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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

#161

Post by rscho »

nickff wrote: post #158
rscho wrote: post #155

All-around-tech-bro-knowledge is strong in this thread. Doctors prescribe opiates all over the world, including oxycontin. Nowhere else is it a problem as big as in the US. Before wanting to withdraw prescription rights and sue MDs on a personal basis, perhaps people could think about the american exception? The US opiate problem is cultural and the responsibility is on both sides of the doctor-patient fence. The mor…

There are huge problems with opiods in many countries, but the USA has the most data. Canada has major issues, but only some provinces are tracking it.[1] [1] https://www.cbc.ca/news/canada/british-columbia/bc-overdose-...

Yes, Canada... a country with a similar healthcare culture.

What about Europe, Asia? They also have oxycontin. How about Germany, for example? How do they manage?

I've practiced both in Europe and in the US. I wouldn't go back to care for americans even for a million bucks. Healthcare culture in the US is incredibly toxic.

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

#162

Post by [deleted] »

GordonS wrote: post #157
TAForObvReasons wrote: post #153

Earlier quoted context omitted.

"doctors should have known the manufacturers' claims were bogus" is shifting the blame. The real blame should be focused on the manufacturers making false claims in the first place.

It wasn't my intention to shift the blame - clearly the manufacturers should be strung up for making the false claims they did. Absolutely no argument there. My point is though, that doctors shouldn't blindly trust whatever a manufacturer tells them, if the evidence right in front of their eyes says different.

[deleted]

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

#163

Post by nickff »

rscho wrote: post #161
nickff wrote: post #158

Earlier quoted context omitted.

There are huge problems with opiods in many countries, but the USA has the most data. Canada has major issues, but only some provinces are tracking it.[1] [1] https://www.cbc.ca/news/canada/british-columbia/bc-overdose-...

Yes, Canada... a country with a similar healthcare culture. What about Europe, Asia? They also have oxycontin. How about Germany, for example? How do they manage? I've practiced both in Europe and in the US. I wouldn't go back to care for americans even for a million bucks. Healthcare culture in the US is incredibly toxic.

What? Canada has a similar healthcare culture? Canada is one of very few single-payer-only systems. Canada and the USA have polar opposite healthcare systems.

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

#164

Post by caycep »

songshu wrote: post #13

I never understand why doctors are not blamed for prescribing these. Are doctors not supposed to be responsible for prescriptions? If they are not, should we stop allowing them to prescribe? Why don’t doctors unions throw out members who would claim to have been hoodwinked by pharmaceutical companies?

Of note, in california, every opiate rx is very rigidly traced in the CURES database.

I'm sure there's some complicated technical way around it, but it's not a willy-nilly rx system, at least in CA.

In general, the rule of thumb is if you need opiates, more that a simple vicodin or tramadol, we refer you to a pain management specialist.

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

#165

Post by chimeracoder »

Scoundreller wrote: post #84
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. The caveat is that once a drug is approved for XYZ, doctors can, and do, prescribe it for a…

> The caveat is that once a drug is approved for XYZ, doctors can, and do, prescribe it for anything else in their judgement. The caveat is that once a drug is approved for XYZ, doctors can, and do, prescribe it for anything else in their judgement.

Yes, but pharmaceutical companies cannot market the drug for non-approved uses or discuss off-label use when promoting or selling the drug. That is illegal.

That illegal activity is exactly what the courts determined Purdue did - bribery, fraudulent marketing, and more. The issue is that Purdue broke the law (and that their sentences for breaking the law were way too light).

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

#166

Post by rscho »

nickff wrote: post #163
rscho wrote: post #161

Earlier quoted context omitted.

Yes, Canada... a country with a similar healthcare culture. What about Europe, Asia? They also have oxycontin. How about Germany, for example? How do they manage? I've practiced both in Europe and in the US. I wouldn't go back to care for americans even for a million bucks. Healthcare culture in the US is incredibly toxic.

What? Canada has a similar healthcare culture? Canada is one of very few single-payer-only systems. Canada and the USA have polar opposite healthcare systems.

Yep, completely different system. Same attitude, though.

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

#167

Post by mturmon »

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.

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

#168

Post by GordonS »

chimeracoder wrote: post #160
GordonS wrote: post #157

Earlier quoted context omitted.

It wasn't my intention to shift the blame - clearly the manufacturers should be strung up for making the false claims they did. Absolutely no argument there. My point is though, that doctors shouldn't blindly trust whatever a manufacturer tells them, if the evidence right in front of their eyes says different.

> My point is though, that doctors shouldn't blindly trust whatever a manufacturer tells them, if the evidence right in front of their eyes says different. Just to be clear, you're advocating doctors eschewing published clinical data (including data from published trials and the FDA approval) on the basis of nonrandomized anecdotal data? The issue here is that the manufacturers committed fraud - falsifying and/or mis…

> The issue here is that the manufacturers committed fraud - falsifying and/or misrepresenting clinical data

This is my point - the claims were BS. A number of doctors should have been raising a number of red flags, because their knowledge contradicted those claims, as did patient evidence right in front of their very eyes.

I'm obviously not saying they should ignore or distrust all clinical data, but if they see such massive discrepancies then they should be speaking up.

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

#169

Post by shirakawasuna »

mmrezaie wrote: post #7

I am not american and I remember hearing about OxyCotin for more around 10 years. So I wonder why controling this problem which casued so many loses of lifes (not necessary deaths), took this long to be the target of the government. I also wonder was there one of these stupid political shows that US is used to them now that was stopping anyone to handle it. In the long legal battle I do not think this money is going…

The United States is neoliberal with a couple social programs tacked on top. The interests of capital nearly always win. Individuals at the top are nearly always shielded from liability using various levels of companies in between them and the "consumer" and plausible deniability. The typical worst-case scenario is that the company has to pay a large fee that is still smaller than the profits they made through their monstrous actions.

These are well-known forces that have acted this way for 150 years. Unfortunately, these systemic problems are not taught in school. Quite the opposite, they are treated more as minor aberrations that are fixed with a touch of social democratic intervention or regulation. And even that is considered an extremist position, extending to all kinds of subjects relevant to this community regarding how tech companies should be structured, labor organized, compensation structured (including healthcare), or even just having more coherent and explicit control over your personal data.

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

#170

Post by nickff »

rscho wrote: post #166
nickff wrote: post #163

Earlier quoted context omitted.

What? Canada has a similar healthcare culture? Canada is one of very few single-payer-only systems. Canada and the USA have polar opposite healthcare systems.

Yep, completely different system. Same attitude, though.

I really don't understand what you mean by 'culture' and 'attitude'; please explain.
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