By Jonathan S. Jones
(We've invited Jonathan Jones, the first presenter of our 2019
Civil War Speakers series to blog for us this week. Jones will be speaking here
at the museum Thursday April 4th at 7 pm. See the link at the bottom to read
the full piece.)
Newly unsealed documents from a lawsuit by the state of
Massachusetts allege that Purdue Pharma, maker of OxyContin and other addictive
opioids, actively sniffed out new, sinister ways to cash in on the opioid
crisis.
Despite years of negative press coverage, unwanted attention
from regulators, multi-million dollar fines and several major lawsuits, Purdue
staff and owners sought to expand the company’s sights beyond its usual array
of opioid painkillers. Purdue planned to become an “end-to-end pain provider,”
by branching into the market for opioid addiction and overdose medicines,
looking to peddle these medicines even while the company continued to
aggressively market its addictive opioids. Internal research materials coldly
explained the rationale behind this plan: “Pain treatment and addiction are
naturally linked.”
As thousands of Americans continue to overdose on opioids
annually, Purdue’s secret marketing
research predicted that sales of naloxone, the overdose reversal drug, and
buprenorphine, a medicine used to treat opioid addiction, would increase
exponentially. Addiction to Purdue’s opioids would thus drive the sale of the
company’s opioid addiction and overdose medicines. Purdue even planned to
target as customers patients already taking the company’s opioids and doctors
who prescribed opioids excessively, according to the Massachusetts lawsuit
filing. To keep the plan quiet, Purdue staff dubbed the scheme “Project Tango.”
The audacity of Project Tango enraged many observers. But
considered in historical context, the news that Purdue sought to peddle opioid
addiction medicines while continuing to sell opioids seems less surprising. In
fact, there is clear historical precedent for Purdue's business plan. Over a
century ago, "patent medicine" sellers pioneered this strategy during
the U.S.'s Gilded Age opiate addiction epidemic.
 |
| Collier’s ad, Dec., 1905, after the publication of articles on patent medicine fraud. Wikimedia Commons |
Opiate addiction in the Gilded Age
Opiates were some of the most commonly prescribed medicines in
American history until the 20th century. Pills containing opium, hypodermic
morphine injections and laudanum, a drinkable liquid concoction of opium and
alcohol, constituted half or more of all medicines prescribed in American
hospitals during most of the 19th century, according to research by the
historian John Harley Warner. Opiates were also present in countless “patent
medicines,” over-the-counter panaceas made of secret ingredients, often sold
under catchy brand names like Mrs. Winslow’s Soothing Syrup. Americans could
choose from 5,000 brands of patent medicines marketed for all manner of
ailments by the 1880s. In 1904, just before federal oversight began, patent
medicines had matured into an astonishingly profitable industry, with estimated
sales at US$74 million dollars annually – equivalent to about $2.1 billion
dollars today.
Opiate-laced prescriptions and patent medicines often caused
addiction. The historian David T. Courtwright estimates that opiate addiction
rates in the U.S. skyrocketed to 4.59 per thousand Americans by the 1890s – a
high rate, although lower than the rate of fatal opioid overdoses in recent
years. Most individuals developed addictions through medicines, rather than the
infamous smoking variety of opium. Victims of “the habit” cut across
demographic lines, encompassing middle-class housewives suffering from
menstrual pain, Civil War veterans reeling from amputations and many others in
between.
To read his complete article published March 4, 2019 in The Conversation:
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