The Sackler Family – A Secretive Billion Dollar Opioid Empire

We are in the middle of an epidemic. An epidemic. In fact, it's called the worst public health epidemic in our history. Because eight members of the Sackler family caused much of the opioid epidemic. And the case is shining a spotlight on the powerful family behind the drug maker. They were all hell-bent on becoming super rich. Imagine a medical industry that's supposed to keep a nation healthy, but becomes so completely corrupt that it causes an epidemic. This has become a reality in the United States where opioids have caused just under 50,000 deaths per year according to recent figures. And that's just the tip of the iceberg. Countless other lives have been destroyed through addiction. In the United States, drug overdoses are the leading cause of death in people under 50. That's a lot to take in, but imagine if most of this tragedy was caused by one secretive family working behind the scenes. Once again, this is a reality. That family's name is Sackler. The Sackler family is not only partly responsible for the epidemic, but has also made a multi-billion dollar empire from it. You may not know about them, but you've surely heard of OxyContin before. Welcome to the story of how billionaires and doctors became the drug dealers that caused an epidemic. You are watching ColdFusion TV. The opioid epidemic in the United States was caused by a variety of factors, but one of the main ones is the involvement of the Sackler family and their infamous opioid painkiller, OxyContin. In 2017, when over 100 people per day were dying, President Trump declared the opioid crisis a national emergency. Here's the problem. Patients are often given strong painkillers when in hospital for surgery or chronic pain, While the drugs are life enabling for many patients to avoid excruciating pain from injury or otherwise, many fall into addiction cycles from withdrawals. Some people graduate from prescription pharmaceuticals onto cheaper and more potent alternatives like heroin or fentanyl. The cases and causes come from far and wide, but research indicates that there is a strong correlation between regions of high opioid prescription rates and high overdose rates. I mean, if you look at it, four of five injectable drug users started getting opioids, whether it be OxyContin prescription or non-prescription pill taking. So there is a direct correlation between the two. Annually, more than 214 million prescriptions for opioid pain have been given out, With more than 11 million people abusing their medication. But how did this problem get so catastrophic? Enter the Sacklers. The Sacklers pushed OxyContin to everyday people who had little use for the drug. They corrupted the entire supply chain, employing armies of sales reps, paying off doctors, lobbying for favourable regulation, and making billions while masses fell into devastating addiction. They didn't care much for the addictive properties of their drugs, they were more concerned with their bottom line. Their name is everywhere, yet not many people know about them. The Sackler family have invested a substantial portion of their $14 billion net worth into many museums, art galleries and universities. The world-famous Louvre Museum in Paris has a Sackler wing. Kate Middleton was stunned when she opened the Sackler courtyard in the Victoria and Albert Museum, which consists of 11,000 handmade porcelain tiles. London's famous Gothic church, Westminster Abbey, even has a window named after the Sacklers. While the family is happy to put their name on any prestigious institution that will receive their money, it's a name that is far removed from their golden product, OxyContin. The reason why will soon be very obvious. So to understand the Sacklers in full, we must first look at the Sackler story. The story of the Sacklers starts in 1952 when three psychiatrist brothers, Arthur, Mortimer and Raymond, purchased a small pharmaceutical company called Purdue. Together, they co-authored over a hundred research papers on the biochemistry of mental illness. Arthur Sackler doubled as an advertising pioneer in pharmaceuticals. Perhaps by using his research papers as leverage, he was the first to convince the Journal of the American Medical Association to run an ad brochure in color. Arthur went on to make Valium the first drug to pass 100 million sales. He did this by marketing it as a drug to cover all kinds of ailments with a made-up term he called psychic tension. Previously, that kind of drug was strictly only for anxiety, so with the introduction of the invented idea of psychic tension, it could be prescribed to a much wider market. Almost anyone could fit the symptoms, not just anxiety sufferers. By this stage, Arthur Sackler was inducted into the Medical Advertising Hall of Fame. During the 1980s, a recent movement in medicine was taking place. It was called hospice. The hospice sector takes care of the terminally ill and end of life patients. Around this time, the Sackler company Purdue would release a morphine-based pill called MS Contin that could help cancer patients sleep. In the hospice market, addiction wasn't an issue because the patients would soon pass. Purdue would take this concept one step further, they would release MS Contin for general use. Unfortunately, MS-Contin would be the precursor to the drug that would help create an epidemic. In the United States, MS-Contin became the benchmark for pain relief among cancer patients. During the 1980s, several papers and articles claimed that the link between opioids and addiction was minimal, and previously overstated. A letter published in the New England Journal of Medicine stated that the risk of addiction was less than 1%. Even though this letter was later retracted by the author, it didn't stop over 600 citations of the letter in medical journals. The misinformation had already spread, and it was difficult to stop. Advertising genius and co-founder of Purdue, Arthur Sackler, had a nephew named Richard. Richard would later become the president of Purdue, But got his start as a research scientist in the company. Richard would constantly be brainstorming ideas, trying to find new uses for MS Contin. Much like his uncle Arthur, he was heavily interested in the commercial and marketing side of the business. Purdue's former executive director of product management recalled that Richard didn't always wait for the research results. Richard Sackler would later become the president of the company in 1999 and co-chair in 2003. His uncle and father became the co-CEOs of Purdue. Within Purdue, Richard was an avid micromanager who would send out bulletins which halfway through read, If you're reading this, call my secretary, and he would leave secret passwords in the text. Based on which sales reps called the secretary and delivered the password, Richard would know exactly who was reading the bulletins and who wasn't. During the 1990s, the company realized that they needed to do something about MS content. The patent was set to expire by the end of the decade. In addition, the use of morphine as an end-of-life medication stigmatized the drug from being more widely available. The company moved to make a new drug called OxyContin with the active ingredient Oxycodone replacing the morphine. Many doctors falsely believed that Oxycodone was weaker than morphine. The truth was, the active ingredient in OxyContin, Oxycodone, was in fact 50% stronger than morphine. Later, in an unpublished study by Purdue in 1999, the company found that the addiction rate was 13%, not 1%. The FDA even approved a claim that OxyContin's delayed absorption would reduce the probability The FDA examiner who was involved in the approval of this claim left the FDA shortly and within two years had accepted a role at Purdue. Sadly, this move hints at corruption. In 2015, Purdue was granted FDA approval to market the drug to children as young as 11. Almost immediately after OxyContin was released, the cases of addiction became apparent. But rather than admit their drug was addictive, the company simply blamed people for not taking the drug as directed. Even Purdue themselves had to fire one of their secretaries after she became addicted to OxyContin. So the question has to be asked, why was the use and abuse of OxyContin so widely spread? Well it wasn't by accident, the company knew exactly what they were doing. Purdue's strategy for marketing their new drug OxyContin began in 1995. First, the company focused the drug on the same market as MS-Contin, cancer patients. The move was made to win wide regulatory acceptance and the integration of the drug into medical programs. The company began their targeted advertisements on health professionals. During this stage, sales representatives were encouraged to lie about the addictive nature of the drug. That our best, strongest pain medicines are the opioids, but these are the same drugs that have a reputation for causing addiction and other terrible things. Now, in fact, The rate of addiction amongst pain patients who are treated by doctors is much less than 1%. They don't wear out, they go on working, they do not have serious medical side effects. And so these drugs, which I repeat are our best, strongest pain medications, should be used much more than they are for patients in pain. Then things got really dirty. Purdue then began paying off all the links in the supply chain. Distributors were guaranteed rebates, pharmacists were given refunds, and patients were given coupons for starter supplies. Academia also got their share in grants. Medical journals were even making money from advertising the drug. Politicians were given campaign donations from both Purdue and the Sackler family. But the most important link in the whole chain was the doctors. After all, they were the ones who used their discretion on what to prescribe patients. Purdue had speaking events where doctors would be flown in to so-called seminars which were essentially golfing trips. Thousands of clinicians were paid to speak at conferences on the company's behalf. Prominent doctors on the Purdue payroll played down the effects of opioids calling them a gift from nature and stated that the notion that opioids caused addiction was a medical myth. During a nine-year stretch from 2006 to 2015, Purdue and other drug manufacturers in the industry had spent almost $900 million in political payments and lobbying. Purdue lobbied and encouraged regulations that required doctors to ask patients to rate their pain on a scale of 1 to 10. This gave them a more quantifiable and tangible reason to prescribe opioids. The company was trying to make OxyContin a viable treatment for non-cancer patients. An excerpt from Esquire who did a piece on the Sacklers reads, The company rebranded pain relief as a sacred right, a universal narcotic entitlement available not only to the terminally ill, but to every American. By 2001, annual OxyContin sales had surged past $1 billion. Business was booming. In the five-year period between 1996 and 2001, in the United States, OxyContin grew from 300,000 prescriptions to almost 6 million. Opioid abuse cases began rising to the surface, and studies would show direct correlations between the location of the cases and the volume of opioid prescriptions in that area. Purdue even targeted poor areas with high labor work. The higher instances of workplace injury led to higher uses of OxyContin. The company also recorded information about prescription quantities that individual doctors were writing. Sadly, this was so that the sales reps would have a better idea of which doctors to target. Like casinos targeting clients that would spend the most, Purdue was targeting doctors that would prescribe the most. People trust their doctor and they think that the doctor is prescribing things appropriately and monitoring them appropriately and they think that if the bottle says take it in such and such a way that it's perfectly okay to do that. It is now possible to find regions in the country where the amount of prescriptions is more than the actual population of the region. Doctors would be arrested in the hundreds for running clinics which prescribed pills to patients without a legitimate reason. These were often called pill mills. The Purdue company not only knew what they were doing, but they were happy about it. The company's memos between sales reps read, dollars, dollars, dollars. It's bonus time in the neighborhood. Some of the better sales reps were earning six-figure commissions, with the company paying out 40 million dollars in bonuses in 2001. But for the Sackler family and Purdue, things weren't going to stay so rosy. By this stage, there was mounting criticism of OxyContin, but Purdue still managed to make things even worse. The effects of OxyContin were supposed to last 12 hours, enough for a good night's rest. However, often the effects are only present for 8 hours. Now, Purdue could have done one of two things. Increase the frequency of the dose, or increase the dosage and increase the potential for addiction. They did the latter. Sales reps were strictly instructed to inform doctors to increase the dosage amounts instead of the frequency. This created the perfect cycle for addiction. The increased dosage would make the patient feel the effects of withdrawal for a short period, and then they would have to take another pill to put them at ease again. This led patients down the slope of being prescribed more than they needed. As their tolerances grew, they fell deeper into addiction. Every night on the news, you'd hear of someone dying in the state or in other states because of OxyContin. And it was so addictive, and they knew that. Pharmaceuticals knew that. To bring this home, I have to show you the real impact of opioid withdrawal from the inside. With this, you can gain an empathetic view and understand why so many people don't make it out. Family time is something Travis Reeder does not take for granted. The Johns Hopkins University bioethics professor soaks up every moment he can. That's because two years ago, prescription opioids stole a chapter of his life. In 2015, a serious motorcycle accident left Travis with a crushed foot. He would have six surgeries to fix it, including a transplant from his thigh, requiring large amounts. I was at a follow-up doctor's appointment with the initial trauma surgeon, the guy who saved the foot, and he's the one who's asked me about my pain level and my drugs, and he's like, oh, you're on a lot of opioids. You probably need to think about getting off them. Travis says his doctor suggested he begin weaning off of the drugs over four weeks. He says three days in, he was going through serious withdrawal. I felt like I got the flu. My temperature kind of went haywire. I couldn't sleep very well. She watched him get worse every day. Uncontrollable crying, you know, very often. He would just burst into tears like, you know, he couldn't sleep. Travis reached out to more than a dozen of his doctors. Some told him to take stool softeners and drink lots of water. But no one could tell him how to get out of the withdrawal hell he was in. I'm really in trouble here. I'm feeling really bad. I said, well, if it's that bad, go back on the drugs. Travis says he is not anti-opioids and believes they do have a place. But doctors need to prescribe them with a plan. The failure was in not following up, never telling me what to look forward to. In my experience, opioid withdrawal was the worst feeling I've ever had, hands down. I have vivid memories of being sick in my bed, sweating with the covers on and freezing with the covers off. I was constantly sick. I vomited almost every single morning. It's something that I would never want to go back to. You can die. Straight up. Your heart can explode for not having it. You can die. Because when you don't have it, your blood pressure goes up. That is why a lot of people's heart feels like it's pounding out of their chest when they have the withdrawal symptoms. And if I didn't have them, the hair on my head hurt. Not only that, withdrawal symptoms, you're going to be throwing up. You're going to be vomiting. You're going to have cold chills, you're going to have hot flashes, you're going to not be able to sleep because you're going to have restless legs, your legs are going to be moving all over the place. This is your legs, this is what they're going to be doing because you can't stand to be in your own skin and that is exactly what it feels like to withdraw. Exactly. You're also going to have probably anxiety attacks, maybe even panic attacks. Your face is flushing, you might get scared, you know, so you start hyperventilating and things like that. There was no counseling along the way. I was never told that dependence was going to be a problem, right? And then at the end, no one knew how or was able or willing to appropriately wean me off. So why wasn't anyone doing anything about this? Well, soon, people did. As time went on, Purdue would go on to face many class-action lawsuits in regard to their practices with the drug. Often the company settled, awarding plaintiffs millions. In 2004, Purdue was sued for deceptive marketing as the drugs were meant to last 12 hours but lasted much less. The company settled the suit for $10 million, sealing the case under confidentiality and admitting no wrongdoing or changing any practices. Purdue always avoided any Sacklers testifying under oath, they always reached a settlement Just as they were going to be called upon. In 2007, the company faced a suit from the federal government in which Purdue was charged for a criminal felony of purposefully pushing misconceptions about OxyContin. Purdue acknowledged that they knew about the misconceptions doctors had about their drug and actively exploited it for profits. This settlement cost Purdue $600 million. Even though a lot of the Sackler family were on the board, and Richard Sackler had a direct hand in operations, the Sackler family name appeared nowhere in the 89-page guilty plea. However, the Sackler name did appear on an agreement attached to the plea, which would mean that the government wouldn't go after any of the listed entities related to the Sackler family. The company's eagerness to settle was in order to avoid anything going on the public record, especially anything from the Sacklers themselves. The family's only testimony on the topic came in 2015 from Richard. Sealed from public view for four years and only released in 2009, the testimony showed that Richard Sackler knew about the dangers of OxyContin. In 2001, after it was reported that 59 people died from OxyContin overdoses, his email to executives read, That is not too bad. It could have been far worse. By 2010, Purdue had realized that they need to address the issue facing them. So they created a new formula for their pill which was harder to snort or inject. After the reformulation a study was conducted that found a third of users switched to other drugs and of those a further 70% began using heroin. It appears that this reformulation simply increased the rate that people turned to cheaper and harder opioids. This was shown by the significant increase in cases post 2010. Probably everybody started like that because that's how you're That's how you're introduced to the drugs, you know, is by... It's by pills, you know, and then little by little, you know, it's like your money gets tight and you're just like, where can I get something close to this but cheaper and then it's terrible, you know. I do sort of think that those pharmaceutical companies do play a big role in that. Purdue's actions went a step further. As the OxyContin patent was nearing its end, Purdue, with an apparent sudden change of heart, stunningly lobbied that the drug was prone to abuse and that no other companies should be allowed to remake it. In 2013, the FDA agreed no generic copies of OxyContin were to be made. But Purdue's version of OxyContin remained on the market. This simply meant that no other competitors could make their own versions of the drug. So what looked like a rare noble act from Purdue was simply a cunning act to move to secure a few more years of competition-free selling of their billion-dollar baby, OxyContin. With its trail of destruction ruining large sections of the American population, Purdue appears to be moving to other markets. Markets with fewer regulations would be a simple way for the Sacklers to keep milking their cash cow. In 2016, an LA Times investigation into Purdue's child company, Mundy Pharma, suggested that it's gearing up to take on international markets with their drug. In response, US lawmakers wrote a letter to the World Health Organization warning the intents of the company owned by the Sackler family. In 2018, the Sacklers obtained a patent for a drug which is used to treat opioid addiction. Ironically, they might make even more money from the crisis they helped create. In March 2019, Purdue settled yet another lawsuit. This time, the company agreed to pay $270 million to the state of Oklahoma for its part in the opioid epidemic. The Sackler family was not called by name as a defendant. However, perhaps in order to not be called to testify, the Sackler family has voluntarily pledged $75 million to the National Center for Addiction Studies at Oklahoma State University. The company is currently said to be considering bankruptcy in the midst of thousands of lawsuits in order to protect their assets. In total, a separate collection of about 1,600 lawsuits are being carried out from various levels of government. The Sackler name was kept far away from their products, and OxyContin wasn't called OxySackler on purpose. But now the world is waking up. We're here to call out the Sackler family who have become synonymous with the opioid crisis. The family who made billions off the bodies of hundreds of thousands. Protesters have began assembling and organizing against the Sacklers. In February 2019, the Guggenheim Museum in New York, a common recipient of Sackler money, was taken over by protesters. Prescription papers fell from the balconies, symbolically as carelessly as doctors on the Sackler payroll once wrote them. The chant, shame on Sackler, echoed throughout the streets of New York as angry groups gathered. It now seems that the Sackler's favourite domain, the art and museum world, has now been overtaken by people who have had enough. In 2019, one by one, art galleries around the world began to reject their work. The National Portrait Gallery in the UK announced that it would be rejecting a $1.3 million donation from the Sackler Trust. London's State Museum and New York's Guggenheim Museum both announced that any further donations from the Sacklers will not be accepted. As far as outrage against the Sacklers goes, the deeper story is more nuanced. Most of the Sackler descendants are involved in philanthropic work, organizing various charities and well-meaning causes. Some have never owned any shares in Purdue, but bear the Sackler name. Should the descendants, some of whom have no interaction with Purdue, apart from collecting their checks, which some estimates put as high as $1 billion per year, be held accountable? The publication, The New Yorker, puts forward a good argument that the money received from ill gains should go to measures to counter the impact that they had. For example, John D. Rockefeller founded Standard Oil which was later broken up into massive oil companies such as Chevron, ExxonMobil and BP. The descendants of Rockefeller have used some of their fortune to fund resources involved in climate change and audit the company's harms due to their enormous moral responsibility. Should the Sacklers do the same? The last of the three original Sackler brothers who started the company back in the 1950s died in 2017. However, Richard who ran the Purdue company and other Sackler members who have served on the board are still alive and being sued. All of these settlements seem like pennies on the dollar for a company which reportedly earned $35 billion in revenue from OxyContin and further fueled an epidemic which has killed over 200,000 people since 1997. One senator even described the settlements as an expensive license for criminal misconduct. Sure, the Sacklers are not solely responsible for the opioid epidemic. A range of other drugs were available both pharmaceutical and on the street, and there were other factors too, but their large role in the entire crisis is undeniable. Perhaps there's a silver lining though. The US government has taken the first steps to addressing the issue on a national level. Emergency response tools such as Narcan nasal spray have saved countless lives in emergency overdose situations. Drugs such as buprenorphine and methadone combined with psychological help are often used to treat patients addicted to opioids. Meanwhile, researchers in Canada are finding that 30% of medicinal cannabis patients use the drug as a substitute for their their previous opioid addictions. 2014 study found that deaths from opioids were 25% lower in states that had legalized cannabis. In total, it's a complicated issue and it's going to be a long road, but understanding addiction and creating medical reforms that make it harder for companies to lie about their drugs will be key in future change. Credit and a bit of thankfulness must be given to the countless people who are who are trying to help those affected by this horrible crisis. Hospital staff, charity workers, local police, fire departments, social workers, in their own way, they all help save lives every day. But it is evident now, more than ever, the effect that the Sackler family has had on the world. Depending on how long the opioid crisis continues, we still may not know the full and true extent of the Sackler's efforts. Ironically, Arthur Sackler once told his Leave the world a better place than it was when you came in. If you've ever seen a bigger case of hypocrisy, please let me know. The Sacklers that were involved in creating an opioid epidemic cared more about their profits than they did about their patients, the very people they were meant to help. It may be too late to bring those responsible to justice, or completely heal from the impact that their actions had on the world, but it's not too late to stop this kind of thing from happening again in the future. For the last 30 years, the Sacklers had a secret, but not anymore, and now you all know it too. So that wraps up our look at the Sackler family and their role in the opioid crisis. If you do know anyone going through this, I'm sorry and I hope things get better for them. So just a bit of housekeeping quickly. If this video does well, like the Theranos video I did before and you guys kind of like this longer form content, then I think I'll do one of these long-form documentaries maybe once a month. We'll see how we go. So again, thanks for watching. This has been Dagogo. You've been watching ColdFusion. Feel free to share this video to anyone who's interested in this topic and wondering how this opioid epidemic actually really started. And I'll catch you again soon for the next video. Cheers guys. Have a good one.