Judge rejects Purdue Pharma's $4.5B opioid settlement

APPENDIX TO WILLIAM S. BURROUGHS Naked Lunch : Burroughs quote in The British Journal of Addiction, Vol 53, No.2

"LETTER FROM A MASTER ADDICT TO DANGEROUS DRUGS (August 3rd, 1956. Venice (p. 189, Paladin 1992 ed.):"

"I have Taken morphine for acute pain. Any opiate that effectively relieves pain to an equal degree relieves withdrawal symptoms. The conclusion is obvious: Any opiate that relieves pain is habit forming, and the more effectively it relieves pain the more habit forming it is. ..."

William Burroughs.

There is no argument about this and there hasn't been any for about at least a century or more. This is medicine/pharmacy 101 stuff.

All those who thought/think otherwise are fools and should not be anywhere near such decision-making processes. Those qualified in pharmacy or medicine and involved in the pushing and peddling of oxycontin had to know EXACTLY what they were doing - that's to say the serious damage they were doing to patients' health not to mention the deaths - the 65-year old Burroughs quote being the scientific orodoxy in hundreds of medical and pharmacopeia texts.

Burroughs, an opiate addict for 15 years, is one of the most articulate drug users to have written on the matter of opiate addiction and the fact that his descriptions of the addictiveness of opioids has been widely published for decades in the popular press meant that not just the professions knew the details intimately but also that everyone did.

Nothing that Purdue or the Shacklers can say or do can absolve them from their responsibility for the deaths of over 800,000 people - a truly staggering number.

The original settlement was a fucking farce of the first order. Why the Shacklers weren't stripped of everything they own then locked up and the key thrown away simply amazes me. What's wrong with US justice that it can fail so terribly? Here, justice is nothing other than a joke - a joke run and told by the accused.

Moreover, what went wrong with the medical profession and the regulators? Why was the FDA AWOL on this matter for decades - a matter with very well known and long-honed parameters?

After all, the matter of narcotics and addiction is the subject of international treaties. We all know the issues and yet it still happened.

The Purdue, Sacklers and oxycontin matter is one of the greatest failures of public health of all time: a tragedy of unprecedented proportions - and as far as I can determine, no one - except the dead - have paid any penalty whatsoever.

Same as per vmception's comments.

Also, what you need to realize is that opiate drugs are almost unique amongst drugs. There are staggering numbers of them in different classes - oral, injectable, short/long-acting etc.

The tragedy is that they're all addictive and the degree of their addictiveness is directly proportional their effectiveness at reducing pain (see Burroughs's perceptive quote in my post).

Thus, titrating the right dose and determining the period for which the drug should be given becomes a very difficult tightrope act, especially so if a long period is involved. Give too little and the patient suffers pain, give even a little too much and addiction is very likely the result. It's a nightmarish problem.

Opiates are the Janus of drugs - one face shows a miracle drug - the other is unmitigated pain and tragedy - and often death.

The issue here is that Purdue deliberately peddled oxycontin, a drug that can be taken by mouth, in ways that encouraged patients to easily slip into the 'too much' side. That this should never happen without supervision is a longstanding axiom of opiate management and has been known and well understood for over one hundred years.

In essence, Purdue and the Shacklers deliberately chucked away years of best practice which then benefited them financially but to the patients' devastating expense.

The matter of what drugs should be legalized etc. is somewhat different matter (which others have covered well so I won't address it except to say that they're not logically in conflict as they address different things).

Yeah, exactly. As I've hinted in my posts, given the millions of pages on opiate info gathered over the last 150 or so years, the many laws in every country, international treaties on drugs then how did this information warfare happen?

As I've said, the FDA was AWOL, so was the medical profession.

How on earth did this happen? Distorting scientific fact to the extent that almost all professionals ignored the problem has to be very serious, somewhat akin to the climate change denial methinks.

We really do need to work on the psychology of how this happened. Right, this happened so easily it will almost certainly happen again.