The problem was so widespread that Super Bowl ads now targeted relievers of opioid-caused constipation. “Purdue had a laxative they marketed, too,” Ramseyer said, of Senokot. In fact, according to the rep-call notes subpoenaed for the case, OxyContin and Senokot were routinely recommended hand in hand. “So they got you on both ends!” Ramseyer said.
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Conspicuously absent from the courthouse drama was the family that owned the company and its 214 affiliates worldwide—and benefited the most from the drug’s sale. Purdue had earned over $2.8 billion from the drug by 2007, including $595 million in earnings in 2006 alone. Unlike a public company that answers to shareholders, privately held Purdue answered only to the Sacklers.
In 2015, the family would earn its way onto Forbes’s “America’s Richest Families” list. With an estimated net worth of $14 billion, the OxyContin clan would edge out such storied families as the Busches, Mellons, and Rockefellers. Having gone from selling earwax remover and laxatives to the most lucrative drug in the world, the family had museum wings and college institutes named for it from Boston to Tel Aviv.
Mortimer Sackler even had a pink climbing rose named after him, courtesy of his gardener wife. The official description of this flower, the Rosa Mortimer Sackler, reminded her of her husband, she said: “The blooms give the impression of delicacy and softness but are, in fact, very tough and little affected by bad weather.”
Mortimer may have inherited his toughness from his older brother, Arthur, who’d put himself and his two brothers through medical school by selling student newspaper ads and delivering flowers, sometimes with holes in his shoes.
The Don Draper of American pharmaceutical marketing, Arthur pioneered the idea of showering doctors with favors and funding experts to back drugmakers’ claims in the 1960s. It was his marketing genius that fueled the emergence of pills as a quick fix, his marketing prowess that delivered Valium and Librium, dubbed Mother’s Little Helper by the Rolling Stones, to countless nightstands.
Realizing the importance of controlling his company’s message, Arthur had launched both a medical advertising agency and a medical newsmagazine before buying Purdue Frederick with his brothers. It was under his direction that preliminary and inevitably flawed scientific studies were first used to buttress the wonders of whatever drug he was hawking; no wonder his brothers thought nothing of excavating the flimsy and outdated letter heralding the “less than 1 percent” addiction rate nearly a decade after Arthur’s death.
What in fact was the addiction rate among those prescribed opioids for chronic nonmalignant pain? More recent studies—not letters to the editor penned in 1980—put the figure as high as 56 percent. At the time of his death, in 1987, Arthur was lionized for his entrepreneurial vision and boundless obsession for collecting things. Especially art. He once talked the Met into letting him reimburse the museum for four major works that the museum already owned just so he could have them displayed with his name as the donor.
Still, he had not been fully embraced by the Upper East Side society to which he aspired—not until his memorial service, held at the storied Temple of Dendur, inside the Met’s Sackler Wing, at which New York mayor Ed Koch remarked: “I don’t know why, but Jews aren’t buried in synagogues. Well, Arthur built his own temple.”
Arthur Sackler hated not just bad press but any press that was not of his own directing, a Vanity Fair writer observed shortly after his death. As obsessive about secrecy as he was about moneymaking and art, he would have abhorred everything about the Abingdon hearing.
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At the courthouse, testifying before the judge, the relatives of the dead argued repeatedly for jail time. As did Public Citizen, a consumer advocacy group that vented: “Why have three wealthy Purdue executives, who have pleaded guilty to orchestrating this dangerous promotional campaign, escaped jail time, and why are they paying merely $34.5 million in penalties?” Even a fellow prosecutor in Brownlee’s office felt Purdue’s punishment was too light: “The dividends may go slightly down, but nobody cares because nobody who made the product goes to jail. If the government were serious, they’d put people in jail, and [others would be] fearful,” said Assistant U.S. Attorney Andrew Bassford, who would spend most of the next decade prosecuting heroin dealers as a direct consequence of the OxyContin epidemic, down the hall from the office where Brownlee worked. “But you can’t put a corporation in jail; you just take their money, and it’s not really their money anyway.
“The corporation feels no pain.”
Van Zee and Sister Beth viewed the settlement with both satisfaction and regret. Though the executives were placed on probation for three years and ordered to perform four hundred hours of community service in a drug abuse or drug treatment program, Van Zee and Sister Beth were furious that the Purdue fine would not be allocated to provide drug treatment in the medically underserved region. “This little county was left with nothing, even though we’ve been disproportionately impacted” by the drug, Sister Beth said.
The $634.5 million fine was instead divided among law enforcement, state, and federal Medicaid programs (to reimburse it for claims resulting from the misbranding); to create Virginia’s Prescription Monitoring Program; and to settle $130 million in civil claims.
The only thing the Lee County sheriff’s office got from Purdue was placebo OxyContin pills for use in drug stings.
Many anti-opioid activists were mad, too, that technically it was Purdue Frederick, Purdue Pharma’s holding company, that was banned from participating in the federal insurance programs Medicaid, Medicare, and Tricare as part of its five-year probation—rather than Purdue Pharma itself, which was still permitted to participate, and therefore to continue selling OxyContin. (“They are independent, associated companies,” a spokesman explained.) The executives were likewise banned from doing business with federal health programs, a decision they repeatedly appealed in intervening years and lost, leading one federal district judge to scold: “Plaintiffs appear to misunderstand or misstate the basic elements of their conviction.”
“It’s very typical for these companies to have an entity that is a shell company, basically, set up to plead guilty to the crime, rather than the actual corporate entity taking the fall,” Meier said.
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Flanked by state and federal flags, Judge Jones admitted that the lack of jail time frustrated him. But the Abingdon federal judge’s hands were tied by the plea agreement struck between Purdue and the prosecutors, he said. He would have preferred that parts of the fine be funneled into treatment, adding that prosecutors were reluctant to “direct treatment funds in a manner beyond their expertise and possibly contrary to national policy.”
Asked nearly a decade later about the aftermath of the Purdue Pharma settlement on the communities his court covers, Judge Jones told me: “Opioid addiction continues to be, frankly, a terrible concern.…It’s rare that I don’t have a case today involving substance abuse.”
He declined to divulge the details of the executives’ probation, citing privacy concerns, other than to say they completed it, to his satisfaction, in their home state of Connecticut.
When Howard Udell died unexpectedly of a stroke, in 2013, at the age of seventy-two, a local newspaper heralded him for having turned his community service into a redemptive experience. After counseling veterans at a Veterans Administration hospital on job skills, Udell went on to found the Connecticut Veterans Legal Center, helping hundreds of veterans navigate problems including evictions, dishonorable discharges, and substance-abuse-related crimes. Even after his community service hours were completed, Udell stayed on to assist the legal center. “It was very unpleasant for Howard, who was scrupulously honest and careful, but we endeavored to make the most out of it,” said Friedman, who also performed his community service at the site, according to the newspaper, which described the executives’ initial service there, euphemistically, as “volunteer.”