Dopesick - Beth Macy Page 0,6
were already walking around with their shirts stained orange and green, it was definitely being abused.
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Approved by the Food and Drug Administration in late 1995, OxyContin was the brainchild of a little-known, family-owned pharmaceutical company called Purdue Frederick, based in Stamford, Connecticut. The company was virtually unheard of when a trio of research psychiatrists and brothers—Mortimer, Raymond, and Arthur Sackler—bought it from its original Manhattan-based owners in 1952, with only a few employees and annual sales of just $20,000. The new owners made their initial fortunes specializing in such over-the-counter products as laxatives, earwax remover, and the antiseptic Betadine, used to wash down the Apollo 11 spacecraft after its historic mission to the moon. Expanding internationally in the 1970s, the Sacklers acquired Scottish and British drug companies and paved the way for their entry into the pain-relief business with the development of an end-of-life painkiller derived from morphine, MS Contin, in 1984. (Contin was an abbreviation of “continuous.”) With annual sales of $170 million, MS Contin had run its profit-making course by the mid-1990s.
As its patent was set to expire, the company launched OxyContin to fill the void, with the intention of marketing the new drug, a reformulation of the painkiller oxycodone, beyond hospice and end-of-life care. It was a tweak of a compound first developed in 1917, a form of oxycodone synthesized from thebaine, an ingredient in the Persian poppy.
Famously private, the brothers were better known for their philanthropy than for their drug-developing prowess, counting among their friends British royalty, Nobel Prize winners, and executives of the many Sackler-named art wings from the Smithsonian to the Metropolitan Museum of Art.
Promotion and sales were managed by the company’s marketing arm, Purdue Pharma, launched in the nation’s best-known corporate tax haven—Delaware.
Purdue Pharma touted the safety of its new opioid-delivery system everywhere its merchants went. “If you take the medicine like it is prescribed, the risk of addiction when taking an opioid is one-half of 1 percent,” said Dr. J. David Haddox, a pain specialist who became the company’s point man for the drug. Iatrogenic (or doctor-caused) addiction, in the words of a 1996 company training session for doctors, was not just unusual; it was “exquisitely rare.”
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In the United States of Amnesia, as Gore Vidal once called it, there were people in history who might have expressed some skepticism about Haddox’s claim, had anyone bothered reading up on them. Ever since Neolithic humans figured out that the juice nestled inside the head of a poppy could be dried, dehydrated, and smoked for the purposes of getting high or getting well, depending on your point of view, opium had inspired all manner of commerce and conflict. The British and Chinese fought two nineteenth-century wars over it. And opium was a chief ingredient in laudanum, the alcohol-laced tincture used to treat everything from yellow fever and cholera to headaches and general pain. In 1804, at the end of Alexander Hamilton’s ill-fated duel, doctors gave him laudanum to numb the agony caused by the bullet that pierced his liver, then lodged in his vertebrae.
In the 1820s, one of Boston’s leading merchants masterminded an opium-smuggling operation off the Cantonese coast, spawning millions for Boston Brahmins with the names of Cabot, Delano (as in FDR), and Forbes. This money would go on to build many of the nation’s first railroads, mines, and factories.
Around that time, a twenty-one-year-old German apothecary urged caution when he published the first major opium breakthrough. Friedrich Sertürner had isolated the active ingredient inside the poppy, an alkaloid he named morphium after the Greek god of dreams, Morpheus. Sertürner quickly understood that morphine was exponentially more powerful than processed opium, noting that its side effects often progressed from euphoria to depression and nausea. He had not at all liked what the compound did to his dogs: It made them pass out drooling, only to awaken in an edgy and aggressive state, with fevers and diarrhea—the same state of withdrawal the opium-addicted in China had long referred to as “yen.” (What modern-day addicted users call dopesick or fiending, William S. Burroughs referred to as junk sick, gaping, or yenning.) “I consider it my duty to attract attention to the terrible effects of this new substance in order that calamity may be averted,” Sertürner wrote, prophetically, in 1810.
But his medical descendants were not so conscientious. Dr. Alexander Wood, the Scottish inventor of the hypodermic needle, hailed his 1853 creation by swearing that, whereas smoking or swallowing morphine caused addiction, shooting it up would not. No one