Crime Pays: How white-collar drug traffickers run amok with impunity while low-level minority crack dealers from impoverished areas are buried alive with prison time
Who says that crime doesn't pay? Tell that to the drug makers who pulled off one of the most brazen schemes ever, at the expense of millions of human lives and incalculable destruction. Unlike the minorities who sold $10 bags of crack in poor neighborhoods, you will not find these drug kingpins rotting away in prison. Oh no. They are a different breed. They are more cunning and well-funded, more sophisticated and calculating. They operate with military precision under the guise of legitimacy. No, you will not find these criminals rotting in prison—far from it. You’ll find them on the golf course or at charity events, or you might even see hospitals and art galleries emblazoned with their names. Their drug empires have amassed wealth that’ll be enjoyed for generations to come, and their names won’t be tainted by the scandal of their deeds.
What if I told you that a certain breed of drug kingpin in the U.S. can operate with impunity? Although they do not use guns to facilitate their drug sales or violence to run their drug empires, they rob people of their lives just the same, en masse, by exploiting the trust and ignorance of their customers, by peddling lies stacked on top of more lies, through a web of illegal deceit.
Since the 1980s, many thousands of young Black and Hispanic men (and women) who possessed just a handful of crack were crushed by the federal government—thousands buried alive with life in federal prison without the possibility of parole and the others who were “only” crushed with three or four decades without parole. They must be caged or buried alive. No mercy. Lock them up and throw away the key. Right? Remember the war on drugs? The crack epidemic?
But I'm not talking about minorities convicted of selling a little crack. I'm talking about the drug makers, and to some extent, the sales reps, doctors and pharmacists who were instrumental in carrying out their evil scheme regarding the mass distribution of OxyContin—white-collar drug trafficking on a massive scale.
The opioid crisis has made the crack epidemic look like child's play. If the crack epidemic was a grenade, then the opioid crisis was an atom bomb dropped on this country, leaving a trail of misery and death. The opioid crisis was and still is a full-blown national epidemic, a public health crisis that has claimed hundreds of thousands of American lives, leaving utter devastation behind. A Black kid slinging $10 bags of crack couldn't do as much damage as these guys did in 1,000 lifetimes—10,000 lifetimes, even.
The doctors and drug maker executives (big pharma) that peddled OxyContin on a grand scale—all in the name of getting filthy rich—will never spend a single day in jail. The problem was not prescribing pain medication for the legitimately managing pain. It was the devious plot that was hatched and intentionally carried out for decades—one that is truly evil.
It has now come out that for years, the owners of drug maker Purdue (the Sackler family), as well as their execs and army of sales representatives, hatched a Machiavellian plot that any evil genius portrayed in a Hollywood movie would be jealous of—a sophisticated, far-reaching, multifaceted scheme.
First, they assured doctors that Oxy was not addictive, that addiction was less than one half of a percent. When a doctor had the audacity to push back and say that a patient was exhibiting signs of addiction, the sales reps and drug maker's head doctor—who was highly regarded in the medical world—instructed the doctor that it was pseudo-addiction, not real addiction—a response to pain and failed treatments. The solution: give them a higher dose and keep them on the drug for longer.
Further, they aggressively told doctors to start patients on the highest possible dose—three, five, or even eight times greater than what the patient needed. In doing so, they told the doctors that there was no downside to putting the patient on the highest dose possible, despite knowing that doing so had dire consequences. What's more, they pushed doctors to keep patients on the highest dose for much longer than needed. In doing so, they yet again told the doctors that there was no downside to extending treatment, even when there was conclusive data that demonstrated the opposite. This doesn't even scratch the surface, nor capture the true extent of the scheme.
The bottom line: more Oxy prescriptions than ever before, at a higher dose, for as long as possible = a mind-boggling payday, billions for the Sackler’s and the pharma execs, and millions in bonuses for the army of sales reps. The cost: millions of human lives and pain and misery that cannot be quantified.
Purdue invested millions in a well-oiled machine that created and then fueled the opioid crisis. To execute this scheme, they employed an army of polished, attractive, aggressive, and highly incentivized sales reps to relentlessly convince doctors to prescribe more Oxy at higher doses and for a longer period—sales reps whose compensation was tied to the number of prescriptions written: sales reps who relentlessly wined and dined doctors to persuade them to do their bidding, all while hiding Oxy’s downside: addiction, overdose, and death.
Notably, one plaintiff's lawyer told Britain's Guardian in December of 2018 that the Sacklers were "essentially a crime family...drug dealers in nice suits and dresses." Columbia University Law School's director on its Center on Corporate Governance, John Coffee, opined that "there is little to distinguish the control the Sackler’s exercised over Purdue from the control that the Godfather held over his mafia family."
What makes this so evil is the element of deceit. Purdue hid the likelihood of addiction, overdose, and death when they had hard data that demonstrated the grave implications of these shady practices. People implicitly trust their doctors when it comes to medication recommendations, and so never knew what they were getting sucked into when their physician prescribed OxyContin. The kid slinging $10 of crack and the wealthy guy slinging Oxy are incomparable—the former is doing something illegal and is given a punishment radically disproportionate to the harm of his crime; the latter is doing something evil, but he is smart enough to game the system so he never spends a single moment in jail.
At least the customers of the crack dealer know that what they are buying is a highly addictive drug—at least there is transparency in that transaction. At least the crack dealer is honest in what he is selling. Can you imagine if doctors prescribed crack for, say, fatigue and depression, assured patients that it wasn't addictive, increased their dose and kept them on crack for as long as possible? And worse, when a patient showed signs of addiction, suppose the doctor increased the dose and kept the patient on crack for longer?
Yeah, selling crack is horrible. But at least there is transparency in the transaction. At least the customer can make an informed choice and he or she is not tricked into an addiction and robbed of their life.
The same cannot be said for the drug makers, the Sackler family, Pharma execs, doctors and money-hungry sales reps who flooded the U.S. with Oxy, who essentially started and fed the national fire of opioid addiction which resulted in the opioid crisis that still claims human lives and continues to wreak devastation on families and communities.
They don't look like drug dealers. They don't talk like drug dealers. But make no mistake, they make El Chapo look like a buffoon—not only did they plan and execute a brilliant scheme, but they rode off into the sunset unscathed.
Although this blog post centers on the Sackler family and Purdue, the responsibility for the opioid crisis and mass human destruction on a grand scale hardly falls squarely on Purdue and the Sackler’s. It extends to thousands of sales reps, executives of rival pharma companies with their own opioid products, overprescribing doctors, FDA bureaucrats, pharmacists who diverted prescriptions to the black market, and pain management experts who touted that opioids were not addictive when prescribed for pain.
Get ‘em hooked by relentlessly hounding doctors to prescribe OxyContin to their patients while hiding the drug's addictive properties
Here's how the multifaceted evil plan worked: how the drug makers and doctors preyed on patients’ ignorance by exploiting their trust. Oxy came on the scene in 1996. It was touted as a game-changing 12-hour pain reliever, compared to the then-available 4-hour opioid pain medications. According to Purdue, "addiction to opioids" in the "management of pain is very rare." Purdue sent an army of sales reps across the country to persuade doctors to prescribe Oxy. The sales reps were incentivized based on how many prescriptions the physicians they had visited later wrote, which fueled their efforts to close as many deals as possible. The bonuses were often twice as large as the sales reps' annual salaries. Drug companies tracked the exact number of scripts written daily. In hotspot states, sales reps visited the doctors two hundred times annually; some called daily. Purdue shelled out about $200 for each time the sales rep visited the doctor, but it translated into $40,000 for each top-tier doctor, which, over an entire network of doctors, translated into a fortune. So, the carefully selected, highly attractive and confident sales reps would charm physicians into doing what they wanted.
In a 2019 complaint filed against Purdue and the Sackler family directors by the Massachusetts Attorney General, it was noted that "Purdue did not spend $40,000 per doctor so sales reps could watch doctors write prescriptions that they were already going to write anyway. Instead, Purdue paid to lobby these doctors because Purdue knew its reps would convince them to put more patients on opioids, at higher doses, for longer periods. Those extra prescriptions paid back Purdue's investment many times over."
Jack up the do$e while hiding the down$ide
In the beginning, Oxy came in four strengths: 10, 20, 40, and 80 milligrams. Purdue's production costs were virtually the same for each, since Oxy was cheap to manufacture. In the marketplace, 20 mg pills cost twice as much as the 10 mg pills. The 80 mg pills were about seven times more expensive than the low dose. If a patient took 20 mg pills twice a week, Purdue's profit was less than $40. The same patient prescribed 80 mg pills twice a week shelled out over $200, a 450% increase.
To encourage its army of sales reps to push the highest dose, Purdue created a campaign called "Individualize the Dose." To deceive the doctors, the sales reps told doctors that Purdue’s studies showed that instead of starting patients on low strengths to see if that worked, it was best to start them on a higher dose. Purdue representatives assured doctors that the higher doses would be dispensed even to people who had never used opioids, all without adverse effects. And the drug maker maintained that the higher-dose pills were no more likely to cause addiction.
These were blatant lies, but necessary to drive profits and bonuses. As eventually came to the surface years later, Purdue knew that stronger doses carried a much higher likelihood of dependence, addiction, and even respiratory suppression that could be lethal. Purdue went as far as issuing a press-release that made clear that "dose was not a risk factor for opioid overdose" while internal communications were replete with hard data about the dangers of "dose-related overdose."
Extend the treatment period
Aside from hiding the addictive properties of Oxy and tricking doctors into prescribing the highest dose possible, Purdue poured millions into a parallel campaign to extend Oxy's treatment period for as long as possible. Purdue told doctors that a common error was putting patients on the drug for too short a period since that resulted in a rebound in pain. Of course, longer treatment was a gold mine for Purdue and the sales reps. A patient, for instance, given 80 mg pills twice a day brought Purdue $200 profit. The company earned $11,000 if that same patient stayed on the drug for a year. Here's the striking part. It was later revealed that Purdue knew that patients were 30 times more likely to die of an overdose if they took Oxy for three months, 46 times more likely to OD after six to eleven months, and 51 times more likely to OD if they remained on Oxy more than a year.
This, of course, was hidden from the doctors.
When Purdue was caught employing these deceptive and aggressive sales tactics, minimizing the risks of Oxy, and overstating its benefits, there was no penalty—just a promise to not do it again.
Responding to signs of addiction by increasing the dose of OxyContin
In a calculated move, Purdue hired the well-respected Dr. J. David Haddox as its medical director. He became the public face for Oxy at physicians' conferences and training courses. He reassured his colleagues that the risk of addiction was only "one-half of one percent," something that was "exquisitely rare." When doctors did raise the possibility that one or more of their patients on Oxy might be addicted, Haddox replied that they were mistaken—they were seeing pseudo-addiction, not true addiction, and the patients’ reaction to pain and the stress of failed treatments. And—get this—the only way to eliminate pseudo-addiction was to eliminate the underlying pain by keeping patients on the drug and increasing the dose. In other words, if a patient started showing signs of addiction, the doctors were to prescribe them more.
Unbelievably, the doctors did as instructed.
In another clever move, Purdue hired the very official from the FDA who had just approved Oxy for sale, which made Purdue’s credibility bulletproof.
$$CHA-CHING$$
The efficacy of Purdue's scheme can be seen by examining the hard numbers. Two years after it went on sale, Oxy's sales soared from $48 million to $1.1 billion. At that point, its sales force was earning over $40 million in bonuses. And the Sackler family fortune ballooned to more than $10 billion.
The complete picture
The guys selling crack were in the wrong hustle. The guys selling crack had to be buried with life sentences and many decades in prison with no parole...to protect the public, of course. But who will protect the public from the real predators who are given a license to commit unspeakable crimes? That's just how it is in the U.S.A. Just look at the 2008 financial crisis, which was precipitated by flagrant fraud that involved everyone from the bankers to the rating agencies, all of whom preyed on investors and gouged the country for trillions. Like the Sackler family and the rival drug makers, they are still sitting pretty, with no recourse for their heinous actions.
Let's face it—justice is for certain people. Justice and the equal application of law is a carefully cultivated illusion. People believe what they want to believe. In reality, a two-tiered justice system exists, depending on who you are: your race, socioeconomic status or family connections. People can criminalize what they want to criminalize and justify what they want to justify. But by and large, justice is for the low-hanging fruit, the easy prey. Federal agents and prosecutors can point to those people who are tossed in a cage for decades to life and tout it as proof of the efficacy of the "war on drugs." Meanwhile, as evidenced by the opioid crisis, the real war is being waged in cities and states across this nation and the body count is rising to an absurdly high level—hitting middle America and affluent enclaves that people thought were immune to such epidemics.
A criminal is who people perceive a criminal to be. Consider this. If the daughter of a prominent judge is a college student at an Ivy League school, and she sells Oxy, Xanax or a little weed to other students, she might violate federal criminal statutes, but in the eyes of people in this country, that her conduct violated a criminal statute is not what makes her a criminal—it's her background, race or socioeconomic standing. She is just an innocent college student. But don't let a poor kid from wrong side of the tracks sell small amounts of crack. He is a criminal because he is poor, because of the kind of drug he sells and because of his background. And there will be no mercy when he is charged and dragged in front of the judge. By contrast, it would be unspeakable to imprison a judge’s daughter for decades. It would never happen. Both violated the same criminal statute. The difference is on who committed the crimes.
No doubt, people who sell crack and other drugs should be punished. But the white-collar drug traffickers run amok with impunity while the little man is given a ludicrously long prison sentence fit for a serial murderer.
A war on drugs? I think not. It's a war on certain drugs that certain people sell. Others can do as they please.
