In this article, we delve into how the label of ‘conspiracy theory’ was strategically used to discredit critics of Big Pharma, focusing on the case of OxyContin. Discover the manipulative tactics of Purdue Pharma, their pivotal role in the opioid crisis in the US, and the broader implications for society. Uncover the sinister interplay of discrediting opponents, redefining terminologies, and the sway of financial interests over public health.
Subject of the Article
In 2022, I watched a series on DISNEY titled Dopesick, which showcases the issue of opioid addiction, based on a book by Beth Macy. I read the book twice. The topic, as well as the ruthlessness and, it should be emphasized, the audacity of the OxyContin producer, outraged me so much that I began to delve into the subject by watching more documentaries on HBO, YT. In the meantime, the opioid crisis was growing in the USA, and social media was flooded with videos of “zombie” people addicted to opioids. After reading a significant amount of material and reflecting, I decided to describe the methods of manipulation and the mechanisms of creating conspiracy theories.
In the article, I will deal with various threads, but above all, the label of “conspiracy theory”. I’m talking about two understandings:
Pejorative labeling of scientists, investigators, journalists, politicians, activists who sought to explain the negative impact of the drug OxyContin. By creating a false narrative, the pharmaceutical company Purdue Pharma made people look uneducated, backward villagers or supporters of detached conspiracy theories who are completely at odds with science and facts.
On the other hand, those fighting against OxyContin argued that there is a big pharma conspiracy with bribed scientists and federal officials. As it turns out, this conspiracy theory was confirmed by facts and ceased to be called a “conspiracy theory” (I explain this distinction more broadly in the article, distinguishing a conspiracy from a conspiracy theory).
A drug used in palliative medicine becomes the most popular analgesic in the USA
It’s worth introducing the reader to the problem of opioid-based painkillers. OxyContin, according to many authors, is at the root of the current opioid crisis in the USA. What is this drug?
Before being introduced to the mass market as an ordinary and, let’s not be afraid to say it, the most popular analgesic in the USA, it was a strictly designated drug used in palliative medicine for pain treatment, e.g., in cancer, as a substitute for morphine. This is a potent drug equivalent to morphine and just as addictive. It contains a substance called oxycodone. It’s an opioid that blocks receptors in the brain and spine, reducing pain perception.
How was the drug approved for mass sale?
To shorten the whole story. A trick was used which consisted of quoting and distorting a letter that was a response in a scientific journal. This text was an excerpted study that was not scientific in nature. The text was selectively quoted, which, according to the applicants to the FDA (the drug-approving agency in the USA), proved that OxyContin is 50% less addictive than morphine. Based on this pseudo-study and Purdue Pharma’s application, the drug was easily approved for sale in 1995. The manipulation of scientific results was that these were not scientific studies because they were conducted on a small group of patients. Presented manipulated and false data.
It’s worth mentioning that FDA approval would not have been possible without Dr. Curtis Wright. As an official of this federal agency, he played a leading role in approving the drug for sale in the USA, but the best part is, after the drug was approved, he was hired as an employee of Purdue Pharma. The fact that a person responsible for reviewing and approving drugs pushes through a drug with manipulated data, only to later start lucrative work and receive huge amounts of money is, to put it mildly, controversial. When journalists drew attention to these controversies and the potential conflict of interest, a wide range of manipulative techniques were used to defuse the crisis.
The media began reporting on the misuse of the drug OxyContin, presenting the issue as a serious social problem leading to an increase in crime. Ordinary and settled individuals, after being prescribed the painkiller by a doctor, quickly became addicted. In response to this, it quickly became apparent that the drug manufacturer had to combat criticism regarding the drug’s effects and usage, employing an aggressive campaign.
The central point of today’s note is the phenomenon of labeling individuals threatening the interests of Big Pharma as “conspiracy theorists”. Various methods are used in manipulation, such as undermining authority. In this context, we refer to the authority of another scientist or institution to question individuals challenging research results or drug efficacy.
The Sacklers, owners of the corporation and producers of the drug, created a network of pain treatment clinics and facade institutes that issued opinions undermining the statements of those who pointed out the addiction problem (opioid crisis) and the drug’s adverse effects.
Let’s analyze in more detail the methods used in this matter…
Manipulation Techniques Used by Purdue Pharma
Ambiguous Terminology, Redefining Pain, and…
As we know, Purdue Pharma manipulated the concept of pain, introducing a scale from 1 to 10 where patients subjectively rated their pain. A whole marketing campaign around pain was developed, from clinics to sponsored and manipulated studies (Purdue Pharma admitted to this in a lawsuit; see the Department of Justice documentation in the footer).
Ambiguous terms were also used to describe potential side effects of the drug, misleading not only doctors but primarily patients. A prime example is the so-called “slow drug release” or twelve-hour cycle, which was allegedly designed to prevent overdosing.
With the escalation of addiction problems to the drug, as the scale of the problem began to be widely noticed by local and national media, PR specialists hired by Purdue Pharma to manage the crisis, along with paid scientists, had to quickly defuse the reputational bomb. They did this by redefining the concept of addiction. All of this was made possible by appealing to common sense (common sense) - this is very intriguing and will be expanded upon in a subsection of this article and in a separate article. Namely, the impact of so-called common sense in building these narratives and mitigating the crisis.
In educational and marketing materials for doctors, the company redefined the concept of addiction, arguing that the problem that emerged and its evaluation (the escalation of the social problem of opioids and addictions) resulted from a misunderstanding of the concept. According to studies and scientists funded by the company, the symptoms of so-called addiction in patients treated for chronic pain were actually manifestations of pseudoaddiction. Following this twisted and paradoxical line of thought, pseudoaddiction is the result of inadequate pain treatment, meaning (yes, you read that right)… the dosage should be increased and the patient should be treated more aggressively. Let common sense prevail over the superstitions of provincial doctors and real science - so shouted the PR experts and paid medical celebrities.
Let’s not be afraid to say it. Purdue Pharma introduced the concept of pseudoaddiction in the USA, leading to even greater addiction in individuals taking opioid-based painkillers and escalating the social crisis. OxyContin is as potent and addictive as morphine. The company’s actions significantly contributed to the opioid crisis in the USA.
The tactic of redefining concepts was part of a broad manipulative strategy aimed at promoting the drug as safe and low-risk for addiction.
Ad Hominem Attack
Among doctors and marketers, those raising the issue of the opioid problem escalation were often called drug addicts, provincial alcoholics, or provincial idiots (see Beth Macy). Specialized PR agencies looked for dirt and published false information. Doctors who refused to prescribe painkillers en masse were accused of lacking empathy and taking away people’s dignity. After all, they are denying people the right to live without pain, said corporate-paid specialists.
This is a well-known manipulation technique where, instead of questioning an opponent’s arguments, one attacks their person, motives, or character traits. Scientists and doctors who raised concerns were discredited by questioning their motives and competence rather than directly addressing the allegations.
Appeal to Authority
Methods were used that involved paying off authorities in the medical and pharmaceutical sectors. Doctors were offered fabulous commissions for prescribing the drug. Medical conferences and educational events were sponsored, where OxyContin was promoted and so-called pain treatment was promoted.
Research was funded that confirmed the drug’s efficacy. Thus, an entire system of allied experts, think tanks, and pseudo-scientific institutes was created, intended to silence negative voices and indicate that the drug is safe (See the article “Inside Purdue Pharma’s Media Playbook…”).
The launch of this information and manipulation campaign convinced doctors that OxyContin was a safe drug, and it quickly became the most popular painkiller in the USA. Consequently, this drug was responsible (as proven) for a sharp increase in opioid addiction rates.
“Only nine years later was it to be revealed that members of the DFA and pharmaceutical company directors had been meeting at least once a year since 2002 for confidential consultations in expensive hotels under the guise of an industry-financed non-profit organization. This ethical issue was revealed by a reporter from the *Milwaukee Journal Sentinel in 2013. These meetings led to the creation of enriched recruitment - aptly named practices that allowed pharmaceutical companies to exclude from studies those who did not respond well to their drugs, undermining their scientific value but making it easier for the FDA to approve a new remedy.” Beth Macy, “Drug Mania: How Pharmaceutical Companies and Doctors Can Get Patients Addicted to Drugs” (2019, LOC 1121 of 6298)
Additionally, as investigative journalists discovered, the company hired lobbyists who pressured the government not to introduce regulations limiting access to opioids. They also blocked the investigation at an early stage. Purdue Pharma also funded information campaigns discouraging opioid addiction treatment, which, looking at the current situation with the opioid crisis, is an exceptional moral degeneration.
Appeal to Emotions
Leveraging the emotions that sick and suffering people evoke. Focusing on the concept of pain relief and the right to a dignified life. Appealing to fear and anger, empathy in opposition to logical arguments that might be raised in the case of addictions. According to this method of manipulation, if you are not empathetic, you are consequently denying people the right to dignity. And why do you ask so much about potential risk, wouldn’t it be better to focus on the positive aspects?
Avoiding Uncomfortable Topics
This is an excellent method of manipulation. It’s essential to remain silent and avoid uncomfortable topics in the discussion, such as overdosing on medication, side effects, or inconsistency with the specification talking about the supposed slow release of the drug meant to protect the patient. The Sacklers were not without reason some of the most significant donors to charitable organizations, museums, and social organizations. Such people surely couldn’t be behind the opioid crisis in the USA.
For your interest, here are some institutions supported by the Sacklers: Metropolitan Museum of Art in New York, Tate Modern in London, Museum of Modern Art in New York, National Gallery of Art in Washington, Harvard University, Yale University, New York University, Massachusetts General Hospital, Brigham and Women’s Hospital, and many more…
Changing the Subject
Controversies were growing. Due to the escalation of the crisis, cities witnessed horrifying scenes and the emergence of “zombie people” ready to do anything to get the drug. Peaceful streets turned dangerous, and pharmacies were robbed in broad daylight by addicted patients. People went into debt, stole, and prostituted themselves just to get another dose of the drug. So, what does the corporation do to defuse the crisis?
They change the subject, for instance, redirecting the narrative to issues related to the need for chronic pain treatment, further seasoned with emotional manipulation.
Creating False Dilemmas
Here’s a fascinating method of manipulation that suggests or creates the impression that the only option for treatment and relief for patients with severe pain is taking painkillers, overlooking other treatment methods. After all, it’s easier to promote popping a pill and washing it down with water than a healthy lifestyle or rehabilitation after an accident. Nonetheless, marketers and scientists paid by the company were pushing only one treatment option.
Confirmation of Cognitive Biases
Narrative Direction and Confirmation of Cognitive Biases. This is a method where you focus solely on positive opinions about OxyContin and promote them, while negative reports and press publications must be ignored and silenced. The essence of this strategy is that people have a natural inclination towards cognitive biases. The job of the manipulator is to reinforce or develop this bias.
The Repetition Method in the media, which broadly introduced manipulated information about so-called pain therapy, the right to live without pain, and redefining the concept of addiction, was based on people’s tendency to interpret and remember information in a way that confirms their beliefs. This is selective perception.
Here, a series of related mechanisms occur. For instance, a person is anchored and accustomed to a certain concept persuasively presented to them. Then, despite new facts contradicting their concepts, they are unable to activate critical thinking because they have invested too much of their own time, resources, and reputation, making it a point from which they cannot or do not want to retreat.
There is also the pumping of pseudo-authorities, the so-called halo or aureole effect, which works in such a way that certain negative information is concealed, for example, that a doctor working for Purdue Pharma is behind the introduction of the drug into circulation as a former FDA employee, and the focus is solely on the positive traits - an excellent specialist. Based on this one trait (halo effect), a range of other unrelated characteristics (honest doctor) are attributed to this person.
The Cognitive Bias Confirmation Technique is, contrary to appearances, a very sophisticated method because it relies on efficiently detailing information and concealing others. The argumentation and narrative seem logical and reliable but are based on false assumptions. In the case of the OxyContin affair, in my opinion, the Anglo-Saxon concept of common sense played the most significant role as it appealed to the natural sense of reason and blocked critical thinking.
In the face of these manipulative techniques, whistleblowers play a crucial role in unmasking false narratives and allow for questioning information sources (e.g., artificially inflated authorities), enabling openness to criticism and critical thinking.
Appeal to “Common Sense”
If you have reached this paragraph and digested the shocking methods used by the pharmaceutical company, it’s worth shedding light on one of the main actors behind the depreciation of science, critical thinking, and the propagation of conspiracy theories.
In the case of the Sacklers, it was this very appeal to “common sense” (common sense - Anglo-Saxon tradition) that was used to undermine scientific arguments indicating the harmfulness of the drug OxyContin, raised by the media and researchers. Critics of the drug were portrayed as “conspiracy theorists” who didn’t understand the realities of everyday life (dealing with pain and access to medication for suffering individuals).
In this way, Purdue Pharma, using the previously mentioned manipulation techniques, tried to convince the public that its product was safe and effective, challenging obvious facts. Even in the face of scientific evidence indicating the contrary, common sense was in favor, because after all, the drug helps, right?
The issue of “common sense” as fuel for conspiracy theory in the Anglo-Saxon tradition will be discussed in a separate article, as it is an incredibly fascinating topic and goes beyond the scope of this article.
In the article, based on investigative articles and books describing the OxyContin case, I demonstrated how Purdue Pharma discredited scientists, media, and activists using a combination of manipulative techniques. This allowed for the discrediting of these people and extended the company’s operational period. It’s worth noting that every year of operation equates to billions of dollars and thousands of deaths…
Nevertheless, in 2007, they admitted to deceiving doctors and patients about the addiction risk of OxyContin (see Kirk Ogorosky’s memorandum from October 2006 and the 2007 settlement). The company agreed to pay $634 million in compensation as part of a settlement with the federal government. However, this was a Pyrrhic victory as the drug was still in circulation and the top executives escaped responsibility.
Manipulated materials were still on the table, the sudden escalation of the opioid crisis in the USA, and only after several years and a series of court trials in 2020 did Purdue Pharma declare bankruptcy. Its owners agreed to pay $8.3 billion as part of a settlement with the federal and state government. No massive payments were made, and the case is still ongoing, with the trial scheduled for December 2023, which is just a few months away. To the best of my knowledge, the money has been transferred abroad to companies, and it’s unlikely that such a penalty will ever be paid…
Based on information from Wikipedia, in 2023, the United States Court of Appeals approved a $6 billion settlement, under which the Sackler family relinquished ownership of Purdue Pharma, and all profits were to be directed to a fund for the prevention and treatment of opioid addiction. However, the settlement protects the owners and most likely those deeply involved in the operation from criminal consequences.
That’s why in August 2023, the United States Supreme Court halted the settlement’s execution and agreed to consider the appeal of the United States Department of Justice on the legality of the settlement, which would protect the Sackler family from civil lawsuits regarding their role in the opioid crisis. The trial for this case is set for December 2023. In short: the ball is in play.
While writing this article, I had to remove many subchapters, quotes, and split the article into several additional articles. I hope I didn’t bore my Model Reader.
Attention: Although the drug OxyContin is still available and sold on the market, this article focuses on examining the issue of fact manipulation and narrative shaping by some pharmaceutical companies in the past, with the aim of concealing potential side effects of the drug.
I want to emphasize that I am not directing this article against the current owners of the OxyContin drug or their marketing strategies. I am also not an advocate of broadly understood conspiracy theories about “evil big pharma”, which became popular during the COVID-19 pandemic. I hope that after reading this article, I will encourage you to reflect more deeply on the relationship between politics and business, as well as on responsibility when introducing new pharmaceutical products to the market and presenting clinical data. I highly recommend acquainting yourself with the source articles and documentary films, which are truly interesting.
Movies and documentaries
DISNEY PLUS “LEKOMANIA”
HBO ORIGINAL: The crime of the Century
HBO ORIGINAL: Warning: This Drug May kill You
NETFLIX: Zabić ból
Beth Macy The OxyContin Express: A Family History of Pain, Addiction, and Lies
Beth Macy Dopesick: Dealers, Doctors, and the Drug Company that Addicted America, polskie tłumaczenie poniżej
Beth Macy Lekomani. Jak koncerny farmaceutyczne i lekarze potrafią uzależnić pacjentów od leków (2019) czytałem tę książkę dwa razy - polecam
PODCAST - BBC Empire of Pain: The Secret History of the Sackler Dynasty by Patrick Radden Keefe
Reports and articles in newspaper
Capitalism gone wrong: how big pharma created America’s opioid carnage
The Family That Built an Empire of Pain
LOS ANGELES TIMES - Full Coverage: OxyContin Investigation Całe śledztwo i seria ciekawych artykułów
Inside Purdue Pharma’s Media Playbook: How It Planted the Opioid “Anti-Story”
WIKIPEDIA: Purdue Pharma
SCIENTIFIC AMERICAN: We’re Overlooking a Major Culprit in the Opioid Crisis
NATIONAL LIBRARY OF MEDICINE The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy
NATIONAL LIBRARY OF MEDICINE Representations of OxyContin in North American newspapers and medical journals
Charles W. Van Way: Bashing Big Pharma
NATIONAL LIBRARY OF MEDICINE The OxyContin crisis: problematisation and responsibilisation strategies in addiction, pain, and general medicine journals
Prescription OxyContin Abuse Among Patients Entering Addiction Treatment
Department of Justice Docs:
U.S. DEPARTMENT OF JUSTICE: Opioid Manufacturer Purdue Pharma Pleads Guilty to Fraud and Kickback Conspiracies
UNITED STATES DISTRICT COURT
DISTRICT OF NEW JERSEY - Conspiracy to Distribute Controlled Substances