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The Family Making Billions from the Opioid Crisis

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Re: The Family Making Billions from the Opioid Crisis

#151

Post by dang »

jsolson wrote: post #91
ygaf wrote: post #62

Earlier quoted context omitted.

The Bible teaches this too.

Yes, but it's tied up in a bunch of other bits like not eating pork and worshipping a particular deity. The secular quip raises the same questions about human motivations without the other baggage.

Please keep HN threads free of religious flamewar. The parent comment wasn't particularly substantive but veering into general litigation of (biblical) religion definitely leads nowhere good. All such discussions are the same and therefore off-topic here.

Re: The Family Making Billions from the Opioid Crisis

#152

Post by mcguire »

refurb wrote: post #2

I love how the article switches between OxyContin and opioids throughout the article, particularly when talking about deaths. It's a clever way to include drugs like heroin, fentanyl, etc in the numbers to inflate them and make the story more gripping. Of course it's silly to hold OxyContin's manufacturer responsible for all opioid deaths.

"In May 2007 the company pleaded guilty to misleading the public about Oxycontin's risk of addiction and agreed to pay $600 million in one of the largest pharmaceutical settlements in U.S. history. Its president, top lawyer and former chief medical officer pleaded guilty as individuals to misbranding charges, a criminal violation and agreed to pay a total of $34.5 million in fines. Those executives are: Michael Friedman, the company’s president, who agreed to pay $19 million in fines; Howard R. Udell, its top lawyer, who agreed to pay $8 million; and Dr. Paul D. Goldenheim, its former medical director, who agreed to pay $7.5 million.

"In addition three top executives were charged with a felony and sentenced to 400 hours of community service in drug treatment programs."

https://en.wikipedia.org/wiki/Purdue_Pharma?wprov=sfla1

I wouldn't really consider them a scapegoat.

"As shown in Figure 1A, the selection of OxyContin as a primary drug of abuse decreased from 35.6% of respondents before the release of the abuse-deterrent formulation to just 12.8% 21 months later (P"

http://www.nejm.org/doi/full/10.1056/NEJMc1204141

The abuse-resistant version had some unhappy consequences.

"Available data indicate that the nonmedical use of prescription opioids is a strong risk factor for heroin use. Yet, although the majority of current heroin users report having used prescription opioids nonmedically before they initiated heroin use, heroin use among people who use prescription opioids for nonmedical reasons is rare, and the transition to heroin use appears to occur at a low rate."

http://www.nejm.org/doi/full/10.1056/NEJMra1508490#conclusio...

Of course, the issue here is not that oxycontin is a gateway drug, but that prescription opioids are being abused, and Purdue and oxycontin are undoubtedly at the forefront of that.

Re: The Family Making Billions from the Opioid Crisis

#153

Post by dang »

neilk wrote: post #120
tclancy wrote: post #83

Earlier quoted context omitted.

This smells of whataboutism and whatever the ethics of making addictive software, it's killed far fewer people so far.

I'm not equating the harms, or attempting to distract from this serious issue. But, if we feel clear outrage about another industry, we should consider applying the same standards to our own. Most everyone who works in opioid marketing probably thinks they are a good person too.

> we

The fallacy in your comment isn't that you're wrong about addictions, it's that you're assuming two population samples are the same: 'HN users who complain about drug addiction' and 'HN users who create addictive technology'. Those are two different values of 'we'. (I worry about being in the latter group. HN is pretty addictive.)

Re: The Family Making Billions from the Opioid Crisis

#154

Post by golergka »

mavhc wrote: post #40
joemag wrote: post #27

Aren’t the doctors to blame for this as well? It always surprised me how quickly and easily they prescribe serious painkillers. A few years ago I had a tooth pulled, and the doctor gave me prescription painkiller. In the end, I ended up using regular ibuprofen, and that was more than enough. I wonder how much of this comes pharmaceutical sales reps pressuring the doctors to use their medicine. That whole system seems…

Capitalist medicine is to blame, when you can vote with your money you can pick the doctor who does what you want, not what's best for you.

If people are idiots, why deny them the possibility to realize their potential?

Re: The Family Making Billions from the Opioid Crisis

#155

Post by chmaynard »

In America, we worship people that create great fortunes. We idolize them and consider them geniuses. The source of their wealth is not important, even if it is obviously illegal or immoral. The only consideration is whether they built a successful business and managed to retain most of their money. This is the dark side of capitalism and the profit motive.

Re: The Family Making Billions from the Opioid Crisis

#156

Post by dirtybird04 »

neilk wrote: post #78

It's interesting how HN has near-universal disdain for people covertly making billions off an addictive product. But much of our industry is explicitly, openly trying to create addictive experiences.

There's a fine line between physical and psychological addictive experiences. You can always delete Candy Crush from your phone, not that easy to delete opiods from your system

Re: The Family Making Billions from the Opioid Crisis

#158

Post by Nomentatus »

nsedlet wrote: post #18

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 co…

Money can travel - your reputation, not so much. China has a solution, a social score that travels with you everywhere. Dystopian, but it could cure that worship of money thing.

Re: The Family Making Billions from the Opioid Crisis

#159

Post by maccard »

refurb wrote: post #77
mavhc wrote: post #40

Earlier quoted context omitted.

Capitalist medicine is to blame, when you can vote with your money you can pick the doctor who does what you want, not what's best for you.

What? Even in single payer systems you can choose your doctor!

Not always. I recently moved, and was forced to change doctor (NHS in the UK). My new GP surgery is farther away from my new apartment than my old surgery was, I’m far less happy with the doctors there, and it’s far more oversubscribed than my previous GP was.

Re: The Family Making Billions from the Opioid Crisis

#160

Post by nsedlet »

joering2 wrote: post #117
nsedlet wrote: post #18

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 co…

I definitely don't wanna play devils advocate for these scumbags, but can't you apply your logic to basically any product? I mean, Coca-Cola. Its at best product of dubious value, and at worst produced for the need for sugar by tens of thousands of people.

I think we all can and should apply our values towards judging companies' usefulness to society. That doesn't mean regulating or prosecuting them - moral clarity goes a long way on its own. People work hard to be held in high esteem by their peers: when we refuse to honor a useless company with prestige, it makes it harder for that company to attract talent; it reduces consumer demand for its products; it makes vendors less excited to work with them. etc. We get companies and products that reflect our values, so let's affirm the right values.

To take your example: Coca-Cola doesn't kill people as efficiently as Oxycontin, but yes, it doesn't really add much. A balanced analysis would probably acknowledge that sugar plays a huge role in our obesity crisis and other public health issues, but also acknowledge that there are many sources of sugar besides soft drinks, that sugar isn't as terrible as heroin, etc. I think Coca-Cola executives should probably feel a little bad for devoting their professional lives to it. I think schools like Emory should feel a little ashamed for taking Coca-Cola money. The fact that Coca-Cola is constantly touted as a great American company (by e.g. Warren Buffett) helps normalize the damage it inflicts on society.

I'd advocate a nuanced view: Coca-Cola isn't great, but it's not the devil. There's worse (like tobacco companies, which are probably correctly rated by society). And there's better (Bank of America, Microsoft) - those companies have their own detractors of course, but on balance they add a lot more to our lives than Coca-Cola.

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