Clobbering Purdue Pharma Makes Drug Warriors Feel Good, but It Won’t Reduce Opioid-Related Deaths
The U.S. Department of Justice today announced an $8.3 billion settlement with OxyContin manufacturer Purdue Pharma, which admitted to lax anti-diversion practices that allowed doctors and pharmacies to distribute its timed-release version of oxycodone far in excess of what was medically appropriate. The misconduct alleged by the government, some of which the company acknowledged in a criminal plea and some of which figured in a lawsuit that has now been settled, includes promoting wider use of OxyContin even when executives knew the legitimate market was saturated, encouraging prescriptions by paying kickbacks to physicians, and disregarding obvious red flags indicating that some distributors, pharmacists, and doctors were doling out pills without regard to medical need.
“Purdue, through greed and violation of the law, prioritized money over the health and well-being of patients,” said Steven D’Antuono, assistant director in charge of the FBI’s Washington Field Office. “Purdue Pharma actively thwarted the United States’ efforts to ensure compliance and prevent diversion,” added Tim McDermott, assistant administrator of the Drug Enforcement Administration (DEA).
All of that seems to be true. Yet the commonly accepted idea that Purdue started the “opioid crisis” by introducing OxyContin in 1996 is highly dubious. So is the notion that dissolving the company and forcing it to pay billions of dollars in fines, forfeiture, and a civil settlement will do anything to address the ongoing rise in opioid-related deaths.
In its report on the settlement, The Hill says “OxyContin is widely blamed for starting the country’s opioid crisis,” which has “killed more than 400,000 Americans over the past two decades.” But is OxyContin rightly blamed for that?
Estimates from the National Household Survey on Drug Abuse (now the National Survey on Drug Use and Health) indicate that nonmedical use of prescription pain relievers rose for 11 consecutive years before OxyContin was introduced, then continued to rise. While Purdue portrayed its product, which was designed to release oxycodone gradually, as abuse-resistant, nonmedical users quickly discovered that the original version could be crushed, then snorted or injected. But as appealing as that may have been to some people, OxyContin never accounted for a very large share of the prescription analgesic market.
Defending itself against numerous lawsuits, Purdue presented DEA data indicating that OxyContin accounted for just 3.3 percent of pain pills sold in the United States from 2006 through 2012. After adjusting for potency, ProPublica calculated that the product’s “real” share of the market was more like 16 percent.
ProPublica’s approach is questionable, assuming the concern is how
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