How much does it cost shake responsibility for 500,000 deaths?
According to the latest ruling in the ongoing lawsuit against the Sackler family and Purdue Pharma, more than $4.5 billion.
Now, the case is getting even more attention thanks to Hulu’s Dopesick.
Dopesick
The 8-episode miniseries is a mosaic of stories told from various viewpoints entangled in the opioid epidemic in different ways – from patients, to doctors, to regulators, to Purdue staff and executive boards, attorneys, politicians, and law enforcement.
Dopesick‘s cast include some heavy hitters, including Michael Keaton, an antihero doctor who finds himself ensnared in the crisis in more ways than one, and Rosario Dawson, a dedicated law enforcement official whose personal life bears some of the cost of the Sackler family’s crimes.
The show is based on investigative journalist Beth Macy’s book Dopesick: Dealers, Doctors, and the Drug Company That Addicted America.
Though the characters in the show are fictional, their stories are composites of real events from the book and Macy’s observations during her 20 years reporting on the escalating calamity.
Perhaps the most provocative aspect of the series that its entire arc serves as a comprehensive framework to a story that is unfolding today.
A new ruling in the case against Purdue Pharma was issued on Dec. 16, 2021 – more than two months since the mini drama series release.
No deal
On Dec. 16, 2021, Judge Colleen McMahon of the U.S. District Court for the Southern District of New York overturned a bankruptcy restructuring plan that had been approved for Purdue Pharma in September.
The key feature of the deal included a $4.5 billion dollar payout by the Sackler family as a quid pro quo for a legal shield against further lawsuits.
In her 142-page ruling, Judge McMahon found that it was not within the bankruptcy court’s power to grant a personal legal shield for company executives. She further notes that the U.S. Trustee – part of the Department of Justice – raised an important point.
“In this case, however,” Judge McMahon writes, “Appellants – most particularly, the U.S. Trustee, with the United States Attorney for this District appearing as amicus – have mounted a full-throated attack on a court’s statutory authority to release third-party claims against non-debtors in connection with someone else’s bankruptcy.”
The bankruptcy settlement and restructuring plan had been approved by bankruptcy Judge Robert Drain of the United States Bankruptcy Court for the Southern District of New York.
Justice for sale
Judge Drain’s approval of the settlement was questionable.
The legal status of corporations as people has a long and rich legal precedence in the U.S. legal system. It is a legacy that has benefited many bad corporate actors, who can let the company ‘take the fall’ should their illegal actions result in catastrophic litigation.
But the Sackler family wanted a special exception – Purdue Pharma would take the fall for the opioid epidemic, but the Sacklers personally would be protected from further lawsuits.
While bankruptcy can provide legal liability shields to companies that recover from bankruptcy, (many companies survive bankruptcies), Purdue Pharma itself would be dissolved as part of the settlement. Therefore, the entity eligible for the legal shield within the context of the bankruptcy’s court power would cease to exist.
That the exceptional provision was approved in the settlement by a seasoned bankruptcy judge raises questions, especially considering the Sackler family would still be multi-billionaires under the proposed terms.
It’s hardly Drain’s first unpopular ruling. In the bankruptcy case of Sears Corp, Drain ruled in favor of predatory hedge fund manager Eddie Lampert.
Lampert served as Sears Holding’s CEO between 2013 and 2019.
In that six-year period, Sears Holdings lost half its value, closed 3,500 stores, and shed 250,000 employees. Lampert was allowed to buyout the skeletal remains of the company in bankruptcy proceeding over which Judge Robert Drain presided at the expense of Sears’ other creditors.
After Judge Drain’s approval in Purdue Pharma’s bankruptcy proceeding was reversed, Judge Drain extended an injunction protecting the Sacklers from further lawsuits through February 1st. It was the 10th time the judge extended protection for the Sacklers stemming back to October 2019.
Chasing the dragon
While the personal golden parachutes for the Sacklers was the key point of contention in the bankruptcy restructuring deal, there were other unsettling aspects of the proposal.
Judge Colleen McMahon, who overturned Judge Robert Drain’s abuse of power, observed that in Purdue’s self-commissioned audit, between the years of 2008–2018, company distributions to Sackler family members soared by as much as 800% relative to the early 2000s.
The timing of the withdrawals coincided with an onslaught of accusations regarding Purdue Pharma’s role in the opioid crisis coupled with mounting evidence that the OxyContin producer was well aware of their flagship drug’s addictive and deadly nature.
They proactively downplayed the dangers, manipulated data, and even launched an internal marketing campaign aimed at demonizing patients who had become addicted to the drug. Of course, stigmatizing addicts as a strategy was at odds with the fact that they expressly marketed OxyContin as non-addictive, well illustrated in Dopesick’s sixth episode. The episode’s title came from a 2001 internal, confidential email sent by Purdue’s then president Richard Sackler, in which he wrote they needed to “hammer on the abusers” as questions were raised about OxyContin’s addictiveness.
In fact, the Sackler family increased annual withdrawals from company’s funds by nearly 800% in the wake of a 2007 lawsuit in which Purdue Pharma paid out $600 million as part of a plea deal. The withdrawal amount stayed elevated for the 10-year period between 2008–2018.
With a precedent set, the Sackler family likely realized they were at risk for an avalanche of liability lawsuits. They proactively began to hide their fortune while continuing to deny any wrongdoing and claiming that OxyContin was not addictive as the death toll continued to climb.
The prescient move meant that even after Purdue’s $4.5 billion settlement was paid out, the Sacklers would still pocket over $10 billion in profits from OxyContin’s sales. That wealth would be protected from further liability.
OxyContin’s sweetheart deal with the FDA
Puppet judge Robert Drain was hardly the only enforcer who empirically obstructed justice or played a role in facilitating the crimes of the Sackler family.
OxyContin was approved by the FDA in 1995. The FDA’s approval may have been the first point of government enablement of the opioid crisis, a major focal point and plotline of the Hulu miniseries Dopesick.
The controversy surrounds then FDA Chief Curtis Wright, who held a series of meetings with officials from Purdue Pharma while OxyContin was in the process of obtaining FDA approval. It is believed that in these meetings, Purdue Pharma officials ‘helped’ Curtis Wright write his recommendation letters, as well as added an unusual endorsement of OxyContin’s addiction-free claim to the FDA’s OxyContin label.
The original FDA label on OxyContin featured a unique line that other types of opioid-based painkiller prescriptions did not have: “Delayed absorption as provided by OxyContin tablets, is believed to reduce the abuse liability of a drug.”
Purdue Pharma claimed – but didn’t bother to scientifically test if – the Contin coating on OxyContin could reduce the swings from the peaks of euphoria to troughs of withdrawal. These fluctuations are known catalysts for the formation of dependency.
But the FDA’s label made it seem as though Purdue Pharma’s drug was safer than other opioid alternatives whose addictive properties were clearly noted on their packaging and well understood by the medical community who were cautious in writing prescriptions. Purdue, it seemed, had solved the dangerous drawbacks of opioids’ use in medicine – and the FDA ‘believed’ them.
Except, they hadn’t. Purdue had not conducted any internal studies regarding whether or not the Contin coating actually curtailed addiction formation. It was an untested, unsupported, and later, found to be an obviously untrue claim.
“To this day, nobody will admit to writing that line,” said investigative journalist Patrick Radden Keefe, author of Empire of Pain: The Secret History of the Sackler Dynasty in an interview with Peter Attia.
“Curtis Wright has been asked about this and he said, ‘Oh yeah, it wasn’t the FDA, it was Purdue Pharma.’ Purdue Pharma officials were there to say ‘it wasn’t us…it was Curtis Wright.'”
One year after OxyContin – and its very special label – was granted FDA approval, Curtis Wright accepted a cushy role at Purdue Pharma.
Assisted suicide, the Trojan horse
Though Hulu’s Dopesick covers many aspects of the opioid crisis, one critical part not expressly covered was a devious and manipulative bill that passed through Congress in 1999. That same year, OxyContin prescriptions skyrocketed into the multi-millions.
The bill was a Trojan horse.
In 1997, the state of Oregon passed the Death with Dignity Act. The bill allowed for Oregon physicians to prescribe a fatal dose of medication to terminally ill patients who elected to end their lives (assisted suicide).
As a counter measure, Congress passed the Pain Relief Promotion Act in 1999.
But a closer examination of the legislation reveals that the Pain Relief Promotion Act wasn’t really about assisted suicide as it was championed to be at the time.
The bill “…encourages practitioners to prescribe and administer controlled substances to relieve pain and discomfort. Practitioners should be encouraged to treat pain aggressively even when the treatment may increase the risk of death,” an accompanying report noted.
Despite the guise of preventing assisted suicide, the net effect of the bill was that doctors were given a legal liability shield in the event of patient death, very specifically, in the pursuit of pain relief.
Fundamentally, granting doctors legal safe haven for deaths resulting from fatal doses in relation to pain management directly contradicts the stated purpose of the bill to ban doctors from administering fatal doses, even in the most dire of situations and with the patient’s consent.
The Pain Relief Promotion Act was a formal recognition by the federal government of pain management as a legitimate medical cause for the prescription of controlled substances. To this end, it modified the Controlled Substances Act of 1970 to include ‘pain management’ to the list of allowable medical reasons to prescribe narcotics.
The Act, or “Promotion” as it was aptly entitled, also declared: “The calendar decade beginning January 1, 2001, is designated as the ‘Decade of Pain Control and Research.'”
In sum, doctors that knowingly prescribed fatal doses to patients who wanted to end their lives were criminally liable; doctors that unknowingly overprescribed to non-elective, non-terminal patients were not legally liable.
The passage of the Pain Relief Promotion Act, nor its hidden agenda, have not been expressly linked to Purdue Pharma and OxyContin. However, it was a rather convenient provision for a pharmaceutical company that was at the same time, aggressively dialing up marketing efforts with an FDA-issued label essentially claiming that their product was a non-addictive painkiller.
The bill was introduced by Senator Nickles of Oklahoma after receiving a depressing $45,000 campaign contribution (bribe) from big pharma via a PAC around that time.
Since the passage of the bill, annual opioid-related overdoses have increase by more than 500%.
Sickness in system
The FDA label, the Sackler pocket judge, and a bill that conveniently exonerated physicians from any legal liabilities related to pain management right as Purdue was dialing up OxyContin sales are just a few of an untold number arrangements instigated by Purdue Pharma and the Sacklers during the 20-year long, ongoing tragedy of the opioid epidemic.
Now, the Sackler family will go back to the drawing board to see if it can come up with a new plan that will satisfy the courts. The injunction granted to the Sacklers by Judge Robert Drain expires on Feb. 1, 2022.
The opioid epidemic is far from over. On the contrary, it is escalating. 2020 was a record-breaking year for opioid-related deaths: 69,710 Americans died from overdoses, up 28% from the 49,860 deaths of 2019.
Unfortunately, 2021 saw a continuation of these elevated numbers: More than 65,000 overdose deaths.
It’s important to understand that had opioids not been prescribed so casually and without accountability, many of those who became part of these staggering numbers would likely still be alive today. The liberal prescription of these dangerous narcotics made them too accessible to people who would have otherwise not sought them out.
The Sacklers caused as much, if not more, pain than they ever alleviated with their lies, manipulation, and primitive avarice. Their legacy – once proudly displayed in wings of museums – is now one of appalling greed and moral bankruptcy.
Now, with the legal shield brought into question and their $10 billion hideaway money brought into the spotlight, the Sacklers are facing their crimes.
While the Sackler story is one that illustrates vile human behavior, Hulu’s Dopesick reminds us of the best in human nature, too.
Thousands of people: families, law enforcement officials, Native American tribes, attorney generals from 48 states and D.C., U.S. Attorneys, doctors like Samuel Finnix, judges like Colleen McMahon, journalists like Beth Macy and Patrick Radden Keefe and others – all stepped up. Many of them took personal risks and made difficult sacrifices to make the Sackler family and Purdue Pharma answer for their crimes.
And now, it’s their turn to ‘hammer the abusers.’