City Councilor Tito Jackson has made the drug addiction epidemic a centerpiece in his campaign for mayor, lamenting “an opioid crisis which has not been addressed.”
But long before the scourge of widespread opioid abuse fully came into public view, Jackson worked as a pharmaceutical sales representative, and it was his job to convince doctors, pharmacies, and medical experts that one opioid in particular — the morphine-based Kadian — was an alternative to better-known drugs like OxyContin.
Jackson marketed Kadian for New Jersey-based Alpharma when he worked for the company from 2004 until 2006. The Food and Drug Administration describes Kadian as a “long-acting (extended-release) opioid pain medicine that can put you at risk for overdose and death.”
In a recent interview, Jackson described his pharmaceutical sales work as long in the past.
“For two years over a decade ago, I marketed a pain medication to doctors who provided care for end-of-life and cancer patients,” Jackson said. “And I was proud to work with talented doctors to help ensure patients received the best care they deserved.”
“I haven’t been in that world for well over a decade,” he said.
In addition to Alpharma, Jackson previously worked in pharmaceutical sales for a year at Eli Lilly and three years at Ortho-McNeil, where he marketed other products.
Regarding his work for Alpharma, Jackson described “huge potential for Kadian growth” in his territory in a document laying out market opportunities and weaknesses for the drug. He said his short-term marketing strategy would be to “identify and develop local thought leaders to promote and educate the advantages of Kadian” and “try to get it stocked in at least one pharmacy in each town covered.”
That document became part of a lawsuit Jackson filed in 2007, claiming that he and others were underpaid for their work. In the document, Jackson noted that one challenge to the pharmaceutical company’s business was “docs’ shyness because of issues . . . with Oxy and also law enforcement.”
Now, as he mounts a campaign for mayor, Jackson’s role as a pharmaceutical salesman more than 10 years ago has not been widely discussed.
The opioid epidemic is seen as a significant health crisis — nearly 2,000 died of overdoses in Massachusetts last year — and public officials and health experts are desperate to find ways to eradicate it.
Policy makers recognized the dangers posed by the pain-relieving drugs in the mid-2000s, though the issue wasn’t as prominent as it is now. State lawmakers established a commission in 2004 aimed at “OxyContin and other drug abuse.” From 2004 until 2006, when the commission released its report, the state’s opioid deaths rose 29 percent, from 494 confirmed deaths to 635.
But the problem had drawn nowhere near the public attention that it has in recent years. In 2016, the state estimated that unintentional opioid-related deaths had reached 1,979.
Several medical professionals contacted for this article were unfamiliar with Kadian.
‘We were wrong. But there was also this tremendous pressure from people who were making a lot of money to get us to [prescribe] them.’Dr. Barbara Herbert, referring to opioids
But discussing opioids broadly, Dr. Barbara Herbert, director of addiction service at Commonwealth Care Alliance, said: “They do help people get out of pain, so the coming consequences were not immediately apparent, because [doctors] were able to help people, and we wanted to believe — and it was very much in the drug industry’s interest to have us believe — that we could make people better.”
She added: “We were wrong. But there was also this tremendous pressure from people who were making a lot of money to get us to [prescribe] them.”
Opioid use has been widely linked to addiction to heroin, which can be purchased more cheaply on the black market than the prescription drugs.
In 2014 Senate testimony, Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, called “aggressive marketing by pharmaceutical companies” one of several factors that probably “have contributed to the severity of the current prescription drug abuse problem.”
Jackson was fired from Alpharma in 2006 after failing to meet company standards for administrative work, including his expenses, according to court documents. Pressed last week on the reasons for his termination, Jackson replied, “The company noted that it was a performance issue.”
The company itself ran into significant trouble, too.
In 2010, Alpharma settled for $42.5 million with the Department of Justice to resolve False Claims Act charges that the firm had paid providers to encourage Kadian prescriptions and misrepresented the drug’s safety and effectiveness. The settlement resolved a 2006 whistle-blower lawsuit in which Jackson was not named. Two years later, the company was acquired by another firm, King Pharmaceuticals, which itself was later purchased by Pfizer.
Jackson, who was elected to the Boston City Council in 2011, is challenging Mayor Martin J. Walsh, arguing that the first-term mayor is too cozy with big business and has not done enough to help improve public schools.
He has also ripped Walsh for closing the Long Island bridge, which connected the mainland to substance abuse treatment programs on the island.
And recently he called a decision by Walsh to shutter a 40-bed drug treatment facility on Southampton Street this month a “disgrace.” The administration maintains that it intends to place residents in permanent housing and continue their treatment services.
“Boston is facing an opioid crisis which has not been addressed,” Jackson says on his campaign website.
Walsh enters the race with the significant advantages of incumbency; no Boston mayor has lost a campaign for reelection since 1949.
To Jackson’s $78,000 in campaign funds, Walsh claims more than $4 million.
But Walsh also brings some of the vulnerabilities of the office, including a federal investigation that has entangled his administration.
In addition to his work in pharmaceutical sales, Jackson worked in Governor Deval Patrick’s economic development office and, later, as political director of Patrick’s reelection campaign.
Jackson’s LinkedIn profile says he was promoted to regional specialist after just six months with Alpharma, where he was “responsible for creating and accelerating sales.” He developed national, regional, and local thought leaders to “support product market penetration” and facilitated education for “key physicians . . . to inform them about Kadian.”
Jackson’s 2007 suit against Alpharma, filed in federal court in New Jersey, alleged that he and other sale representatives were not paid “for all hours worked as required by law.” It was ultimately dismissed.Jim O’Sullivan can be reached at firstname.lastname@example.org. Follow him on Twitter @JOSreports.