Purdue Pharmaceuticals L.P is a private pharmaceutical company founded in 1892 that develops, manufactures, and markets medications and consumer health products. The company has been accused of contributing to the opioid epidemic by aggressively marketing its opioid medications, which are highly addictive. The opioid epidemic refers to the increasing number of deaths and hospitalizations from opioids. Opioids are a type of drug derived from opium, which is a substance from the opium poppy plant. The increased marketing and prescriptions of opioid medications contributed to an uptick of opioid addictions, thus fueling the epidemic. The multiple lawsuits against Purdue Pharma attempt to hold Purdue Pharma accountable for their contributions to the opioid epidemic.

A Brief History of Purdue Pharma

Purdue Pharma was founded in 1892 by John Purdue Gray M.D. and George Frederick Bingham M.D. as the Purdue Frederick Company and was later sold to members of the Sackler family. By 1995, the company was focusing on launching medications that reduced pain. The main product was OxyContin, an opioid meant to relieve chronic pain for those suffering from cancer and other chronic conditions. In efforts to successfully launch the drug, Richard Sackler, the head of the company, hosted dinner programs for physicians who were prescribing greater amounts of OxyContin. The goal became to market the drug to anyone with chronic pain, rather than just those with malignant pain. OxyContin sales reached $48 million. However, the danger of overprescribing powerful pain medications is they are highly addictive. Most who become addicted to opioids do so through prescriptions. Concern grew about the illegal use of OxyContin, as people began to seek out other means to get the drugs, and in the fall of 2000 the problem grew to epidemic proportions. Meanwhile, Purdue Pharma’s sales increased to just under $1.1 billion.

Impacts on the Opioid Epidemic

The opioid epidemic has three main waves – the first starting with drug companies, like Purdue Pharma, encouraging doctors to overprescribe opioids. Doctors told patients that opioids were the answer to chronic pain. However, opioids are one of the most addictive drugs on the market.  21-29% of people prescribed opioids misuse them and continue seeking them out when they are no longer needed. As a result, there were hundreds of thousands of new addictions during the 1990s and 2000s. When doctors give them to patients who don’t require them, it needlessly increases the risk of becoming addicted. The growing opioid addictions brought attention to the problem of overprescribing opioids. 

In 2011 there was a crackdown on pill mills, or pain clinics that gave away pills for money, in efforts to decrease prescriptions. As prescription pills became more limited, drug prices rose which led to people seeking street drugs like heroin. The third wave occurred when drug dealers began making synthetic drugs, like fentanyl, that are much smaller and easier to distribute, but are much more potent. 

The lawsuits argue that Purdue Pharma played a role in the opioid epidemic when they encouraged overprescribing opioids and engaged in aggressive campaigning that downplayed the risks of using and becoming addicted to opioids. Purdue cited a letter that stated only 2 of 11,000+ patients became addicted when given opioid medicines to validate the safety of OxyContin. In reality, as with most other opioids, it takes a while for the full pain relief effect of OxyContin to settle in. Individuals may look for ways to take the drug quicker to feel the full effects instantly. Additionally, tolerance to the drug builds over time, resulting in the person needing more and more of it to experience the same effects. This is how addictions begin and this is what Purdue Pharma downplayed when marketing the drug. In fact, Purdue Pharma spent more than $400 million in promotional spending. This aggressive campaigning helped spread the word, increase the sale of, and claim the false safety of OxyContin. 

The Lawsuits

• 2002 – Florida attorney general’s office was one of the first law agencies to investigate Purdue Pharma. It cited almost 400 pill deaths in three Florida counties in the past 2 years and claimed Purdue Pharma was the one responsible.
• 2007 – Purdue pleaded guilty to felony charges of misbranding OxyContin. The company confessed to telling doctors the drug was less addictive than other opioids and paid a series of fines.
• There were many other lawsuits in many other states over the years.
• 2018 – Lawsuit by the state of Massachusetts, accusing Purdue executives of aggressively marketing pills and misleading doctors and patients about the risks. It said Purdue contributed to overdose deaths of over 670 Massachusetts residents.
• The final claim: Purdue’s marketing of powerful prescription pain meds contributed to the opioid epidemic, which has killed almost 500,000 people in the US in the last two decades.
• 2019 – Purdue Pharma filed for bankruptcy to settle the 3,000 lawsuits from state, local governments, and other impacted parties.

What’s Next

The new settlement as of July 7, 2021 is called the reorganization plan. It has several requirements, including:

• Making public tens of millions of internal documents, connecting the company and family to the opioid crisis.
• Contributing a total of $4.5 billion to charities aimed at ending the opioid epidemic. These funds will come from both the Purdue Pharma company and the Sackler family’s individual funds.
• Produce overdose-reversal drugs and medicated-assisted therapy (MAT) for those in recovery. MAT can be used to alleviate withdrawal symptoms.
• The Sackler family will give up ownership of Purdue Pharma by 2024 or will close down the company.
• The Sackler Family is banned from the opioid business.
• The Sackler Family is banned from naming rights of the money donated to charitable foundations until all obligations are paid.

The over 600 companies, people, and governments with claims against Purdue will vote on the package. The confirmation hearing is scheduled for August 9, 2021. 9 states have yet to approve the deal.

Is this solution enough? 

This case is the highest profile case against drug makers, pharmacies, and distribution companies, which are the main producers of opioids. However, the Sackler Family didn’t actually admit to any wrongdoing. The settlement doesn’t hold the family accountable and they’ll continue to be one of the richest families in the US. Furthermore, some attorneys argue that the settlement gives the Sackler family immunity through Purdue’s bankruptcy. In addition, the harm caused by the opioid epidemic is vast and while holding a major pharmaceutical company accountable is a step in the right direction, it won’t reverse the costs of the epidemic.

There were more overdose deaths in 2020 during the pandemic than any other year, reaching nearly 100,000 deaths. Every day around 128 people die from an opioid-related overdose. One problem that has persisted when trying to address the opioid epidemic is cutting supply, rather than focusing on reducing the demand. As a result, people resort to other more dangerous means, making that solution inadvertently further the epidemic. Perhaps more focus should be on drugs like buprenorphine and methadone, which help reduce the overdose death rate by 50% or more. In addition, naloxone, the life-saving medication that can prevent deaths from overdoses, should be widely distributed. More recovery centers, mental health resources, and training to administer life-saving medications are also needed to help combat the opioid epidemic, along with holding large pharmaceutical companies accountable.