The Opioid Epidemic: An Under the Table Drug Deal
Nearly 6 years after former President Trump declared the opioid crisis an epidemic in the United States, the Sackler family, aka the world’s worst drug dealers, have yet to be suitably punished for their scientific and moral crimes. Whilst the opioid epidemic has troubled other countries such as Scotland and Canada, the United States is substantially ahead in the statistics of overdoses. In just 2020, opioids were the cause of nearly 75% of the deaths related to drug overdoses in the United States, reaching a record high.
With no universal healthcare, legalised advertising of prescription drugs, and an overall societal reliance on medication, it is clear why and how Purdue Pharma, and arguably the FDA, were able to successfully produce highly addictive narcotics hidden as pain medication. Although OxyContin and opioids are physically detrimental, they are economically beneficial to some. Drug companies will spend upwards of $3 billion (£2.5 billion) to incentivise doctors to promote their drugs to patients, whether it be by paying them salaries of $1 million (£831,050) or bribing them with lavish free meals. By the time of their dissolution, Purdue Pharma, responsible for OxyContin, had a revenue of $35 billion (£29 billion), leaving the Sackler family with a fortune of $14 billion (£11.6 billion). Out of this $14 billion, the Sackler’s had to pay $6 billion (£5 billion) in lawsuits for their responsibility in the opioid crisis in the United States – without facing any criminal charges.
Opioids refer to drugs, medicinal or not, that can be synthetic (i.e., heroin) or semi-synthetic (i.e., OxyContin and codeine). The opioid crisis in the United States cannot be limited to one being solely addicted to pain relievers orillicit drugs; they are intertwined and often operate together. The first wave of the opioid crisis was initiated when OxyContin hit the markets. When OxyContin and prescription opioid addicts have reached their max, they turned to heroin, resulting in the second wave of the opioid crisis. Heroin, cheaper, more attainable, and resulting in similar highs, was OxyContin’s illegal, non-prescription twin. With no signs of slowing down, the third wave of the opioid crisis is undoubtedly in need of urgent concern – fentanyl addiction. A drug that is upwards of 100 times stronger than morphine and 50 times higher than heroin is the result of an irregulated prescription pain killer. As prices decrease, addictions increase.
A paramount statistic of the opioid crisis in the U.S. is that it primarily affects rural, low-income parties. When hurt in a physically demanding job, they have been prescribed OxyContin due to its promise of immediate pain relief. At a certain point, OxyContin can no longer provide its euphoric feeling, leaving many to turn to heroin and eventually fentanyl. Low-income areas are most affected by such an epidemic because they cannot afford to take time off when injured, and essentially require OxyContin to continue working to generate income. Not only are these areas impacted by the necessity of medicine so they can continue making a living, but also lack the funds to combat the crisis caused by big pharma and the lack of government assistance.
The opioid crisis, albeit starting in the United States, has spread to countries such as Italy, and developing countries like India. Mundipharma, another Sackler-owned pharmaceutical company, has pushed European countries with weak medical regulations to push the prescription of medical opioids. The trafficking and transportation of fentanyl introduced a new actor – China. 99% of the fentanyl being sold within the United States has been bought from China, being currently responsible for the ‘slaughtering [of] so many Americans,’ according to Representative Chris Smith. In the 2018 hearing regarding fentanyl connections from China, the U.S. government expressed ironic and arguably ignorant accounts. While it is factual to claim that there is a mass of fentanyl being sent from China, to impute the blame of the opioid crisis on the Chinese government is indecorous. The U.S. government has not only as much, but considerably more, responsibility in the continuation and lack of tackling the opioid epidemic. While Beijing puts fentanyl on its drug control export list, when will the U.S. place better control on the prescribing of OxyContin and other addictive painkillers?
It is plausible to say that Purdue Pharma and their development of OxyContin -- and misrepresentation of its addictive properties -- led to the opioid crisis which involves fentanyl and heroin abuse. In just 2020, the opioid epidemic cost the U.S. government $1.5 trillion (£1.2 trillion), and whilst the rates of opioid-related deaths continue to rise, so will the costs of the race to curb the epidemic. So, whilst the opioid epidemic is not beneficial for the U.S. government and economy, the question lingers of how Purdue Pharma was able to achieve that level of success. The answer is simple – reputation laundering was performed by the Sacklers by donating to government-owned and sponsored museums such as the Metropolitan Museum of Art and the Tate Gallery. The Sackler family themselves donated upwards of 30% more in a year than the oil company BP did to the Tate Gallery. The Metropolitan Museum of Art, owned by the state of New York, has a donor dependency of 98%, with the government only funding 2.6% of the total revenue that the museum generates. If governments were to push action against Purdue Pharma, they would be risking some of their biggest contributors to state-owned and governmentally funded institutions.
As of February 2023, despite a promise of a $125 billion (£103.8 billion) plan by President Biden to combat it, there seems to be no end to the opioid crisis. If the Sackler family, leaders of the crisis, can generate new pharmaceutical companies, then the stage is open for new waves of the opioid crisis. It is spreading faster than can be contained, and soon, it will be too late. The daunting slang term “dope sick” may be one that makes its way to the medical dictionary.
Image courtesy of Rose Wong via The Commonwealth Fund, © 2021, some rights reserved.
The views and opinions expressed in this article are those of the author and do not necessarily reflect those of the wider St Andrews Foreign Affairs Review team.
