Painkiller: Greed and the Opioid Epidemic

Netflix’s series Painkiller is an attempt to reckon with a national crisis. Although it is a dramatized account, it opens each episode with real people sharing their heart-wrenching stories of losing loved ones to opioid abuse. The show transports us back to the early days of the opioid epidemic when OxyContin emerged, a potent opioid introduced in 1996 by Purdue Pharma, a privately held company linked to the Sackler family.

Painkiller unravels the origins of this devastating tragedy, highlighting unscrupulous actors, corporate misdeeds, medical laziness, and the human suffering it led to. At MAT Care Clinics, we know the daily toll of this crisis and believe that chronicling its history and exposing the dangers of opioid overprescription is a critical lesson to prevent future catastrophes. We combat this daily with safe, guaranteed options that don’t impede your life.

But it’s crucial to take stock of how we got here. In 2021, the National Institute on Drug Abuse reported 80,411 opioid-related deaths. This number was up from 68,630 the previous year. How did the opioid epidemic get so bad? In this piece, we delve into the show Painkiller, explore the OxyContin saga, dissect the role of the infamous Purdue, and analyze the intricate web of factors behind the opioid epidemic.

The Evolution of Purdue Pharma

At the heart of this story is Purdue Pharma, owned by the Sacklers, a family whose billion-dollar fortune, according to Forbes, eclipses the Rockefellers. Purdue began as a modest enterprise founded by three brothers in New York. Among them, Arthur Sackler played a pivotal role in pioneering medical advertising. Instead of advertising to consumers, he’d go for the doctors who prescribe medication. His company engaged directly with physicians to influence prescription patterns. Arthur spent most of the family’s fortune promoting various drugs, including the immensely popular Valium. He also started medical journals which published studies he thought were favorable to what he was selling.

Initially, Purdue Pharma was a minor part of their enterprises, but it gained prominence after Arthur’s death. His nephew, Richard, rose through the ranks just as the family scrambled to figure out what to do with Arthur gone. Purdue faced the expiration of their MS Contin patent, an opiate. Purdue needed a magic pill to survive the competitive pharma market, and that’s when OxyContin was born.

The Genesis of OxyContin

OxyContin marked a revolutionary advancement in prescription opiates, but not in a good way. This medication featured oxycodone as its sole active ingredient, a potent pain reliever that, according to the British Journal of Pharmacology, is two times more powerful than morphine. Oxycodone, at the time of OxyContin’s introduction in the 1990s, had previously been used in drugs like Percocet but only combined with over-the-counter pain relief like acetaminophen. OxyContin was unique in that it contained only oxycodone.

How could a drug twice as potent as morphine have only one active ingredient? The answer lay in its extended-release formulation. Traditional opioids offered rapid but short-lived pain relief; the sort one would have while suffering from cancer or immediately after surgery. According to its marketing, OxyContin time-release provided continuous and extended pain relief for 12 hours. Was it appropriate to issue an opioid for non-extreme pain?

Purdue Pharma said it was. They marketed pain as the “fifth vital sign” and promoted OxyContin for its treatment. The drug quickly became a source of abuse, addiction, and overdose for many patients and recreational users. The advertised “one pill at 8 AM and one at 8 PM” slogan proved false, as numerous users experienced withdrawal symptoms after just eight hours.

The Role of OxyContin in the Opioid Epidemic

Painkiller took inspiration from several sources, including a seminal article in The New Yorker titled The Family That Built an Empire of Pain, which provides insights into how the opioid epidemic unfolded:

1. FDA Approval: Purdue Pharma obtained FDA approval by concealing negative experiences with OxyContin during human trials. In Puerto Rico, where the trials involved women suffering from labor pains, many woke up at night needing additional doses before the promised 12-hour interval. Here was a drug that didn’t work as promised, and two a day wouldn’t cut it while building dependence.

The FDA official responsible for assessing OxyContin’s safety later joined Purdue, creating a glaring conflict of interest. This cozy relationship with regulators allowed them to officially market the drug as a new, safer opioid, even though they knew this claim was false

2. Public Relations: Purdue was in the PR business and recruited numerous renowned doctors as consultants. They would publish favorable studies and go on speaking tours touting OxyContin and pushing Purdue’s agenda that pain was not a symptom but deserved extreme relief. The company also sponsored medical conferences that downplayed the risks of OxyContin addiction while highlighting its benefits. Doctors who attended these events were more inclined to prescribe the drug. This campaign successfully shifted doctor’s opinions from conservative on opioids to using them for minor injuries.

3. Direct Influence: Purdue wasn’t merely a pharmaceutical company; it operated as a formidable sales force. They employed a large team of dedicated sales representatives who visited doctors’ offices to persuade them to use OxyContin for mild and chronic pain. When doctors raised objections, the sales representatives came armed with gifts, biased studies, one-mont-free coupons for Oxycontin, and ready-made responses to assure doctors of the drug’s safety. They conveyed. Doctors had a financial incentive to overprescribe.

Purdue specifically targeted physicians without experience with heavy-duty opiates in blue-collar areas with high workplace accidents. Some offices became “pill mills,” places anyone could go and get a subscription by feigning pain.

Painkiller and the Opioid Epidemic

Wherever OxyContin made its way, dire consequences followed. In the early 2000s, law enforcement agencies and prosecutor’s offices observed something that, to many, looked similar to the crack cocaine epidemic. There was a surge in overdoses, ER visits, and crime, many linked to opiate addiction. American families were unprepared for their family doctors prescribing them one of the most addictive substances on earth.

The instructions on OxyContin bottles warned of how not to take the drug, so it was straightforward to figure out that if you crushed and snorted it, you could bypass the time release and experience a high immediately and all at once. Many also dissolved and injected it.

As fatalities mounted, prosecutors and regulators sounded the alarm, while Purdue publicly denied all accusations, often blaming the victims as addicts who misused their supposedly excellent product. Purdue evaded accountability for years, offering only superficial gestures and the occasional settlement unbefitting of a company accused of poisoning entire communities.

Painkiller chronicles these early efforts to hold Purdue accountable for its deceptive marketing practices. It details the misleading of doctors and patients, manipulating research to support their claims, unduly influencing officials and regulators to evade scrutiny, and the efforts of many individuals to make the company admit this.

The series weaves together the lives of three individuals: Richard Sackler, President of Purdue and a central figure behind OxyContin; Edie Flowers, a fictionalized attorney deeply concerned about the drug’s consequences; and Glen Gryger, a mechanic trapped by addiction. Together, they address addiction at every level.

The Aftermath

Purdue is currently bankrupt and rebranding. In 2007, Purdue paid a staggering $634 million, marking the largest fine ever imposed on a pharmaceutical company. In 2020, the Department of Justice announced an $8.3 billion settlement in which Purdue admitted to the abovementioned wrongdoing. However, no financial penalty can fully account for the thousands of lives lost to opioid abuse.

The CDC describes the opioid epidemic unfurling in three waves. OxyContin was the start, and those who fell prey to it switched to heroin as prescriptions became harder to refill—in 2010, Purdue made the drug slimy when crushed, preventing people from snorting it.

The second wave is heroin, supplied by Mexican gangs who moved in to fill the OxyContin vacuum. The third was fentanyl, a drug more fatal than before introduced as heroin was surging, responsible for more deaths than the other two combined. OxyContin broke the glass ceiling, normalizing heroin use under the guise of treatment, reaching people who would have never tried opioids before, and destroying cities, post-industrial towns, and rural communities.

Painkiller is a poignant effort to confront the depths of this crisis, offering a stark warning to future generations.

MAT Care Clinics and Combating Opioid Abuse

Facing opioid abuse alone is incredibly challenging, and you deserve help. At MAT Care Clinics, we specialize in medication-assisted treatment (MAT), a guaranteed way to make overcoming addiction less of a life-consuming burden. We offer medications like Vivitrol and Suboxone, the latest and safest iterations that combat cravings. Administered in a medical setting by professionals with monthly injections or controlled dispensing, they have a low chance of abuse.

Less than 45 minutes from Boston, in Nashua, New Hampshire, you can get the help you need. Call 888-660-6470 or message us to schedule a life-changing appointment.

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