Purdue Pharma, manufacturer of OxyContin, bankrupt

Purdue Pharma, the maker of OxyContin, went bankrupt on Sunday. This is the first step of an agreement in principle that the company entered into last week to settle thousands of lawsuits related to its alleged involvement in the opioid epidemic.

Under the settlement, Purdue agreed to file for bankruptcy and dissolve effectively. If all goes according to plan, a new company will be formed and will continue to sell OxyContin, the proceeds of the sale to the plaintiffs in the settlement. Purdue will also donate drugs to treat addiction and overdoses.

The regulation does not contain a statement of wrongdoing. Purdue is accused of aggressive – and misleading – marketing of its potent OxyContin opioid opioid analgesic, contributing to an opioid crisis that has contributed to the deaths of more than 700,000 people through drug overdose since 1999.

The deal is expected to be about $ 10 billion to $ 12 billion, including at least $ 3 billion from the Sackler family, which owns Purdue. However, according to the New York Times, state attorneys general rejected the overly optimistic amount of debate.

In 2016, Purdue had made more than $ 31 billion in revenue with OxyContin.

The settlement would be the biggest payment of any company accused of fueling the opioid crisis. So far, 24 states and more than 2,000 municipal governments have accepted the bylaw.

But the rest of the states and Washington, DC, rejected the deal, calling it too small, too late. These jurisdictions should try to hold bankruptcy and further prosecute the Sacklers, valued at $ 13 billion by Forbes, and who would withdraw from the current agreement as billionaires.

The purpose of the lawsuits is not only to keep Purdue and others allegedly involved in the epidemic of opioids responsible for the crisis, but also to force them to pay for treatment against the addiction that could help fight the epidemic. In the United States, the treatment is notoriously underfunded, and in recent years, experts have urged the federal government to invest tens of billions of dollars in the establishment of a treatment infrastructure. (For reference, a study conducted in 2017 by the Council of Economic Advisers of the White House associates a year of crisis with opioids to economic losses of 500 billion dollars.)

Some politicians and activists have gone further than prosecutions, demanding not only that the manufacturers and distributors of opioids pay the financial loss they caused, but also that they be held criminally responsible. Several Democratic presidential candidates have proposed a bill to empower the various leaders on the role they play in the over-prescription of opioids.

"If no sackler gets behind bars, an entire class will continue to think that writing a check is the worst thing that can happen to them. [matter] what they do, "Keith Humphreys, Drug Expert at Stanford, says on Twitter.

At least for now, however, Purdue and the Sacklers only face financial consequences.

How pharmaceutical companies contributed to the epidemic of opioids

The epidemic of opioids can be understood in three waves. In the first wave, beginning in the late 1990s and early 2000s, doctors prescribed many opioid analgesics. This has led to a widespread proliferation of drugs and their addictions – not only patients, but also friends and families of patients, teenagers who were taking drugs in their parents' medicine cabinets and those who were buying drugs in their homes. excess on the black market.

A second wave of drug overdoses took off in the 2000s, when heroin invaded the illicit market. Traffickers and drug traffickers have benefited from a new population of people who have used opioids but have lost access to painkillers or are simply seeking a higher, cheaper drug. And in recent years, the United States has experienced a third wave, with fentanyl offering an alternative to heroin that is even more powerful, less expensive, and more lethal.

This is the first wave that really triggered the opioid crisis – and this is where the marketing of opioid analgesics is probably the most relevant. Many studies now combine the marketing of opioid analgesics with addiction and overdoses, particularly direct marketing to physicians who have encouraged them to prescribe more drugs. Another study also linked the increase in the supply of opioid analgesics and the number of overdose deaths.

Beyond the research, we have seen more and more reports in recent years about opioid companies selling their products aggressively, even though it had become apparent that the drugs were not the safe and effective alternative to other painkillers on the market. to be opioids.

The complaint lodged by Attorney General Maura Healey against Purdue reveals that Richard Sackler, then president of Purdue and a member of Purdue's family, was personally involved in some of these efforts. The filing claims that Sackler pushed OxyContin into the market as "non-narcotic" in other countries, even though it was an opioid; Robert Kaiko, who created OxyContin, had to dissuade him from the idea.

The company also reportedly neglected excessive prescriptions in the United States, even though some Purdue staff had warned that pill mills should have been reported to federal officials, said Maia Szalavitz for Tonic.

Purdue retorted that the filing "is littered with biased and inaccurate descriptions of these documents and each of the defendants, often highlighting potential solutions that were eventually rejected by the company."

Other reports, however, suggest that opioid societies were largely irresponsible. As a group of public health experts explained in the Annual Public Health Review, opioid companies have exaggerated the benefits and safety of their products, supported advocacy groups and "education" campaigns encouraging widespread use of opioids and urged legislators to ease access to medicines. Purdue, as the maker of the all-new OxyContin, has played an important role in these efforts, as have companies such as Johnson & Johnson, Endo, Teva and Abbott Laboratories.

The result: with the increase in opioid sales, addiction and overdoses have also increased.

Annual Public Health Review

It's not just that the drugs were deadly; they were also nowhere as effective as Purdue and others claim. There is very little scientific evidence that opioid analgesics can effectively treat long-term chronic pain as patients become opioid-tolerant – but there is ample evidence that prolonged use can lead to very serious complications, including increased risk of addiction, overdose, and death. In short, the risks and harms outweigh the benefits for most patients with pain.

Yet, even though these risks have emerged over the years, pharmaceutical companies have continued to market opioids. (Purdue has been advertising opioids to doctors until last year.)

As a result, different levels of government are now trying to hold corporations accountable – and having them pay to help fix the mess they have contributed to.

To learn more about lawsuits against opioid companies, read the Vox Explainer.