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How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

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Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#201

Post by Nasrudith »

IMTDb wrote: post #144
civilized wrote: post #119

Earlier quoted context omitted.

It's a good point to raise - at the same time, I think it's generally accepted that THC is on the safer side of the "problematic drug" spectrum, while opioids are on the riskier side?

I agree that opiods are definitely on the riskier side of the spectrum, while THC definitely seem on the safer side - at least for adults. But we know that: that's why opioids are mainly sold after a prescription by a doctor and in a pharmacy. At least we are trying to limit access to opioids. On the other hand THC is currently almost advertised as being "good for you" (see all the papers/studies around it), and a so…

The reason THC is even an issue is because the law has insistently been an ass for over half a century. The DEA has a complete tautology of Schedule 1 classification when its effects are far less dangerous. Yet it is federally more controlled than cocaine.

The consequences make a huge difference. So a plan to make a million dollars selling sandwiches vs killing people on the street to rifle through their pockets should be treated very differently.

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#202

Post by R0b0t1 »

rscho wrote: post #194
R0b0t1 wrote: post #191

Earlier quoted context omitted.

I see these as a consequence to having no real way to remove bad doctors through the legal system. They all protect each other. There's some idiots looking for narcotics, but that isn't all of it.

The more you'll sue doctors, the more MDs will practice defensive medicine and you'll end up with shit quality overly invasive care. The way to go is to sue the institutions, but not the practitioners themselves. Then the institution punishes the doc if warranted. In opposition to what you think, doctors are highly egoistical individuals and absolutely do not cover for one another.

We already have defensively practiced, shit quality medicine. I was diagnosed late with ADHD, had to leave that doctor's practice, and finding another doctor who agrees with that diagnosis has been impossible.

The tendency I observed when competency was questioned was to not punish in any way that had strong ramifications. They might badmouth them, but the desire to strip of their license or award large punitive damages isn't there because they are worried about it happening to them, real or imagined.

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#203

Post by s1artibartfast »

vanderZwan wrote: post #50
songshu wrote: post #35

Earlier quoted context omitted.

They are supposed to have learned about it in medical school. If not, that's fine, maybe doctors shouldn't be allowed to prescribe and maybe only pharmacists should be allowed. My point is that it's a very valuable professional quality and we should put the responsibility where the quality is.

This is (well, was) a new drug. Doctors cannot have learned about a drug in medical school when that drug did not exist when they were studying. My parents are retired Dutch GPs who also ran a small pharmacy[0], so I know a little about how this works, at least in the Netherlands (I admit that this is a pretty big caveat, because (aside from the obvious biases that this introduces) the opioid crisis doesn't exist her…

>Doctors only start prescribing a drug after it has been approved by the relevant governmental bodies for their usage. So if OxyContin got through the FDA, and was marked as safe for the usage it was advertised for, then I do not understand why you suggest that it's the fault of doctors that they prescribed it in those cases.

Given that the same opioids are approved in the US and Netherlands, with the same warnings and information, why do you think the outcomes are so different between countries?

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#204

Post by iorrus »

mturmon wrote: post #167
iorrus wrote: post #3

What this family did was pure evil, they should all be in jail not negotiating a settlement that will leave them financially secure and amongst the richest Americans. Imagine if this scenario played out in China.

The China hypothetical is not really helpful, is it? Because it didn't happen, people will just impose their own preconceptions on it.

Why is it not helpful? Sometimes people accept the reality of a certain situation as the only possible reality. It’s helpful to suggest what might happen in an alternative situation in order to put the current situation into context.

The simple reality is that the Chinese would absolutely not accept this resolution and in fact would consider the actions of the Sacklers to be completely unforgivable, which brings the American reaction into stark contrast.

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#205

Post by refurb »

s5300 wrote: post #195
refurb wrote: post #148

Earlier quoted context omitted.

The guidelines also reiterate the group’s 2002 code, which prohibited more expensive goods and services like tickets to professional sports games and junkets to resorts. And it asks companies that finance medical courses, conferences or scholarships to leave the selection of study material and scholarship recipients to outside program coordinators. [1] https://www.nytimes.com/2008/12/31/business/31drug.html

Huh. Call me crazy, but it almost seems as if guidelines and codes haven't meant much for a while. Like, real life "air quotes" oh yes, we won't send them to resorts. Well, if I had to make an educated guess, they really did cross their fingers and nobody seems to be investigating/enforcing otherwise and they're getting away with it - because I'm telling you, first hand... it's happening, quite frequently, at least o…

I used to work in the industry when all this changed. Could there be a one-off company doing it? Sure. They are risking being brought up on Federal charges for it. The gov't has gone after drug companies for much less.

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#206

Post by peter_d_sherman »

Look at this article.

10.8 Billion Dollars (not million, billion with a 'b'), of which 4.6 Billion, close to half of it, went to the Government as tax payments...

And yet the article seems to imply fault of some sort that various Sacklers moved millions (millions with an 'm') -- an order of magnitude less money of their post-tax-paid-for money, when 4.6 Billion, close to half of it, went to the Government as tax payments.

I mean, with respect to the people that paid for the opioids, the Government doesn't give that tax money they collected, that $4.6 Billion back to the opioid purchasers, does it?

Also, why is it that federal investigators seem to have no problems finding all sorts of ways that big corporate entities misspend millions of dollars -- but simultaneously overlook government misspending in the billions of dollars?

I for one (and I realize my opinion is in the minority!), think the opioid addicts should get their $4.6 Billion dollars directly back from the Government -- and in cash -- not in political promises, treatment programs, hammers, or government cheese...

You know, like give them all a "hey, you were an opioid addict and here's the money we took from you (as Sackler tax money!) back as an opiod stimulus package, an opioid stimulus check!"

And yes, I realize my opinions are politically incorrect.

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#207

Post by sizzle »

R0b0t1 wrote: post #202
rscho wrote: post #194

Earlier quoted context omitted.

The more you'll sue doctors, the more MDs will practice defensive medicine and you'll end up with shit quality overly invasive care. The way to go is to sue the institutions, but not the practitioners themselves. Then the institution punishes the doc if warranted. In opposition to what you think, doctors are highly egoistical individuals and absolutely do not cover for one another.

We already have defensively practiced, shit quality medicine. I was diagnosed late with ADHD, had to leave that doctor's practice, and finding another doctor who agrees with that diagnosis has been impossible. The tendency I observed when competency was questioned was to not punish in any way that had strong ramifications. They might badmouth them, but the desire to strip of their license or award large punitive dama…

What about blame for the DEA and the classification of stimulants that cause doctor to fear losing their license?

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#208

Post by vanderZwan »

s1artibartfast wrote: post #203
vanderZwan wrote: post #50

Earlier quoted context omitted.

This is (well, was) a new drug. Doctors cannot have learned about a drug in medical school when that drug did not exist when they were studying. My parents are retired Dutch GPs who also ran a small pharmacy[0], so I know a little about how this works, at least in the Netherlands (I admit that this is a pretty big caveat, because (aside from the obvious biases that this introduces) the opioid crisis doesn't exist her…

>Doctors only start prescribing a drug after it has been approved by the relevant governmental bodies for their usage. So if OxyContin got through the FDA, and was marked as safe for the usage it was advertised for, then I do not understand why you suggest that it's the fault of doctors that they prescribed it in those cases. Given that the same opioids are approved in the US and Netherlands, with the same warnings a…

I cannot say, because I don't know enough about the US system

Re: How the Sacklers shifted $10.8B of an opioid fortune built on OxyContin

#209

Post by nickff »

rscho wrote: post #192
nickff wrote: post #190

Earlier quoted context omitted.

The USA is definitely very litigious, but I am not sure that Canada is similar. Cultural explanations are interesting, but they can be molded to explain almost anything. I could for instance say that US doctors are motivated to prevent overdoses, as their patients are a source of recurring revenue, whereas Canadian and European doctors and systems see their patients as cost centres.

Yes, of course my assertions are subjective and based upon personal experience. However, here is a very objective thing: you're a US doc and your patient is in pain. Very simple, you prescribe oxycodone and it solves the immediate problem. Then, your patient dies of overdose. But most of the time, you won't even be aware of the cause of death and simply archive the file. And, most important of all: _the patient did n…

I understand that you think it's an incentive problem, and I agree that opiod issues are probably driven by incentive issues, but I am not sure we have the data to support your explanation. I also don't think most doctors keep track of patient fatalities at all, let alone the causes of death.
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