Opioid Industry Documents Archive Launched
March 27, 2021 10:47 AM Subscribe
On March 24, UC San Francisco and Johns Hopkins University announced the launch of "the Opioid Industry Documents Archive, a digital repository of publicly disclosed documents from recent judgments, settlements, and ongoing lawsuits concerning the opioid crisis. The documents come from government litigation against pharmaceutical companies, including opioid manufacturers and distributors related to their contributions to the deadly epidemic, as well as litigation taking place in federal court on behalf of thousands of cities and counties in the United States."
As the home page for the Opioid Industry Documents Archive states, "The opioid epidemic is the worst drug epidemic in our nation’s history, and nothing is more important to those who have been impacted than the truth–full transparency regarding how the epidemic occurred and how further harms can be abated."
The archive currently consists of 3,300 documents, including emails, memos, presentations, sales reports, budgets, audit reports, Drug Enforcement Administration briefings, meeting agendas and minutes, expert witness reports, and depositions of drug company executives. The archive's ultimate goal is to consolidate all opioid litigation documents–and potentially additional information from sources such as the U.S. Food and Drug Administration, professional societies, and individuals and family members directly impacted by the epidemic–into a universally accessible and easy-to-use digital archive.
The archive includes documents that referring to consulting firm McKinsey & Company, which recently agreed to pay $573 million to settle investigations into its role in the opioid crisis. That these documents have been made public may be the result of work by a group of medical historians. In 2019, "35 historians from universities including Harvard, the University of Pennsylvania, Johns Hopkins and Yale said in a Sept. 12 filing with U.S. District (sic) Dan Aaron Polster in Ohio that the documents are necessary to perform 'impactful research into the origins and ramifications of this defining crisis in the recent history of our nation.' "
Of course, that crisis is not over. It appears that 2020 was the worst year for opioid overdoses the US has ever seen, according to Michael Barnett, M.D., assistant professor of health policy and management at Harvard T.H. Chan School of Public Health. "What I’m worried about is the lack of a robust treatment infrastructure for substance use disorder. It was already strained before the pandemic, and now we need to provide even more comprehensive services for this population, but we won’t have the capacity to take care of them unless there are really drastic policy changes. ...
"The pandemic is in many ways a perfect storm for anyone who is struggling with substance use disorder. People have lost their jobs. Social and family interactions have been limited. And the pandemic itself is depressing and anxiety provoking. These are all stimuli that can stress the psyche and the finances of someone who has an addiction. In some cases, it could push a person who was getting their addiction under control back toward substance use."
Yeah, no kidding. Here's something upbeat, however distantly: the Scripps Research laboratory of chemist Kim Janda, PhD, has been working on new therapeutic interventions that may (someday) be able to prevent the bulk of deaths from opioid overdose, according to ScienceDaily. In mice, an experimental vaccine blunted the deadliest of synthetic opioids and was able to diminish fatal respiratory effects of fentanyl and carfentanil. Again, in mice. But with luck and hard work, maybe eventually in people.
As the home page for the Opioid Industry Documents Archive states, "The opioid epidemic is the worst drug epidemic in our nation’s history, and nothing is more important to those who have been impacted than the truth–full transparency regarding how the epidemic occurred and how further harms can be abated."
The archive currently consists of 3,300 documents, including emails, memos, presentations, sales reports, budgets, audit reports, Drug Enforcement Administration briefings, meeting agendas and minutes, expert witness reports, and depositions of drug company executives. The archive's ultimate goal is to consolidate all opioid litigation documents–and potentially additional information from sources such as the U.S. Food and Drug Administration, professional societies, and individuals and family members directly impacted by the epidemic–into a universally accessible and easy-to-use digital archive.
The archive includes documents that referring to consulting firm McKinsey & Company, which recently agreed to pay $573 million to settle investigations into its role in the opioid crisis. That these documents have been made public may be the result of work by a group of medical historians. In 2019, "35 historians from universities including Harvard, the University of Pennsylvania, Johns Hopkins and Yale said in a Sept. 12 filing with U.S. District (sic) Dan Aaron Polster in Ohio that the documents are necessary to perform 'impactful research into the origins and ramifications of this defining crisis in the recent history of our nation.' "
Of course, that crisis is not over. It appears that 2020 was the worst year for opioid overdoses the US has ever seen, according to Michael Barnett, M.D., assistant professor of health policy and management at Harvard T.H. Chan School of Public Health. "What I’m worried about is the lack of a robust treatment infrastructure for substance use disorder. It was already strained before the pandemic, and now we need to provide even more comprehensive services for this population, but we won’t have the capacity to take care of them unless there are really drastic policy changes. ...
"The pandemic is in many ways a perfect storm for anyone who is struggling with substance use disorder. People have lost their jobs. Social and family interactions have been limited. And the pandemic itself is depressing and anxiety provoking. These are all stimuli that can stress the psyche and the finances of someone who has an addiction. In some cases, it could push a person who was getting their addiction under control back toward substance use."
Yeah, no kidding. Here's something upbeat, however distantly: the Scripps Research laboratory of chemist Kim Janda, PhD, has been working on new therapeutic interventions that may (someday) be able to prevent the bulk of deaths from opioid overdose, according to ScienceDaily. In mice, an experimental vaccine blunted the deadliest of synthetic opioids and was able to diminish fatal respiratory effects of fentanyl and carfentanil. Again, in mice. But with luck and hard work, maybe eventually in people.
This is especially good news because UC San Francisco has a strong track record of preserving and researching this kind of evidence: UCSF is the home of the Truth Tobacco Industry Documents, an archive of 14 million documents created by tobacco companies about their advertising, manufacturing, marketing, scientific research and political activities, and the Tobacco Control Archives, which contains government and activist records on stopping smoking.
The new opioid archive includes Insys litigation documents (Insys executives were found guilty of racketeering for bribing doctors to prescribe opioids). They also have documents related to opioid litigation in Oklahoma and Kentucky. And as new documents become available, the UCSF archive may become a home for them, as well; they just posted more than 2000 additional documents to the tobacco archive last week.
This is another area where the Biden administration could make some real headway against a massive and tragic American problem. He is a man who knows what it's like to see a loved one struggle with addiction, and his response to his son's cocaine addiction resonated with so many people, acknowledging the hurt and pain of addiction, but also the hope of dealing with it:
It is so important to have these records, where anyone can see them, to know who made the choices to hurt other people.
This is such important work, and I am so glad to know about it. Thank you for this outstanding post, Bella Donna.
posted by kristi at 1:07 PM on March 27, 2021 [9 favorites]
The new opioid archive includes Insys litigation documents (Insys executives were found guilty of racketeering for bribing doctors to prescribe opioids). They also have documents related to opioid litigation in Oklahoma and Kentucky. And as new documents become available, the UCSF archive may become a home for them, as well; they just posted more than 2000 additional documents to the tobacco archive last week.
This is another area where the Biden administration could make some real headway against a massive and tragic American problem. He is a man who knows what it's like to see a loved one struggle with addiction, and his response to his son's cocaine addiction resonated with so many people, acknowledging the hurt and pain of addiction, but also the hope of dealing with it:
My son, like a lot of people, like a lot of people you know at home, had a drug problem. He’s overtaken it. He’s fixed it. He’s worked on it, and I’m proud of him. I’m proud of my son.We all make choices every hour of every day. Some of us will choose to help people struggling with physical pain and with addiction. Some of us will choose to sneer at people struggling with physical pain and with addiction. Some of us will try to make money by increasing other people's struggles.
It is so important to have these records, where anyone can see them, to know who made the choices to hurt other people.
This is such important work, and I am so glad to know about it. Thank you for this outstanding post, Bella Donna.
posted by kristi at 1:07 PM on March 27, 2021 [9 favorites]
Thank you for all those great links and additional context, kristi. Much appreciated!
posted by Bella Donna at 4:09 PM on March 27, 2021 [1 favorite]
posted by Bella Donna at 4:09 PM on March 27, 2021 [1 favorite]
Purdue Pharma Offers Restructuring Plan, Sackler Family Would Give Up Ownership
They issued a joint statement describing Purdue as a "criminal enterprise" and demanded more money up front to help communities affected by opioid addiction to pay for treatment and public health services.posted by benzenedream at 6:16 PM on March 27, 2021 [1 favorite]
"What the Sacklers are offering is a way for the payments to be structured that makes it convenient for them," said Massachusetts Attorney General Maura Healey.
If you, like me, are overwhelmed by "3,300 documents", have no fear. The archive's front page has a nice convenient little slide deck at the bottom with highlights, including this choice quote from a pharmaceutical sales representative:
posted by The genius who rejected Anno's budget proposal. at 6:22 PM on March 27, 2021 [6 favorites]
Keep 'em comin'! Flyin' out of here. Its like people are addicted to these things or something. Oh, wait, people are...Thanks for the great post, Bella Donna!
posted by The genius who rejected Anno's budget proposal. at 6:22 PM on March 27, 2021 [6 favorites]
The one thing that bugs me about using quotes like that too illustrate the callousness of Purdue and the Sacklers (and the reporting on the crisis in general) is that it ignores the major difference between dependence and addiction.
There isn't anything inherently wrong with people who have otherwise incurable pain being dependent on opioids given proper management. The problems come from lying about the risk profile of the drug, paying doctors to write more prescriptions, and worst, completely ignoring even obvious signs of massive amounts of diversion.
Unfortunately, the response from the DEA and other agencies has only fucked the situation far beyond anything Purdue and the pill mil doctors managed on their own. There are still to this day such low limits on the number of substance abuse patients any given doctor can treat with MAT that in many places it is functionally unavailable despite the continuing high rates of abuse.
posted by wierdo at 7:28 PM on March 27, 2021 [14 favorites]
There isn't anything inherently wrong with people who have otherwise incurable pain being dependent on opioids given proper management. The problems come from lying about the risk profile of the drug, paying doctors to write more prescriptions, and worst, completely ignoring even obvious signs of massive amounts of diversion.
Unfortunately, the response from the DEA and other agencies has only fucked the situation far beyond anything Purdue and the pill mil doctors managed on their own. There are still to this day such low limits on the number of substance abuse patients any given doctor can treat with MAT that in many places it is functionally unavailable despite the continuing high rates of abuse.
posted by wierdo at 7:28 PM on March 27, 2021 [14 favorites]
Good point, weirdo. I also feel like the progress we were making on improving pain treatment in the US got lost as a result of these greedy, for lack of a better phrase, capitalist fuckers.
Welcome to becoming an official MeFite, The genius who who rejected Anno’s budget proposal! Glad the post is helpful. I really debated whether or not to post this, because the topic is so grim. But the existence of this archive is incredibly important, and I want to help spread the word.
posted by Bella Donna at 2:46 AM on March 28, 2021 [5 favorites]
Welcome to becoming an official MeFite, The genius who who rejected Anno’s budget proposal! Glad the post is helpful. I really debated whether or not to post this, because the topic is so grim. But the existence of this archive is incredibly important, and I want to help spread the word.
posted by Bella Donna at 2:46 AM on March 28, 2021 [5 favorites]
First point:
It would be a good project to link this Opioid document links with the similar Tobacco one; along with any and all documents related to the Climate Denial by the Oil companies and other such related public health malfeasance by corporations. Like one portal that will lead to all these and Meta describing the similarity in the way it was done.
I wonder if there was a similar coverup of the Radium Watchmakers problems, Lead in Gasoline research; and other such chemical industry disasters.
The reason I think a one stop portal will be a valid project, is that I remember reading a book by a couple of Harvard Science Historians on how the same people involved with the Tobacco denialism in the 60's (people and their related thinktanks) were coopted to serve the Oil Industry to start with the Climate Denialism. The methodology was eerily similar. It will be fascinating to see if the Tobacco denialism methodology formed a part of this Purdue Pharma strategy. I have a feeling that these kinds of coverups are all linked and the denialism industry is also similarly linked.
Secondly:
As weirdo mentions; this has made the life of people dealing with chronic pain using opioids under supervision and proper management; vastly more difficult for no fault of their own. Also, Doctors have become increasingly really wary of prescribing pain medications too. Isn't it the case that the vast majority of patients given these pain medications after surgery and other such trauma; never get addicted and basically are done once their prescription is over with?
As a recovering alcoholic; I see the devastation caused by prescription medication abuse in the rooms. I also anecdotally know of a lot of folks who have relapsed, and the unfortunate few who have died. The lacing of Fentanyl into the supply of street opioids is the additional aspect of this epidemic. The cheapness and the availability of something so potent as Fentanyl is exacerbating the epidemic that is caused by bad actors like Purdue.
posted by indianbadger1 at 11:35 AM on March 28, 2021 [3 favorites]
It would be a good project to link this Opioid document links with the similar Tobacco one; along with any and all documents related to the Climate Denial by the Oil companies and other such related public health malfeasance by corporations. Like one portal that will lead to all these and Meta describing the similarity in the way it was done.
I wonder if there was a similar coverup of the Radium Watchmakers problems, Lead in Gasoline research; and other such chemical industry disasters.
The reason I think a one stop portal will be a valid project, is that I remember reading a book by a couple of Harvard Science Historians on how the same people involved with the Tobacco denialism in the 60's (people and their related thinktanks) were coopted to serve the Oil Industry to start with the Climate Denialism. The methodology was eerily similar. It will be fascinating to see if the Tobacco denialism methodology formed a part of this Purdue Pharma strategy. I have a feeling that these kinds of coverups are all linked and the denialism industry is also similarly linked.
Secondly:
As weirdo mentions; this has made the life of people dealing with chronic pain using opioids under supervision and proper management; vastly more difficult for no fault of their own. Also, Doctors have become increasingly really wary of prescribing pain medications too. Isn't it the case that the vast majority of patients given these pain medications after surgery and other such trauma; never get addicted and basically are done once their prescription is over with?
As a recovering alcoholic; I see the devastation caused by prescription medication abuse in the rooms. I also anecdotally know of a lot of folks who have relapsed, and the unfortunate few who have died. The lacing of Fentanyl into the supply of street opioids is the additional aspect of this epidemic. The cheapness and the availability of something so potent as Fentanyl is exacerbating the epidemic that is caused by bad actors like Purdue.
posted by indianbadger1 at 11:35 AM on March 28, 2021 [3 favorites]
The lacing of Fentanyl into the supply of street opioids is the additional aspect of this epidemic.
I saw some people on reddit saying you can't even get real heroin anymore. They said fentanyl just knocks your ass out and there is none of the mellow euphoric state that the junk of yore supposedly promoted. They said it wasn't worth relapsing for. It was like something out of Burroughs.
posted by thelonius at 12:36 PM on March 28, 2021 [2 favorites]
I saw some people on reddit saying you can't even get real heroin anymore. They said fentanyl just knocks your ass out and there is none of the mellow euphoric state that the junk of yore supposedly promoted. They said it wasn't worth relapsing for. It was like something out of Burroughs.
posted by thelonius at 12:36 PM on March 28, 2021 [2 favorites]
When I was 16 a girl I liked said I should come over cause she had some really good weed. It made my mouth taste like a hospital. It was pcp. It became profoundly unpleasant but didn't kill us.
I know two people whose kids died last year because they thought they bought one thing and wound up with fentanyl-laced stuff. They are not over it.
posted by Mr. Yuck at 5:52 PM on March 28, 2021 [3 favorites]
I know two people whose kids died last year because they thought they bought one thing and wound up with fentanyl-laced stuff. They are not over it.
posted by Mr. Yuck at 5:52 PM on March 28, 2021 [3 favorites]
This is a very important archive to have available.
Best of the web, indeed.
posted by doctornemo at 7:20 AM on March 29, 2021 [1 favorite]
Best of the web, indeed.
posted by doctornemo at 7:20 AM on March 29, 2021 [1 favorite]
This data represents over 150,000 visits by Purdue Pharma sales representatives to Massachusetts prescribers and pharmacists between 2007-2018.
Why would the reps visit pharmacists? How could a pharmacist drive sales?
posted by Mr. Yuck at 8:35 AM on March 29, 2021
My former psychiatrist, in California, literally gets a free lunch delivered every day by different pharma reps. I asked him if he was getting anything from Big Pharma once, and he told me about the lunches and claimed they didn't affect his prescribing decisions. I did't believe him but he was a great meds shrink so I kept seeing him anyway. One day, before my appointment, I arrived when a rep was doing a monthly drop-by to see how my doc was doing.
I knew that the industry would not be buying my doc's lunch every day unless it made money as a result. And it does. Drug companies' payments and gifts affect physicians' prescriptions, according to a STAT article from December 2020.
"The results were unanimous: All 36 studies showed that receiving industry money increases prescribing. This was consistent across all medical specialties and types of drugs. Industry money affects how doctors prescribe cholesterol medications. It affects drugs for Alzheimer’s disease, for multiple sclerosis, and for blood thinners. It even affects which drugs are used to treat cancer. Perhaps most worrisome, it increases how many opioids doctors prescribe."
My sister used to be a pharmacy tech and she confirmed that industry reps would visit pharmacists but never understood why, either. Apparently the reps would chat, offer information, and then leave a bunch of pens or something.
posted by Bella Donna at 1:44 PM on March 29, 2021 [1 favorite]
I knew that the industry would not be buying my doc's lunch every day unless it made money as a result. And it does. Drug companies' payments and gifts affect physicians' prescriptions, according to a STAT article from December 2020.
"The results were unanimous: All 36 studies showed that receiving industry money increases prescribing. This was consistent across all medical specialties and types of drugs. Industry money affects how doctors prescribe cholesterol medications. It affects drugs for Alzheimer’s disease, for multiple sclerosis, and for blood thinners. It even affects which drugs are used to treat cancer. Perhaps most worrisome, it increases how many opioids doctors prescribe."
My sister used to be a pharmacy tech and she confirmed that industry reps would visit pharmacists but never understood why, either. Apparently the reps would chat, offer information, and then leave a bunch of pens or something.
posted by Bella Donna at 1:44 PM on March 29, 2021 [1 favorite]
Oh hey, this is why reps visit pharmacists. The excerpt below is from an article written by a freelance writer that apparently ran in Pharmaceutical Representative magazine back in 2005. Don't imagine the thinking has changed much since then.
A pharmacist is a pharmaceutical sales partner. The most successful pharmaceutical reps recognize that pharmacists can have tremendous impact on their territories. Pharmacy support is crucial for successful pull-through programs, patient education, and supplemental physician contact. A pharmacist may be able to provide information about managed care formularies and drug pricing, as well as alert you to patient questions or concerns.
Although it isn't appropriate for a pharmacist to recommend that a physicians prescribe your drug instead of your competitors, the more educated a pharmacist is about your product, the more effectively they can present relevant information (including benefits) to prescribing physicians.
What can you do to establish or expand your impact on the pharmacists in your territory? I will share with you some suggestions from a variety of retail chain, independent and hospital pharmacists interested in partnering with pharmaceutical representatives for more productive relationships. But first, the bottom line.
Pharmacy Calls Are Sales Presentations
posted by Bella Donna at 1:51 PM on March 29, 2021 [2 favorites]
A pharmacist is a pharmaceutical sales partner. The most successful pharmaceutical reps recognize that pharmacists can have tremendous impact on their territories. Pharmacy support is crucial for successful pull-through programs, patient education, and supplemental physician contact. A pharmacist may be able to provide information about managed care formularies and drug pricing, as well as alert you to patient questions or concerns.
Although it isn't appropriate for a pharmacist to recommend that a physicians prescribe your drug instead of your competitors, the more educated a pharmacist is about your product, the more effectively they can present relevant information (including benefits) to prescribing physicians.
What can you do to establish or expand your impact on the pharmacists in your territory? I will share with you some suggestions from a variety of retail chain, independent and hospital pharmacists interested in partnering with pharmaceutical representatives for more productive relationships. But first, the bottom line.
Pharmacy Calls Are Sales Presentations
posted by Bella Donna at 1:51 PM on March 29, 2021 [2 favorites]
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This is such important work.
Glad to see McKinsey get their comeuppance. Sometimes it’s better to walk away from the table, fellas.
posted by armoir from antproof case at 12:01 PM on March 27, 2021 [5 favorites]