Sackler family knew but denied and downplayed risks of opioids, stigmatized addicted people, then moved to profit from addiction
AG Ellison’s office files unredacted complaint that shows family that controls Purdue paid themselves $4B in profit from opioids, while calling addicted people ‘criminals,’ ‘scum of the earth’ — then exploiting addiction treatment as an ‘attractive market’ that is ‘naturally linked’ to the crisis they created
AG Ellison: Complaint shows Sacklers ‘motivated not by human dignity or the value of human life, but by unlimited greed above all else’
August 5, 2019 (SAINT PAUL) — The Sackler family that controls Purdue Pharma — the manufacturer of the blockbuster opioid OxyContin and other opioids — knew as early as 20 years ago of the risks of addiction and death that their products posed, but denied and downplayed those risks, stigmatized addicted people, then moved to profit from the market for addiction treatment. All this and more is revealed in the unredacted First Amended Complaint against Purdue and eight members of the Sackler family— Richard Sackler, Kathe Sackler, Mortimer D.A. Sackler, Jonathan Sackler, David Sackler, Ilene Sackler Lefcourt, Beverly Sackler, and Theresa Sackler — who are named as individual defendants. Minnesota Attorney General Keith Ellison’s office filed the unredacted First Amended Complaint today in Hennepin County District Court.
Notably, the amended complaint reveals that the Sackler defendants, who controlled Purdue at all times, paid themselves a total $4 billion in profits they made off opioids nationally, including tens of millions of dollars in profits that they made off Minnesotans. They enriched themselves while calling people who were addicted to OxyContin, an opioid they knew was twice as powerful as morphine, “culprits,” “reckless criminals,” and “scum of the earth.” Then, the amended complaint reveals, they realized that treating addiction was an “attractive market” that was “naturally linked” to the crisis they had created and moved to profit from addiction treatment as their next business opportunity.
“The unredacted complaint makes it starkly clear that the Sackler defendants were motivated not by human dignity or the value of human life, but by unlimited greed above all else,” Attorney General Ellison said. “The Sackler defendants knew they were distorting facts, deceiving people, and destroying lives, and they kept going for the sake of greed. They didn’t see addiction, epidemic, and death as reasons to change course — they saw them as opportunities for profit.
“On behalf of the people of Minnesota, my office and I are doing everything we can to hold the Sackler defendants personally accountable for the irreparable pain and damage they willingly inflicted on every part of our state in the pursuit of their greed,” Ellison concluded.
From 2000 through 2017, a total 3,628 Minnesotans died of opioid-involved overdoses, including 422 in 2017 alone, the highest yearly figure yet recorded by the Minnesota Department of Health. From 2000 to 2017, the number of Minnesotans who died from opioid-related overdoses increased nearly 800 percent.
The unredacted complaint reveals that when defendant Richard Sackler learned as early as 2001 of a federal prosecutor’s report that 59 people had died of opioid-related overdoses in a single state, he wrote to Purdue executives that “[t]his is not too bad. It could have been far worse.”
Additionally, the unredacted complaint shows how the Sackler defendants reacted to and actively attempted to influence Minnesota’s pain-management standards to their benefit.
The State of Minnesota first filed suit against Purdue in Hennepin County District Court on July 2, 2018. In the suit, the State alleges consumer fraud, including that Purdue deliberately minimized the addiction risk of long-term opioid use and failed to sufficiently disclose the risks of long-term opioid use; deceptive and unlawful trade practices, including that Purdue made misrepresentations designed to mislead healthcare providers about the benefits of opioids; false statements in advertising; public nuisance; unjust enrichment; false claims; and other causes of action.
On May 17, 2019, Attorney General Ellison announced that his office had amended the original complaint against Purdue Pharma to include eight members of the Sackler family, which controls Purdue, as individual defendants. The amended complaint the State filed at that time was redacted. Today, Attorney General Ellison’s office filed the unredacted complaint, which allows the public to learn about the Sacklers’ words and conduct directly from internal company documents.
Below are excerpts from the unredacted complaint filed today, with paragraph and page numbers from the complaint supplied for reference, that show in verbatim quotes and stark detail that:
- The Sackler defendants were personally behind Purdue’s deception about OxyContin’s risk of abuse and addiction;
- The Sackler defendants were personally aware of the risks of abuse and addiction with OxyContin as early as 1999 — and intentionally blamed individuals for it;
- Despite their denials that opioids were addictive, the Sackler defendants moved to profit from treatments for addiction;
- The Sackler defendants also monitored and attempted to influence Minnesota pain-management standards and education;
- The Sackler defendants were personally involved in maximizing returns from OxyContin from the start; and
- The Sackler defendants paid themselves $4 billion in opioid profits, including tens of millions of dollars they made off of Minnesotans.
Newly-unredacted language from the complaint that is publicly available for the first time today is highlighted in bold. Other previously released passages are highlighted in italics for emphasis.
I. The Sackler defendants were personally behind Purdue’s deception about OxyContin’s risk of abuse and addiction. (¶225, p. 67)
- For example, in 1997, Richard and Kathe Sackler, along with other Purdue executives, were personally involved in the decision to perpetuate health care providers’ misconception that OxyContin was weaker than morphine, which led a wide variety of health care providers to prescribe OxyContin much more often. For instance, Purdue executive Michael Friedman (who later pleaded guilty to federal criminal charges of misbranding OxyContin due to his actions at Purdue) told Richard Sackler in May 1997 that the company was “well aware of the view, held by many physicians, that oxycodone is weaker than morphine,” but opined that “it would be extremely dangerous, at this early stage in the life of [OxyContin], to tamper with this ‘personality,’ to make physicians think the drug is stronger or equal to morphine.” Richard agreed with this approach despite knowing that, in reality, OxyContin is about twice as potent as morphine. (¶226, pp. 67-8)
- Around the same time, Richard Sackler was personally involved in correcting what he believed was a “critical misconception”: that experts believed that OxyContin “has a ceiling effect” which would limit health care providers from prescribing higher doses of the drug. Richard asked Michael Friedman to “put together some approaches and test whether they would be potent weapons” in “smash[ing] this critical misconception.” (¶228, p. 68)
- From the start, the Sackler Defendants were also the driving force behind Purdue’s marketing strategy to push opioids with the false promise that they create an enhanced “lifestyle.” In 1998, Richard Sackler personally instructed Purdue’s executives that OxyContin tablets provide more than merely “therapeutic” value and instead “enhance personal performance,” like Viagra. (¶230, p. 69)
II. The Sackler defendants knew of OxyContin’s risk of abuse and addiction as early as 1999 — and intentionally blamed individuals for it. (¶238, p. 72)
- In January 2001, Richard Sackler received an email from a Purdue sales representative describing a community meeting at a local high school organized by mothers whose children overdosed on OxyContin and died. The sales representative reported that “[s]tatements were made that OxyContin sales were at the expense of dead children and the only difference between heroin and OxyContin is that you can get OxyContin from a doctor.” (¶239, p. 72)
- In February 2001, a federal prosecutor reported 59 deaths from OxyContin in a single state. Richard Sackler’s reaction, in an email to Purdue executives, was that “[t]his is not too bad. It could have been far worse.” (¶240, p. 72)
- At the end of 2000, Time Magazine published an article about OxyContin deaths, and Purdue employees told Richard Sackler they were concerned. Richard responded in early 2001 with a message to his staff. He wrote that Time’s coverage of people who lost their lives to OxyContin was not “balanced,” and the deaths were the fault of “the drug addicts,” not Purdue. He claimed that the increasing sales of OxyContin made Purdue a “target for sensational reports in the media,” and implored Purdue staff to “continue to focus upon our noble mission.” (¶241, p 72-3)
- Throughout 2001, Richard Sackler personally dictated Purdue’s strategy for responding to the increasing evidence of abuse of prescription opioids and addiction to Purdue’s opioids: blame and stigmatize victims of opioid addiction. He wrote in an email that “we have to hammer on the abusers in every way possible. They are the culprits and the problem. They are the reckless criminals.” (¶242, p. 73)
- That same year, in an email exchange discussing whether people dependent on opioids “want to be addicts,” Richard wrote: “I’ll tell you something that will totally revise your belief that addicts don’t want to be addicted. It is factually untrue. They get themselves addicted over and over again.” Richard emphasized: “[Opioid addicts] are criminals, and they engage in it with full, criminal intent. Why should they be entitled to our sympathies?” He further wrote: “This vilification is shit.” (¶243, p. 73)
- In another email exchange that year, Richard said that those who abused opioids “aren’t victims; they are victimizers. And we decent people are the people they attack.” In earlier correspondence with the same person, Richard had complained that he couldn’t “call drug addicts ‘scum of the earth’” because he would “become the poster child for liberals who … just want to distribute the blame to someone else.” (¶244, p. 73)
III. The Sackler defendants’ understanding of the risk of opioid addiction is underscored by their moves to profit from addiction. (¶283, p. 84)
- Richard and Kathe Sackler, along with Purdue staff, determined that the millions of people who became addicted to opioids were the Sackler Defendants’ next business opportunity. Staff reported to Kathe that opioid addiction treatment “is an attractive market” with a “[l]arge unmet need for vulnerable, underserved and stigmatized patient population suffering from substance abuse, dependence and addiction.” (¶283, p. 84)
- In September 2014, Kathe Sackler participated in a call about Project Tango—a plan for Purdue to expand into the business of selling drugs to treat opioid addiction. In internal Purdue documents, Kathe Sackler and staff memorialized what Purdue publicly denied for decades: “Pain treatment and addiction are naturally linked.” (¶284, p. 84-5)
- Kathe Sackler and Purdue staff illustrated this point, and the business opportunity it presented, as a funnel that began with pain treatment leading into addiction treatment which emphasized Purdue’s “opportunity to expand our offering as an end-to-end pain provider” [See graphic in amended complaint entitled “Addiction treatment is a good fit and new natural step for Purdue”] (¶285, p. 85)
- The same presentation also provided that opioid addiction can “happen to anyone—from a 50 year old woman with chronic lower back pain to a 18 year old boy with a sports injury, from the very wealthy to the very poor.” This internal statement directly contradicts Purdue’s public-facing message that opioid addiction only affects patients that are already predisposed to addiction. (¶286, p. 85)
- Kathe Sackler and Purdue’s Project Tango team reviewed findings that sales of treatment medication to people addicted to opioids had more than doubled from 2009 to 2014. Kathe and the staff found that the national catastrophe Defendants caused provided an excellent compound growth rate (“CAGR”): “Opioid addiction (other than heroin) has grown by ~20% CAGR from 2000 to 2010.” (¶287, p. 85-6)
- In February 2015, staff presented Kathe Sackler’s work on Project Tango to the Purdue board. The plan was for a joint venture controlled by the Sackler Defendants to sell Suboxone film and acquire an addiction medicine pipeline. The presentation claimed that this would result in the Sackler Defendants’ acquisition of the “market lead in the addiction medicine space.” (¶289, p. 86)
- During the presentation, the Tango team outlined how patients could get addicted to prescription opioid analgesics, like OxyContin, or heroin, and then become consumers of the joint venture’s Suboxone film—and likely become repeat customers, as the presentation noted a “40–60% relapse rate in 1 year.” (¶290, p. 86)
- In June 2016, the Sackler Defendants met to discuss a revised version of Project Tango and considered a different scheme to sell the opioid overdose antidote Narcan… The Sackler Defendants viewed Narcan as a “complementary” product to their opioid portfolio, and identified patients on Purdue’s prescription opioids as the target market for Narcan. Their plan called for studying “long-term script users” to “better understand target end patients” for Narcan. The Sackler Defendants planned to “leverage the current Purdue sales force” to “drive direct promotion to targeted opioid prescribers” and determined that Purdue could profit from government efforts to use Narcan to save lives, including specifically in Minnesota, because Minnesota allows dispensing of naloxone without a prescription. (¶¶291-2, pp. 86-7)
- In December 2016, Richard, Jonathan, and Mortimer Sackler had a call with staff regarding yet another version of Project Tango: acquisition of a company that treated opioid addiction with implantable drug pumps. The business was a “strategic fit,” because Purdue sold opioids and the new business treated the “strategically adjacent indication of opioid dependence.” (¶293, p. 87)
IV. The Sackler defendants monitored and directed Purdue’s influence of Minnesota pain management standards and education. (¶235, p. 70-71)
- For example, in 2000, Michael Friedman sent Richard Sackler a report from a Purdue representative’s visit with the Minnesota Board of Medical Practice. The Purdue representative reported that the Board was using a video to educate physicians about chronic pain patients that encouraged physicians to utilize “careful prescribing, vigilance, documentation,” and “vigorous” management of chronic pain patients to avoid “manipulative behavior of addicted persons in their need to secure [opioid] drugs.” In response, Richard called the representative’s description of the video “illuminating and scary,” and asked a series of questions:
- What sort of take away is it that if you treat patients with chronic severe pain and they get better they want you to continue the treatment. Is this a surprise? And why can’t they give better advice than to say that they appear to disapprove the use of opioids in such treatments? That isn’t very helpful, either. (¶235, p. 70-71)
- In 2001, Michael Friedman then informed Richard and other Sackler Defendants that Purdue was setting up “educational pain management programs” throughout Minnesota, funded by a “significant unrestricted grant from Purdue.” These programs asserted that Minnesota health care providers’ reluctance to prescribe opioids was misplaced, that patient pain was being under-treated, and that Minnesota health care providers could treat “the pseudoaddict.” The Sackler Defendants were told by Purdue staff that these Minnesota programs would serve as a model that was being replicated by Purdue in other states. (¶236, p. 71)
V. Richard Sackler was personally involved in maximizing OxyContin’s returns for Purdue from the start. (¶224, p. 67)
- At the OxyContin launch party, Richard asked the audience to imagine a series of natural disasters: an earthquake, a volcanic eruption, a hurricane, and most importantly, a blizzard. Richard then claimed to have spoken with the “Wise One” during a journey “high in the Himalayas,” and boasted that the “Wise One” had told him that “the launch of OxyContin Tablets will be followed by a blizzard of prescriptions that will bury the competition. The prescription blizzard will be so deep, dense, and white that you will never see their [w]hite [f]lag.” (¶224, p. 67)
VI. The Sackler defendants paid themselves $4 billion in opioid profits, including tens of millions of dollars earned in Minnesota. (¶¶298-300, p. 84)
- According to publicly available information, annual revenue at Purdue averaged about $3 billion, mainly due to OxyContin sales, and Purdue has made more than $35 billion since releasing OxyContin in 1995. According to Purdue board documents, Purdue, at the direction of the Sackler-controlled board, paid the Sackler families approximately $4 billion in profits stemming from the sale of Purdue’s opioids between 2007 and 2018. (¶298, p. 89)
- Purdue also projected that the Sackler Defendants would be paid billions more. In June 2010, Purdue’s staff gave the Sackler Defendants an updated 10-year plan for growing Purdue’s opioid sales, in which the Sackler Defendants stood to receive at least $700 million each year from 2010 through 2020. (¶299, p. 89)
- Purdue and the Sackler Defendants tracked revenue from Minnesota. For example, after the 2016 CDC guideline was released, staff analyzed the potential negative effect of the guideline on Purdue’s opioid sales and reported to the Sackler Defendants that the approximately 40,000 annual prescriptions of Purdue’s high-dose opioids in Minnesota provided Purdue nearly $20 million per year, or about 2.3% of Purdue’s annual high-dose opioid sales. If this percentage is applied to the overall distributions paid to the Sackler Defendants since May 15, 2007, the Sackler Defendants have paid their family approximately $92,000,000 from Minnesota. (¶300, p. 89)