Dr. Thomas A. Andrew, the chief medical examiner of New Hampshire, recently decided to quit working in the morgue and instead pursue a divinity degree. According to a recent New York Times profile, Andrew is distraught about the country’s opioid epidemic — which, according to a 2016 figures report by the American Society of Addiction Medicine, is the reason why drug overdose is the leading cause of accidental death in the U.S. Per the same report, four in five new heroin users began by abusing prescription painkillers; in a 2014 survey, 94% of respondents in treatment said they used heroin because prescription opioids were too expensive. The heroin epidemic is only getting worse.
According to a new investigation by Esquire’s Christopher Glazek, the epidemic is due in no small part to the Sackler family, the ubiquitous and powerful art patrons, and Purdue Pharma, “the American branch of the Sacklers’ pharmaceutical empire.” As Glazek reveals, they committed an unusually cruel crime of cartoon-villainous proportions: deliberately downplaying the addictive effects of OxyContin — a pill containing oxycodone, a chemical 50% percent stronger than morphine — and knowingly subjecting millions to often irreversible addictions.
There are Sackler-branded spaces in several major museums, including the Guggenheim, the American Museum of Natural History, and the Metropolitan Museum of Art, whose Sackler Wing houses the Temple of Dendur. (It’s worth noting that many relatives, including Elizabeth Sackler, “emphatically distanced themselves” from this onerous branch of the family.) According to Glazek, here’s how it began: Once known as Purdue Frederick, Arthur Sackler purchased Purdue Pharma in 1952; his brothers, Mortimer and Raymond, went on to run the company. About a decade later, Arthur was contracted by Roche, another pharmaceutical company, to create an advertising strategy for Valium. Arthur had a knack for clever marketing, a skill he’d unfortunately pass onto his kin. Says Glazek, “As Arthur’s fortune grew, he turned his acquisitive instincts to the art market.”
When he donated his collection or money to institutions, “he often imposed onerous terms,” such as those that’d help him evade taxes, and he became obsessed with the recognition. When the brothers donated $3.5 million to the Met to erect the Temple of Dendur, says Glazek, “they stipulated that all museum signage, catalog entries, and bulletins referring to objects in the newly opened Sackler Wing had to include the names of all three brothers, each followed by ‘M.D.’”
In 1972, Napp, the family’s drug company in the UK, created and marketed MS Contin, a time-released morphine pill for hospice patients, at a time when many clinicians were focusing on cures for chronic pain — the crisis of pain was one the Sacklers took great strides to promote. According to Glazek, Richard Sackler — Raymond’s son, a patron of “organizations classified as hate groups by the Southern Poverty Law Center”—sought to bank on this, looking for new ways to market the Contin system. Glazek adds, “while Purdue did not invent the chronic-pain movement … it used that movement to engineer a crucial shift,” which eventually took the form of aggressive prescribing practices. Pain was marketed as its own industry. Richard received a suggestion to create an oxycodone pill; “many doctors,” explains Glazek, “believed — wrongly — that it was substantially less powerful [than morphine].” Due to its delayed absorption, Purdue marketed their new drug, OxyContin, “as less addictive than older opioids on the market.”
Anyone who’s been in bad need of a fix knows such delays are sidestepped by crushing and snorting the pill, and the drug’s “own packaging warned that consuming broken pills would thwart the timed-release system and subject patients to a potentially fatal overdose.” Then, explains Glazek, “Purdue pioneered a high-cost promotion strategy, effectively providing kickbacks —which were legal under American law — to each part of the distribution chain.” The accompanying perks, such as free vacations and seminars, were “unprecedented in the marketing of a Schedule II narcotic.”
After the abuse caught up with Purdue, and they finally pleaded guilty to felony charges in 2007, they “acknowledged exploiting doctors’ misconceptions about oxycodone’s strength. In court documents, the company said it was ‘well aware of the incorrect view held by many physicians that oxycodone was weaker than morphine’ and ‘did not want to … take any steps that would affect the unique position that OxyContin’ held among physicians.” Glazer adds: “No Sacklers were named in the 2007 suit … even though Richard had been one of the company’s top executives during most of the period covered by the settlement.” Eventually, they “released a new formulation of the medication that was harder to snort or inject,” effectively, says Glazer, “rebranding” themselves.”
Glazek notes in his story that, prior to the 2007 trial, OxyContin abuse was reported in states like West Virginia, Maine, and Florida. West Virginia has the highest overdose death rate in the country; it was the subject of a recent New Yorker story, which specifically noted that prescription painkillers were part of the problem. Last month, an article in the Miami Herald stated that the city — in response to Florida’s overwhelming opioid crisis — was planning to “pursue a complaint against prescription opioid manufacturers and distributors that would seek compensation for the resources Miami has been forced to dedicate to reviving overdose victims, policing drug-related crimes and healthcare.”
But, in Glazek’s story, he mentions that the Sacklers “will likely emerge untouched: Because of a sweeping non-prosecution agreement negotiated during the 2007 settlement, most new criminal litigation against Purdue can only address activity that occurred after that date. Neither Richard nor any other family members have occupied an executive position at the company since 2003.” Says Glazek, “according to an investigation last year in the Los Angeles Times, Mundipharma, the Sackler-owned company charged with developing new markets, is employing a suite of familiar tactics in countries like Mexico, Brazil, and China to stoke concern for as-yet-unheralded ‘silent epidemics’ of untreated pain.” When congressional lawmakers sent a letter to the World Health Organization, warning that Sackler-owned companies were “preparing to flood foreign countries with legal narcotics,” they named Purdue directly: “‘Purdue began the opioid crisis that has devastated American communities.’”
I live in Miami, ten minutes from the local epidemic’s epicenter; given its monstrosity, that I can count the number of people I know suffering from addiction on one hand — and the number I’ve people I’ve lost to it, so far, on even less — is a cruel kind of blessing. In stories like these, of meticulous, mostly silent injustice, the sad irony writes itself. During distress, one looks to beacons of hope — like the medical examiner on a spiritual journey. Deeply saddened by the epidemic’s effect on my hometown, feeling its reverberating effects too closely, I was comforted by a ceramic hippo I’ve had since I was a toddler. The hippo has an officially branded name, William, and it’s a replica of an artifact from the Metropolitan Museum of Art’s Egyptian art wing, steps away from the Temple of Dendur. Strangely, there’s a certain joy in knowing that the Sackler fortune has helped contribute to institutions that are free, accessible, and enriching, places that produce William the Hippo. But it is no relief.