I've got to say that I am pleasantly surprised, since it was pretty obvious that the fix was in.
The Feds and forty-three states had already approved a settlement that that only required the family return a fraction of their ill-gotten gains, and stripped the victims of their right to seek redress in the courts.
If ever there was a case that called for piercing the corporate veil and clawing back all of the ill-gotten earnings, this would be it.
> Steve Miller, chair of the Purdue board of directors, said in an emailed statement that the ruling "will delay, and perhaps end, the ability of creditors, communities, and individuals to receive billions in value to abate the opioid crisis."
> "These funds are needed now more than ever as overdose rates hit record-highs, and we are confident that we can successfully appeal this decision and deliver desperately needed funds to the communities and individuals suffering in the midst of this crisis," Miller added.
I mean, if that's what you're concerned about, you can just do that now, without a court decision. You can just spend money on opiod addiction relief. You fucking muppet.
> Should you be free to use whatever drug you want?
Your body, your choice? There are many ways to answer this, and no matter how it is answered there will always be a group of people who disagree. This is why as a society we have a framework for making those decisions which sometimes gets it right and sometimes gets it wrong.
If we legalized all drugs and let people do what they want, do we stop a 10 year old from taking meth, after all it their choice. I think it would be absurd to have 0 restrictions, but that would go against the concept of being able to make free choices.
> Do doctors hold any responsibility over getting you addicted by drugs they prescribe? (Aren't doctors the experts?)
If they prescribed them outside of the boundaries of their professional framework, then yes.
> Now that marijuana is legal, should you sue the legal stores if you get addicted?
You buying marijuana intentionally is a little different from being under the mindset that a licensed medical professional (and health system) is acting within your best interest. Part of this problem also is Purdue mislead people on the addictiveness of their product.
However in saying the above, there is a lot more to this than just supplying a drug. They broke other laws such as the anti kickback.
I want every drug to be on the shelf at the store, but depending on what it is you may have to show your ID to prove you are at the age of majority or emancipated. A pharmacist may still exist to answer questions but nobody is filling pill bottles. Every bottle has the factory safety seal. Scan the label with your phone to locally validate what risks are specific to you without the use of a cloud.
> Do doctors hold any responsibility over getting you addicted by drugs they prescribe? (Aren't doctors the experts?
In this case doctors wrongly prescribed ( when it wasn't necessary or in too high doses) a drug for personal profit. They're guilty, and so is the company that paid them to do that and kept bullshit marketing reassuring doctors and patients everything is ok.
I keep hearing this, but there is no mechanism I am aware of for a doctor to see a cent related to prescription of outpatient medication. What’s the purported mechanism by which docs were making money on this?
Hmm. There are five drug classes for controlled substances and oxycontin was always a class 2 narcotic which carries the second highest risk of being abused. I don't think most doctors/pharmacist really bought into the idea there was zero chance of abuse. I think in the beginning Richard Sackler the best intentions (by Creating a successful drug and racking in a bunch of money and there is no crime in that)but ended getting in way over his head leading to Purdue spiral out of control. I don't believe he created the opiod pandemic but he certainly played a role in it. But as Al Pacinos character says in scarface, "You need people like me so you can point your fckn’ fingers and say, “That’s the bad guy.” And that guy happened to he Richard Sackler
"I don't think most doctors/pharmacist really bought into the idea there was zero chance of abuse."
APPENDIX TO WILLIAM S. BURROUGHS Naked Lunch : Burroughs quote in The British Journal of Addiction, Vol 53, No.2
"LETTER FROM A MASTER ADDICT TO DANGEROUS DRUGS (August 3rd, 1956. Venice (p. 189, Paladin 1992 ed.):"
"I have Taken morphine for acute pain. Any opiate that effectively relieves pain to an equal degree relieves withdrawal symptoms. The conclusion is obvious: Any opiate that relieves pain is habit forming, and the more effectively it relieves pain the more habit forming it is. ..."
William Burroughs.
There is no argument about this and there hasn't been any for about at least a century or more. This is medicine/pharmacy 101 stuff.
All those who thought/think otherwise are fools and should not be anywhere near such decision-making processes. Those qualified in pharmacy or medicine and involved in the pushing and peddling of oxycontin had to know EXACTLY what they were doing - that's to say the serious damage they were doing to patients' health not to mention the deaths - the 65-year old Burroughs quote being the scientific orodoxy in hundreds of medical and pharmacopeia texts.
Burroughs, an opiate addict for 15 years, is one of the most articulate drug users to have written on the matter of opiate addiction and the fact that his descriptions of the addictiveness of opioids has been widely published for decades in the popular press meant that not just the professions knew the details intimately but also that everyone did.
Nothing that Purdue or the Shacklers can say or do can absolve them from their responsibility for the deaths of over 800,000 people - a truly staggering number.
The original settlement was a fucking farce of the first order. Why the Shacklers weren't stripped of everything they own then locked up and the key thrown away simply amazes me. What's wrong with US justice that it can fail so terribly? Here, justice is nothing other than a joke - a joke run and told by the accused.
Moreover, what went wrong with the medical profession and the regulators? Why was the FDA AWOL on this matter for decades - a matter with very well known and long-honed parameters?
After all, the matter of narcotics and addiction is the subject of international treaties. We all know the issues and yet it still happened.
The Purdue, Sacklers and oxycontin matter is one of the greatest failures of public health of all time: a tragedy of unprecedented proportions - and as far as I can determine, no one - except the dead - have paid any penalty whatsoever.
The problem was never that they don't work the problem was that they're addictive.
So since they do work this means it remains appropriate to prescribe them, it just isn't appropriate to give them to everybody to pop one every day before work and say it's "non-addictive".
Drugs that work but have a terrible reputation are almost always still available. For example Thalidomide works, but it causes birth defects. Well, if you're a 45 year old man and the doctor can fix what's wrong with you using Thalidomide, what do you care about birth defects? You get a lecture about why child-bearing age women must under no circumstances take this drug, and then you're issued a prescription.
If you were a young woman, and there was no other option, you'd get an even sterner lecture, explaining that you absolutely must not become pregnant while taking this drug, that the best way to not become pregnant is to not have sex, but that if you're going to have sex you absolutely must prevent pregnancy, and if you get pregnant you must immediately stop using Thalidomide and come see a doctor... and then you're issued a prescription.
The main exception is drugs that had powerful societal bias (often driven by racism or sexism) against them, which might get outlawed even though if doctors were allowed to they'd probably sometimes prescribe them. In the UK these are "Schedule 1" drugs and it requires a specific government license to even test what they do.
We learned the lesson that opioids are too addictive to be used to treat everyday pain back in the 1970's.
However, Purdue Pharma's claim to fame with opioids was that their time release formulation was not addictive, so unlike traditional opioids these could be safely used on a daily basis.
Obviously, this claim was fraudulent.
Opioids still have their place, for treating terminal cancer patients, for instance. Short term use after a catastrophic event is still warranted.
The idea that opioids are addictive is a myth. People taking them are treating “pain” that isn’t diagnosed in the medical system. For example, joblessness. It’s an easy scapegoat for politicians to let them avoid dealing with harder structural problems.
As someone who had major surgery a few months ago I am glad they are for sale and prescribed. No I am not taking opioids now but in the few days after surgery they kept me mostly pain free.
Perdue deserves to be punished. Opioids are a public health crisis when abused. That doesn’t mean that they don’t have legitimate uses.
... you'll see that every pain drug has tradeoffs and opioids are still often the "best" solution even though it has potential for abuse and addiction.
- acetaminophen/aspirin like Tylenol/Excedrin and ibuprofen like Advil are not addictive but they can only treat mild pain
- local anesthesia can eliminate sensation of severe pain but it only lasts a few hours and also causes localized numbness and paralysis. This means you're not functional. So hypothetically trying to use it for knee pain will mean the person can't even walk around.
The ineffectiveness of alternatives means doctors and patients will keep relying on opioids until science comes up with something better.
But what are the the criteria to decide legitimacy of those needs? Pain is a symptom. It is your body signaling a problem. Indeed, sometimes, there are no solution to those problems but I doubt that all those who got prescribed opioids and got addicted didn't have an underlying solvable problem.
If you are obese because you eat too much and your knees hurt, the solution is not an opioid. The whole discourse about pain being a condition that must be addressed is nefarious. Except in some pretty rare case (like terminal illness), pain is a symptom for which the healthcare organizations must find the root cause of and treat properly. Using expedient like opioids is a recipe for failure and a problem of that only the medical community can address. Serious introspection for those in charge of healthcare system in the US (and many other countries) is necessary.
Also, serious failures of the FDA for labeling opioids as not addictive and putting the breaks on fixing it for years.
One of my family members gets terrible debilitating migraines. When they get it, the whole day gets lost, vomiting, dehydration, maybe a trip to urgent care.
An opioid based tablet they are prescribed for migraine cuts this to about 2 hours. The tablet is issued only by the clinic itself or in a major hospital pharmacy and you can't buy it in regular pharmacies.
The problem in US is lack of controls and perverse profit incentives in the American healthcare business.
Because they work. When I had a relatively mild hip fracture (greater throcanter broken clean off) they enabled me to walk and sleep. I went off them as quickly as I could and switched to paracetamol only, but the first week would have been hell without them. Sure I could have survived on week of pain but one week of opiates has no risk of addiction.
Hi, I prescribe opiates often as a cancer doc. Opiates act on the central nervous system and decrease the perception of pain but don't address the pain itself. They are quite useful in the short term as bridging therapy (a few days to weeks) analgesia while you work as hard and as quickly as possible to address the physical cause of pain.
On the same token, there are great alternatives too. For musculoskeletal pain, a combination of 1000mg Tylenol and 800mg Ibuprofen all at once has efficacy close to that of low dose opiates. This regimen however carries increased kidney and liver injury.
There are also less addictive opiates such as tramadol (rate of addiction 1 in 100,000).
But again, all of the above is simply to mask the pain. The most important aspect is quick and vigorous pain source control.
Opioids took me from suicide level pain to just tolerable pain over 6 months after I had a half golf ball sized hole scooped out of the base of my tongue due to cancer. It was a bad week when I stopped but it's doable. Opioids have a place.
It's used in all sorts of surgical procedures. I've had it a few times, used as a relatively minor painkiller under those circumstances. Which sounds crazy considering how much news is about how strong it is. But it works well in those controlled circumstances
Because they're extremely effective in treating extreme pain. In some cases, this is necessary because pain limits recovery. Use of them needs to be managed extremely well though and when that doesn't happen it's easy to get addicted.
OxyContin is not significantly more (or less) addictive or dangerous than other opiates. The problem with it is that it has been marketed by Purdue as 'safe', and that it is over-prescribed. I recommend the book Pharma by Gerald Posner, which goes into this in excruciating detail - but well worth a read.
Readit News
The Feds and forty-three states had already approved a settlement that that only required the family return a fraction of their ill-gotten gains, and stripped the victims of their right to seek redress in the courts.
If ever there was a case that called for piercing the corporate veil and clawing back all of the ill-gotten earnings, this would be it.
> "These funds are needed now more than ever as overdose rates hit record-highs, and we are confident that we can successfully appeal this decision and deliver desperately needed funds to the communities and individuals suffering in the midst of this crisis," Miller added.
I mean, if that's what you're concerned about, you can just do that now, without a court decision. You can just spend money on opiod addiction relief. You fucking muppet.
Do doctors hold any responsibility over getting you addicted by drugs they prescribe? (Aren't doctors the experts?)
Now that marijuana is legal, should you sue the legal stores if you get addicted?
Your body, your choice? There are many ways to answer this, and no matter how it is answered there will always be a group of people who disagree. This is why as a society we have a framework for making those decisions which sometimes gets it right and sometimes gets it wrong.
If we legalized all drugs and let people do what they want, do we stop a 10 year old from taking meth, after all it their choice. I think it would be absurd to have 0 restrictions, but that would go against the concept of being able to make free choices.
> Do doctors hold any responsibility over getting you addicted by drugs they prescribe? (Aren't doctors the experts?)
If they prescribed them outside of the boundaries of their professional framework, then yes.
> Now that marijuana is legal, should you sue the legal stores if you get addicted?
You buying marijuana intentionally is a little different from being under the mindset that a licensed medical professional (and health system) is acting within your best interest. Part of this problem also is Purdue mislead people on the addictiveness of their product.
However in saying the above, there is a lot more to this than just supplying a drug. They broke other laws such as the anti kickback.
In this case doctors wrongly prescribed ( when it wasn't necessary or in too high doses) a drug for personal profit. They're guilty, and so is the company that paid them to do that and kept bullshit marketing reassuring doctors and patients everything is ok.
APPENDIX TO WILLIAM S. BURROUGHS Naked Lunch : Burroughs quote in The British Journal of Addiction, Vol 53, No.2
"LETTER FROM A MASTER ADDICT TO DANGEROUS DRUGS (August 3rd, 1956. Venice (p. 189, Paladin 1992 ed.):"
"I have Taken morphine for acute pain. Any opiate that effectively relieves pain to an equal degree relieves withdrawal symptoms. The conclusion is obvious: Any opiate that relieves pain is habit forming, and the more effectively it relieves pain the more habit forming it is. ..."
William Burroughs.
There is no argument about this and there hasn't been any for about at least a century or more. This is medicine/pharmacy 101 stuff.
All those who thought/think otherwise are fools and should not be anywhere near such decision-making processes. Those qualified in pharmacy or medicine and involved in the pushing and peddling of oxycontin had to know EXACTLY what they were doing - that's to say the serious damage they were doing to patients' health not to mention the deaths - the 65-year old Burroughs quote being the scientific orodoxy in hundreds of medical and pharmacopeia texts.
Burroughs, an opiate addict for 15 years, is one of the most articulate drug users to have written on the matter of opiate addiction and the fact that his descriptions of the addictiveness of opioids has been widely published for decades in the popular press meant that not just the professions knew the details intimately but also that everyone did.
Nothing that Purdue or the Shacklers can say or do can absolve them from their responsibility for the deaths of over 800,000 people - a truly staggering number.
The original settlement was a fucking farce of the first order. Why the Shacklers weren't stripped of everything they own then locked up and the key thrown away simply amazes me. What's wrong with US justice that it can fail so terribly? Here, justice is nothing other than a joke - a joke run and told by the accused.
Moreover, what went wrong with the medical profession and the regulators? Why was the FDA AWOL on this matter for decades - a matter with very well known and long-honed parameters?
After all, the matter of narcotics and addiction is the subject of international treaties. We all know the issues and yet it still happened.
The Purdue, Sacklers and oxycontin matter is one of the greatest failures of public health of all time: a tragedy of unprecedented proportions - and as far as I can determine, no one - except the dead - have paid any penalty whatsoever.
For those that haven't watched them yet, there are 3 John Oliver segments on the subject that will back up the "Good." statement:
Opioids https://www.youtube.com/watch?v=5pdPrQFjo2o
Opioids II https://www.youtube.com/watch?v=-qCKR6wy94U
Opioids III (this one focuses 100% on the Sacklers) https://www.youtube.com/watch?v=uaCaIhfETsM
https://www.netflix.com/ie/title/81002576
So since they do work this means it remains appropriate to prescribe them, it just isn't appropriate to give them to everybody to pop one every day before work and say it's "non-addictive".
Drugs that work but have a terrible reputation are almost always still available. For example Thalidomide works, but it causes birth defects. Well, if you're a 45 year old man and the doctor can fix what's wrong with you using Thalidomide, what do you care about birth defects? You get a lecture about why child-bearing age women must under no circumstances take this drug, and then you're issued a prescription.
If you were a young woman, and there was no other option, you'd get an even sterner lecture, explaining that you absolutely must not become pregnant while taking this drug, that the best way to not become pregnant is to not have sex, but that if you're going to have sex you absolutely must prevent pregnancy, and if you get pregnant you must immediately stop using Thalidomide and come see a doctor... and then you're issued a prescription.
The main exception is drugs that had powerful societal bias (often driven by racism or sexism) against them, which might get outlawed even though if doctors were allowed to they'd probably sometimes prescribe them. In the UK these are "Schedule 1" drugs and it requires a specific government license to even test what they do.
However, Purdue Pharma's claim to fame with opioids was that their time release formulation was not addictive, so unlike traditional opioids these could be safely used on a daily basis.
Obviously, this claim was fraudulent.
Opioids still have their place, for treating terminal cancer patients, for instance. Short term use after a catastrophic event is still warranted.
It's stronger than that, you get a three page consent form that you sign to say that, for instance, you won't get anyone pregnant.
Perdue deserves to be punished. Opioids are a public health crisis when abused. That doesn’t mean that they don’t have legitimate uses.
Dead Comment
If you take a look at the various alternatives for pain medication: https://en.wikipedia.org/wiki/Analgesic
... you'll see that every pain drug has tradeoffs and opioids are still often the "best" solution even though it has potential for abuse and addiction.
- acetaminophen/aspirin like Tylenol/Excedrin and ibuprofen like Advil are not addictive but they can only treat mild pain
- local anesthesia can eliminate sensation of severe pain but it only lasts a few hours and also causes localized numbness and paralysis. This means you're not functional. So hypothetically trying to use it for knee pain will mean the person can't even walk around.
The ineffectiveness of alternatives means doctors and patients will keep relying on opioids until science comes up with something better.
If you are obese because you eat too much and your knees hurt, the solution is not an opioid. The whole discourse about pain being a condition that must be addressed is nefarious. Except in some pretty rare case (like terminal illness), pain is a symptom for which the healthcare organizations must find the root cause of and treat properly. Using expedient like opioids is a recipe for failure and a problem of that only the medical community can address. Serious introspection for those in charge of healthcare system in the US (and many other countries) is necessary.
Also, serious failures of the FDA for labeling opioids as not addictive and putting the breaks on fixing it for years.
An opioid based tablet they are prescribed for migraine cuts this to about 2 hours. The tablet is issued only by the clinic itself or in a major hospital pharmacy and you can't buy it in regular pharmacies.
The problem in US is lack of controls and perverse profit incentives in the American healthcare business.
On the same token, there are great alternatives too. For musculoskeletal pain, a combination of 1000mg Tylenol and 800mg Ibuprofen all at once has efficacy close to that of low dose opiates. This regimen however carries increased kidney and liver injury.
There are also less addictive opiates such as tramadol (rate of addiction 1 in 100,000).
But again, all of the above is simply to mask the pain. The most important aspect is quick and vigorous pain source control.
Not every opiate has the issues OxyContin does.
Dead Comment