Purdue Pharma will give up control of their company and pay more than $8 billion dollars after pleading guilty to three criminal charges in their handling of opioid medications like OxyContin, which may have played a significant role in the United State’s opioid crisis.
Purdue pleaded guilty to three criminal charges, including a violation of anti-kickback laws, which seek to prevent remunerations or the payment of rewards to doctors for patient referrals or prescriptions in order to generate business. These remunerations could include things like money, free rent, hotel stays, or “gifts.” Remunerations may encourage medical professionals to give out excessive prescriptions to patients who don’t need them.
Purdue provided remunerations to doctors for prescribing excessive opioids. This could have contributed to the increase in opioid prescribing rates between 2006 and 2012 when the peak prescribing rate was 81.3 prescriptions per 100 people in the United States.
Purdue was also guilty of misleading the U.S. Drug Enforcement Administration about the company’s internal controls that ensure opioids didn’t end up in the wrong hands. Purdue-produced opioids were likely diverted, which refers to drugs being diverted from the legitimate path of manufacturing, to medical professionals, and then to the patients to whom they are prescribed.
What Penalties Does Purdue Face?
Overall, the company faces fines of up to $8.3 million dollars in both civil and criminal penalties. However, since Purdue Pharma doesn’t have that amount of cash on hand, they will have to file for bankruptcy. However, though the company will not seek to exist, it will no longer be controlled by its original owners, the Sackler family. Instead, it will be held as a public trust as it continues to make pain-killing opioids and opioid overdose medications. The Sackler Family will also pay $225 million out of pocket, though they also pulled as much as $10 million out of the company prior to the lawsuits, much of which is held in offshore accounts.
Last year, the Sackler family was also sued by the New York Attorney General. The company still faces thousands of cases from states and local governments. Purdue suggested a wider settlement of $10 billion to settle these other claims.
No one in the Sackler family or in Purdue leadership faces prison time as a penalty for this guilty plea. However, the Justice Department is still pursuing other open criminal investigations into the company and new charges may be brought forward in the future.
Critics of the settlement argue that these penalties are insignificant compared to the total cost of the opioid epidemic, for which they feel Purdue bears some responsibility. Some feel the company and leaders involved in criminal actions should face penalties similar to illicit drug dealers.
Is Purdue Responsible for the Opioid Crisis?
Purdue and other pharmaceutical companies like Johnson and Johnson have been accused of contributing to the opioid crisis in the U.S. The crisis refers to an epidemic of opioid use disorders and overdose that started to increase in the late 1990s and spiked around 2017. However, the coronavirus may have an impact on the opioid crisis that could cause it to worsen.
The opioid crisis is a multi-faceted problem with more than one overall cause. However, recent investigations have revealed that Purdue and other pharmaceutical companies have contributed to the crisis and widespread opioid use problems. However, an influx in illicit opioids like heroin from foreign sources has increased the availability of opioids and lowered their price. Likewise, powerful synthetic opioids like fentanyl that also come from foreign sources have caused a spike in opioid overdose deaths.
Many people use opioids as prescribed and never develop a substance use disorder. However, the overprescription of opioids contributes to the misuse of opioid medications. Excessive pills may collect in medicine cabinets where other people can get them or they may be given to friends and family members who don’t have a prescription. Diverted opioids could make their way to drug dealers that sell them illegally.
The misuse of opioid medications can lead to chemical dependence and addiction. People that are addicted to opioid pills may switch to illicit sources when legal opioids become too expensive or difficult to obtain. According to the National Institute on Drug Abuse (NIDA), nearly 80 percent of people that use heroin report starting with prescription opioids. The misuse of prescription painkillers may increase your chances of heading down a path of addiction, illicit drug use, and opioid overdose. Though many people start using heroin without using pills, opioid misuse may make illicit drug use more likely.
Will This Help Curb the Opioid Epidemic?
It’s difficult to know what the next few years will bring when it comes to public health problems related to opioids. Pharmaceutical companies are only one source of opioids that may be misused by Americans, though prescription opioids overprescription is a significant problem. The epidemic is a multifaceted issue that is related to a host of problems like socioeconomic issues, mental health problems, access to treatment, social stigmas around addiction, and the illegal drug trade.
Between the opioid prescribing spike in 2012 and 2018, opioid prescribing rates fell to the lowest they have been in over a decade. Opioid overdose rates also fell for the first time in many years in 2018. However, the COVID-19 pandemic may exasperate the previously stabilized opioid crisis. COVID-19 has put extra strain on the healthcare system, which people with substance use need access to. This could lead to more fatal overdoses among people that can’t get help in time.
Though addiction treatment is important and necessary healthcare for people with substance use disorders, the pandemic may be a deterrent to getting treatment. People that may otherwise seek addiction treatment might experience worsened substance use problems. Economic issues are a risk factor for substance misuse and the economic downturn caused by the pandemic can worsen those issues.
Still, pharmaceutical companies like Purdue Pharma that thwart the DEA’s efforts to avoid diversion and encourage the overprescription of opioids through kickbacks contributed to flooding the U.S. in opioids. Reducing the number of excessive opioids in the country is no small step in the fight against the opioid crisis. Plus, the money won in the lawsuit will go toward addiction treatment efforts. As a public trust, the profits will ideally go toward the public good. However, the $8.2 billion is a small portion of the total cost of the opioid problem in the U.S.
Still, this lawsuit paves the way for the thousands of other suits against Purdue Pharma and similar pharmaceutical companies that have mishandled their opioid products. This suit doesn’t mark the end of the opioid crisis, but it may help the people on the front lines gain momentum in dealing with this complex problem.