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


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


Addiction is such a great business model.


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?


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.


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.


Janssen Pharmaceuticals makes an appearance

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


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


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.


codeine is an opioid.


Sure, but not like oxycontin is.