The Addictive Profits of Pain

“My teenage daughter recently had some blood work done, and the total cost was more than $1000. After insurance, we have the honor of paying $200 for a bloodtest …”, complains Annie Reneau in an article entitled “If Americans-understood how absurd our system is …”    She may have forgotten that all these costs must be right. As right as those efficiently pricing free markets make them.  And high prices all add up into GDP!  The more a nation spends on sickness the richer it is. Like $63,742 GDP per head in the US  compared to only  $40,447 in the UK.

Poor Old Europe…

On the other hand, the three high tech cancer ops I recently received from the NHS personally cost me £0,00 – well, I did pay for the taxi to the hospital.

Would that be capitalism with socialist characteristics?

As you breathe in the pleasurable profits of pain below you may ponder the idea of a once pleasure seeking capitalism having gone masochistic?

Just follow the money…

P R Keefe twitter

amazon blurb  5/2021   ‘Put simply, this book will make your blood boil . . . Keefe . . . paints a devastating portrait of a family consumed by greed and unwilling to take the slightest responsibility or show the least sympathy for what it wrought.’ John Carreyrou, author of Bad Blood, in the New York Times

The gripping and shocking story of three generations of the Sackler family and their roles in the stories of Valium and Oxycontin, by the prize-winning, bestselling author of Say Nothing.

The Sackler name adorns the walls of many storied institutions – Harvard; the Metropolitan Museum of Art; Oxford; the Louvre. They are one of the richest families in the world, known for their lavish donations in the arts and the sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing Oxycontin, a blockbuster painkiller that was a catalyst for the opioid crisis-an international epidemic of drug addiction which has killed nearly half a million people.

In this masterpiece of narrative reporting and writing, Patrick Radden Keefe exhaustively documents the jaw-dropping and ferociously compelling reality. Empire of Pain is the story of a dynasty: a parable of 21st century greed.

reviews                kindle sample       amazon reviews         goodreads  reviews  27/11/2021 Empire of Pain by Patrick Radden Keefe review – all the moral power of a Victorian novel – This prizewinning account of a band of brothers who struck gold with the opioid OxyContin is a masterfully told story of corruption and greed  by

“The worthy winner of the Baillie Gifford prize earlier this month, Patrick Radden Keefe’s Empire of Pain is a work of nonfiction that has the dramatic scope and moral power of a Victorian novel. It’s about corruption that is so profitable no one wants to see it and denial so embedded it’s almost hereditary….”…


science/  21/8/2021  Sackler Dynasty: A Searing Portrait of Greed From the Pharmaceutical Industry   by Mohammad Anas

…”Part-biography, part-investigation, the book chronicles the lives of Arthur Sackler – a pioneer of medical advertising – and his two brothers, Raymond and Mortimer, all of them doctors. Arthur, the family patriarch and son of Jewish immigrants, popularised drugs such as Terramycin and Betadine in the 1950s through an ad agency called William Douglas McAdams. He helped Pfizer transform itself from a supplier of chemicals to a major player in the pharmaceutical business.  His biggest success came through marketing Valium. It would become the first $100 million drug. And its makers, the Swiss healthcare company Roche, reaped billions of dollars in revenue.  All of this was achieved through a blitzkrieg of revolutionary marketing techniques, creative advertisements and an army of salespersons. The Medical Advertising Hall of Fame would eulogise Arthur’s legacy thus: “no single individual did more to shape the character of medical advertising than the multi-talented Dr Arthur Sackler. His seminal contribution was bringing the full power of advertising and promotion to pharmaceutical marketing”. …”…

Sackler Dynasty: A Searing Portrait of Greed From the Pharmaceutical Industry  16/5/2021  Empire of Pain by Patrick Radden Keefe, review — the Sacklers and the opioid crisis – An exposé of the family that allegedly fuelled painkiller addiction in America is jaw-dropping   by John Arlidge
“Some books make you so angry you want to chuck rocks at the bad guys they expose. This book is one of those. …”…  15/5/2021 Patrick Radden Keefe traces the roots of America’s opioid epidemic
Introduced in 1996, OxyContin generated vast sales—and led to enormous suffering

…”…“The prescription blizzard will be so deep, dense and white,” Richard Sackler, son of Raymond, promised at the launch party for OxyContin. His words proved all too prophetic. The plan for mass-market opioids was abetted by misleading advertising, which claimed that less than 1% of patients would become addicted, and a vast salesforce incentivised by lucrative commissions.

The company peddled theories of “pseudo-addiction” (for which the cure was said to be more opioids) and of “opiophobia” among sceptical doctors. The guardrails against harm buckled in the face of Purdue’s wealth and the lawyers and lobbyists it could buy. Regulators endorsed ludicrous claims about the drug’s safety. A serious case brought by federal prosecutors in Virginia in the early 2000s was watered down by the Department of Justice. Thousands of doctors were given all-expenses-paid trips. Altogether, OxyContin took in $35bn in sales. The results were brutal.” …  15/5/2021  Last year, more people in San Francisco died of overdoses than of covid-19 – This is part of a worrying national trend, following changes in drug markets  13/5/2021 Empire of Pain review by Patrick Radden Keefe – the dynasty behind an opioid crisis –  This examination of the Sackler family, purveyors of OxyContin, lays bear its responsibility for the US’s opioid epidemic  by Samanth Subramanian

… “The things they knew! They knew that OxyContin was more potent than morphine, and they exploited the fact that doctors thought the reverse to be true. (“It is important that we be careful not to change the perception of physicians,” a Purdue official advised.) They claimed OxyContin posed little risk of addiction, even though Purdue had carried out no tests to that effect at all. They knew they were using flimsy literature to reassure physicians about OxyContin’s safety: “not a peer-reviewed study,” Keefe writes, “but a five-sentence letter to the editor by two doctors at Boston University”. They knew the drug could be injected, but they didn’t let on. They argued that OxyContin’s slow-release mechanism was a barrier to abuse, but they knew they also owned another company that made immediate-release oxycodone. Studying their sales data, they maintained a secret list of doctors who overprescribed OxyContin – and did little to alert the authorities to these pill mills, preferring to grow rich off the proceeds instead. …

Keefe’s narrative is so lush with details that only in the chinks do we spot the story behind the story: the rotting structure of American healthcare that almost wills disasters into being.” …”   12/5/2021 Empire of Pain by Patrick Radden Keefe review — the family who profited from America’s opioid crisis   The story of the ruthless promotion of OxyContin by Purdue, the pharma company owned by the Sackler dynasty, is a shocking page –  by Melanie Reid  2021 What Did the Sacklers Know? – Patrick Radden Keefe’s new book provides the fullest accounting so far of Purdue Pharma’s role in the opioid crisis.  2021 Empire of Pain review: the Sacklers, opioids and the sickening of America – Patrick Radden Keefe delivers a damning account of Purdue Pharma, OxyContin and a family that grew rich   by Lloyd Green  2021 Protect the Family at All Costs – A damning portrait of the Sacklers, the billionaire clan behind the OxyContin epidemic. BY Laura Miller

FT 5/2021 Deadly Painkillers  review by John Gapper

updates + more relevant articles  6/9/2021    5/9/2021  Opioids have killed 600,000 Americans. The Sacklers just got off basically scot-free – A bankruptcy court gave members of the pharma family immunity from further civil suits. They don’t have to admit wrongdoing – and they may end up richer than they started    by Chris McGreal  (author of American Overdose: The Opioid Tragedy in Three Acts)

…”The US has 375 bankruptcy judges but, as Levitin told Congress, just three oversaw the majority of cases filed by large companies last year. Purdue Pharma chose to file with one of those three, Judge Robert Drain, to decide the conditions of its bankruptcy. Although Purdue is based in Connecticut, it filed for bankruptcy in White Plains, New York, where Drain is the only bankruptcy judge. It’s unlikely to have gone unnoticed by the Sacklers’ lawyers that Drain had an unusual record of staying lawsuits against third parties who have not filed for bankruptcy.  One of Drain’s first steps was to block efforts to sue individual members of the Sackler family, even though they were separate from the Purdue bankruptcy case. Then he permitted the Sacklers to effectively hold the plaintiffs hostage by offering a stark choice between settling for a cut of the profits of misery in return for wiping the legal slate clean or facing years of court battles. States, municipalities and families desperate for money to cope with the huge social consequences of the epidemic were left with little choice but to agree, although many expressed their distaste.  …

Judge Drain said he was unhappy with the outcome of the case but that his hands were tied. “This is a bitter result,” he said, arguing that he had little choice but to agree to the Sacklers’ demands or risk no financial settlement at all. The judge’s critics say the outcome was preordained from the moment Purdue filed its case in his court.  But it is an outcome that fits with the history of a uniquely American epidemic. No other country has experienced the same scale of opioid addiction and death, in part because corporations in other countries do not wield the same influence over the practice and regulation of medicine. Neither did Purdue act alone in this crisis. Drug distributors and pharmacies jumped on the bandwagon. Other opioid manufacturers, such as Johnson & Johnson, raked in the profits of narcotic painkiller addiction.

Even as evidence of a crisis grew and doctors witnessing the devastation sounded warnings, the din of corporate money drowned them out. The quarter of a billion dollars a year the drug industry spends on lobbying bought the complicity of politicians, influenced regulators, weakened investigations by the justice department and stalled action by the Drug Enforcement Administration. Purdue used its political muscle to head off even more serious criminal charges and to keep its executives out of prison.

Above all, the drug industry kept the doors to mass prescribing of opioids open for years not because they were an effective way to treat pain but because they were hugely profitable. Those same firms are now increasingly agreeing to payouts to head off a torrent of lawsuits – but it’s hard to conclude that they regard it as anything more than the cost of doing business. Not least because, like the members of the Sackler family behind Purdue, none of them admit to having done anything wrong.” …  4/9/2021 US drug companies say $26bn opioid settlement will proceed – Companies say ‘enough’ US states joined a settlement resolving claims they fuelled the opioid epidemic, allowing it to move ahead. 3/9/2021 What is the bankruptcy “loophole” used in the Purdue Pharma settlement?
A controversial legal arrangement shields the owners of companies from personal liability

ON SEPTEMBER 1ST a long legal wrangle in America’s opioid epidemic, which continues to kill thousands of people a year, at last came to an end. A federal judge in New York approved the bankruptcy plan of Purdue Pharma, which developed and manufactured OxyContin, a highly addictive painkiller. The deal settles thousands of lawsuits against the firm filed by states, localities, tribes and individuals. Purdue will be re-organised as a public-benefit company called Knoa Pharma, and its future profits will go towards alleviating the damage done by opioid addiction. Members of the Sackler family, who own Purdue, will relinquish control of the firm and pay $4.5bn to plaintiffs. But nine states and Washington, DC opposed the final deal and some—Connecticut, Washington state and the District of Columbia —will appeal against it. Their objections stem from a legal arrangement shielding parties associated with bankrupt companies (which have not filed for bankruptcy themselves) from liability, which many people want to change.  18/8/2021  Purdue Pharma chair denies responsibility for US opioid crisis
…”Richard Sackler, 76, says in bankruptcy court he, his family and company are not responsible for epidemic … Richard Sackler’s denial of responsibility for the opioid crisis comes a day after another Sackler family member said the group wouldn’t accept a settlement without guarantees of immunity from further legal action….”…  24/7/2021  What Those in Power Are Missing About the Opioid Epidemic “This is what happens when public health fails.” By Jack Shuler

The CDC estimates that more than 93,000 Americans died from drug overdoses in 2020, up 29 percent from the year before. And since 1999, more than 840,000 Americans have died from overdoses. In recent years, the overwhelming majority died from using the synthetic opioid fentanyl, which is used on its own or found in other drugs, resulting in people taking it unintentionally.

Joe Biden’s platform for ending the opioid crisis supports important interventions, including expanded access to treatment, harm reduction, and health care. But he has spoken in favor of measures such as mandatory treatment for substance use, which takes away a person’s agency and is not proven to be effective, and drug courts, in which a judge essentially supervises treatment. The people most harmed by the structural violence of these policies, and by a lack of adequate health care, are poor, and many of them are people of color. Combatting the overdose crisis by punishing people who use drugs through the criminal-justice system will not work.

Read: The opioid epidemic might be much worse than we thought  15/7/2021  Pharmaceutical firms want to move on from the opioid crisis – but its victims cannot – how corporations funnelled hundreds of millions of prescription pain pills into West Virginia    by Richard Hall

There is a passage in John Steinbeck’s The Grapes of Wrath that details an exchange between a representative of a bank and a tenant they are in the process of evicting. It was published 80 years ago, but still feels relevant today.

“We’re sorry. It’s not us. It’s the monster. The bank isn’t like a man,” the banker tells the tenant.

“Yes, but the bank is only made of men,” comes the tenant’s reply, expecting some kind of reprieve.

“No, you’re wrong there – quite wrong there. The bank is something more than men, I tell you. It’s the monster. Men made it, but they can’t control it.”

I thought of those words recently as I sat in a courtroom in Charleston, West Virginia, listening to a drug company executive defend his employer’s role in fuelling the opioid epidemic.

The executive, a former compliance officer for one of the “Big Three” pharmaceutical companies that collectively funnelled hundreds of millions of prescription pain pills to the state, was asked why they had not stopped the shipments when it became clear there was a problem.

“We’re a company. We’re not an enforcement agency and we’re not a regulatory agency,” said Chris Zimmerman, senior vice president of regulatory affairs at AmerisourceBergen.   12/5/2021  US states oppose ‘unjust’ plan to shield Sackler wealth in opioid settlement – by Chris McGreal   –   Twenty-four states object to bankruptcy proposal for Sacklers to settle lawsuits by paying $4.3bn but family would keep about $7bn –  –  Nearly half of US states have joined growing opposition to a highly unusual bankruptcy plan that would protect the wealth of the Sackler family after it made billions of dollars from selling the drug that kickstarted the   US opioid epidemic.  5/2021  Big pharma doesn’t want us to expand Medicare. We have to fight them – By lifting the ban on Medicare negotiating prescription drugs prices we can expand benefits and lower the age of eligibility –  by Bernie Sanders

Americans spend $477 billion a year MORE on health care than other advanced countries, which amounts to $1,645 per person every year. So why do we pay so much compared to other wealthy nations? mu AMERICA VS. THE WORLD Where does all our money go? A breakdown of our ‘routine’ visits as compared to other wealthy nations.  2017  The Family That Built an Empire of Pain- The Sackler dynasty’s ruthless marketing of painkillers has generated billions of dollars—and millions of addicts.  By Patrick Radden Keefe   Since 1999, two hundred thousand Americans have died from overdoses related to OxyContin and other prescription opioids. The company funded research and paid doctors to make the case that concerns about opioid addiction were overblown, and that OxyContin could safely treat an ever-wider range of maladies. OxyContin is a controversial drug. Its sole active ingredient is oxycodone, a chemical cousin of heroin which is up to twice as powerful as morphine. Upon its release, in 1995, OxyContin was hailed as a medical breakthrough, a long-lasting narcotic that could help patients suffering from moderate to severe pain. The drug became a blockbuster, and has reportedly generated some thirty-five billion dollars in revenue for Purdue. health-care-facts-whats-wrong-american-insurance -us-health-care-is-an-ongoing-miserable-failure

Deaths of Despair and the Future of Capitalism  2020  Deaths of Despair and the Future of Capitalism   by Anne Case, Angus Deaton

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