FIGHTING BACK - A PILL, A LIE, AND HALF A MILLION DEAD: THE SACKLERS AND PURDUE PHARMA — PART 1

0:03 Callaroga Shark Media. Good morning, I'm Garrett Fischer. Wednesday May thirteenth, twenty twenty six. Before nineteen ninety six, the medical standard in the United. States was clear. Opioid painkillers were powerful, they were effective, and they were dangerous enough that they should be reserved primarily for cancer patients and people in end of life care. The risk of addiction was real and well understood, and most physicians approach opioid prescribing cautiously. As a result. That caution was not perfect, but it was grounded in evidence, and it had been the medical consensus for decades. In nineteen ninety six, one company decided that consensus was a business obstacle. Purdue Pharma, owned and controlled by the Sackler family of Stamford, Connecticut, launched OxyContin, a controlled release oxy codone tablet, with a marketing campaign built on a claim that the company's own internal documents show they knew was false, that OxyContin was less addictive than other opioids because of its slow release mechanism. They told doctors this, they trained their salespeople to say it, they paid physicians to repeat it at conferences, and in doing so, they did not just sell a drug. They rewrote the medical consensus on opioid prescribing in America, flooded the country with a powerful narcotic under false pretenses, and set in motion a chain of events that has now killed more than half a

1:34 million people. This is part one of the Purdue Pharma's story, how they built it, what they knew, and what they did with that knowledge. The Sackler family and Purdue Pharma. The Sackler family bought Purdue Frederick, a small pharmaceutical company in Connecticut, in nineteen fifty two. The three Sackler brothers, Arthur, Mortimer, and Raymond, were all physicians, and Arthur in particular had a background in pharmaceutical advertising that shaped how the company thought about marketing drugs. Arthur died in nineteen eighty seven. His share passed to his brothers. Mortimer died in twenty ten, Raymond in twenty seventeen. Under their ownership and the subsequent ownership of the next generation of Sacklers, Purdue grew into a focused, privately held company specializing in pain management medications.

2:31 The Sacklers were known philanthropists. Their name appeared on galleries at the Metropolitan Museum of Art, The Louver, the Guggenheim, the Tate Modern, the National Portrait Gallery in London, the Smithsonian and Harvard Sackler Museum, among dozens of other institutions. They were, by any visible measure, one of the most prominent charitable families in the Western world. Generous patrons of art, culture and medicine, their name associated with prestige and beneficence. The donations were real. What was underneath them is what this episode is about. The modern Purdue Pharma was incorporated in nineteen ninety one, focused entirely on pain management. In nineteen eighty four, they had launched MS content, a controlled release morphine tablet, with reasonable success. The experience gave them a template, a powerful opioid with a mechanism that released the drugs slowly over time, marketed as a safer and more manageable alternative to immediate release formulations. OxyContin was the same concept applied to oxycodone, a chemical cousin of heroin, and launched at a scale and with a marketing intensity that MS content had never approached. The lie at the center of it all. OxyContin was approved by the FDA in nineteen ninety five and launched in nineteen ninety six.

3:53 The central claim of Purdue's marketing campaign was that OxyContin, because it released oxycodone slowly over twelve hours rather than all at once, produced a steadier blood level of the drug that was less likely to produce the peaks and troughs associated with addiction. This was the core message. OxyContin is different, oxy Contin is safer. Oxy Contin is less addictive than what you've been using. Perdue's own internal documents, which came to light through litigation years later, show that the company knew this claim had a serious problem. OxyContin did not, in fact last twelve hours. For many patients. The controlled release. Mechanism wore off before the next dose was due, leaving patients in a gap period, a window of withdrawal like symptoms and craving before the next pill. Purdue's own data showed this. Patient reports showed this, and when prescribers began raising the problem with Purdue sales representatives, the company's instructed response was not to acknowledge the twelve hour claim was wrong.

4:54 The instructed response was to tell the doctor to increase the dose h more opioid, which is more addictive, more dangerous, and more profitable. Richard Sackler, who served as president and then co chairman of Purdue and was by all accounts deeply involved in the operational management of the company, sent an email in the months after Oxycontin's launch describing how he wanted the drug positioned. He called for Purdue to be feared as a tiger with claws, teeth and balls in the market, and described the goal of building excitement among prescribers. An internal memo to Purdue sales team introduced in evidence in subsequent lawsuits, said simply, your priority is to sell oxy content. Before the drug launch, the company had surveyed more than five hundred health professionals to understand their attitudes about prescribing OxyContin to opioid naive patients people who had never been on opioids before. Seventy six percent said they would. That number told Perdue that the market they were targeting was not the narrow population of cancer and palliative care patients who had always been the primary recipients of strong opioids. It told them that the much larger market of people with chronic, non malignant pain, back pain, arthritis, sports injuries, post surgical pain was open to them if they could get doctors comfortable prescribing.

6:21 That is what they set out to do. Produced sales strategy for OxyContin was comprehensive and methodical in ways that would have been impressive if they had been selling something benign. The company hired three thousand sales representatives and equipped them with a specific script built around the less addictive claim. Sales reps were given uncapped commission incentives tied directly to OxyContin prescription volume, meaning the more pills a doctor prescribed, the more money the rep made. With no sealing, the targeting of high volume prescribers was deliberate. Purdue use using McKinsey and company as consultants, focused their salesforce on the physicians who wrote the most opioid prescriptions, visiting them more frequently and offering more generous inducements. Those inducements were not subtle. Purdue sponsored pain management seminars at luxury resorts and vacation destinations, all expenses paid weekend retreats for physicians where Purdue funded speakers would present on pain management and the benefits of OxyContin. More than five thousand physicians, pharmacists, and nurses attended these events between nineteen ninety six and two thousand and two. The company also ran a speaker's bureau of three thousand doctors paid to give presentations about oxy content to their colleagues, essentially a paid advocacy network inside the medical community, amplifying Purdue's message through voices that carried the authority of independent physicians rather than salespeople. Richard

7:52 Sackler tracked the dinner programs and weekend meetings personally. An internal email from nineteen ninety six showed him analyzing whether these events were cost effective in driving prescription increases among attendees. They were. His own data. Showed that physicians who attended dinner programs wrote more than double the number of new OxyContin prescriptions compared to those who didn't attend. Weekend meetings were even more effective, increasing new prescriptions by a factor of more than two. He knew exactly what the machine was producing, and he was managing it closely. The company also worked the medical literature. Purdue and other pharmaceutical companies funded pain researchers and advocacy groups that published studies and guidelines supporting broader opioid prescribing.

8:38 Russell Portinoy, a prominent neurologist and pain specialist, whose pain center at Beth Israel Hospital in New York received significant Purdue funding, became one of the most influential voices, arguing that the risks of opioid addiction had been overstated and that withholding opioids from patients with chronic pain amounted to medical negligence. He later acknowledged having financial relationship with more than a dozen opioid manufacturers. The medical consensus was. Being rewritten, and it was being rewritten with perdues money. The results were staggering. Prescriptions for OxyContin went from roughly six hundred seventy thousand in nineteen ninety seven to six point two million in two thousand and two.

9:21 Revenue grew from forty. Eight million dollars in nineteen ninety six to nearly one point one billion dollars in two thousand and As prescription spread not just to cancer patients and end of life care, but to people with back pain, knee pain, dental pain. Post surgical recovery. The overdose deaths began slowly at first, then faster, then in a cascade that built over years into one of the worst public health disasters in American history. After the break the company's first reckoning in two thousand and seven, the guilty plea that cost them six hundred million dollars and changed almost nothing, and the decade of lawsuits during which the Sackler family moved approximately eleven billion dollars out of the company and into private trusts. There is a word for what you call it when you drain a company's assets into personal accounts while it faces liability for mass casualties. Accountability doesn't have a legal department. The Sacklers did the addiction they wouldn't name. By the late nineteen nineties, reports of OxyContin addiction and.

10:37 Abuse were reaching Purdue from the field. Sales representatives filed reports, pharmacists raised concerns. State medical boards began tracking the pattern. Purdue was aware, formally documentably aware that OxyContin was being abused, that patients were becoming addicted, that some people were crushing the pills to defeat the controlled release mechanism and inhaling or injecting the oxycodone directly, and that the drug was finding its way from legitimate prescriptions onto the street. The company knew this as early as nineteen ninety six, its first year on the market. What they did with that knowledge was not changed the drugs labeling not alert physicians, not modify the marketing. What they did was instruct their sales representatives to tell doctors that only patients with an addictive personality became addicted to OxyContin.

11:30 The implication was clear, addiction is the patient's problem, not the drugs. If someone became dependent, it was because of who they were, not because of what Purdue had told their doctor about what they were taking. The company also launched an OxyContin savings card program in two thousand and eight, offering patients discounts on their first five prescriptions. Purdue's own internal data showed these discount cards led to sixty percent more patients staying on OxyContin for longer than ninety days. Ninety days of opioid use is the threshold beyond which physical dependence becomes highly likely. The Massachusetts Attorney General's lawsuit described the savings card this way, in language drawn from internal company documents. Perdue determined that opioid savings cards worked like the teaser rate on a long term and very high stakes mortgage. They knew what they were doing, they had modeled it. They called it a teaser rate. Two thousand and seven, the first guilty plea in two thousand and seven. Under sustained pressure from law enforcement investigations and the accumulating evidence of the drugs devastation and communities across the country, particularly in Appalachia, where the pills had saturated the market and overdose debts were rewriting local mortality statistics, Perdue finally faced a federal reckoning. A subsidiary company, Perdue Frederick pleaded guilty to a federal felony charge of misbranding oxycontent by claiming it was less addictive and less subject

13:02 to abuse than other pain medications. Three senior Purdue executives, the company's top lawyer, chief medical officer, and former president, pleaded guilty to misdemeanor charges for their roles in the deception. The total fine was six hundred million dollars at the time, one of the largest ever levied against a pharmaceutical company. The Sackler family was not charged. No member of the family faced criminal liability. The guilty plea was entered by the subsidiary, not by the parent company, and critically, Purdue Pharma itself continued operating, continued selling oxy contin continued employing the same sales force with the same incentive structures and continued marketing opioids aggressively right up until twenty nineteen. This is what I mean when I say accountability doesn't have a legal department. The six hundred million dollar fine was real, the guilty plea was real, But the structure of who was charged, what entity paid, and who kept their freedom and their fortune was the product of legal maneuvering that insured the people who had run the deception personally, who had sent those emails, who had reviewed those sales data, who had approved those marketing strategies, walked away from two thousand and seven richer than they had been before. In the years following two thousand and seven, the Sackler family began systematically moving money out of Purdue Pharma and into private trusts and holding companies. The timing of this was not coincidental. More than two thousand, six hundred federal and

14:34 state lawsuits had been filed against Purdue since the guilty plea. The legal exposure was growing, the opioid crisis was deepening, and the public understanding of Purdue's role in it was expanding, And while the lawsuits accumulated, the Sacklers transferred approximately eleven billion dollars eleven billion dollars out of the company they owned and into accounts that were legally separate from the entity being sued. The US government, in briefings before the Supreme Court years later, called this a milking program. That is the government's characterization in a formal legal filing. They were milking the company, taking out the assets while the liability grew, so that when the reckoning finally came, the company would be facing it largely empty, and the family's personal wealth would be insulated behind a set of legal structures that made it very difficult for any individual victim to reach. I want to close Part one with some numbers, because I think the scale of this crisis gets lost in the legal arguments about bankruptcy and trusts and settlement structures, and it deserves.

15:45 Not to get lost. Between nineteen ninety nine and twenty twenty one, approximately six hundred and forty five thousand people in the United States died from opioid overdoses. That number includes prescription opioids heroin, and synthetic opioids like femanl, but the pathway from prescription opioids to heroin to fentanyl is documented and direct of people who use heroin. Eighty percent first misused a prescription opioid. Perdue did not create the entire opioid crisis alone. Other pharmaceutical companies were involved. Distributors and pharmacies played roles, but Purdue with OxyContin, was the catalyst. They rewrote the medical consensus.

16:25 They put the pills in circulation at a scale that had never existed. They built the infrastructure of dependency that then followed its own terrible logic when the prescriptions dried up and people found the next available opioid. The Sackler family, at the height of their OxyContin wealth, was richer than the Rockefellers. Forbes called them the OxyContin Clan. Their name was on museums and galleries and university buildings on two continents, and the source of that wealth was a drug they had marketed with a lie, managed with full knowledge of the harm it was causing, and continued selling for more than two decades while the country buried its dead Tomorrow.

17:07 The lawsuits the depositions where families held photographs of their dead children and refused to sit down. The bankruptcy filing designed to stop those families from reaching the sacklers personally, and what the Supreme Court of the United States did about it in June twenty twenty four. That's part one of the Purdue Pharma story. A lie embedded in a drugs label, a marketing machine that spent millions paying doctors to repeat the lie, A company that knew what was happening and told their salespeople the patients. Were the problem, not the pill. And a family that made billions from all of it and called it pain management. Do Better. Disclaimer.

17:50 Daily Crime and Justice is produced by Callaroga Shark Media. This episode draws on court records, congressional testimony, Patrick rad and Keef's Empire of Pain, stat news investigations, Massachusetts AG filings, CDC data, and AI assisted research. We do our best to get it right. We are a podcast, not a courtroom. This is entertainment and commentary, not legal fact.