The family behind OxyContin raked in billions of dollars as it pushed to keep patients on the powerful painkiller longer despite evidence that the drug was helping to fuel the nation's deadly opioid crisis, Massachusetts authorities allege in newly public court documents.
While aggressively marketing OxyContin, the Sackler family also sought to profit off the drug abuse crisis its company helped create by exploring selling drugs used to treat addiction and reverse overdoses, state lawyers contend in previously secret parts of their lawsuit against Purdue Pharma.
Attorney General Maura Healey is suing Connecticut-based Purdue Pharma, along with some company executives and members of the wealthy Sackler family, in an effort to hold them accountable for the toll of the state's drug crisis. Massachusetts' is the first state case to personally name members of the Sackler clan, whose name is emblazoned on walls at some of the world's great museums and universities.
Purdue had fought to keep the new allegations secret, but three courts ruled against the company. Its lawyers said after the wholly unredacted complaint was released late Thursday that Massachusetts is trying to "single out Purdue, blame it for the entire opioid crisis, and try the case in the court of public opinion rather than the justice system."
Health officials say nearly 48,000 overdose deaths in the U.S. in 2017 involved some type of opioid, including illicit drugs.
Massachusetts accuses Purdue of keeping track of doctors who were potentially overprescribing OxyContin, but failing to report them to authorities. In 2012, one Purdue employee told an executive that the company should tell insurance companies the names of the doctors suspected of illegal prescribing, calling it the "right and ethical thing to do."
"If it reduces abuse and diversion of opioids then it seems like something we should be doing," the employee wrote in an email. The executive rejected the employee's suggestion, and the secret list of the suspected illegal prescribers, known as "Region Zero," continued to be kept, lawyers say in the complaint.
The lawsuit, filed in state court, also details tactics that the state says Purdue and the Sacklers used to keep patients on the drugs longer and get more patients taking higher doses -- even as that made them more prone to addiction. Meanwhile, the Sacklers paid themselves more than $4 billion from 2007 through last year, according to the lawsuit.
Richard Sackler, who served as Purdue president for several years, told management in a 2008 email that they should "measure our performance by Rx's by strength, giving higher measures to higher strengths."
Years later, the state says in the suit, consulting firm McKinsey & Co. advised Purdue that it could increase opioid prescriptions by sending sales reps dozens of times per year to visit prolific prescribers.
The Sackler family was given a report in 2012 that found savings cards to help pay for OxyContin led to 60 percent more patients using the drug for more than three months. An internal company report from that year found that every dollar invested in the savings cards brought in more than $4 in additional sales.
In 2014 and 2015, Purdue considered selling suboxone, a drug used to treat addiction, the lawsuit says. "It is an attractive market," an internal memo read, according to the suit.
The company later explored selling naloxone -- known by its brand name Narcan -- which reverses overdoses, the state's lawyers contend. A presentation made to the board in 2016 said that Narcan could bring in $24 million in sales to Purdue through 2025, the complaint says.
"Purdue's analysis of the market for Narcan confirmed that they saw the opioid epidemic as a money-making opportunity and that the Sacklers understood -- in private, when no one was watching -- how Purdue's opioids put patients at risk," attorneys for Massachusetts wrote.
Purdue said the lawsuit is taking pieces of company documents out of context.
"Massachusetts seeks to publicly vilify Purdue, its executives, employees and directors while unfairly undermining the important work we have taken to address the opioid addiction crisis," the company said in an email.
The company said it was doing due diligence on buying rights to the anti-addiction drug, which was already on the market. Purdue never went into the suboxone or naloxone business.
The suit is one of more than 1,000 by state and local governments pending against Purdue. A federal judge in Cleveland overseeing lawsuits filed in federal court is pushing for a settlement aimed at stemming the crisis.
Massachusetts lawyers say while the company was secretly considering ways to profit off trying to cure addictions, it was while publicly deflecting blame for the crisis. For instance, Richard Sackler said in an email at one point that the company had to "have to hammer on the abusers," calling them "the problem" and "reckless criminals."
Jonathan Novak, a Dallas lawyer who is representing several governments, including the state of Utah and the city of Albuquerque, in lawsuits against the drug industry, said the Massachusetts lawsuit could provide a roadmap of documents for other plaintiffs. Novak said the state's approach is important to the telling of the opioid crisis story.
"These are the people who invented the drug," he said. "These are people who blame patients who got addicted and call them criminals."