Supreme Court blocks controversial Purdue Pharma opioid settlement • Hacker News Board

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#501

Post by skellera » Thu, Jun 27, 2024, 11:41 PM UTC

jnovek wrote: post #484

darth_avocado wrote: post #451

Earlier quoted context omitted.

> 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 sayin…

Even the chronic pain patients should not have had the amounts prescribed to them that they were. Doctors were incentivized to give as much as possible. Creating addicts in people who may otherwise would not have been.

I personally knew people getting more than a cancer patient should’ve been given for day to day chronic pain.

I’m sorry if you were personally affected by regulation but that doesn’t mean they didn’t cause the crisis.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#502

Post by nickburns » Thu, Jun 27, 2024, 11:42 PM UTC

voisin wrote: post #446

It’s pretty wild that everyone acknowledges that the Sacklers engaged in a “milking program” going from 15% to 70% distributions after the first lawsuits in order to strip the company of assets and then hide behind the company to shield liability. This alone should allow claimants to pierce the corporate veil and go after the family directly.

> allow claimants to pierce the corporate veil and go after the family directly.

This decision is a win both for that cause, and also forestalling precedent that would allow future wrongdoing corporations from 'shielding the veil' so to speak through bankruptcy. A win-win indeed.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#503

Post by galleywest200 » Thu, Jun 27, 2024, 11:42 PM UTC

Spivak wrote: post #487

dylan604 wrote: post #448

Earlier quoted context omitted.

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…

> And we still prescribed them like candy.

Part of the claim is that the Sacklers were involved in this portion.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#504

Post by clhodapp » Thu, Jun 27, 2024, 11:45 PM UTC

jnovek wrote: post #484

darth_avocado wrote: post #451

Earlier quoted context omitted.

> 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 sayin…

Do remember that some of them were acute pain patients, who were supposed to be on oxy for a limited amount of time but got hooked.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#505

Post by worik » Thu, Jun 27, 2024, 11:47 PM UTC

darawk wrote: post #459

worik wrote: post #419

Earlier quoted context omitted.

> Opioids can't be banned until we can replace them with something equally generally effective. Opioids should not be banned Opioid addiction (I have seen a lot of it, not had it) is a social problem and is best managed with, opioids The problems stem from putting unreasonable obstacles between adicts amd their appropriate treatment. Practical legal and financial obstacles, sadistic legal obstacles, and bizarre moral…

> Opioid addiction (I have seen a lot of it, not had it) is a social problem and is best managed with, opioids I don't entirely disagree with you, but I have also seen enough people stop, who probably wouldn't have if that were the typical treatment, to be pretty cautious about that. There are a number of promising addiction treatments in the wings at the moment, in particular Ozempic and the general GLP-1 agonist cl…

An agree fest ensues

I am not advocating pure herion (ironically quite a safe drug aside from addiction) or cocaine powder as modern consumer products.

Opium caused upheavals when used as a wedge by Westerners in China, but remember it had been present, and used for millenia in Arabia.

The same, roughly, with cocaine and coca

It is not a choice between continued sadism or free reign herion and cocaine dealing.

We can do better

And I think the "psychological elements that come with long term use" is largely confusing cause and effect.

From my experience people having drug problems recover when the problems recede. Hence advocating treating drug addiction with drugs

One size does not fit all, and some halt and are abstinent. Good on them, I know no-one like that

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#506

Post by MavisBacon » Thu, Jun 27, 2024, 11:47 PM UTC

api wrote: post #428

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…

Wasn't Oxycontin kind of the boot loader for the present opioid crisis in that it mainstreamed opioid use and got a huge number of people introduced to it? Then it was taken away and things like illicit fentanyl filled the gap, but that came later.

Indeed. At the undergrad college I went to in New England in 2008 it wasn’t uncommon to see people at house parties doing lines of oxycontin out in the open. Was fairly socially acceptable.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#507

Post by Terr_ » Thu, Jun 27, 2024, 11:48 PM UTC

shawndrost wrote: post #486

Terr_ wrote: post #395

Earlier quoted context omitted.

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 "charita…

> multiple taco trucks

Trucks? The lawsuit involves one discrete corporation, and its small size is underscored by how it's just one stand/kiosk. (I suppose it could be mobile, but that's not what I was thinking of.)

However same owner/investor happens to be involved in many un-enumerated companies, some of which might easily be guilty of the same problems, including ones that would normally "pierce the corporate veil" and affect investors directly.

> but Scrooge would get immunity, and so would the taco truck.

The taco-stand corporation isn't immune, it's going bankrupt paying judgements. CEO/Owner Scrooge is coming in from the sidelines to preempt a personal lawsuit, and also trying to get someone in authority to (wrongly) grant him immunity from other potential lawsuits from other claimants.

> plus, the taco truck is still selling tacos

Oh, I think I see: No, this isn't a duck-ified version of the entire national controversy, I'm just trying to illustrate the how an "immunity" grant can be bogus.

In other words, the taco-stand is not a 1:1 analogy placeholder for Purdue Pharma, you can assume it's been bankrupted into Chapter 7 and broken up and sold off.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#508

Post by qarl » Thu, Jun 27, 2024, 11:48 PM UTC

jjk166 wrote: post #457

qarl wrote: post #216

Earlier quoted context omitted.

But also very likely that the case will go to court and the damages will be substantially higher.

Victory is not guaranteed, and even if the victims do win, going to court takes a lot of time and costs a lot of money. The victims agreed to the settlement because they preferred that option to going to court.

OK - but the individual payouts are going to be small and do little to compensate for the harm caused.

The primary goal for the suit is to punish the wrongdoing and disincentivize similar future behavior by others. Higher costs and uncertainty does that.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#509

Post by darawk » Thu, Jun 27, 2024, 11:49 PM UTC

com2kid wrote: post #460

mcguire wrote: post #429

Earlier quoted context omitted.

Purdue aggressively marketed OxyContin as having a very small rate of addiction to doctors who weren't pain specialists and thus had little experience with controlled medications, while providing a dosing regime that was almost designed to cause addiction. (It's sole advantage was as a timed-release medication; if pain returned before time for the next dose, doctors were instructed (strongly) to raise the dosage rath…

> . (It's sole advantage was as a timed-release medication; if pain returned before time for the next dose, doctors were instructed (strongly) to raise the dosage rather than increase the number of doses per day.) The same thing happens with ADHD medications, the timed release dosages are supposed to last 12+ hours, but in reality they vary from 8 to 16. Thankfully most doctors will willingly prescribe a small after…

> The same thing happens with ADHD medications, the timed release dosages are supposed to last 12+ hours, but in reality they vary from 8 to 16.

Modern ADHD meds are really not comparable to powerful opioids. They are both dopaminergic, but they are night and day in terms of addictiveness. Even weak opioids vs strong opioids is night and day.

> There is a large delta between the average response curve and an individual's response curve!

True! But the word "average" is actually not, itself, precise. It has at least three typical meanings: mean, median, mode. These all have quite large deltas to each other when talking about dose-response curves, and since they are curves, you would also have to pick a norm first.

There are a lot of sources of variability, but variation does not actually make it very difficult to detect improper opioid prescribing behavior. Just like the variation in people's weights would not tell you much about the strength of asphalt roads. These things are not measured in the same scale.

The majority of the pharmaceutical problem came from a very small number of people who churned out prescriptions like a literal mill. Like 5 minute appointments all day every day - not random doctors overprescribing their patients by accident. What is true is that the random doctors overprescribing provided a certain amount of cover for the corrupt doctors, for a while.

Re: Supreme Court blocks controversial Purdue Pharma opioid settlement

#510

Post by BobbyJo » Thu, Jun 27, 2024, 11:58 PM UTC

jnovek wrote: post #484

darth_avocado wrote: post #451

Earlier quoted context omitted.

> 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 sayin…

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

When a pain patient becomes an addict, their demand tends to be in excess of their prescription. I don't think anything you're saying is a reasonable response to the comment you're responding to.