Last week I started watching Dopesick while I rode the stationary bike. My mom recommended it and it's so interesting. It totally got me excited to workout so I could watch another episode. Watching people's stories spin out of control is weirdly motivating health wise. It's like I can relate to some of their issues on a different kind of level. This is a dramatized series and I don't think the characters are real. But I did look up a lot of the marketing they depicted and that part was accurate!
I had read news articles about the Purdue Oxycontin lawsuit and their role in the opiate epidemic. But I didn't really understand the full extent of what happened. How could a pharmaceutical company be liable for people becoming dependent on their drugs? Everyone already knows opiates are addictive. I didn't know the history of their deceptive marketing to both doctors and patients.
My history with painkillers is that I was raised to avoid them. (Thanks mom!) I've really only taken one or two when I got my wisdom teeth removed and had a dry socket. Even when prescribed stronger drugs, I take ibuprofen instead. Jared has had them when younger for his broken wrists and it made him sick and he hated the side effects. I'm grateful to have had a parent who warned me about these things.
Once in 2005 or so Jared had a dentist try to just give him oxycontin for a toothache so that he could schedule him a week later. We said no thanks. We found someone else that can get us in quickly. I had worked as a dental assistant and typically if someone called their dentist because of an abscess, the dentist would squeeze them in. I stayed late many many times because of these dental emergencies. I was annoyed. Primarily because we had seen a friend who had always been a disciplined, upstanding person that started taking oxy for back pain and it really messed up his life when he got addicted. It seemed irresponsible that a dentist would offer a week or two of opiates to make their schedule work better. But maybe the show provides more background on why that might have happened.
This series was so eye opening! It was really sad to see how the company could pursue such a deceptive marketing strategy. The FDA took very little action for decades, aside from a scolding letter, it was really not proactively watching out for the patients at all. Their position now is STILL one of defensiveness. They need to take a hard look at what DIDN'T work and the opiate crisis and make some real changes. It's really sad actually.
If you really want to see how a company like this operates from the inside, you need to watch the show. Purdue's actions in promoting the drug as safe and less addictive resulted in a huge increase of overdoses, emergency room visits, babies born drug dependent, crime, foster care issues, etc. It resulted in a huge social impact. I think the most maddening part was that after all they had done to lie to doctors and patients, they used deflection to blame the people who became addicted. Purposefully and aggressively portraying them as weak. So wrong.
Their marketing was originally designed to get people to trust their product was less addictive than other alternatives due to the time release coating. They doubled their sales force when Oxycontin was released. They targeted doctors who deal with chronic pain patients and trained their reps to say that only 1% of people using Oxycontin became addicted. (this was based on a VERY faulty non-real world application of inpatients in a hospital burn unit.)
First they obtained a label with wording written by Curtis Wright, director of the FDA. Wright later left the FDA and within a year or so got a job at Purdue making $400K per year.
“Delayed absorption, as provided by OxyContin tablets, is believed to reduce the abuse liability of a drug”
“Iatrogenic ‘addiction’ to opioids legitimately used in the management of pain is very rare.”
In the following years they ignored evidence that it wasn't any less addictive. Their solution to people becoming addicted (and needing higher doses to stay effective) was to promote higher dosages to doctors. They created a term "breakthrough pain" and told doctors to "personalize the dose". Which also sold a lot more of their drug and boosted sales. The later promoted the invented term of "Pseudoaddiction." Which is gaslighting the doctors and patients into believing people were not actually addicted and just kicking the can down the road and making more money in the meantime. Anyway, there is so much more. It's pretty concrete. Purdue executives plead guilty and were fined $634 million. Their company is now bankrupt and yet the Sackler family still retains over $10 billion dollars in assets.
Moral of the story: Don't trust people that make billions off lying. They don't care if they get a $634 million fine. They still made BILLIONS. It was all worth it to them. Be skeptical. Ask questions. You don't have to blindly trust your doctor. Some Doctors blindly trust the FDA, who is blindly trusting Big Pharma. There are all kinds of problems there. Consider the inherent bias that exists in this framework and use your brain to think independently.
Great article from the Journal of Ethics with some of the details and how the FDA and Purdue were unethical:
https://journalofethics.ama-assn.org/article/how-fda-failures-contributed-opioid-crisis/2020-08
