`Pain
`The Sackler dynastyʼs ruthless marketing of
`painkillers has generated billions of dollars—and
`millions of addicts.
`Patrick Radden Keefe
`October 30, 2017 Issue
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`An addiction specialist said that the Sacklersʼ firm, Purdue Pharma, bears the “lionʼs share” of the blame
`for the opioid crisis.
`
`Illustration by Ben Wiseman
`
`The north wing of the Metropolitan Museum of Art is a vast, airy
`enclosure featuring a banked wall of glass and the Temple of Dendur, a
`sandstone monument that was constructed beside the Nile two
`millennia ago and transported to the Met, brick by brick, as a gift from
`the Egyptian government. The space, which opened in 1978 and is
`known as the Sackler Wing, is also itself a monument, to one of
`Americaʼs great philanthropic dynasties. The Brooklyn-born brothers
`Arthur, Mortimer, and Raymond Sackler, all physicians, donated
`lavishly during their lifetimes to an astounding range of institutions,
`many of which today bear the family name: the Sackler Gallery, in
`Washington; the Sackler Museum, at Harvard; the Sackler Center for
`Arts Education, at the Guggenheim; the Sackler Wing at the Louvre;
`and Sackler institutes and facilities at Columbia, Oxford, and a dozen
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`other universities. The Sacklers have endowed professorships and
`underwritten medical research. The art scholar Thomas Lawton once
`likened the eldest brother, Arthur, to “a modern Medici.” Before
`Arthurʼs death, in 1987, he advised his children, “Leave the world a
`better place than when you entered it.”
`
`Mortimer died in 2010, and Raymond died earlier this year. The
`brothers bequeathed to their heirs a laudable tradition of benevolence,
`and an immense fortune with which to indulge it. Arthurʼs daughter
`Elizabeth is on the board of the Brooklyn Museum, where she
`endowed the Elizabeth A. Sackler Center for Feminist Art. Raymondʼs
`sons, Richard and Jonathan, established a professorship at Yale
`Cancer Center. “My father raised Jon and me to believe that
`philanthropy is an important part of how we should fill our lives,”
`Richard has said. Marissa Sackler, the thirty-six-year-old daughter of
`Mortimer and his third wife, Theresa Rowling, founded Beespace, a
`nonprofit “incubator” that supports organizations like the Malala Fund.
`Sackler recently told W that she finds the word “philanthropy” old-
`fashioned. She considers herself a “social entrepreneur.”
`
`When the Met was originally built, in 1880, one of its trustees, the
`lawyer Joseph Choate, gave a speech to Gilded Age industrialists who
`had gathered to celebrate its dedication, and, in a bid for their support,
`offered the sly observation that what philanthropy really buys is
`immortality: “Think of it, ye millionaires of many markets, what glory
`may yet be yours, if you only listen to our advice, to convert pork into
`porcelain, grain and produce into priceless pottery, the rude ores of
`commerce into sculptured marble.” Through such transubstantiation,
`many fortunes have passed into enduring civic institutions. Over time,
`the origins of a clanʼs largesse are largely forgotten, and we recall only
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`the philanthropic legacy, prompted by the name on the building.
`According to Forbes, the Sacklers are now one of Americaʼs richest
`families, with a collective net worth of thirteen billion dollars—more
`than the Rockefellers or the Mellons. The bulk of the Sacklersʼ fortune
`has been accumulated only in recent decades, yet the source of their
`wealth is to most people as obscure as that of the robber barons.
`While the Sacklers are interviewed regularly on the subject of their
`generosity, they almost never speak publicly about the family
`business, Purdue Pharma—a privately held company, based in
`Stamford, Connecticut, that developed the prescription painkiller
`OxyContin. Upon its release, in 1995, OxyContin was hailed as a
`medical breakthrough, a long-lasting narcotic that could help patients
`suffering from moderate to severe pain. The drug became a
`blockbuster, and has reportedly generated some thirty-five billion
`dollars in revenue for Purdue.
`
`But OxyContin is a controversial drug. Its sole active ingredient is
`oxycodone, a chemical cousin of heroin which is up to twice as
`powerful as morphine. In the past, doctors had been reluctant to
`prescribe strong opioids—as synthetic drugs derived from opium are
`known—except for acute cancer pain and end-of-life palliative care,
`because of a long-standing, and well-founded, fear about the
`addictive properties of these drugs. “Few drugs are as dangerous as
`the opioids,” David Kessler, the former commissioner of the Food and
`Drug Administration, told me.
`
`Purdue launched OxyContin with a marketing campaign that
`attempted to counter this attitude and change the prescribing habits
`of doctors. The company funded research and paid doctors to make
`the case that concerns about opioid addiction were overblown, and
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`that OxyContin could safely treat an ever-wider range of maladies.
`Sales representatives marketed OxyContin as a product “to start with
`and to stay with.” Millions of patients found the drug to be a vital salve
`for excruciating pain. But many others grew so hooked on it that,
`between doses, they experienced debilitating withdrawal.
`
`Since 1999, two hundred thousand Americans have died from
`overdoses related to OxyContin and other prescription opioids. Many
`addicts, finding prescription painkillers too expensive or too difficult to
`obtain, have turned to heroin. According to the American Society of
`Addiction Medicine, four out of five people who try heroin today
`started with prescription painkillers. The most recent figures from the
`Centers for Disease Control and Prevention suggest that a hundred
`and forty-five Americans now die every day from opioid overdoses.
`
`Andrew Kolodny, the co-director of the Opioid Policy Research
`Collaborative, at Brandeis University, has worked with hundreds of
`patients addicted to opioids. He told me that, though many fatal
`overdoses have resulted from opioids other than OxyContin, the crisis
`was initially precipitated by a shift in the culture of prescribing—a shift
`carefully engineered by Purdue. “If you look at the prescribing trends
`for all the different opioids, itʼs in 1996 that prescribing really takes
`off,” Kolodny said. “Itʼs not a coincidence. That was the year Purdue
`launched a multifaceted campaign that misinformed the medical
`community about the risks.” When I asked Kolodny how much of the
`blame Purdue bears for the current public-health crisis, he responded,
`“The lionʼs share.”
`
`Although the Sackler name can be found on dozens of buildings,
`Purdueʼs Web site scarcely mentions the family, and a list of the
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`companyʼs board of directors fails to include eight family members,
`from three generations, who serve in that capacity. “I donʼt know how
`many rooms in different parts of the world Iʼve given talks in that were
`named after the Sacklers,” Allen Frances, the former chair of
`psychiatry at Duke University School of Medicine, told me. “Their
`name has been pushed forward as the epitome of good works and of
`the fruits of the capitalist system. But, when it comes down to it,
`theyʼve earned this fortune at the expense of millions of people who
`are addicted. Itʼs shocking how they have gotten away with it.”
`
`“Dr. Sackler considered himself and was considered to be the
`patriarch of the Sackler family,” a lawyer representing Arthur Sacklerʼs
`children once observed. Arthur was a gap-toothed, commanding
`polymath who trained under the Dutch psychoanalyst Johan H. W. van
`Ophuijsen, whom Sackler proudly described as “Freudʼs favorite
`disciple.” Arthur and his brothers, the children of Jewish immigrants
`from Galicia and Poland, grew up in Brooklyn during the Depression.
`All three attended medical school, and worked together at the
`Creedmoor Psychiatric Center, in Queens, collectively publishing some
`hundred and fifty scholarly papers. Arthur became fascinated, he later
`explained, by the ways that “nature and disease can reveal their
`secrets.” The Sacklers were especially interested in the biological
`aspects of psychiatric disorders, and in pharmaceutical alternatives to
`mid-century methods such as electroshock therapy and
`psychoanalysis.
`
`But the brothers made their fortunes in commerce, rather than from
`medical practice. They shared an entrepreneurial bent. As a teen-ager,
`Mortimer became the advertising manager of his high-school
`newspaper, and after persuading Chesterfield to place a cigarette ad
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`he got a five-dollar commission—a lot of money at a time when, he
`later said, “even doctors were selling apples in the streets.” In 1942,
`Arthur helped pay his medical-school tuition by taking a copywriting
`job at William Douglas McAdams, a small ad agency that specialized in
`the medical field. He proved so adept at this work that he eventually
`bought the agency—and revolutionized the industry. Until then,
`pharmaceutical companies had not availed themselves of Madison
`Avenue pizzazz and trickery. As both a doctor and an adman, Arthur
`displayed a Don Draper-style intuition for the alchemy of marketing.
`He recognized that selling new drugs requires a seduction of not just
`the patient but the doctor who writes the prescription.
`
`Sackler saw doctors as unimpeachable stewards of public health. “I
`would rather place myself and my family at the judgment and mercy of
`a fellow-physician than that of the state,” he liked to say. So in selling
`new drugs he devised campaigns that appealed directly to clinicians,
`placing splashy ads in medical journals and distributing literature to
`doctorsʼ offices. Seeing that physicians were most heavily influenced
`by their own peers, he enlisted prominent ones to endorse his
`products, and cited scientific studies (which were often underwritten
`by the pharmaceutical companies themselves). John Kallir, who
`worked under Sackler for ten years at McAdams, recalled, “Sacklerʼs
`ads had a very serious, clinical look—a physician talking to a physician.
`But it was advertising.” In 1997, Arthur was posthumously inducted
`into the Medical Advertising Hall of Fame, and a citation praised his
`achievement in “bringing the full power of advertising and promotion
`to pharmaceutical marketing.” Allen Frances put it differently: “Most of
`the questionable practices that propelled the pharmaceutical industry
`into the scourge it is today can be attributed to Arthur Sackler.”
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`Advertising has always entailed some degree of persuasive license,
`and Arthurʼs techniques were sometimes blatantly deceptive. In the
`nineteen-fifties, he produced an ad for a new Pfizer antibiotic,
`Sigmamycin: an array of doctorsʼ business cards, alongside the words
`“More and more physicians find Sigmamycin the antibiotic therapy of
`choice.” It was the medical equivalent of putting Mickey Mantle on a
`box of Wheaties. In 1959, an investigative reporter for The Saturday
`Review tried to contact some of the doctors whose names were on the
`cards. They did not exist.
`
`During the sixties, Arthur got rich marketing the tranquillizers Librium
`and Valium. One Librium ad depicted a young woman carrying an
`armload of books, and suggested that even the quotidian anxiety a
`college freshman feels upon leaving home might be best handled with
`tranquillizers. Such students “may be afflicted by a sense of lost
`identity,” the copy read, adding that university life presented “a whole
`new world . . . of anxiety.” The ad ran in a medical journal. Sackler
`promoted Valium for such a wide range of uses that, in 1965, a
`physician writing in the journal Psychosomatics asked, “When do we
`not use this drug?” One campaign encouraged doctors to prescribe
`Valium to people with no psychiatric symptoms whatsoever: “For this
`kind of patient—with no demonstrable pathology—consider the
`usefulness of Valium.” Roche, the maker of Valium, had conducted no
`studies of its addictive potential. Win Gerson, who worked with Sackler
`at the agency, told the journalist Sam Quinones years later that the
`Valium campaign was a great success, in part because the drug was
`so effective. “It kind of made junkies of people, but that drug worked,”
`Gerson said. By 1973, American doctors were writing more than a
`hundred million tranquillizer prescriptions a year, and countless
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`patients became hooked. The Senate held hearings on what Edward
`Kennedy called “a nightmare of dependence and addiction.”
`
`While running his advertising company, Arthur Sackler became a
`publisher, starting a biweekly newspaper, the Medical Tribune, which
`eventually reached six hundred thousand physicians. He scoffed at
`suggestions that there was a conflict of interest between his roles as
`the head of a pharmaceutical-advertising company and the publisher
`of a periodical for doctors. But in 1959 it emerged that a company he
`owned, MD Publications, had paid the chief of the antibiotics division
`of the F.D.A., Henry Welch, nearly three hundred thousand dollars in
`exchange for Welchʼs help in promoting certain drugs. Sometimes,
`when Welch was giving a speech, he inserted a drugʼs advertising
`slogan into his remarks. (After the payments were discovered, he
`resigned.) When I asked John Kallir about the Welch scandal, he
`chuckled, and said, “He got co-opted by Artie.”
`
`In 1952, the Sackler brothers bought a small patent-medicine
`company, Purdue Frederick, which was based in Greenwich Village
`and made such unglamorous staples as laxatives and earwax remover.
`According to court documents, each brother would control a third of
`the company, but Arthur, who was occupied with his publishing and
`advertising ventures, would play a passive role. The journalist Barry
`Meier, in his 2003 book, “Pain Killer: A ‘Wonderʼ Drugʼs Trail of
`Addiction and Death,” remarks that Arthur treated his brothers “not as
`siblings but more like his progeny and understudies.” Now Raymond
`and Mortimer, who became joint C.E.O.s, had a company of their own.
`
`In the early sixties, Estes Kefauver, a Tennessee senator, chaired a
`subcommittee that looked into the pharmaceutical industry, which was
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`growing rapidly. Kefauver, who had previously investigated the Mafia,
`was especially intrigued by the Sackler brothers. A memo prepared by
`Kefauverʼs staff noted, “The Sackler empire is a completely integrated
`operation in that it can devise a new drug in its drug development
`enterprise, have the drug clinically tested and secure favorable reports
`on the drug from the various hospitals with which they have
`connections, conceive the advertising approach and prepare the
`actual advertising copy with which to promote the drug, have the
`clinical articles as well as advertising copy published in their own
`medical journals, [and] prepare and plant articles in newspapers and
`magazines.” In January, 1962, Arthur travelled to Washington to testify
`before Kefauverʼs subcommittee. A panel of senators assailed him with
`pointed questions, but he was a formidable interlocutor—slippery,
`aloof, and impeccably prepared—and no senator landed a blow. At one
`point, Sackler caught Kefauver in an error and said, “If you personally
`had taken the training that a physician requires to get a degree, you
`would never have made that mistake.” Quizzed about his promotion of
`a cholesterol drug that had many side effects, including hair loss,
`Sackler deadpanned, “I would prefer to have thin hair to thick
`coronaries.”
`
`As the Sacklers grew wealthy, they became patrons of the arts. In
`1974, the brothers gave the Met three and a half million dollars,
`enabling the construction of the wing housing the Temple of Dendur.
`Mortimer used the space for a lavish birthday party. The cake was in
`the shape of the Great Sphinx, but its face had been replaced with
`Mortimerʼs.
`
`In April, 1987, when Arthur Sackler was seventy-three, he demanded
`that his third wife, Gillian, account for all their household expenditures.
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`He dictated a terse memo: “I am determined to take command of all
`situations for which I personally and my estate bear the ultimate
`obligation.” A month later, he had a heart attack, and died. The family
`gathered for a fond memorial service at the Met, but Arthurʼs children
`fought bitterly with Gillian, and sparred with Mortimer and Raymond,
`over the estate. They accused Gillian of trying to steal their
`inheritance, and of being “inspired variously by greed, malice, or
`vindictiveness toward her stepchildren.” According to the minutes of a
`family meeting, Arthurʼs daughter Elizabeth suggested that he had
`hidden the true worth of some family investments, “because he didnʼt
`want Morty and Ray to think they were more valuable.” A family lawyer
`told the children, “There were no absolutely white lilies here on either
`side.”
`
`Arthurʼs descendants still owned a third of Purdue Frederick, and
`Mortimer and Raymond were interested in buying the stake. The
`company, which had moved to Connecticut and would eventually
`change its name to Purdue Pharma, had made a great deal of money
`under their stewardship. But such riches were about to seem paltry. By
`the time the brothers made their bid, Purdue was already developing a
`new drug: OxyContin.
`
`Humans have cultivated the opium poppy for five thousand years. The
`father of medicine, Hippocrates, recognized the therapeutic properties
`of the plant. But even in the ancient world people understood that the
`benevolent powers of this narcotic were offset by the perils of
`addiction. In his 1996 book, “Opium: A History,” Martin Booth notes
`that, for the Romans, the poppy was a symbol of both sleep and death.
`During the nineteen-eighties, Raymond and Mortimer Sackler had a
`great success at Purdue with an innovative painkiller called MS Contin,
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`a morphine pill with a patented “controlled release” formula: the drug
`dissolved gradually into the bloodstream over several hours. (“Contin”
`was short for “continuous.”) MS Contin became the biggest seller in
`Purdueʼs history. But, by the late eighties, its patent was about to
`expire, and Purdue executives started looking for a drug to replace it.
`
`One executive who was centrally involved in this effort was Raymondʼs
`son Richard, an enigmatic, slightly awkward man who, in the family
`tradition, had trained as a doctor. Richard had joined Purdue in 1971 as
`an assistant to his father, and worked his way up. His name appears on
`numerous medical patents. In the summer of 1990, a Purdue scientist
`sent a memo to Richard and several other colleagues, pointing out that
`MS Contin could “face such serious generic competition that other
`controlled-release opioids must be considered.” The memo described
`ongoing efforts to create a product containing oxycodone, an opioid
`that had been developed by German scientists in 1916.
`
`Oxycodone, which was inexpensive to produce, was already used in
`other drugs, such as Percodan (in which it is blended with aspirin) and
`Percocet (in which it is blended with Tylenol). Purdue developed a pill
`of pure oxycodone, with a time-release formula similar to that of MS
`Contin. The company decided to produce doses as low as ten
`milligrams, but also jumbo pills—eighty milligrams and a hundred and
`sixty milligrams—whose potency far exceeded that of any prescription
`opioid on the market. As Barry Meier writes, in “Pain Killer,” “In terms
`of narcotic firepower, OxyContin was a nuclear weapon.”
`
`Before releasing OxyContin, Purdue conducted focus groups with
`doctors and learned that the “biggest negative” that might prevent
`widespread use of the drug was ingrained concern regarding the
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`“abuse potential” of opioids. But, fortuitously, while the company was
`developing OxyContin, some physicians began arguing that American
`medicine should reëxamine this bias. Highly regarded doctors, like
`Russell Portenoy, then a pain specialist at Memorial Sloan Kettering
`Cancer Center, in New York, spoke out about the problem of untreated
`chronic pain—and the wisdom of using opioids to treat it. “There is a
`growing literature showing that these drugs can be used for a long
`time, with few side effects,” Portenoy told the Times, in 1993.
`Describing opioids as a “gift from nature,” he said that they needed to
`be destigmatized. Portenoy, who received funding from Purdue,
`decried the reticence among clinicians to administer such narcotics for
`chronic pain, claiming that it was indicative of “opiophobia,” and
`suggesting that concerns about addiction and abuse amounted to a
`“medical myth.” In 1997, the American Academy of Pain Medicine and
`the American Pain Society published a statement regarding the use of
`opioids to treat chronic pain. The statement was written by a
`committee chaired by Dr. J. David Haddox, a paid speaker for Purdue.
`
`Richard Sackler worked tirelessly to make OxyContin a blockbuster,
`telling colleagues how devoted he was to the drugʼs success. The
`F.D.A. approved OxyContin in 1995, for use in treating moderate to
`severe pain. Purdue had conducted no clinical studies on how
`addictive or prone to abuse the drug might be. But the F.D.A., in an
`unusual step, approved a package insert for OxyContin which
`announced that the drug was safer than rival painkillers, because the
`patented delayed-absorption mechanism “is believed to reduce the
`abuse liability.” David Kessler, who ran the F.D.A. at the time, told me
`that he was “not involved in the approval.” The F.D.A. examiner who
`oversaw the process, Dr. Curtis Wright, left the agency shortly
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`afterward. Within two years, he had taken a job at Purdue.
`
`Mortimer, Raymond, and Richard Sackler launched OxyContin with one
`of the biggest pharmaceutical marketing campaigns in history,
`deploying many persuasive techniques pioneered by Arthur. Steven
`May, who joined Purdue as an OxyContin sales representative in 1999,
`recalled, “At the time, we felt like we were doing a righteous thing.” He
`used to tell himself, “Thereʼs millions of people in pain, and we have
`the solution.” (May is no longer working for Purdue.) The company
`assembled a sales force of as many as a thousand representatives and
`armed them with charts showing OxyContinʼs benefits. May attended
`a three-week training session at Purdueʼs headquarters. At a
`celebratory dinner following the training, he was seated at a table with
`Richard Sackler. “I was blown away,” he recalled. “My first impression
`of him was ‘This is the dude that made it happen. He has a company
`that his family owns. I want to be him one day.ʼ ”
`
`A major thrust of the sales campaign was that OxyContin should be
`prescribed not merely for the kind of severe short-term pain
`associated with surgery or cancer but also for less acute, longer-
`lasting pain: arthritis, back pain, sports injuries, fibromyalgia. The
`number of conditions that OxyContin could treat seemed almost
`unlimited. According to internal documents, Purdue officials
`discovered that many doctors wrongly assumed that oxycodone was
`less potent than morphine—a misconception that the company
`exploited.
`
`A 1995 memo sent to the launch team emphasized that the company
`did “not want to niche” OxyContin just for cancer pain. A primary
`objective in Purdueʼs 2002 budget plan was to “broaden” the use of
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`OxyContin for pain management. As May put it, “What Purdue did
`really well was target physicians, like general practitioners, who were
`not pain specialists.” In its internal literature, Purdue similarly spoke of
`reaching patients who were “opioid naïve.” Because OxyContin was so
`powerful and potentially addictive, David Kessler told me, from a
`public-health standpoint “the goal should have been to sell the least
`dose of the drug to the smallest number of patients.” But this
`approach was at odds with the competitive imperatives of a
`pharmaceutical company, he continued. So Purdue set out to do
`exactly the opposite.
`
`Sales reps, May told me, received training in “overcoming objections”
`from clinicians. If a doctor inquired about addiction, May had a talking
`point ready. “ ‘The delivery system is believed to reduce the abuse
`liability of the drug,ʼ ” he recited to me, with a rueful laugh. “Those
`were the specific words. I can still remember, all these years later.” He
`went on, “I found out pretty fast that it wasnʼt true.” In 2002, a sales
`manager from the company, William Gergely, told a state investigator
`in Florida that Purdue executives “told us to say things like it is
`‘virtuallyʼ non-addicting.”
`
`May didnʼt ask doctors simply to take his word on OxyContin; he
`presented them with studies and literature provided by other
`physicians. Purdue had a speakersʼ bureau, and it paid several
`thousand clinicians to attend medical conferences and deliver
`presentations about the merits of the drug. Doctors were offered all-
`expenses-paid trips to pain-management seminars in places like Boca
`Raton. Such spending was worth the investment: internal Purdue
`records indicate that doctors who attended these seminars in 1996
`wrote OxyContin prescriptions more than twice as often as those who
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`didnʼt. The company advertised in medical journals, sponsored Web
`sites about chronic pain, and distributed a dizzying variety of
`OxyContin swag: fishing hats, plush toys, luggage tags. Purdue also
`produced promotional videos featuring satisfied patients—like a
`construction worker who talked about how OxyContin had eased his
`chronic back pain, allowing him to return to work. The videos, which
`also included testimonials from pain specialists, were sent to tens of
`thousands of doctors. The marketing of OxyContin relied on an
`empirical circularity: the company convinced doctors of the drugʼs
`safety with literature that had been produced by doctors who were
`paid, or funded, by the company.
`
`David Juurlink, who runs the division of clinical pharmacology and
`toxicology at the University of Toronto, told me that OxyContinʼs
`success can be attributed partly to the fact that so many doctors
`wanted to believe in the therapeutic benefits of opioids. “The primary
`goal of medical practice is the relief of suffering, and one of the most
`common types that doctors see is pain,” he said. “Youʼve got a patient
`in pain, youʼve got a doctor who genuinely wants to help, and now
`suddenly you have an intervention that—we are told—is safe and
`effective.”
`
`Watch “The Backstory”: Philip Montgomery on his portfolio about
`the American opioid crisis.
`
`Keith Humphreys, a professor of psychiatry at Stanford, who served as
`a drug-policy adviser to the Obama Administration, said, “Thatʼs the
`real Greek tragedy of this—that so many well-meaning doctors got co-
`opted. The level of influence is just mind-boggling. Purdue gave
`money to continuing medical education, to state medical boards, to
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`faux grassroots organizations.” According to training materials, Purdue
`instructed sales representatives to assure doctors—repeatedly and
`without evidence—that “fewer than one per cent” of patients who
`took OxyContin became addicted. (In 1999, a Purdue-funded study of
`patients who used OxyContin for headaches found that the addiction
`rate was thirteen per cent.)
`
`Within five years of its introduction, OxyContin was generating a billion
`dollars a year. “There is no sign of it slowing down,” Richard Sackler
`told a team of company representatives in 2000. The sales force was
`heavily incentivized to push the drug. In a memo, a sales manager in
`Tennessee wrote, “$$$$$$$$$$$$$ Itʼs Bonus Time in the
`Neighborhood!” May, who was assigned to the Virginia area, was
`astonished to learn that especially skillful colleagues were earning
`hundreds of thousands of dollars in commissions. One year, Mayʼs own
`sales were so brisk that Purdue rewarded him with a trip to Hawaii. As
`prescriptions multiplied, Purdue executives—and the Sackler family
`members on the companyʼs board—appeared happy to fund such
`blandishments. Internal budget plans described the companyʼs sales
`force as its “most valuable resource.” In 2001, Purdue Pharma paid
`forty million dollars in bonuses.
`
`One day, May drove with a colleague to Lewisburg, a small city in West
`Virginia. They were there to visit a doctor who had been one of Mayʼs
`top prescribers. When they arrived, the doctor was ashen. A relative
`had just died, she explained. The girl had overdosed on OxyContin.
`
`Arthur and Mortimer Sackler each married three times, and Raymond
`married once. There are fifteen Sackler children in the second
`generation, most of whom have children of their own. The Sackler clan
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`has pursued a variety of causes and interests. In 2011, Mortimerʼs
`widow, Theresa, who sits on the board of Purdue, was awarded the
`Prince of Wales Medal for Art Philanthropy. When the medal was
`conferred, Ian Dejardin, the Sackler Director of the Dulwich Picture
`Gallery, remarked, “Itʼs going to be difficult not to make her sound
`utterly saintly.” Theresaʼs daughter, Sophie, is married to the English
`cricket player Jamie Dalrymple, and lives in a forty-million-dollar house
`in London. Raymondʼs thirty-seven-year-old grandson, David Sackler,
`runs a family investment fund, and is the only member of the third
`generation who sits on Purdueʼs board. The fact that Purdue is
`privately held is a major reason that the Sacklersʼ connection to
`OxyContin has remained obscure. A publicly traded company makes
`periodic disclosures to its shareholders. But Purdue, Barry Meier
`writes, “was the Sackler familyʼs private domain.”
`
`On occasion, press accounts about OxyContin note that profits from
`the drug flow to the Sacklers, but these stories tend to depict the
`family as a monolith. As with any large clan, however, there are fissures
`of discord. In the eighties, Mortimer sued his ex-wife Gertraud,
`claiming that she had illegally taken possession of an apartment that
`he owned on Fifth Avenue and had loaned it out to a contingent of
`models and photographers. None of Arthurʼs descendants sit on the
`companyʼs board. At a courthouse in Long Island, in files stemming
`from the family fight over Arthurʼs fortune, I came across a document
`indicating that, after a “protracted negotiation,” Arthurʼs estate “sold
`its one third interest in Purdue” to Raymond and Mortimer.
`
`“I have never owned any shares in Purdue,” Michael Sackler-Be