When I first investigated the opioid epidemic ravaging Kentucky the villain was obvious: Purdue Pharma, owned by the Sackler family. In the 1990s Purdue spent tens of millions marketing OxyContin, lavishing health professionals with promotional gifts and expenses-paid conferences at resorts. It touted the drug as non-addictive and safe for anything from back pain to headaches.
Purdue compiled profiles of physicians who prescribed opioids often and had the most chronic-pain patients. It targeted physicians in rural areas with poor patients in Appalachia, and from Maine to Mississippi. By 2002, deaths from overdoses shot up, a fourth of them nationwide in Kentucky. By then, Purdue’s spending on a huge new sales force paid off with sales of $1.5 billion.
OxyContin quickly became known as “hillbilly heroin” as abusers could crush pills into powder for an immediate high. Not until 2010 did Purdue modify the pill to prevent this tactic; that year Oxy sales were $3 billion.
More research revealed, however, that those responsible for our plague of addiction, deaths, crime, broken families and homeless students extended well beyond Purdue. Add to the devil’s roll-call prominent lawyers who work for law firms that defend corporate criminals.
In 2004, just before West Virginia’s suit against Purdue (filed in 2001) accusing it of “coercive and deceptive practices” went before a judge, then corporate lawyer Eric Holder negotiated a settlement in which the firm paid the state a paltry $10 million and admitted no wrongdoing.
In 2007, Virginia’s U.S. Attorney John Brownlee won a guilty plea from three Purdue executives and fines totaling $669 million. Brownlee accused the firm of fraudulent marketing of OxyContin that resulted in scores of deaths. Purdue’s defenders included Mary Jo White, later appointed to head the Securities and Exchange Commission by President Barack Obama, and Rudolph Giuliani, then partner in a Houston law firm that specialized, appropriately, in defending energy companies accused of polluting.
White and Giuliani succeeded in getting a dozen charges against Purdue dropped, including Medicaid fraud and unjust enrichment. But later U.S. Attorney General Eric Holder’s earlier work in West Virginia did more to keep opioids flowing because the negotiated settlement prevented a trial and sealed a mass of documents related to the firm’s criminal activities.
Many of those documents were relevant to the suit Kentucky filed, instead of accepting $500,000 as part of the Virginia case. In December 2015, Attorney General Jack Conway settled with Purdue for $24 million. Conway agreed to destroy the state’s copies of those documents that revealed extensive criminal behavior by Purdue.
But in West Virginia, originals remained; and in 2016, STAT, an investigative arm of Boston Globe Media, got them into daylight. They showed that Purdue and Abbott Laboratories bribed pharmacy benefits manager Merck Medco to prevent insurers from limiting prescriptions of Oxy and to enable unlimited access — in effect to addiction.
Big Pharma, the drug manufacturers and their agencies, in the past decade, spent over $900 million to lobby against laws that would limit access to opioids such as Oxy, Vicodin and fentanyl. The money was often laundered through the American Cancer Society. Big Pharma’s campaign spending paid off with congressional Republicans and Democrats passing the oxymoronic Ensuring Patient Access and Effective Drug Enforcement Act that gutted the Drug Enforcement Administration’s ability to act against manufacturers and distributors committing crimes.
Wholesale distributors AmerisourceBergen, McKesson and Cardinal Health, who control 85 percent of the market, ignore DEA warnings to police about who gets shipments; they have hired dozens of former DEA agents as lobbyists. The Food and Drug Administration and other agencies also are among many other enablers that grease the supply chain, along with fronts like the American Chronic Pain Association.
This killing epidemic will continue because profiteering from drug abuse is woven into every fabric of government and society — from Congress to small towns in Kentucky.
Ron Formisano is the William T. Bryan Chair of American History emeritus at the University of Kentucky and the author of “Plutocracy in America: How Increasing Inequality Destroys the Middle Class and Exploits the Poor (Johns Hopkins University Press.)”