The Sackler family have a net worth of 13 billion. Their wealth derives from deceptive, aggressive sales tactics pushing deadly, addictive opioids like OxyContin.

Amy Sterling Casil

Mar 18, 2019·13 min read

Note: 22 January 2021 — this company and the family continues to operate and sell drugs despite BILLIONS in lawsuits filed by state and local governments and tribal governments. These lawsuits are because of the public cost to these governments, totally disregarded by Federal regulators who assessed minimal penalties and the “law” that continues to support them and not citizens.

How is it possible, I wondered, that Purdue Pharma, the company that makes OxyContin, could have paid over $630 million in criminal and civil fines in 2007 for its wrongdoing in the early years of the opioid epidemic, yet still be making, selling and marketing OxyContin and other opioids with nary a hitch today?

The opioid epidemic has been going on almost 25 years. Opioid overdoses are now the leading cause of accidental death for U.S. residents under age 50. OxyContin was one of the four legally prescribed pain and anti-anxiety drugs that killed Heath Ledger in 2008. Heath and 200,000 others have died — so far.

Some might say continued sales of OxyContin depend on what the definition of murder is and whether the federal government or any state can stop a family with all the money in the world and allegedly, no moral compass.

In 2007, the holding company for Purdue Pharma and three of its executives pled guilty to over $636 million in civil violations and criminal wrongdoing in Federal court.

No members of the Sackler family were named in the 2007 federal judgment in which the Purdue Frederick Company and three former officers admitted to falsely presenting OxyContin to doctors as safe and non-addictive. In 2007, controlling board members of the Sackler family voted to put three paid employees’ names on the complaint while omitting themselves as owners and board members. The Sackler-controlled board indemnified itself of any criminal or financial responsibility. It was hardly an issue, because none of Purdue’s top employees who pled guilty served one second of jail time. After the plea, the Sacklers paid each of the former employees millions of dollars.

Sometimes looking at written information in its original form is instructive.

Purdue’s paid executive scapegoats paid less of a penalty than a DUI conviction in most states. By the next year, over 11,800 people died from prescription drug overdoses.

How are street drug dealers punished in Massachusetts for being caught dealing — let’s say — a few hundred OxyContin pills?

The Purdue Frederick Company ceased to exist after Federal Judge James P. Jones signed the guilty plea agreement July 23, 2007.

One of Purdue’s legal representatives at the time was a well-known former federal prosecutor and Mayor of New York.

Purdue Pharma L.P. in Connecticut and a shadowy Rhode Island-based subsidiary company, Rhodes Pharma, continued operations using the same facilities and the same sales force, making the same misrepresentations of OxyContin and other opioids including newer drugs Butrans and Hysingla. After 2007, aggressive Purdue Pharma sales tactics ordered by Richard Sackler and other members of the Sackler family expanded to target veterans, the elderly, osteoarthritis (OA) and “opioid-naive” patients with addiction risk factors. The Centers for Disease Control has proven that these groups have the highest risk of opioid dependency, addiction, and overdose death.

How many people have died from prescription opioids so far?

According to the CDC, between 1999 to 2017, almost 218,000 people have died in the United States from overdoses related to prescription opioids. Overdose deaths involving prescription opioids were five times higher in 2017 than in 1999.

Not only did the 2007 federal judgment and fines, the largest in history at the time, have no negative impact on sales of OxyContin, the ‘new regime’ at Purdue Pharma turbo-charged profits paid directly to the family.

The Sackler family state they have no responsibility for the deaths of over 200,000 people from opioid overdoses. The Sacklers paid themselves hundreds of millions of dollars with the same regularity as pain patients took maximum doses of OxyContin. These payments, totaling over $4 billion since the company agreed to stop its illegal practices in 2007, make it clear by which means the Sacklers have been able to quickly and easily settle hundreds of prior lawsuits from states, counties, cities, and individuals harmed by OxyContin. To coin a phrase,

“money talks, bs squawks, truth is silenced.”

In 2017, a spate of investigative reports published in prestigious magazines like Esquire and respected newspapers like the Guardian documented the rise of litigation against the family and company. The articles told the story of Sackler wealth, charitable contributions, and overviews of their efforts to escape public scrutiny and legal culpability for what they’ve done over the past 40 years (Oh! Before OxyContin, Purdue Pharma made and sold Valium. Perhaps you’ve heard of “mother’s little helper”). Also before OxyContin, the company made MS Contin (still made by Rhodes Pharma, the secretive Purdue subsidiary based in Rhode Island). MS Contin is timed-release morphine. OxyContin was developed because people already feared morphine thanks to hundreds of thousands of deaths and millions of addicts dating back to the Civil War. OxyContin, often mispronounced as “Oxy-Codeine,” was a marketing dream compared to MS Contin.

The tragic reality for millions of addicts and their families is that lawsuits and federal and state penalties for violations of the law have been nothing more than a modest cost of doing business for Purdue Pharma and other drug makers. Once adverse events further overtake the Sacklers, expect another defense to ring out: we’re not the worst! Look at Johnson and Johnson, Teva, GlaxoSmithKline …

According to Public Citizen, a not-for-profit organization which has issued three prior reports on federal and state court judgments against pharmaceutical companies, the top 11 world pharma companies earned $711 billion net profit between 2003 and 2012. During the same time period, the 11 companies received an aggregate total of $38.6 billion in civil and criminal penalties from the federal government and states. The penalties equal about 5 percent of net profits, which any company might regard as a cost of doing business. Purdue Pharma certainly did.

Family members of people who died from OxyContin overdoses and individuals who recovered from OxyContin addiction have protested the Sackler family for years. Only recently have the protests begun to have an impact.

According to Esquire’s Christopher Glazek,

… the family’s leaders have pulled off three of the great marketing triumphs of the modern era: The first is selling OxyContin; the second is promoting the Sackler name; and the third is ensuring that, as far as the public is aware, the first and the second have nothing to do with one another

The Sacklers have contributed millions to the most renowned art museums around the world, including a $3.5 million donation that erected the Egyptian Temple of Dendur at the Met.

They have established institutes for pain management, obesity, and other medical fields of study at major universities including Harvard, Yale, Cornell, Columbia, McGill, Edinburgh, Glasgow, Sussex, and King’s College London.

All of this charitable money came from the work of hundreds of employees following direct, explicit orders issued by the Sackler family to undertake excessive, immoral, and allegedly fraudulent and illegal high- pressure opioid sales campaigns and marketing schemes designed for one purpose: enriching the billionaire Sackler family as individuals.

Why are the Sacklers Under Fire Now?

The Sackler family contend that as board members, not paid employees, not only do they have no responsibility for the illegal prescription opioid sales tactics that made them billionaires, OxyContin is not the cause of the opioid epidemic. They state that OxyContin represents only a small portion of total opioid sales. Their corporate structure includes Rhodes Pharma; between Rhodes and Purdue, the companies sell over 6 percent of the opioids prescribed in the U.S. annually. OxyContin is also a special type of opioid. It is long-lasting and time released and has a high potential for addiction.

Hard evidence has finally come forward documenting the family’s direct statements and actions before and after 2007’s $630 million federal judgment. Connecticut and Massachusetts have filed the first lawsuits in the new battle to stop the OxyContin-fueled opioid epidemic. These lawsuits individually name the Sackler family as the originators and creators of the opioid crisis which has officially taken over 200,000 lives and cost the U.S. an estimated $1 trillion since inception in 1999. After months of legal requests, a Massachusetts’ judge ordered the Commonwealth’s complaint to be unredacted and made available for public view in January.

Why did the Sackler family fight to keep Massachusetts’ lawsuit secret?

Massachusetts’ complaint documents the Sackler family’s roles as leaders and decision-makers for Purdue Pharma throughout the company’s history. The complaint provides evidence of Sackler orders and actions taken after the July, 2007 agreement which settled the previous federal and state cases.

Massachusetts contends, with ample direct, documentary evidence, that the Sacklers were not only personally responsible for ordering their employees to execute unscrupulous plans to sell as many OxyContin prescriptions for the highest possible doses, they personally circumvented or ordered employees to ignore every agreement the company had made to stop these practices in 2007.

The Commonwealth’s complaint is beautifully written and includes mountains of evidence, much like the 2012 Grand Jury report which led to the 2013 murder convictions of Philadelphia “House of Horrors” doctor Kermit Gosnell. What many may have forgotten is: Gosnell’s abortion-fueled murders might have continued undiscovered if he hadn’t been identified by the DEA as an excessive opioid prescriber.

Philadelphia “House of Horrors” Doctor Kermit Gosnell was a Star Prescriber for the Sackler OxyContin Empire

Memories are short, a human tendency the Sacklers have benefited from time and again. Convicted Philadelphia pill mill purveyor Kermit Gosnell wrote over 600,000 prescriptions for oxycodone (OxyContin) between 2007 and 2010. He only stopped when the DEA raided his office and shuttered his practice.

This places Gosnell’s OxyContin prescription pill sales value to Purdue well above that of Massachusetts doctor Walter Jacobs, featured in Massachusetts’ complaint. Jacobs was Purdue’s #1 prescriber in Massachusetts from 2008 to 2012, when he lost his medical license.

According to the Commonwealth’s complaint, Jacobs wasn’t just a high-volume OxyContin prescriber, he was Purdue’s top paid consultant in Massachusetts over the four years prior to losing his medical license. Jacobs received over $80,000 in consulting fees from Purdue Pharma and frequently gave speeches extolling the virtues of OxyContin to other physicians. Before the state stopped him, Jacobs prescribed more than 347,000 OxyContin pills in five years for an estimated value to Purdue of $3 million.

In a disturbing side note, Jacobs, now 70, appears to have obtained a license to practice law in Massachusetts in 2008. Jacobs’ law practice looks to have been as ethical as his medical practice — he received a reprimand in March, 2018 for unethical practices related to wrongful legal representation of a personal friend and former patient who in 2013, was indicted on 15 counts of sexual assault of a minor (step-daughter) in New Hampshire. Both Jacobs and his daughter, also an attorney, are named by New Hampshire in the separate legal malpractice case.

Sacklers Heard Many Reports About Illegal “Region Zero” Prescribers

So, Kermit Gosnell in Philadelphia, writing Oxy scripts for street drug dealers and addicts from his crumbling building in one of the city’s worst neighborhoods, seems to have been qualified for membership in Purdue Pharma’s secret coded Region Zero list. The Region Zero list, frequently named in Massachusetts’ complaint, was a confidential list of prescribing physicians who the company had reason to believe were involved in wrongful prescribing. In 2007, the company had agreed to document reports of suspicious prescribing and report them to authorities in the state of occurrence. But we must be joking! That was Purdue FREDERICK that made the agreement! They’re no longer in business.

At their board meetings, the Sacklers received regular reports about the Region Zero list doctors. This list was closely held by Purdue execs and unknown to the majority of Purdue employees. It was the ultimate resting place for staff reports of suspected bad prescribing behavior. In July 2010, meeting in Bermuda, board members including Beverly, Ilene, Jonathan, Kathe, Mortimer, Richard, and Theresa Sackler heard a report about hundreds of prescriptions written by Massachusetts doctors Michael Taylor and Alvin Chua.

Taylor’s New Bedford, Mass. office had already been raided in December, 2009. He was convicted of illegal prescribing in 2013 and surrendered his license to practice medicine. Chua’s license to practice medicine in Massachusetts was suspended in June, 2011.

Did the Sacklers and other board members express shock about these unscrupulous doctors? Aww, heck no.

According to board meeting records obtained by Massachusetts’ prosecutors, Purdue Pharma’s board, including non-Sackler family members Peter Boer, Judith Lewent, and Cecil Pickett, asked staff to document how much money the company was earning from these two and other Region Zero prescribers but took no other action.

The Region Zero list stayed secret.

Sacklers Ordered Sales Staff to Target Top 10% of Prescribers

By June 2008, OxyContin’s potential for addiction and dependency had become well-known enough that Purdue’s competitors were growing their market share just by saying “We’re not OxyContin.” Perhaps Heath Ledger’s death in January of that year had made a small impression.

Reading the bad news in trade publications, Richard Sackler wrote sales staff:

That’s all it took for Richard Sackler to order staff to ramp up Purdue’s sales force and launch a new initiative, the Options campaign. The Options campaign focused on doctors who already prescribed a lot of OxyContin. The goal of the campaign was calling on these physicians repeatedly, encouraging them to titrate the dosage of OxyContin prescriptions up as rapidly as possible.

Before I began researching prescription painkillers, I didn’t know what “titrate” meant. Titrate is a pharmaceutical term that means tying a dose of medication to symptoms and patient response. According to Purdue’s Options campaign, the best OxyContin doses were the highest doses: 60 and 80 mg per pill. At one point Purdue was marketing a massive 160 mg time-release pill. The high-value prescribers were giving out prescriptions to patients who were taking more than 24 pills a day. Purdue’s marketing materials said the time-release formula had advantages over other pain relievers because it provided pain relief with two pills a day.

By October 2009, Purdue Pharma had increased its sales force to 475 representatives, all focused on the Options campaign.

In October, 2009, Richard Sackler ordered sales staff to send him weekly reports on OxyContin sales progress.

Also that month, the Sackler family discussed Federal Sunshine Regulations which would force the company to disclose direct payments to physicians. All 50 states have their own disclosure rules. The database finally got off the ground in 2013.

In case you were wondering, “do these companies pay doctors to write prescriptions for their medications?” Like, the top 10% of prescribers? Aw heck yeah.

How much do they pay?

See for yourself.

Direct payments to physicians were only one way that Purdue Pharma continued profits for Sackler family members.

Other methods included blanketing physicians and patients with thousands of copies of deceptive marketing materials, promotional websites encouraging OxyContin for all types of chronic pain, prescription drug savings cards (a rebate program proven to lengthen prescription use, Purdue profits, and addiction potential), and frequent sales visits to “top decile prescribers” — the top 10% issuing the most prescriptions to the greatest number of patients in the highest dosage.

How frequent?

This calendar is for just one sales rep and one physician from 2015.

In addition to the visits and social opportunities with Purdue’s sales rep, the Fall River doctor eventually received a $48,000 consulting contract. He prescribed more than $1.5 million worth of Purdue Pharma products to his patients.

The Sackler family billions came directly from the company’s sales tactics that never ceased for even a day since OxyContin’s launch party in 1996 when Richard Sackler asked the audience to imagine a series of natural disasters. including a volcanic eruption, a hurricane, and a blizzard.

“the launch of OxyContin Tablets will be followed by a blizzard of prescriptions that will bury the competition,” Sackler said. “The prescription blizzard will be so deep, dense, and white…”

This article was originally envisioned as a stand-alone piece but the OxyContin story is so deep, of such long-standing, and so shocking, and the need for justice is so great that this article is the first in a series. Coming next: Sackler Sales Schemes Targeted the Most Vulnerable Patients. Also, check out Health Care Renewal, a gonzo blog by ethical medical professionals with vocabularies that would strike Ambrose Bierce pale with envy. Sign photographer Nan Goldin’s PAIN Sackler Change.org petition to hold the Sackler family accountable. I have previously written about fentanyl and Narcan /naloxone.