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Supreme Court blocks controversial Purdue Pharma opioid settlement

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Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#481

Post by darawk »

doctorpangloss wrote: post #440
shawndrost wrote: post #435

Earlier quoted context omitted.

No, my question is about how people judge our opioid status quo: a medical system that prescribes addictive opioids for routine and low-grade pain.

I just wonder why random people would know better about this than your highly educated providers. Go ahead and ask. You can say those exact words. They will give better answers! If you want a poll, this court case was a poll. A majority of victims who had ample time to participate in litigation agreed to the settlement terms. They told you that addiction is bad, the new Purdue would help, and that money from its owne…

Oxycontin was, and still is, a prescription drug. I'm not sure if you're aware, but at least in the United States (where this court judgment was), it is doctors that write prescriptions. Listening to them is how the first opioid crisis happened. McKinsey dangled some shiny slides in front of Purdue, Purdue dangled them in front of doctors, and then doctors prescribed them en masse. This has, arguably, not gone well.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#482

Post by [deleted] »

shawndrost wrote: post #464
doctorpangloss wrote: post #440

Earlier quoted context omitted.

I just wonder why random people would know better about this than your highly educated providers. Go ahead and ask. You can say those exact words. They will give better answers! If you want a poll, this court case was a poll. A majority of victims who had ample time to participate in litigation agreed to the settlement terms. They told you that addiction is bad, the new Purdue would help, and that money from its owne…

My question is specifically about the judgements that uninvolved people have formed. I can't learn about this from my doctor, or from the victims' decision in the context of a highly-constrained kabuki dance. It seems most commenters here are fine with a settlement that clears Purdue to sell opioids (for the benefit of victims), but not with a settlement that lets the Sacklers off with a fine. That is exactly the opp…

[deleted]

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#483

Post by hn_throwaway_99 »

addicted wrote: post #425
janalsncm wrote: post #398

Pound for pound, the Sacklers probably did more damage to America than any other drug dealers in history. More damage than any serial killer or mass shooter. In my mind they should be considered public enemies 1 through N. I sincerely hope they face civil and criminal liabilities for what they’ve done.

I’d argue it’s the opposite. Look at what’s happened since Oxycontin was heavily regulated. Opioid deaths in America have exploded by an order of magnitude. There’s a direct correlation between higher regulation of OxyContin and opioid deaths in the U.S. The Sacklers have done illegal stuff. Misrepresenting the addictiveness of their drugs (well, it was immoral and wrong…it’s not clear how illegal it was). But it’s q…

> a slow acting opioid (it had to be crushed to be fast acting)

You seem to just skip over that point in a bit of a blasé fashion, as if OxyContin's slow release formulation is somehow a defense of the Sacklers' behavior, when the exact opposite is true.

That is, a primary argument is that Purdue pushed OxyContin because they argued it was safer due to its slow release formula. Except they knew full well that "slow release" was pretty much bullshit because people were getting addicted by simply crushing the pills.

Purdue sales people deliberately pushed Oxy with the false promise of additional safety even though they knew this wasn't true.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#484

Post by jnovek »

darth_avocado wrote: post #451
addicted wrote: post #425

Earlier quoted context omitted.

I’d argue it’s the opposite. Look at what’s happened since Oxycontin was heavily regulated. Opioid deaths in America have exploded by an order of magnitude. There’s a direct correlation between higher regulation of OxyContin and opioid deaths in the U.S. The Sacklers have done illegal stuff. Misrepresenting the addictiveness of their drugs (well, it was immoral and wrong…it’s not clear how illegal it was). But it’s q…

> But it’s quite clear that America had a parallel opioid crisis going on I don’t think that’s really the case. What happened here was that peddling oxy, created the excess demand that is now met by illicit sources that cause more deaths now that oxy is regulated. But what you’re missing in your understanding is that without oxy, demand wouldn’t exist in the first place. And that’s the harm everyone is talking about.…

You’re saying “created excess demand” like the people that you’re referring to weren’t chronic pain patients.

I know some of them were drug-seekers but we decided it was OK to throw chronic pain patients under the bus so we could eliminate those drug-seekers.

Now, in addition to dealing with pain every day, I also have to “prove” that I’m not an opioid seeker if I end up in the ER for overwhelming pain. Because saying that you’re hurting is clearly a sign that you’re actually an addict trying to get a fix.

This might sound cold-hearted, but as someone who deals with chronic pain I’m fine with some street ODs in exchange for people who are in pain being cared for. Now we just torture patients by doing nothing.

Recreational drugs are a choice. My pain was not. Why we punished for others’ bad choices?

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#485

Post by jnovek »

beaeglebeachedd wrote: post #441
sailingparrot wrote: post #431

Earlier quoted context omitted.

Sure, OxyContin is better than Fentanyl, and banning Oxy can push people to way more dangerous opioids. But before painting Purdue as a hero of the people, let’s remember that million of people were pushed to opioids through Oxy when they shouldn’t have in the first place. Purdue played a big part in creating the epidemic in the first place. People that are now pushed to harder drugs because of an addiction they got…

It's the same shit practically all the way back to opium wars. Always the drug dealers fault. I blame the patient. We've known opiates were bad since at least the 1800s, and really longer than that. What the doc said was just what they needed to hear to lie to themselves, but this is taught in every highschool.

This is spoken like someone who has enjoyed the privilege of living without chronic pain.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#486

Post by shawndrost »

Terr_ wrote: post #395
doublet00th wrote: post #308

Earlier quoted context omitted.

I think there's a misunderstanding in what the settlement is about. As part of Purdue's bankruptcy, the Sackler family is voluntarily providing 6 billion dollars to help settle claims opioid victims have brought against Purdue Pharma. As a condition to provide the 6 billion dollars, the Sackler family has asked the bankruptcy judge to not even allow any new suits against the Sacklers related to the Opioid epidemic. T…

To try to illustrate the (bad) principle with a starker hypothetical: 1. Scrooge McDuck owns a thousand different corporations that are restaurants and eateries. 2. A one-taco-stand company is in bankruptcy court, after recklessly inflicting severe food-poisoning on a dozen customers. 3. Scrooge McDuck says: "Out of the goodness of my heart, I will charitably donate $X of my personal funds to help these poor unfortun…

I don't understand why your analogy requires multiple taco trucks. So if I'm missing something please explain.

Otherwise, I find your analogy helpful and illustrative of my confusion. Here is the simplified analogy:

1. Scrooge owns a nasty taco truck that makes everyone sick. He runs to the bahamas and is gone. 2. A dozen customers take it to bankruptcy court and get ownership of the taco truck and Scrooge's "charitable" donation, but Scrooge would get immunity, and so would the taco truck. 3. Meanwhile, the victims that weren't in the settlement are outraged that Scrooge might be immune. Not everyone was a part of the first suit -- plus, the taco truck is still selling tacos, and people are still getting sick!

This illustrates my confusion.

To me it seems like we should shut down the taco truck, and not give it immunity. I'm kind of a utilitarian and I don't much care about Scrooge, though I wish I could take his money away and put him in jail.

But it seems like most of the people who are mad about the diarrhea are not talking about the taco truck's continued operations and immunity??? And they are chiefly concerned about Scrooge, who is no longer involved with the taco truck??? What gives?

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#487

Post by Spivak »

dylan604 wrote: post #448
Spivak wrote: post #432

Earlier quoted context omitted.

Because car manufacturers exist, and this isn't theoretical or a jab at cars themselves. We are 100% certain that people will die while using cars, and by cars. Vehicular manslaughter even has a high bar for real punishment precisely because driving a car has an inherent risk of killing others and that risk is legal to take on. Knowing that some people using your product will die, and even that selling more of your p…

Except Purdue clearly stated that addiction was not an issue with their product. Car manufactures never say that death is no longer possible with their product. They blatantly misrepresented the dangers of their product in ways none of the other examples you listed come close.

They didn't though, they cited a medical journal article where an unaffiliated doctor reported the extremely low addiction rate. Which was true and misleading because short term opioid use addiction rates don't predict long term addiction rates — lying with statistics. And they should be charged and convicted for this, in fact they already were. However, since 2001 every bottle of oxy has made no claim that it's less addictive than other opioids. And we still prescribed them like candy.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#488

Post by worik »

thegrimmest wrote: post #424
worik wrote: post #423

Earlier quoted context omitted.

> Either something is a clearly articulated, written, rule with an enforcement mechanism, or it's fair game. No. There are many legal and bad things. Laws are a boundary, that few of us need. Laws are not a target

I would argue that fiduciary responsibility mandates that corporate leaders do everything right up to the legal boundary in pursuit of their shareholders interests. In fact profitably violating regulations would also be the right thing to do in this case. Certainly most shareholders seem to appoint executives that do exactly that.

> corporate leaders do everything right up to the legal boundary in pursuit of their shareholders interests.

Yes, that happens

Those are evil, short sighted people, sociopaths, who should not be emulated

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#489

Post by zardo »

hn_throwaway_99 wrote: post #483
addicted wrote: post #425

Earlier quoted context omitted.

I’d argue it’s the opposite. Look at what’s happened since Oxycontin was heavily regulated. Opioid deaths in America have exploded by an order of magnitude. There’s a direct correlation between higher regulation of OxyContin and opioid deaths in the U.S. The Sacklers have done illegal stuff. Misrepresenting the addictiveness of their drugs (well, it was immoral and wrong…it’s not clear how illegal it was). But it’s q…

> a slow acting opioid (it had to be crushed to be fast acting) You seem to just skip over that point in a bit of a blasé fashion, as if OxyContin's slow release formulation is somehow a defense of the Sacklers' behavior, when the exact opposite is true. That is, a primary argument is that Purdue pushed OxyContin because they argued it was safer due to its slow release formula. Except they knew full well that "slow r…

It's much worse than that. In order to protect the big selling point (10hrs between doses, once per nursing shift) they encouraged larger doses which were more likely to cause addiction instead of more frequent doses which were actually appropriate.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#490

Post by jnovek »

darawk wrote: post #389
shawndrost wrote: post #280

I understand people who think the Sacklers are villains who destroyed lives, Purdue should be shut down, and we should transform the legal regime around opioids. I understand people who think Purdue should continue, the status quo is OK, and the Sacklers are not [simply] villainous. I don't understand people who think the Sacklers are villains who destroyed lives, but Purdue should continue operating more-or-less as-…

Yes of course there are realistic ways to prescribe opioids routine and safely. Purdue did not invent opioids, what they did is patent a particularly strong formulation, and then work to undermine the cultural taboo in medicine around their use. That last thing was their crime. There isn't, at this time, any other way to treat serious pain (in all cases). Opioid prescriptions will continue to be an unfortunately nece…

“Opioids can't be banned until we can replace them with something equally generally effective.”

If only doctors took this advice! When the CDC made its first recommendation against using opioids there was a chilling effect and thousands of chronic pain patients who desperately in need of opioids to function were cut off. There were suicides.

It wasn’t until 2022 that the CDC loosened its recommendations and, in my experience, only a few doctors have caught up.

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