The Family Making Billions from the Opioid Crisis

Very good write-up from Esquire, I'm thoroughly impressed with the article.

That said, my visceral emotional response is strongly negative especially when reading the following paragraph:

>In May, a dozen lawmakers in Congress, inspired by the L.A. Times investigation, sent a bipartisan letter to the World Health Organization warning that Sackler-owned companies were preparing to flood foreign countries with legal narcotics. “Purdue began the opioid crisis that has devastated American communities,” the letter reads. “Today, Mundipharma is using many of the same deceptive and reckless practices to sell OxyContin abroad.” Significantly, the letter calls out the Sackler family by name, leaving no room for the public to wonder about the identities of the people who stood behind Mundipharma.

Do you have ties to Purdue or the pharama industries? You seem super defensive about this/not open to discussion and your submission history seems to be pharma related.

What do you mean by switching? All of the drugs you listed are opioids. It's not clever, it's a fact.

The Sacklers have ingratiated themselves at the highest levels of society using a fortune that's at best built on a product of dubious value, and at worst obtained at the cost of the lives of tens of thousands of people. I think this piece points to a big problem: we worship money and those that accumulate it, and often ignore the question of how much societal value was created in exchange for it. The least we can collectively do is not confer status and prestige upon those who make money in a destructive way. I love the line of inquiry in this piece because it puts pressure on the high-society keepers-of-culture whose admiration the Sacklers likely most crave.

FYI you can also see an interview with the author on Democracy Now: https://www.democracynow.org/2017/10/19/who_profits_from_the...

(disclaimer: I am friends with the author)

> A lot of people, who, as a result, got addicted to Oxy, at some point ended up switching to heroin because it's cheaper.

Counter-point: no, they largely did not.

There is a huge population using prescription opiates and a tiny tiny population using heroin.

Check out https://grokinfullness.blogspot.com/2017/09/debunking-standa... for a lot more detail.

> There is no convincing evidence that prior prescription opioid use caused subsequent heroin use. ... This is much like the argument, popular among drug warriors, that marijuana is a gateway drug because most users of hard drugs start with marijuana. There are simply so many current and past prescription opioid users that most heroin users will probably have had past experience with these drugs, but that says nothing at all about a causal link. Indeed, the vast majority of prescription opioid users never go on to use heroin, so the causal link is dubious.

> In 2015, 85 million people used prescription opioids legally, and there were ~200 million legal prescriptions. By contrast, there were half a million heroin users. But there were comparable numbers of deaths in both categories (~13,000 from prescription opioids and 12,000 heroin deaths, or 18,500 heroin deaths if you add the "heroin" and "synthetic opioids" together to capture the fact that some dealers have been mixing fentanyl in with heroin). Some relevant numbers in my piece here, once again from the CDC's website. Deaths per legal opioid user are in the 0.015% range; deaths per heroin user are probably somewhere in the 1% to 3.5% range.

> In other words, the prescription opioid deaths are a very small risk applied to a very large population. The heroin-related deaths are an extremely high risk applied to a relatively small population. These are very different issues with very different underlying social causes.