This was almost two weeks ago but deserves a mention - the Sackler family, of Purdue Pharma infamy for pushing OxyContin, reached an agreement in federal court where they secured total immunity from future lawsuits by victims of the opioid crisis. They will pay restitution of up to $4.5B and sell holdings.

https://www.jurist.org/news/2021/09/fed ... -lawsuits/

This is already rubbing many people the wrong way as they are not insolvent but used loopholes to appear so on paper. Have to agree with this take by the WA state attorney general:

This order lets the Sacklers off the hook by granting them permanent immunity from lawsuits in exchange for a fraction of the profits they made from the opioid epidemic — and sends a message that billionaires operate by a different set of rules than everybody else…This order is insulting to victims of the opioid epidemic who had no voice in these proceedings — and must be appealed.

It bears repeating the Sacklers denied wrongdoing even though several states used Purdue Pharma’s internal marketing discussions and sales employees’ bribes of doctors against them in court. These people have ZERO shame.

https://khn.org/morning-breakout/opioid ... p-in-ohio/

I feel mixed. I don't really feel like they should be bankrupted just because of human's affinity to oxycodone/acetaminophen (Oxycontin), but their sales employees pushing it to doctors (who should have known better themselves) is VERY problematic.

Pellegrine wrote:

I feel mixed. I don't really feel like they should be bankrupted just because of human's affinity to oxycodone/acetaminophen (Oxycontin), but their sales employees pushing it to doctors (who should have known better themselves) is VERY problematic.

Their internal documents showed they knew it was problematic, but they continued pushing for more sales anyway. That's just plain irresponsible - and unethical.

Aaron747 wrote:

Pellegrine wrote:

I feel mixed. I don't really feel like they should be bankrupted just because of human's affinity to oxycodone/acetaminophen (Oxycontin), but their sales employees pushing it to doctors (who should have known better themselves) is VERY problematic.

Their internal documents showed they knew it was problematic, but they continued pushing for more sales anyway. That's just plain irresponsible - and unethical.

I agree with that. What I don't agree with is making the pharmaceutical company 100% responsible and make prescribing doctors 0% responsible. A lot of the problems of the US opioid epidemic were because of pill mills with corrupt doctors and pharmacists included in it. The DEA itself knew what was going on for years...these were still scheduled drugs.

Pellegrine wrote:

Aaron747 wrote:

Pellegrine wrote:

I feel mixed. I don't really feel like they should be bankrupted just because of human's affinity to oxycodone/acetaminophen (Oxycontin), but their sales employees pushing it to doctors (who should have known better themselves) is VERY problematic.

Their internal documents showed they knew it was problematic, but they continued pushing for more sales anyway. That's just plain irresponsible - and unethical.

I agree with that. What I don't agree with is making the pharmaceutical company 100% responsible and make prescribing doctors 0% responsible. A lot of the problems of the US opioid epidemic were because of pill mills with corrupt doctors and pharmacists included in it. The DEA itself knew what was going on for years...these were still scheduled drugs.

There have been some pretty stiff prosecutions of pill mill MDs, especially here in CA. But you're right in that response was slow and there are still many who have not been held responsible. For its part though, I could care less if Purdue is hung out to dry.

Aaron747 wrote:

Pellegrine wrote:

Aaron747 wrote:

Their internal documents showed they knew it was problematic, but they continued pushing for more sales anyway. That's just plain irresponsible - and unethical.

I agree with that. What I don't agree with is making the pharmaceutical company 100% responsible and make prescribing doctors 0% responsible. A lot of the problems of the US opioid epidemic were because of pill mills with corrupt doctors and pharmacists included in it. The DEA itself knew what was going on for years...these were still scheduled drugs.

There have been some pretty stiff prosecutions of pill mill MDs, especially here in CA. But you're right in that response was slow and there are still many who have not been held responsible. For its part though, I could care less if Purdue is hung out to dry.

The real loser is the American patient. Oxycodone/acetaminophen is just another opioid like any other. It has a morphine equivalency of around 1.5. I've taken it after knee surgery, maybe I'm one of the weird ones who didn't get "high" off it. Now, even if our bones are broken and poking out of skin they'll be like, "are you sure you're not an addict?" "you're not going to share/abuse this are you"... All this mess. When I pick up my Adderall script it's always a show. And people still want drugs so nothing has changed. I remember when I was in high school pills were easy to get. Since they're harder to get now people turn to the street and fentanyl kills everyone. It's just sad.

Pellegrine wrote:

Aaron747 wrote:

Pellegrine wrote:

I feel mixed. I don't really feel like they should be bankrupted just because of human's affinity to oxycodone/acetaminophen (Oxycontin), but their sales employees pushing it to doctors (who should have known better themselves) is VERY problematic.

Their internal documents showed they knew it was problematic, but they continued pushing for more sales anyway. That's just plain irresponsible - and unethical.

I agree with that. What I don't agree with is making the pharmaceutical company 100% responsible and make prescribing doctors 0% responsible. A lot of the problems of the US opioid epidemic were because of pill mills with corrupt doctors and pharmacists included in it. The DEA itself knew what was going on for years...these were still scheduled drugs.

Every time I see a "pain management center" I shake my head. You might be shocked to know that these tend to be in areas hit hard by the opioid epidemic.

Don't care much about the money, if only they had gotten life behind bars...

I wonder if some angry victims will find other ways to get "justice".

Pellegrine wrote:

The real loser is the American patient.

Quoted for truth.

Drug dealers who have negligently killed the most people, far outnumbering street dealers who get long prison sentences, happily escape. The American Way. Yeah.

frmrCapCadet wrote:

Drug dealers who have negligently killed the most people, far outnumbering street dealers who get long prison sentences, happily escape. The American Way. Yeah.

The REAL Cartel which the DEA (how many different law enforcement agencies does the 'land of the free' need?) will never touch.
Not that the 'drugs problem' was ever the reason Nixon set it up, it's on his own tapes, the paranoia and racism.

Old man Sackler who died in the 80's started out pushing Valium as totally harmless, the White Cartel family were only getting started...

I don't know how I feel about this one.
I get wanting to punish the company that did the marketing and the sales, but I think a lot more needs to be done to hold the doctors and pharmacists liable. Most of the people I knew that got hooked, were done in by Doctors and Pharmacists that looked past obvious glaring signs of addiction, and doctor shopping. The ones I really think need to be in prison are the ones that just kept refilling for whoever wanted it.

We can blame the creators, but the trained professional doctors were way too willing to bypass integrity for money.

Pellegrine wrote:

Aaron747 wrote:

Pellegrine wrote:

I agree with that. What I don't agree with is making the pharmaceutical company 100% responsible and make prescribing doctors 0% responsible. A lot of the problems of the US opioid epidemic were because of pill mills with corrupt doctors and pharmacists included in it. The DEA itself knew what was going on for years...these were still scheduled drugs.

There have been some pretty stiff prosecutions of pill mill MDs, especially here in CA. But you're right in that response was slow and there are still many who have not been held responsible. For its part though, I could care less if Purdue is hung out to dry.

The real loser is the American patient. Oxycodone/acetaminophen is just another opioid like any other. It has a morphine equivalency of around 1.5. I've taken it after knee surgery, maybe I'm one of the weird ones who didn't get "high" off it. Now, even if our bones are broken and poking out of skin they'll be like, "are you sure you're not an addict?" "you're not going to share/abuse this are you"... All this mess. When I pick up my Adderall script it's always a show. And people still want drugs so nothing has changed. I remember when I was in high school pills were easy to get. Since they're harder to get now people turn to the street and fentanyl kills everyone. It's just sad.

The unfortunate reality for patients is doctors were burned by this as well -- not as much as patients but it hasn't been a cakewalk. Most of the meds that created the mess were (by design) written by primary care physicians who had minimal knowledge and training -- a great many of them have been retiring leaving those of us who trained and entered practice in the midst of this over-prescription trend to clean up the mess. We entered training with this issue on the forefront, never started the meds that caused the problem but are harangued and harassed by patients 20 years into opioid or benzo dependency. We walk into this in residency having never written a controlled substance. Not only are we socially, politically, and legally discouraged from continuing these medications, we have medical reasons to go WHOA! such as a man in his 70s who's been taking Valium for over thirty years. Now he's losing his memory, taking a month's worth of pills in a week because he forgets, he's falling, the medications worsening his cognition, goes into mild withdrawal and shows up in the ED screaming at staff, etc etc and can't process why I can't keep giving him more Valium. This happens every day. And yes, we've not done a good job at providing supportive treatment for people who've been on them for years, but so many of them REFUSE treatment, and will only accept another opioid. It's not cut and dry. Most states do not have an avenue for compelling this type of treatment, and not a lot of evidence that compelled substance use treatment works. To be frank, it shouldn't have been that hard for you to get pills in high school, but since it was...Fentanyl isn't the problem itself, but rather a symptom of the problem that industrial drug labs in Mexico, and possibly North Korea and China are more than happy to fuel.

c933103 wrote:

Aaron747 wrote:

Pellegrine wrote:

I feel mixed. I don't really feel like they should be bankrupted just because of human's affinity to oxycodone/acetaminophen (Oxycontin), but their sales employees pushing it to doctors (who should have known better themselves) is VERY problematic.

Their internal documents showed they knew it was problematic, but they continued pushing for more sales anyway. That's just plain irresponsible - and unethical.

In such case, shouldn't the people involved in making the decision and enacting the decision be held criminally responsible personally?

You would think so but billionaires can usually hire legal teams clever enough to avoid this responsibility.

luckyone wrote:

Pellegrine wrote:

Aaron747 wrote:

There have been some pretty stiff prosecutions of pill mill MDs, especially here in CA. But you're right in that response was slow and there are still many who have not been held responsible. For its part though, I could care less if Purdue is hung out to dry.

The real loser is the American patient. Oxycodone/acetaminophen is just another opioid like any other. It has a morphine equivalency of around 1.5. I've taken it after knee surgery, maybe I'm one of the weird ones who didn't get "high" off it. Now, even if our bones are broken and poking out of skin they'll be like, "are you sure you're not an addict?" "you're not going to share/abuse this are you"... All this mess. When I pick up my Adderall script it's always a show. And people still want drugs so nothing has changed. I remember when I was in high school pills were easy to get. Since they're harder to get now people turn to the street and fentanyl kills everyone. It's just sad.

The unfortunate reality for patients is doctors were burned by this as well -- not as much as patients but it hasn't been a cakewalk. Most of the meds that created the mess were (by design) written by primary care physicians who had minimal knowledge and training -- a great many of them have been retiring leaving those of us who trained and entered practice in the midst of this over-prescription trend to clean up the mess. We entered training with this issue on the forefront, never started the meds that caused the problem but are harangued and harassed by patients 20 years into opioid or benzo dependency. We walk into this in residency having never written a controlled substance. Not only are we socially, politically, and legally discouraged from continuing these medications, we have medical reasons to go WHOA! such as a man in his 70s who's been taking Valium for over thirty years. Now he's losing his memory, taking a month's worth of pills in a week because he forgets, he's falling, the medications worsening his cognition, goes into mild withdrawal and shows up in the ED screaming at staff, etc etc and can't process why I can't keep giving him more Valium. This happens every day. And yes, we've not done a good job at providing supportive treatment for people who've been on them for years, but so many of them REFUSE treatment, and will only accept another opioid. It's not cut and dry. Most states do not have an avenue for compelling this type of treatment, and not a lot of evidence that compelled substance use treatment works. To be frank, it shouldn't have been that hard for you to get pills in high school, but since it was...Fentanyl isn't the problem itself, but rather a symptom of the problem that industrial drug labs in Mexico, and possibly North Korea and China are more than happy to fuel.

Your account and listening to my cousin’s stories since she completed residency a few years ago lead me to believe this is the most difficult time in recent memory for health care professionals. It’s a real shame what you all go through.

With political prosecutors and judges, and unlimited money flowing to politics, what do you expect ?

c933103 wrote:

Aaron747 wrote:

c933103 wrote:

In such case, shouldn't the people involved in making the decision and enacting the decision be held criminally responsible personally?

You would think so but billionaires can usually hire legal teams clever enough to avoid this responsibility.

For one, certainly not everyone in the process of decision making and execution are billionaires?
Second, then at least have it been attempted on court?

Prosecutors in the US typically go after the highest decision making entity when going after a corporation. Purdue Pharma was prosecuted on charges of conspiracy and defrauding US government programs - they pled guilty.

Aaron747 wrote:

luckyone wrote:

Pellegrine wrote:

The real loser is the American patient. Oxycodone/acetaminophen is just another opioid like any other. It has a morphine equivalency of around 1.5. I've taken it after knee surgery, maybe I'm one of the weird ones who didn't get "high" off it. Now, even if our bones are broken and poking out of skin they'll be like, "are you sure you're not an addict?" "you're not going to share/abuse this are you"... All this mess. When I pick up my Adderall script it's always a show. And people still want drugs so nothing has changed. I remember when I was in high school pills were easy to get. Since they're harder to get now people turn to the street and fentanyl kills everyone. It's just sad.

The unfortunate reality for patients is doctors were burned by this as well -- not as much as patients but it hasn't been a cakewalk. Most of the meds that created the mess were (by design) written by primary care physicians who had minimal knowledge and training -- a great many of them have been retiring leaving those of us who trained and entered practice in the midst of this over-prescription trend to clean up the mess. We entered training with this issue on the forefront, never started the meds that caused the problem but are harangued and harassed by patients 20 years into opioid or benzo dependency. We walk into this in residency having never written a controlled substance. Not only are we socially, politically, and legally discouraged from continuing these medications, we have medical reasons to go WHOA! such as a man in his 70s who's been taking Valium for over thirty years. Now he's losing his memory, taking a month's worth of pills in a week because he forgets, he's falling, the medications worsening his cognition, goes into mild withdrawal and shows up in the ED screaming at staff, etc etc and can't process why I can't keep giving him more Valium. This happens every day. And yes, we've not done a good job at providing supportive treatment for people who've been on them for years, but so many of them REFUSE treatment, and will only accept another opioid. It's not cut and dry. Most states do not have an avenue for compelling this type of treatment, and not a lot of evidence that compelled substance use treatment works. To be frank, it shouldn't have been that hard for you to get pills in high school, but since it was...Fentanyl isn't the problem itself, but rather a symptom of the problem that industrial drug labs in Mexico, and possibly North Korea and China are more than happy to fuel.

Your account and listening to my cousin’s stories since she completed residency a few years ago lead me to believe this is the most difficult time in recent memory for health care professionals. It’s a real shame what you all go through.

Health care providers are heroes while you have no responsibility, but when you do, we're villains. The reality is, it's nothing new. Too many people only listen to doctors (and a lot of other people...) only when it's too late. We have a large number of people who've been trained to act like they're smarter than somebody else if they don't know what's going on and that comes out as "I'm my own man, it was good enough for my daddy, I just don't trust the government [that tells me I'm not right], etcetc."

Not quite sure how "securing total immunity" is actually possible at all. Seems unconstitutional to me, as it deprives victims of due process.