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    Yvonne Abraham

    Maura Healey’s suit against Purdue Pharma shows recipe for addiction

    Attorney General Maura Healey’s lawsuit against Purdue Pharma claims that the company, led by members of the Sackler family, incentivized the opiate explosion every step of the way.
    Jessica Rinaldi/Globe Staff/file 2017
    Attorney General Maura Healey’s lawsuit against Purdue Pharma claims that the company, led by members of the Sackler family, incentivized the opiate explosion every step of the way.

    Want to feel (more) enraged?

    Take a spin through Attorney General Maura Healey’s lawsuit against Purdue Pharma. In excruciating detail, it lays out how the maker of OxyContin and other opioids pushed its deadly products on vulnerable patients as aggressively as any street dealer would — and with less regard for the consequences, according to damning internal documents recently made public as part of the lawsuit.

    The complaint — one of many filed against the company across the country — claims that Purdue, led by members of the Sackler family, incentivized the opiate explosion every step of the way.

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    The company allegedly denied and downplayed the addictive potential of its drugs. It gave patients discounts for their first prescriptions, making it more likely they’d stay on the drugs for longer. It pressured doctors into prescribing OxyContin more often, in higher doses, and for longer periods, lavishing them with gifts and money for doing so.

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    The company marshalled an ever-expanding army of sales reps, rewarding them with free trips and bonuses for growing prescriptions, even as the bodies of overdose victims piled up.

    And the Sackler family whitewashed their obscene profits via donations to prestigious medical and cultural institutions, including Tufts University and Mass. General Hospital.

    All of it helped fuel an epidemic of addiction across the country. The attorney general claims Purdue was aware of how its drugs and its aggressive marketing practices were harming people, but that company officials, led by Richard Sackler, hid the abuse and deflected blame — largely onto those who had become addicted.

    “We have to hammer on the abusers in every way possible,” he wrote in a 2001 e-mail. “They are reckless criminals.”

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    According to an unredacted version of the complaint obtained this week by ProPublica and STAT, Healey contends that Purdue paid consultants McKinsey & Co. to counteract damaging stories about addiction and overdose deaths, including “the emotional messages” of grieving mothers.

    In Massachusetts alone, Purdue sold more than 70 million doses of opioids between 2007 and 2018, collecting $500 million in revenue. In that period, sales reps paid more than 150,000 visits to prescribers and pharmacists.

    Purdue’s 100 most prolific prescribers were targeted more than 200 times each on average, according to the lawsuit. These doctors were at least 10 times more likely to prescribe Purdue opioids to patients who later overdosed and died.

    Some of the doctors were punished for doing what Purdue sales reps had urged. Dr. Walter Jacobs, Purdue’s highest paid spokesman in Massachusetts, prescribed more than 347,000 pills between 2008 and the time he lost his license in 2012, delivering a return of $3 million on Purdue’s $80,000 investment in him. Sales reps visited Jacobs more than 100 times in that period. Purdue reps visited another doctor in Fall River more than 600 times, including almost every day in 2015, and he committed to prescribing ever more opioids, even discussing specific patients.

    Even when sales reps recognized clear red flags, Purdue almost never alerted authorities to potential over-prescribers, as required. Instead, they continued to push some of these very doctors to write yet more prescriptions. Richard Sackler micromanaged sales reps to make sure they were raking in enough money for his family, according to the lawsuit.

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    Whenever this rotten arrangement was exposed, doctors and patients took the fall. The Sacklers kept their billions.

    Purdue Pharma has denied the claims contained in the Massachusetts complaint, arguing that Healey has mischaracterized and cherry-picked internal documents.

    The denials would be more convincing if Purdue hadn’t been busted before for misleading doctors and patients. In 2007, company officials pleaded guilty to federal felony charges for misbranding OxyContin “with the intent to defraud or mislead,” by downplaying the drug’s addictiveness.

    According to ProPublica, the lawsuit claims Purdue paid two of those officials millions of dollars to ensure their loyalty. The company paid a fine of $600 million, and promised not to deceive doctors and patients again.

    Since 2009, the attorney general’s office says, 671 people who filled prescriptions for Purdue opioids in Massachusetts have died of opioid-related overdoses.

    That is one heck of a broken promise.

    Globe columnist Yvonne Abraham can be reached at yvonne.abraham@globe.com. Follow her on Twitter @GlobeAbraham.