In New York, Massachusetts, Connecticut, Rhode Island and Utah, as well as a case brought by a coalition of local entities and Native American tribes, lawsuits also target eight members of the Sackler family. Owners of Purdue Pharma, which produces OxyContin, the Sacklers are now being held to account for actions taken by the company. While the family has described recent filings as "littered with biases and inaccurate characterizations," pressure continues to mount.
Recent developments in Oklahoma have added to that pressure. On March 26, Purdue Pharma settled a lawsuit with the state and agreed to pay $270 million. The lawsuit, filed by Oklahoma Attorney General Mike Hunter, accused 13 major pharmaceutical companies, including Purdue, of using deceptive marketing that led to a spike in opioid use across the state
Hunter told the Oklahoman last year, "We need to hold these people accountable. Manufacturers have in a consistent and ... coldblooded fashion marketed these drugs in a way that has misrepresented their tendency to be addictive and the extent to which they can be deadly."
Purdue Pharma acknowledged in 2007 that staffers had violated prescription requirements for OxyContin and that its "fraudulent conduct caused a greater amount" of the drug to be "available for illegal use than otherwise would have been available." A former sales representative for the company also told CBS that Purdue trained employees to push the idea of "pseudoaddiction" by claiming that people who appeared to suffer from the symptoms of opioid addiction were simply in pain and needed more opioids. And even though Purdue acknowledged that staffers had violated prescription requirements for its OxyContin painkiller, it denied wider responsibility. In a recent statement made to CBS News, Purdue claimed that it "is confident that its past marketing and sales of its prescription opioid medications have been consistent with the information contained in the FDA-approved label ..."
The Oklahoma settlement is a positive development for the country, and a bad sign for Big Pharma. Although Purdue and the other drugmakers named in the Oklahoma suit deny wrongdoing, the settlement sets an important precedent.
Settlements like the one in Oklahoma will funnel private money into state institutions that are working to address drug addiction from multiple perspectives. Under the terms of the settlement, OSU's Center for Recovery and Wellness, located in Tulsa, will receive a lump sum payment of $102.5 million to establish a National Center for Addiction Studies and Treatment, along with $20 million worth of medicine
The Sackler Family, which founded Purdue Pharma, will contribute an additional $75 million. The center will study and treat addiction in addition to focusing on finding new, more effective treatment methods. In this way, at least some money made by Big Pharma will be siphoned-off for researchers and professionals working hard to help those most affected by opioid addiction.
Finally, the settlement has the potential to expand desperately needed treatment. In 2017 alone, opioids accounted for about 400 deaths in the state of Oklahoma, and 48,000 deaths across the country. In this settlement, Oklahoma counties and municipalities will receive $12.5 million to address their local needs. While this number may be a fraction of what it would cost to adequately deal with the effects of addiction, it nonetheless will enable local communities to start addressing it.
Lawsuits alone, though, will not fix this problem. After all, what will happen if individual companies claim bankruptcy, as Purdue has publicly floated in recent weeks? Further, this sets up a competition between states, effectively creating a zero-sum game as they scramble to secure their share of damages. Who is to determine which states suffered the most? It also remains unclear whether victims and their families will see any financial benefit from litigation. Understandably, many victims are angry about the Purdue settlement, seeing it as just another example of a company treating lawsuits as the 'cost of doing business.' Justice for their loved ones has yet to be seen.
What is also missing from the litigation tactic is a systemic, long-term, and sustained approach that actually addresses the underlying practices that enabled this problem to grow. We need legislation at the state and federal level that will retool the oversight of the pharmaceutical industry -- especially its marketing techniques and relationships to physicians.
Congress moved in this direction in 2018, with the passage of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act. The law addresses drug addiction from both a public health and law enforcement approach. This includes, for example, expanding existing programs to prevent substance-use disorders, and allowing federal agencies to stop the flow of drugs through the mail.
While this legislation provided an important -- and rare -- moment of bipartisan attention to the issue of addiction, the bill really just tweaks our current failing approach. The law, for example, omits any meaningful harm reduction methods, which have been used in cities across the US, Canada, and Europe. These include the expansion of overdose prevention centers, supervised injection facilities, and making Naloxone -- an FDA-approved drug that helps to reverse the effects of an opioids overdose -- more widely available. It also falls far short of providing any significant increase in funding for opioid treatment across the nation. This leaves states like Oklahoma having to turn to the courts. In short, it bolsters an ineffective system without providing any meaningful changes.
If history teaches us anything, there will be another drug "crisis." Drug use, it seems, is cyclical. In recent decades alone, we have seen the nation shift its focus from crack cocaine, to MDMA, to crystal meth, to Fentanyl, and so on. Without preventative measures, one-time payments will do little to stem the rise of the next 'it' drug. It will also do little to address the problem of incarceration, that has long served as a 'solution' to the nation's drug obsession. As of 2018, Oklahoma now has the highest incarceration rate -- not just in the nation -- in the world. This has to be central to our conversations about treatment and prevention.
Finally, it remains to be seen whether settlement money will be effectively funneled into channels that can actually help those in need right now. Oklahoma's settlement is a move in the right direction, as it earmarks specific funds for research and local treatment. It seems that those who negotiated the settlement learned important lessons from the mismanagement of funds that occurred in the wake of the 1998 Tobacco lawsuits. Clear vision and careful oversight, though, will be needed to ensure those in need receive the treatment they require.
The Purdue settlement is an important win. It is also only just the beginning.
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