Falsehoods in Massachusetts Lawsuits That Were Copied by Other States

In 1998, Dr. Richard Sackler instructed Purdue’s executives that OxyContin tablets provide more than merely “therapeutic” value and instead “enhance personal performance,” like Viagra.

The next month, a federal prosecutor reported 59 deaths from OxyContin in a single state. The Sacklers knew that the reports underestimated the destruction. Dr. Richard Sackler wrote to Purdue executives: “This is not too bad. It could have been far worse.”

That same month, Dr. Richard Sackler wrote down his solution to the overwhelming evidence of overdose and death: blame and stigmatize people who become addicted to opioids. Sackler wrote in a confidential email: “we have to hammer on the abusers in every way possible. They are the culprits and the problem. They are reckless criminals.”

When Time magazine published an article about OxyContin deaths in New England, Purdue employees told Richard Sackler they were concerned. Richard responded with a message to his staff. He wrote that Time’s coverage of people who lost their lives to OxyContin was not “balanced,” and the deaths were the fault of “the drug addicts,” instead of Purdue. “We intend to stay the course and speak out for people in pain – who far outnumber the drug addicts abusing our product.”

When Dr. Richard Sackler wrote to managers, “This is bad,” to criticize the sales of Purdue’s Butrans opioid, the managers in turn drafted a warning for employees: “Just today, Dr. Richard sent another email, ‘This is bad,’ referring to current Butrans trends. I am quite sure that Dr. Richard would not be sympathetic to the plight of the Boston District.” The manager then threatened to fire every sales rep in the Boston district: “I am much closer to dismissing the entire district than agreeing that they deserve a pass for poor market conditions.”

Every time the Sacklers voted to spend tens of millions of dollars on sales reps, they knew and intended that they were sending reps to promote opioids in Massachusetts.

The Sacklers wanted more details on tactics for pushing sales. Richard Sackler wrote to Russell Gasdia, Vice President of Sales and Marketing (hereinafter “Sales VP”), demanding information about Purdue’s opioid savings cards.

Meanwhile, when staff proposed a plan to get pharmacies to increase their inventory of OxyContin from 2 bottles to 3 bottles, Dr. Richard Sackler demanded to know why they couldn’t get up to 4 bottles or more.

The Sacklers also knew and intended that the sales reps would push higher doses of Purdue’s opioids. That same month, Dr. Richard Sackler directed Purdue management to “measure our performance by Rx’s by strength, giving higher measures to higher strengths.”

As far back as the 1990s, Jonathan and Kathe Sackler knew that patients frequently suffer harm when “high doses of an opioid are used for long periods of time.”

The Sacklers learned that another company was planning clinical research to test whether crush-proof opioids are safer for patients. Mortimer Sackler suggested that Purdue conduct similar studies to find out whether reformulated OxyContin was really safer before selling it to millions of patients… Richard didn’t want a paper trail, so he instructed Mortimer to call him, and CEO John Stewart met with his staff to plan how to phrase a carefully worded reply.

Richard chimed in at 8:30 p.m. to instruct the staff to find answers “before tomorrow.” Staff emailed among themselves about how the Sacklers’ demands were unrealistic and harmful and then decided it was safer to discuss the problem by phone.

Richard Sackler did not back off. Instead, he pushed staff to sell more of the highest doses of opioids and get more pills in each prescription.

At the same time, Jonathan, Kathe, and Mortimer Sackler were also pushing staff about sales.

On April 18, Richard Sackler sent Kathe, Ilene, David, Jonathan, and Mortimer Sackler a secret memo about how to keep money flowing to their family. Richard wrote that Purdue’s business posed a “dangerous concentration of risk.”

On April 18, the Sacklers voted to increase the 2008 budget for Sales and Promotion to $155,802,000. Then, Richard Sackler sent Sales VP Russell Gasdia a series of questions about Purdue’s efforts to get patients to take higher doses and stay on opioids for longer times.

Richard Sackler told staff that he was not satisfied with OxyContin sales and demanded a plan to “boost” them. He asked for the topic to be added to the agenda for the Board.

In August, Richard Sackler convened a meeting of Board members and staff about “all the efforts Sales and Marketing is doing and planning to do to reverse the decline in OxyContin tablets market.” He emphasized that $200,000,000 in profit was at stake.

Richard Sackler directed staff to send him weekly reports on OxyContin sales. No one in the company received reports that often, so staff were not sure how to reply.

In March, Richard Sackler instructed sales staff to send him monthly reports on sales of OxyContin and its competitors. They complied within ten minutes.

In January 2011, staff reported to the Sacklers that a key initiative in Q4 2010 had been the expansion of the sales force. Staff told the Sacklers that Purdue employed 590 sales reps and, during Q42010, they visited prescribers 12,715 times.

The second tactic staff reported to Richard, Jonathan, Kathe, Mortimer, and Theresa Sackler in the May 25, 2011 email was “positioning of Butrans for specific patient types.” In Massachusetts, promotion for “specific patient types” meant pushing opioids for elderly patients with arthritis…”

In September, Richard Sackler directed staff to study a savings card program for a widely-used cholesterol medication (not an addictive narcotic) to learn how Purdue could use it for opioids.

Staff told Richard that the increase in prescriptions was caused by tactics that Purdue taught sales reps: pushing opioids for elderly patients with arthritis (“proper patient selection”) and encouraging doctors to use higher doses of opioids (“quick titration”).

Meanwhile, staff contacted Richard Sackler because they were concerned that the company’s “internal documents” could cause problems if investigations of the opioid crisis expanded. Early the next year, staff told Jonathan Sackler about the same concern. Jonathan studied collections of news reports and asked staff to assure him that journalists covering the opioid epidemic were not focused on the Sacklers.

Kathe and Mortimer Sackler wanted staff to break out productivity data by indication versus prescriber specialty for each drug. Richard Sackler sought details on how staff was calculating 2016 mg/tablet trends. Jonathan Sackler sought a follow-up briefing on how public health efforts to prevent opioid addiction would affect OxyContin sales.