public officials are furious at the makers of powerful painkillers. Prescriptions are expensive, and taxpayers often foot the bill, through programs like Medicaid. Then, as the ruinous consequences of opioid addiction take hold, the public must pay again—this time for emergency services, addiction treatment, and the like. Moore feels that the Sackler family, as the initial author and a prime beneficiary of the epidemic, should be publicly shamed. “I don’t call it Purdue. I call it the Sackler Company,” he said. “They are the main culprit. They duped the F.D.A., saying it lasted twelve hours. They lied about the addictive properties. And they did all this to grow the opioid market, to make it O.K. to jump in the water. Then some of these other companies, they saw that the water was warm, and they said, ‘O.K., we can jump in, too.’ ” There may be significant legal distinctions between a tobacco company and an opioid producer, but to Moore the ethical parallel is unmistakable: “They’re both profiting by killing people.”

    One day in August, 2015, a plane landed in Louisville, Kentucky, and Richard Sackler stepped out, surrounded by attorneys. Eight years earlier, the State of Kentucky had sued Purdue, charging the company with deceptive marketing. Greg Stumbo, the state attorney general at the time, initiated the suit; the son of a cousin of his had fatally overdosed on OxyContin. Purdue fought the suit with its customary rigor, pushing to move the proceedings elsewhere, on the ground that the company could not get a fair trial in Pike County, Kentucky—the rural stretch of coal country where the state intended to try the case. In support of this motion, the company commissioned a demographic study of Pike County and submitted it to the court, as an illustration of potential bias in the jury pool. The report was revealing in ways that Purdue may not have intended: according to the filing, twenty-nine per cent of the county’s residents said that they or their family members knew someone who had died from using OxyContin. Seven out of ten respondents described OxyContin’s effect on their community as “devastating.”

    A judge ruled that Purdue could not shift the venue for the trial, and so Richard Sackler flew to Louisville. He gave a deposition at a law firm. Four lawyers questioned him about his role in the development and the marketing of OxyContin. Tyler Thompson, the lead attorney, told me that Sackler’s demeanor during the session reminded him of Jeremy Irons’s portrayal of Claus von Bülow, the aristocrat accused of murdering his wife, in the 1990 bio-pic “Reversal of Fortune.” “A smirk and a so-what attitude—an absolute lack of remorse,” Thompson said. “It reminded me of these mining companies that come in here and do mountaintop removal, and leave a mess and just move on: ‘It’s not my back yard, so I don’t care.’ ” Mitchel Denham, a former litigator in the Kentucky attorney general’s office, also attended the deposition. “It was surreal,” he recalled. “We were face to face with the guy whose company had helped to create the opioid epidemic.” Denham told me that, in preparing for trial, he discovered a photograph of the 1997 Pikeville High School football team. “Nearly half the players had died of overdoses, or were addicted,” he said. “It was going to be a pretty good visual.”

    But Denham never presented the photograph to a jury, because before the case could go to trial Purdue settled, for twenty-four million dollars. This was a coup for the Sacklers. The settlement was more than Purdue’s original offer—half a million dollars—but still totally incommensurate with Pike County’s needs; Purdue admitted no liability; and, in settling, the company sealed from public view both Richard Sackler’s deposition and internal documents obtained through discovery. Purdue has sometimes claimed to have never “lost a case” related to OxyContin, but it’s more accurate to say that the company has never allowed a case to go to trial, often settling rather than litigating the culpability of the company—and the Sacklers—in open court. “That’s the main reason these folks don’t go to trial,” Denham said. “Because all these documents could end up in the public record.” The Kentucky prosecutors were required to destroy millions of documents, or return them to Purdue. The medical-news Web site STAT subsequently sued to unseal Richard Sackler’s deposition. A state judge ruled in its favor, but Purdue appealed. I spent several months trying to obtain a copy of the deposition, but, because it remains under a protective order while Purdue appeals the matter, no lawyer would share it with me. Mike Moore said, “The idea that they’re fighting so hard to keep this deposition hidden should tell you something.”

    Richard Sackler stepped down as Purdue’s president in 2003, but stayed on as co-chairman of the company’s board. After spending several years as an adjunct professor of genetics at Rockefeller University, he moved to Austin, Texas, in 2013. He lives in a modern hilltop mansion on the outskirts of the city, in an area favored by tech entrepreneurs. According to tax disclosures from his personal foundation, he has continued giving money to Yale, but his largest donation in 2015 was a hundred-thousand-dollar gift to a neoconservative think tank, the Foundation for Defense of Democracies. Through a representative, Sackler declined to speak with me. I contacted a dozen other members of the Sackler family, but none of them would answer questions about OxyContin. Jo Sheldon, a London-based media adviser, called me, and said that she works with some of the Sacklers. (She would not identify which ones.) When I told her that I had questions for the Sacklers, she said that my inquiries would be better directed to Purdue. She said of the Sacklers, “Some of them are still quite involved in Purdue, but some have absolutely nothing to do with it,” apart from depositing checks.

    Given the sometimes fractious nature of the Sackler family, it was striking that they were united in their silence on the subject of OxyContin. These were urbane, expensively educated, presumably well-informed people. Could they conceivably be unaware of the accumulated evidence about the tainted origins of their fortune? Did they simply put it out of mind? “Greed can get people to rationalize pretty bad behavior,” Andrew Kolodny had told me. Someone who knows Mortimer, Jr., socially told me, “I think for him, most of the time, he’s just saying, ‘Wow, we’re really rich. It’s fucking cool. I don’t really want to think that much about the other side of things.’ ”

    Paul Hanly, the lawyer, said that the Sacklers’ steadfast refusal to address the legacy of OxyContin may just be a legal tactic—and a shrewd one. “The more interviews you give, the more targets you create for lawyers like me, and for government investigators,” he said. I wondered whether philanthropy might represent, for at least some of the Sacklers, a form of atonement. But, when you consider the breadth of the family’s donations, one field is conspicuously lacking: addiction treatment, or any other measures that might serve to counter the opioid epidemic.

    In August, 2010, Purdue quietly replaced OxyContin with a drug that was subtly different. The company had been granted patents for a reformulated version of OxyContin. If you crushed these new pills, they became not a fine, dissolvable powder but an unwieldy gummy substance. Purdue had received F.D.A. approval for the reformulation, in part, by touting the ostensible safety of the new product. The F.D.A. had approved a label, the first of its kind, that included a claim about the drug’s “abuse deterrent” properties.

    In an interview, Craig Landau, Purdue’s C.E.O., told me, “A very large proportion of Purdue’s R. & D. efforts post-2001 was dedicated toward addressing the specific vulnerability of the original OxyContin product.” To a casual observer, it might have seemed that the makers of OxyContin, after years of obstructing efforts to curb the disastrous impacts of their painkiller, had finally seen the error of their ways. But Purdue was almost certainly motivated by another consideration: it needed to block competition from generic drugs. Arthur Sackler had often used the pages of the Medical Tribune to criticize generics. In 1985, the paper had published a story, “Schizophrenics ‘Wild’ on Weak Generic,” describing how “all hell broke loose” at a veterans’ hospital after the psychiatric unit switched from a brand-name antipsychotic to a generic. (According to the Times, the F.D.A. investigated and found that the story was bogus, because “the generic had been introduced six months before the purported problems began.”) I spoke with a leading patent lawyer who frequently represents manufacturers of generic drugs, and she said that companies often make a minor tweak to a branded product shortly before the patent expires, in order to obtain a new patent and reset the clock on their exclusive right to produce the drug. The patent for the original OxyContin was set to expire in 2013.

    
    

    Purdue had long denied that the original OxyContin was especially prone to abuse. But, upon receiving its patents for the reformulated drug, the company filed papers with the F.D.A., asking the agency to refuse to accept generic versions of the original formulation—because they were unsafe. The F.D.A., ever obliging, agreed, blocking any low-cost generic competition for Purdue. For more than a year, Purdue continued to sell the original formulation of OxyContin in Canada. According to a recent study, OxyContin sales in Windsor, Ontario—just across the border from Detroit—suddenly quadrupled, a clear indication that the pills were being purchased for the U.S. black market. Through I.M.S. tracking data, Purdue would have been able to monitor the Canadian surge, and to deduce the reason for it. (The company acknowledges that it was aware of the spike in sales, and maintains that it alerted authorities, but will not say when it did so.)

    By the time Purdue reformulated OxyContin, the country was in the middle of a full-blown epidemic. Andrew Kolodny, the addiction specialist, told me that many older people remain addicted to the reformulated OxyContin, and continue to obtain the drug through prescriptions. These people purchase the drug legally, and swallow the pills whole, as instructed. “That’s Purdue’s market now,” Kolodny said. Younger people, who can less readily secure prescriptions for pain—and for whom OxyContin may be too expensive—have increasingly turned to black-market substitutes, including heroin. As Sam Quinones details in his 2015 book, “Dreamland: The True Tale of America’s Opiate Epidemic,” heroin dealers from Mexico fanned out across the U.S. to supply a burgeoning market of people who had been primed by pill addiction. This is one dreadful paradox of the history of OxyContin: the original formulation created a generation addicted to pills; the reformulation, by forcing younger users off the drug, helped create a generation addicted to heroin. A recent paper by a team of economists, citing a dramatic uptick in heroin overdoses since 2010, is titled “How the Reformulation of OxyContin Ignited the Heroin Epidemic.” A survey of two hundred and forty-four people who entered treatment for OxyContin abuse after the reformulation found that a third had switched to other drugs. Seventy per cent of that group had turned to heroin.

    Perhaps the most surprising aspect of Quinones’s investigation is the similarities he finds between the tactics of the unassuming, business-minded Mexican heroin peddlers, the so-called Xalisco boys, and the slick corporate sales force of Purdue. When the Xalisco boys arrived in a new town, they identified their market by seeking out the local methadone clinic. Purdue, using I.M.S. data, similarly targeted populations that were susceptible to its product. Mitchel Denham, the Kentucky lawyer, told me that Purdue pinpointed “communities where there is a lot of poverty and a lack of education and opportunity,” adding, “They were looking at numbers that showed these people have work-related injuries, they go to the doctor more often, they get treatment for pain.” The Xalisco boys offered potential customers free samples of their product. So did Purdue. When it first introduced OxyContin, the company created a program that encouraged doctors to issue coupons for a free initial prescription. By the time Purdue discontinued the program, four years later, thirty-four thousand coupons had been redeemed.

    Purdue Pharma now acknowledges that there is an opioid crisis, but maintains that it has taken every available step to address it, from sponsoring “prescription monitoring” programs in some states to underwriting drug-abuse education. Craig Landau, the C.E.O., told me, “If the Holy Grail is a pain medicine that is safe and effective for patients with severe pain but carries no abuse risk, we haven’t found it yet.” He added that the company has been trying to develop “non-opioid pain products.” Purdue likes to emphasize that there are many other powerful painkillers, and that OxyContin never had more than two per cent of the market for opioids. This is true in terms of the number of prescriptions. But most painkillers are prescribed for very short periods—following surgery, for instance—and in relatively small doses, whereas OxyContin’s sales have been driven by long-term, high-dose prescriptions. If one measured market share by the actual volume of narcotics administered, OxyContin’s would be considerably higher. Some doctors I spoke with estimated that it could be as high as thirty per cent.

    The United States accounts for roughly a third of the global market for opioid painkillers. But, as politicians and journalists have raised alarms over the addiction crisis, many American doctors have grown leery, again, of prescribing these drugs. In a statement, Purdue acknowledged that even patients “who take OxyContin in accordance with its F.D.A.-approved labeling instructions will likely develop physical dependence.” The company maintains that physical dependence is different from addiction, but Jane Ballantyne, the president of Physicians for Responsible Opioid Prescribing, said that, for patients, this can be a me

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14. FDA chief supports opioid prescription limits, regrets agency's prior inaction

    Oct 23, 2017 | USA Today

    By Jayne O'Donnell

    The Food and Drug Administration's new chief says he doesn't want to repeat the mistakes made when he was at the agency in the 2000s and the government failed to regulate opioids more.

    “We didn’t get ahead of it. Nobody got ahead of it,” physician Scott Gottlieb said last week at a National Academy of Medicine conference. "The type of action we need to take to finally (address) this crisis is going to be far more dramatic than we would have had to do had we made certain decisions years ago."

    Now in his third stint at the agency — his first as chief — Gottlieb is advocating shorter-duration opioid prescriptions, increasing oversight of highly addictive immediate-release opioids and tightening requirements for abuse-deterrent formulas. 

    That's a "very candid" admission that Gottlieb was at the FDA "at a time when opioid use was rising rapidly in this country and being very inappropriately marketed," says Josh Sharfstein, a doctor who was the FDA's principal deputy commissioner in the Obama administration. 

    After his May swearing-in, "Scott was quick out of the gate to take some steps on opioids," says Sharfstein, now a professor and associate dean at Johns Hopkins University's Bloomberg School of Public Health. "He recognizes there's a lot more to be done at the FDA."

    The moves come too late for Chris Barth, 42, who fell hard for the painkiller Percocet the first time he tried it at 15. It was an on-again, off-again romance for nearly two decades, fueled in part by prescriptions for his own injuries and the occasional opioid swiped from his parents' medicine cabinet.

    When Percocet, a brand-name version of oxycodone and acetaminophen, became easier to get in the early 2000s, Barth dabbled with the drug. He had a major relapse in 2006 and quit for good six months later when his wife got pregnant.

    When Barth's mother got a 30-day supply of Percocet recently for a knee replacement surgery that only required three days of the drug, Barth was shocked they gave her so many pills. 

    "Easy access to the drug can create a full-blown addiction in a surprisingly short amount of time," he said. 

    More than 64,000 people died of all drug overdoses last year, up from fewer than 20,000 in 1999, according to the National Institute on Drug Abuse. Nearly 35,000 people overdosed on heroin and other opioids in 2015, the latest year available. Every day, 62 people die because of prescription opioids.

    Here is some of what's being done: 

    • Prescription limits. Several states have passed laws that would cap first-time opioid prescriptions at seven days, and CVS announced last month that it would limit initial opioid prescriptions to a week. The pharmaceutical industry and most other industries have backed the prescription limits, which Gottlieb called "an inevitability." Perry Lewis of CoverMyMeds — a company that does quick, electronic versions of the approvals needed by insurers for certain prescriptions — is among those pushing FDA to use their authority to issue regulations so the health care industry doesn't have to meet different regulations in every state.STORY FROM USA TODAY NETWORK SHOPAre you considering getting your MBA?

    • Immediate-release opioids. These fast-acting pain pillsmake up about 90% of opioid prescriptions and can be more addictive, yet have had weaker oversight. The FDA now plans to regulate these drugs as they do the extended release formulas. That means drugmakers have to make training available to doctors that includes safe prescribing and non-opioid alternatives. Because the effect of the painkiller wears off faster, patients may think, "I'll just take another or take three," says Lewis. "People just want more and more." 

    • Abuse-deterrent formulas. FDA is preparing for an expected onslaught of generic versions of these drugs — which currently don't exist — and will release guidance for drugmakers soon. Abuse-deterrent drugs can actually lead to riskier behavior, as FDA learned with the drug Opana ER. FDA asked the maker of the purportedly safer opioid to withdraw it in June because a reformulated version led users to inject it. That led one Indiana county to have the highest number of HIV cases in the U.S.  Unforgettable euphoria

    Barth, an electrician, first tried Percocet after a dirt bike crash when he was 15 and immediately had a feeling of "euphoria that is hard to forget." At 23, he was hit by a drunk driver while walking and was prescribed Percocet again. He asked for a new prescription after going through his 30-day supply and went through "mild withdrawal" when that ran out. 

    Barth, who is tapering off the opioid blocker Probuphine, says if he was at the "stage I used to be, I certainly would have helped myself to the unused portion" of his mother's 30-day Percocet prescription.

    Gottlieb, a former fellow of the conservative American Enterprise Institute, says he spent years "lamenting the growing federal intrusion into the practice of medicine but I would say that with respect to controlled substances in particular, it’s different." 

    Those who advocate for people with chronic pain say federal regulators have already gone too far. 

    "We’re very concerned about the opioid epidemic; it would be stupid to say you're not," says Myra Christopher, who directs the Pain Action Alliance to Implement a National Strategy (PAINS) project. "But the efforts to control it are causing great harm to those who live with chronic pain."

    Lewis has seen both sides of the debate. His 28-year-old son, Chandler, was addicted to a variety of opioids after trying pain medication he found at home. Now working and sober for the past three years, Chandler once even figured out the code to a safe where his father hid his own pain pills after back surgery seven years ago. 

    "It’s grueling," says Lewis. "We felt like failures."

    Still, he worries regulatory roadblocks for prescriptions could cause literally painful delays for many patients. 

    "Are we going too far in putting in restrictions on those who would need it in a timely manner?" asks Lewis.

    The more than 30 million people PAINS estimates are living with high levels of chronic pain "have really become collateral damage" of the opioid epidemic, Christopher says. Many doctors have decided to stop prescribing opioids altogether due to the excessive oversight. Christopher's group has been controversial because it gets funding from the pharmaceutical industry, including the makers of OxyContin.

    Lewis shares some of the concerns about access to pain medications, but when it comes to FDA regulations, he says "I wish we would have had some of these things in place several years ago for my family."

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15. Another View: Drug companies did not have best interest in mind (OPINION)

    Oct 23, 2017 | Delco Daily Times (DE)

    By Tricia Soutch

    CBS aired a very important “60 Minutes Whistleblower” on Sunday, Oct. 15. Joe Rannazzisi, who ran the Drug Enforcement Agency’s (DEA) Diversion Control that investigates the pharmaceutical industry had a very important message we all needed to hear. Did you see it? Maybe not as it ran during Sunday night football.

    Joe Rannazzisi’s authority for fining pharmaceutical companies was taken away and he was demoted for going after these unscrupulous murderers.

    Pharmaceutical companies like Purdue Pharma, Johnson & Johnson, Amerisource Bergen, Cardinal Health and McKesson have distributed millions and millions of drugs to pharmacy’s and doctors’ offices. In 2001, a Purdue executive told Congress: “Addiction is not common, addiction is rare in the pain patient who is properly managed.” (I agree if a patient is managed by limiting ppioid medication as short-term treatment followed by non-medication treatments). Pain clinics and pill mills began popping up like wild fire.

    Rannazzisi says, “That’s not an implication, that’s a fact. That’s exactly what they did. These were professionals, they were just drug dealers in lab coats.” He knew then to go after the distributors. Distributors know exactly how many pills go to every drug store they supply and are required to report and stop unusually large or frequent orders, but they ignored that. They were not using good faith efforts.

    In 2008, the DEA fined McKesson with a $13.2 million dollar fine and Cardinal Health paid a $34 million dollar fine. There have been more than $341 million dollars companies had paid in fines until they went to the Justice Department. They got a bill passed (H.B. 4069) to make it virtually impossible for the DEA to prosecute. This bill passed without any problem or dissent, why? I guess the money from lobbyists was more important than our loved ones!

    Some people in my life told me not to write this article. Afraid I would get push back. I have been pushed to my limit. I lost to this greed. My 19-year-old daughter became addicted to these opioids and overdosed March 27, 2010. I have already lost and am not afraid of these murdering money grubbers. I have made the ultimate sacrifice already.

    I have great respect for Mr. Rannazzisi, for trying to save not only my daughter, but the thousands and thousands of lives affected by this greed and these disgusting tactics by distributors and Congress.

    Shame on you all! You should pay to make the people you diseased well again. You should open recovery centers, for free, to us families that your greed destroyed. You all have the money. Throw us back that lobby money and the millions you’ve made from our pain and suffering that no pill you would make can heal.

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Broadcast Media Coverage

16. Good Morning El Paso

    Oct 24, 2017 | KVIA ABC El Paso, TX

    View clip here: https://app.criticalmention.com/app/#clip/view/30236349?token=2a2ea22f-adc5-48f8-9fb7-9b50dc18a4ea

    Rough transcript: el paso's commissioners court is discussing whether to join a lawsuit against several pharmaceutical companies over opioid addiction costs. the firm's presentation was initially placed on the regular agenda, but was later moved to executive session. that means the public was not able to see it. still -- the firm provided a power point of the presentation -- and that is available from the county's website for all to see. the firm calls out these six pharmaceutical companies, accusing them of creating and benefiting from an opioid epidemic. those firms are: purdue pharma entities, teva pharmaceuticals cephalon inc., johnson and johnson, janssen pharmaceutical entities, and endo pharmaceutical entities. the commissioners discussed the presentation among themselves, and ultimately decided to not take any action for now. you can get more information on our website. 

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