Internal company documents, congressional testimony, and the $6 billion bankruptcy settlement show that Purdue Pharma and the Sackler family knew OxyContin was addictive, concealed that knowledge from physicians, and extracted $12 billion in personal wealth before the company collapsed. 500,000 Americans died of opioid overdoses between 1999 and 2019. Every connection on this map is sourced to a primary document.
Purdue Pharma LP launched OxyContin — a controlled-release formulation of oxycodone — in 1996. [1] In its initial FDA labeling, the drug carried a claim that its controlled-release mechanism was believed to reduce the potential for abuse. That claim, Purdue's own internal research had found, was not supported by the evidence. [2]
What followed was one of the most aggressive pharmaceutical marketing campaigns in American history. Purdue's sales force grew to over 900 representatives by the early 2000s, and they visited physicians at a rate that dwarfed the industry average. [3] Sales representatives were paid bonuses directly tied to the volume of OxyContin prescriptions written in their territories, creating a financial incentive structure that rewarded aggressive promotion regardless of appropriate prescribing. [4]
Purdue Pharma was privately owned by the Sackler family, descendants of Raymond Sackler and Mortimer Sackler, who had acquired the company in 1952. [5] Because Purdue was private, the Sackler family was not required to disclose its finances publicly. The full scale of what they extracted from the company would only become visible during the bankruptcy proceedings.
Congressional investigators and state attorneys general found that between 2008 and 2018, members of the Sackler family withdrew approximately $10 to $12 billion from Purdue Pharma — a period that coincided with the peak of the opioid crisis and the height of state and federal investigations into Purdue's marketing practices. [6]
"The Sackler family is not just a bystander to the opioid crisis. They are the architects of it."
— Massachusetts Attorney General Maura Healey, filing Commonwealth of Massachusetts v. Purdue Pharma LP, January 2019. Source: Mass. AG press release, Jan. 15, 2019.In the bankruptcy proceedings, the Sackler family initially sought broad immunity from future civil litigation as a condition of their financial contribution to the settlement. A 2023 Supreme Court ruling held that the bankruptcy court had exceeded its authority in granting that immunity to family members who had not themselves filed for bankruptcy. [7] The case was remanded, and negotiations over a revised settlement continued into 2024.
Richard Sackler, son of Raymond Sackler, served as President of Purdue Pharma from 1999 to 2003 and as co-chairman of the board until 2018. Internal documents produced in litigation show that he was personally involved in shaping Purdue's sales strategy for OxyContin. [8]
In a 2001 internal email produced in the Massachusetts litigation, Richard Sackler wrote that the company's response to concerns about addiction should be to "cast doubt on the addicts" — framing people who became dependent on OxyContin as morally deficient rather than as victims of a product his company had marketed deceptively. [9]
A deposition of Richard Sackler, taken in the course of litigation and released by courts in 2019, showed him repeatedly claiming inability to recall decisions about the company's marketing and safety communications. [10] He has not been criminally charged.
In 2007, Purdue Frederick Company — Purdue's affiliate — pleaded guilty to federal criminal charges of misbranding OxyContin with the intent to defraud and mislead. [11] The company agreed to pay $600 million in fines and penalties. Three senior executives — the chief medical officer, the general counsel, and the chief scientific officer — pleaded guilty to misdemeanor misbranding charges. [12] None served prison time.
The plea agreement's statement of facts confirmed that Purdue's sales representatives had told physicians that OxyContin was less addictive and less subject to abuse than other opioids — a claim the company knew was not supported by clinical evidence. Sales representatives had also been instructed to downplay the risk of addiction in their conversations with prescribers. [13]
"Purdue Pharma used its vast wealth to fuel the fire of this crisis, and the Sackler family lit the match."
— New York Attorney General Letitia James, press statement on the New York opioid settlement, March 2022. Source: NY AG press release, March 3, 2022.OxyContin's initial FDA approval in 1995 included labeling language stating that the drug's delayed-absorption mechanism was "believed to reduce the abuse liability of a drug." [14] This language — which Purdue used extensively in its marketing materials and sales training — had not been proven in clinical trials at the time of approval.
A 2003 GAO report found that FDA oversight of OxyContin's post-approval marketing had been inadequate and that the agency had failed to take timely action against misleading promotional materials. [15] In 2001, the FDA did require Purdue to send a letter to physicians correcting the misleading abuse-deterrence claims in its sales materials. [16] That letter came five years after OxyContin had already been aggressively promoted on the basis of those claims.
McKinsey & Company provided consulting services to Purdue Pharma from 2004 through at least 2019 — a period spanning the peak of the opioid crisis, the 2007 federal guilty plea, and the filing of thousands of civil lawsuits against the company. [17]
Internal McKinsey documents produced in the federal opioid multidistrict litigation showed that consultants had advised Purdue on strategies to increase OxyContin sales to high-prescribing physicians, including physicians who were already being investigated for prescription drug diversion. [18] One document proposed that Purdue pay pharmacy companies — including CVS and Express Scripts — rebates for each OxyContin overdose attributable to pills dispensed from their pharmacies, as a means of incentivizing pharmacies to continue carrying the drug despite diversion concerns. [19]
In February 2021, McKinsey agreed to pay $573 million to settle claims brought by 47 states related to its consulting work for Purdue. [20] McKinsey did not admit wrongdoing.
Opioids reach patients through a distribution chain that runs from manufacturers to wholesale distributors to pharmacies. Three distributors — McKesson, Cardinal Health, and AmerisourceBergen — collectively controlled approximately 90 percent of pharmaceutical drug distribution in the United States during the height of the opioid crisis. [21]
Under federal law, distributors are required to identify and report suspicious orders — unusually large or frequent orders that may indicate diversion. Congressional investigations found that all three major distributors had systematically failed to comply with this requirement, shipping quantities of opioids to pharmacies in small communities that vastly exceeded any plausible legitimate medical need. [22]
In 2022, McKesson, Cardinal Health, and AmerisourceBergen agreed to pay a combined $21 billion over 18 years to settle claims brought by state and local governments. [23]
Purdue Pharma filed for Chapter 11 bankruptcy in September 2019 as a means of aggregating the thousands of civil claims against it into a single proceeding and negotiating a global settlement. [24]
In November 2020, the Department of Justice announced that Purdue Pharma had agreed to plead guilty to federal criminal charges — conspiracy to defraud the United States and violating federal anti-kickback laws — and to pay over $8 billion in penalties. [25] Because the company was in bankruptcy, the majority of that penalty was to be paid through the civil settlement process.
The Sackler family agreed to contribute $6 billion to the settlement. [26] In exchange, they initially sought — and a bankruptcy court initially granted — broad immunity from future civil litigation across all family members, including those who had never been parties to any lawsuit. The Supreme Court's 2024 ruling in Harrington v. Purdue Pharma LP struck down that immunity grant, holding it exceeded the bankruptcy court's statutory authority. [27]
No member of the Sackler family has been criminally charged. The $6 billion settlement, spread over years and paid from proceeds of a company that had already extracted $12 billion in family distributions, represents a fraction of the wealth the family accumulated during the period the misconduct occurred.
The CDC estimates that approximately 500,000 people died of opioid overdoses in the United States between 1999 and 2019. [28] That figure encompasses overdoses from both prescription opioids and illicit opioids including heroin and fentanyl — the latter two markets having expanded in part because of the population of people who first became dependent on prescription opioids.
A peer-reviewed study published in JAMA Network Open in 2021 estimated that the economic cost of the opioid epidemic between 2002 and 2017 — including healthcare costs, lost productivity, criminal justice costs, and the value of lives lost — totaled approximately $1.5 trillion. [29]
The Sackler family's contribution to the settlement — $6 billion — represents approximately 0.4 percent of that estimated economic cost.