Here’s what the Sacklers didn’t want you to see in the OxyContin lawsuit

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1 Sell an addictive drug
2 Sell an anti-addictive drug
3 Goto 1

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Addiction is such a great business model.

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I recall reading an impassioned argument (either on boingboing or here) against the practice of combining a liver-damaging over the counter drug with an opiate-- the net effect being not greater pain relief as claimed but as vindictive “punishment” for needing opiates to treat a chronic condition. Might this person be better served by easy access to Oxycontin?

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There is a role for opioids in medicine, yes.

The problem with the Sacklers is not that they produced opioids; the problem is that they deliberately and dishonestly marketed them with the intention of maximising sales, regardless of medical need.

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The established roles for opioids were surgery/immediate post surgical care; and cancer/hospice. The expectation with surgery is that the patient recovers before addiction takes hold; the expectation with cancer is that the patient dies before addiction takes hold. Together, they aren’t the biggest of markets, and are well served by existing drugs. Purdue Pharma wanted a piece of the chronic pain market-- where addiction is a serious concern, and opioids are avoided.

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Janssen Pharmaceuticals makes an appearance

They were mentioned in this old analysis of Sackler’s marketing campaign.

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And they got into getting it prescribed to children because just plain old evil was too boring and they went for the extra points.

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True. But.

This article struck me because I’d had my gallbladder removed not long before I read it. Like the author’s father, I hadn’t received any opiods for pain management – it was Tylenol 3s for the first 48 hours, then regular Tylenol when I felt I needed it thereafter (which in my case was about 3 over the course of a week):

Yes, you have to be careful about your liver with Tylenol, but liver function is checked as part of gallbladder surgery anyhow. I liked that I wasn’t in pain unless I moved in a way I shouldn’t have been anyhow – it helped me take care of myself as the healing process commenced.

Now, compare that to the gallbladder attack which put me in hospital overnight and triggered the surgery being scheduled. I was in so much pain I was throwing up. They gave me an IV drip of morphine, and the last thing I remember thinking before I drifted into some desperately-needed sleep was, “I can see how people get addicted to this stuff.”

But wow, did I need it that night.

Conclusion: there’s pain, and there’s pain. Post-surgery pain, at least for some procedures, is maybe not so much pain.

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codeine is an opioid.

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Sure, but not like oxycontin is.

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