Book review: the American love affair with opioids, accelerated by McKinsey

Loyal readers may remember a review here of a book by a Los Angeles Times reporter on America’s taxpayer-fueled heroin habit (see Who funded America’s opiate epidemic? You did.). Empire of Pain: The Secret History of the Sackler Dynasty covers the same story from the angle of the family behind OxyContin. The Sacklers, whose names adorn university and art museum buildings throughout the U.S. and Europe, have been convenient scapegoats, but it turns out that they didn’t do it alone. Some things that I learned from the book…

Arthur M. Sackler, the patriarch, died before OxyContin was invented (the slow-release coating was actually the invention of a British company that had been acquired by the Sacklers’ sleepy Purdue Pharma and was used originally for morphine pills called “MS Contin”). He was the significant art collector and benefactor of AOC’s party venue at the Metropolitan Museum (how did it cost $587 for a car ride from the Bronx to the Upper East Side?). With the help of some friendly bureaucrats at the FDA, who would go on to be of much greater assistance to his brothers’ company Purdue, he pushed the limits of what was legal/ethical in medical advertising, especially for Valium and Librium, but museums are still happy to display the name of Hoffmann-La Roche, which actually made the drugs.

The book describes McKinsey, “The firm that built the house of Enron”, working to help Purdue Pharma increase sales of OxyContin even after the company and three executives had pleaded guilty to federal crimes regarding claims made regarding the drug. McKinsey’s biggest idea, according to the author, was that Purdue Pharma’s salespeople should make more frequent calls on the doctors who were the biggest prescribers, i.e., the “pill mills” such as Eleanor Santiago‘s (1 million pills, which resulted in a 20-month prison sentence for the physician). McKinsey also consulted for Johnson & Johnson, the author says, to help them push more opioids out to consumers. (See “Behind the Scenes, McKinsey Guided Companies at the Center of the Opioid Crisis” (NYT 2022))

Speaking of Johnson & Johnson, they owned a division in Tasmania where all of the poppies were grown to enable the production of OxyContin and competitive opioid pills from Janssen (J&J’s pharma subsidiary, now famous for its never-FDA-approved one-shot COVID vaccine) and other companies (in-depth background). The Federal DEA was also complicit in allowing a massive increase in the import quota for this critical raw material.

The author describes Mary Jo White, later appointed by Barack Obama to chair the Securities and Exchange Commission, as instrumental in weakening the government’s efforts to punish Purdue, which was owned entirely by the Sacklers (not, however, by any of Arthur M’s descendants or cash-hungry former wives, “the Valium Sacklers” as opposed to the “OxyContin Sacklers”).

Consistent with Dreamland, the book previously reviewed here, Empire of Pain says that it was common for people to transition from Oxy to heroin sold by migrants from Nayarit, Mexico and that, in fact, 80 percent of heroin overdoses were among people who’d previously been prescribed OxyContin. (See also “From Nayarit to Your Neighborhood: Heroin’s Path to a Ready Local Market”.)

The book supports the heritability of success theory advanced in The Son Also Rises: economics history with everyday applications. Even after a couple of generations that could have succumbed to idleness, the Sackler descendants are reasonably hard-working and successful. Madeleine Sackler, for example, has been successful as a filmmaker (ironically, a couple of them are about life in prison, which is not unrelated to the drug that has funded her lifestyle).

Empire of Pain: The Secret History of the Sackler Dynasty is timely given that a lot of our American brothers, sisters, and binary-resisters were just paid $600/week to stay home for two years and consume drugs and alcohol (this Senate document says there was a 30 percent increase in overdose deaths, but blames the “pandemic” rather than the “lockdown”). The antiracism experts at Mass General say that heavy drinking increased by 21 percent during lockdown.

If nothing else, reading the book will make you cautious about taking that first bottle of painkillers that a doctor prescribes!

The author is a New Yorker writer and he asserts as fact that HIV/AIDS would have been a solved problem if Republicans had not blocked federal funding for research into a cure for this disease (yet SARS-CoV-2 continues to kill steadily despite literally $trillions in tax money that has been thrown at it; see Did vaccines or any other intervention slow down COVID?). He also asserts as fact that if Purdue Pharma was liable for opioid-related deaths then gun manufacturers are obviously liable for shooting deaths (never mentioning that the gun manufacturers have always been quite candid about the lethality of guns/bullets and that the theory of liability for the opioid industry is that the companies lied to Americans about heroin-style drugs not being addictive/harmful).

Loosely related… the Temple of Dendur at the Met, in what used to be called “The Sackler Wing” (funded by Arthur M, blameless in the OxyContin debacle), “temporarily closed” in June 2021 for coronapanic:

11 thoughts on “Book review: the American love affair with opioids, accelerated by McKinsey

  1. Legalize all drugs (my body, my choice – right?). Then users could sue the producers and sellers for any actual harm suffered, just like any other product. The truly harmful drugs would soon disappear.

  2. Thank you for the extended reading – it fills in a lot of blanks from a different perspective but draws some of the same lessons. As I’ve noted before, I was initially prescribed Oxycodone and learned the hard way how rapidly the tolerance builds while the side effects remain and actually get worse. I am 0.0% surprised that 80% of heroin addicts reported being previous Oxycontin users. I put mine way, way away and haven’t touched one since my fall.

    As far as gun manufacturers being candid inre: lethality, you should take a look at a modern Ruger firearm manual, shot through as they are with red triangles and dire warnings. I think these drugs are more dangerous than firearms on many levels, especially once the “boundaries were pushed” on the promotion.

    Now I’ve got another book to read!

  3. I’ve been prescribed Oxycodone several times for dental or post-surgical pain relief and I suffered no side effects or apparently increased tolerance. The only effect that I found was just pain relief for a few hours. Eventually after a few days when the pain was gone I was left with a mostly full bottle of Oxycodone that I kept in the medicine cabinet until I threw it out. I experienced no “high” or any sort of compulsion to take a pill for anything other than pain relief.

    So I am confused about how people are being hooked. What is the feeling like for people who are addicted to Oxycodone? Am I a physiological outlier? Just lucky? Or do you have to crush, sniff, or otherwise prepare the pills to get this addicting stimulus? Seriously, I’m not being sarcastic. I felt nothing other than pain relief so I’m suspicious of people that claim they were hooked even though they were properly taking the pills for a real medical condition.

    Alex you said that your recent usage gave you a much stronger feeling of happiness the next day. Is sort of feeling what people are looking for? Something people would risk jail time or their life for?

    • Re-read your own post

      “after a few days when the pain was gone ”

      Not all pain does this.

    • @lf: That’s not really what I said. For those who didn’t read it, I was responding to philg’s statement about someone who had successfully gone through drug and alcohol rehab and then started partying with Hollywood people, became addicted to heroin, overdosed and died.

      I began my reply with: “Opioids are dangerous.”

      I said that yes – it’s true – they work to block acute pain. If you’ve just had a root canal, they’re great because you can take a few over a couple of days, the wound will heal, the pain will go away on its own, and you can stop taking them because you don’t need them. Same thing with bone breaks, burns, and post-op surgery. I had some morphine while I was recuperating from a major surgery and it worked! I was able to get some rest, and a few days later I left the hospital and that was it for the morphine.

      The problem with opioids is that when you’re abusing them, you quickly develop a tolerance. I started taking one tiny 5mg pill of Oxycodone. Then it was two to achieve the same level of pain suppression. Then it was four. Then it was five a day, 25mg (which is still a relatively small dose by addict standards.) Then one night I got up from bed and promptly fell straight to the floor. My legs were wobbly and I recognized what I was feeling as withdrawal: I needed more Oxycodone! And this was just three weeks in.

      I pulled the plug on it and never touched them again. If I have an acute injury in the future and the pain is unbearable, I’ll probably take them again, but ONLY if the injury has a rapidly approaching time horizon.

      I repeat: Opioids are dangerous. Be careful out there.

  4. I don’t think the general public understands that JCOHA accreditation which allows hospitals to stay open (government requirement) pushed the idea that doctors weren’t giving out enough opiates starting in the year 2000.

    What’s not clear to me is where JCOHA got the idea that doctors needed to be prodded into helping out the opiate industry. They certainly haven’t assumed any responsibility for the opiate addiction problem.

  5. Unlike “Dr.” Jill Biden, I have no “Dr.” in my name, so take what I’m about to say as you will.

    Drug addiction, be it through Oxycodone or any other illegal drugs has nothing to do with pain. It all has to with the “high” experience that the drug user may get and will want more of it. It’s like giving a kid his/her favorite candy nonstop. The side effect of that awful after taste or stomach cramp will not sway away kids from not asking for more, because s/he doesn’t know any better — unless there is an adult to tell the kid enough-is-enough. Sadly, those drug addicts do not get the family discipline to be told enough-is-enough and in many cases the parents themselves are drug users.

  6. You can buy tianeptine at gas stations if you want an over-the-counter anti-depressant. However, there seems to be a movement afoot amongst government nannies to have it declared illegal.

    Of course, people like George A. who had family discipline instilled in them will be able to refuse it.

    • After a difficult period in my life almost 20 years ago (job loss, parental & sibling death all in the same year), I requested a prescription for Wellbutrin from my PCP. It alleviated my anger and sadness, and helped me sleep; no side effects. I still take a half dose from time to time when angry or ruminating on a problem and can’t sleep.

Comments are closed.