just say no
In a recent interview actor Matthew Broderick conceded that to many, myself included, he will always be Ferris Bueller. Having just binged-out on the Netflix series, Painkiller, I’d like to say to Ferri…er, Matthew, not to sweat it too much as there are far worse characters to be permanently associated with than the movie’s eternal teenage optimist, a chancer with chutzpa. About as far removed from a 80s comedy classic, Painkiller tells the harrowing true story of America’s opioid epidemic and the insidious role played by the Sackler family who, via their company, Purdue Pharma’s development of OxyContin, singlehandedly created a devastating health crisis.
In the time before OxyContin, drug overdose deaths in the US remained fairly steady at around 9,000/year, largely because illegal heroin markets were small and stable. Then in the 90s deaths began to rise sharply and by 2000, almost 20,000 were dying from overdoses annually. A year later the number topped 100,000. For context, at the height of the HIV epidemic, fewer than 50,000 were dying from the disease; over the past 25 years, the US has lost more lives to drug overdoses than to both World Wars combined. The lion’s share of these were caused by opioids, a term which encompasses both natural opiates such as morphine and heroin, and synthetic compounds possessing similar properties.
The 1995 approval of Purdue Pharma’s OxyContin is as reasonable a point as any to date the beginning of the modern opioid crisis. Incredibly, without any detailed evidence or discernible clinical trials, the US Food and Drug Administration (FDA) approved the painkiller for use in pain management scenarios such as arthritis, back pain and sports injury. Consequently, it was handed out in unprecedented quantities with precious little consideration to any addictive nature and prescriptions peaked in 2012 at 255 million. However, the Sacklers fully understood the addictive nature of their new wonder drug and (SPOILER ALERT) had co-opted a complicit FDA: the regulator, who oversaw the approval of OxyContin left the agency shortly after its acceptance for a big-ticket job at, surprise-surprise, Purdue Pharma.
And just when you’d’ve thought it couldn’t get any worse, it did. Enter stage left, fentanyl, an opioid up to a hundred times more powerful than morphine. While a lethal dose of heroin is about 30mg, just 3mg of fentanyl, equivalent to a few grains of salt, would kill an average-sized adult. Being synthetic – made in labs from chemicals – it’s way cheaper to produce and so much easier to transport and smuggle. Cutting it into your crushed OxyContin pill turned an already dire situation into a public health catastrophe.
Meanwhile, back in the family’s boardroom, Purdue Pharma pleaded guilty to federal felony charges that it had mislead regulators, doctors and patients about OxyContin’s risk of addiction and abuse. In 2019, it filed for bankruptcy and, the following year, concluded a settlement deal in excess of $8bn. Perhaps not quite as dramatic as a Ferrari 250GT California Spyder being written off, and certainly no form of compensation for the loss of hundreds of thousands of lives, but be thankful for your endearing legacy, Ferris.
