The Business of Addiction Oxycontin

The makings of an epidemic

In 1995 Purdue Pharma, owned by the Sackler family, began manufacturing Oxycontin, an extended-release version of the opioid Oxycodone. It was marketed as having low abuse liability as a result of it being slowly released into the body.

The packaging stated that “delayed absorption as provided by OxyContin tablets is believed to reduce the abuse liability of this drug“.

These claims were all subsequently found to be untrue. Purdue Pharma sent forth the message of its new product by arranging over 40 pain management and speaker training conferences from 1996 to 2001, the purpose being to recruit more physicians to prescribe the medication.

A database was built to identify clinical professionals who prescribed large amounts of opioids and the company increased the numbers of representatives to these individuals. Promotional items were provided. Brochures, stuffed toys, and OxyContin fishing hats.

BIG Media exposure

Marketing did not stop there. Television, magazines, newspapers, the internet, billboards, and direct mailing were all used to inform the public.

The techniques were an outstanding success for the company, and sales rose from $48 million in 1996 to $1.1 billion in 2000.

It wasn’t till March 2016 that CDC issued guidelines that advised doctors to only prescribe Oxycontin and other opioids as a last resort for pain, and then only at the lowest effective dose.

In 2018, Purdue Pharma patented a new type of buprenorphine, designed to help manage cravings for opioids such as Oxycontin.

The Florida Shuffle

It is not only pharmaceutical companies who are making big bucks from “the business of addiction”, where addicts are exploited for profit.

This same mentality exists within the rehab industry too. On paper, the rehab industry serves the interests of those with substance abuse problems. Addicts who go there are weaned off the drugs they had been taking and are given new skills so that they can go back out into the world and live respectable and fulfilling lives. And this is absolutely the case for many rehab centers.

Of course, it is naïve to think of rehabs as existing only for the benefit of addicts. They are, for the most part, businesses owned by private individuals who are seeking to turn a profit. But most rehabs strike a good balance between the clinical needs of the clients and the financial needs of the owners or shareholders.

This is not the case for some sections of the industry, where unscrupulous brokers work with treatment facilities that promise the brokers kickbacks to send them patients. Patients are found by seeking them out at 12-step fellowship meetings, drug courts, and homeless camps.

The brokers will then call round their list of rehabs to seek out the most competitive bid for the business of the patient.

Once the patient is at the facility, their insurance is billed for as much as can be got.

Facilities do this by gaming the system.

A common approach to maxing out bills for insurance companies is having clients complete drug tests daily.

Each drug test taken nets the rehab a couple of hundred dollars, which soon adds up when clients are spending 30 days at a facility.

The scam is so common that it has a name: the “Florida shuffle”, a title given to it based on the most common places for the rehabs operating the scam, and how clients are shuffled around in and out of rehabs, without receiving any real care.

Steps have now been taking to get tough on those operating the shuffle and dozens of those who got rich from the racket went to jail. We have not seen the end of the Florida shuffle, though.

There are still centers up and down the country that are making money from it, but their activities have now been driven underground, making it more difficult for law enforcement agencies to put a stop to it.

Pill mills

It is not only rehabs that made money on the suffering of others in Florida.

“Pill mills”, which until the mid-2010s handed out opioids such as Purdue Pharma’s Oxycontin, also did very well.

The mills operated in a similar way to the exploitative rehab centers, and enlisted brokers who would receive around $100 for each patient they brought who would pay in cash.

Summary

These three industries prey on the most vulnerable members of our society, which is perhaps why they were and, in some cases, are still able to get away with their immoral actions.

The people being exploited, in the lowest rungs of society and often seen as criminals and deviants, are people for whom no love is lost.


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