OxyContin maker fined $634.5 million

MSNBC.com: AP

ABINGDON, Va. - Purdue Pharma L.P., the maker of OxyContin, and three of its executives were ordered Friday to pay a $634.5 million fine for misleading the public about the painkiller’s risk of addiction.

U.S. District Judge James Jones levied the fine on Purdue, its top lawyer and former president and former chief medical officer after a hearing that lasted about three-and-a-half hours. The hearing included statements by numerous people who said their lives were changed forever by addiction to OxyContin, a trade name for a long-acting form of the painkiller oxycodone.

Designed to be swallowed whole and digested over 12 hours, the pills can produce a heroin-like high if crushed and then swallowed, snorted or injected.

Note to the plaintiffs' bar: If smoking cigarettes is viewed by most juries as constituting assumption of risk, I shudder to contemplate crushing and snorting of oxycontin pills.

Which isn't to say this fine was improper or undeserved.

But there is real pain out there (as I know all too well), and a need for effective, safe medications (and attentive, compassionate physicians) to treat it. Our national paranoia about drug use can and does go overboard, too often resulting in untreated or undertreated real pain.

Updated: OxyContin Maker Pleads Guilty, Says It Downplayed Risk

From The New York Times:
By BARRY MEIER

ABINGDON, Va., May 10 —The company that makes the narcotic painkiller OxyContin and three current and former executives pleaded guilty today in federal court here to criminal charges that they misled regulators, doctors and patients about the drug’s risk of addiction and its potential to be abused.

To resolve criminal and civil charges related to the drug’s “misbranding”, the parent of Purdue Pharma, the company that markets OxyContin, agreed to pay more than $600 million in fines. That is the third-highest amount ever paid by a drug company in such a case.

Also, in a rare move, three executives of Purdue Pharma, including its president and it top lawyer, pleaded guilty today as individuals to misbranding charges, a criminal violation. They agreed to pay a total of $34.5 million in fines.

And in case you missed this piece:
The Blotter
OxyContin: The Giuliani Connection
By Brian Ross, Richard Esposito and R. Schwartz
ABC News

Wednesday 09 May 2007

Rudolph Giuliani and his consulting company, Giuliani Partners, have served as key advisors for the last five years to the pharmaceutical company that pled guilty today to charges it misled doctors and patients about the addiction risks of the powerful narcotic painkiller OxyContin.

TierneyLab: Hurwitz Jurors Explain Their Verdict

John TierneyLab Blog From The New York Times

Since the verdict in the Hurwit trial on Friday, I’ve interviewed three of the twelve jurors, and they told pretty much the same story. They said that the jury considered Dr. William Hurwitz to be a doctor dedicated to treating pain who didn’t intentionally prescribe drugs to be resold or abused. They said he didn’t appear to benefit financially from his patients’ drug dealing and that he wasn’t what they considered a conventional drug trafficker.

So why did find him guilty of “knowingly and intentionally” distributing drugs “outside the bounds of medical practice” and engaging in drug trafficking “as conventionally understood”? After attending the trial and talking to the jurors, I can suggest two possible answers:

1. The jurors were confused by the law.
2. The law is a ass (to quote Mr. Bumble from “Oliver Twist”).

I can’t blame the jurors for being confused, because that’s the norm in trials of pain-management doctors. The standard prosecution strategy is to charge the doctor on so many counts and introduce so much evidence that the jurors assume something criminal must have happened. Their natural impulse, after listening to weeks of arguments, is to look for a compromise by digging into the mountain of medical minutiae – and getting in so deep that they lose sight of the big picture.

Tierney is sympathetic to the often desperate situation of those experiencing chronic pain, and their difficulties in getting help from most physicians. His reporting and analysis, and the comments by others, make for an important conversation on the topic.

One more in the long line of casualties in our self-defeating War on Drugs. I suspect historians will regard this "war" as even more catastrophic in its pernicious consequences for American society (not least in its devastating destruction of respect for law and legal institutions) than our failed efforts in Iraq.

William E. Hurwitz Trial : Overreaching prosecution and miscarriage of justice?

By John Tierney - From The New York Times:

Two of the leading pain experts, Dr. Russell K. Portenoy of Beth-Israel Medical Center and Dr. James N. Campbell of Johns Hopkins University, testified without pay as experts for the defense. They said Dr. Hurwitz was widely known as a knowledgeable physician and passionate advocate of giving patients full pain relief, unlike many doctors who were reluctant to prescribe opioids because they feared legal repercussions, particularly when dealing with patients who sometimes used illegal drugs.

Such “problem patients” consumed so much time and energy that most doctors refused to treat them “regardless of what the consequences would be for the patient,” Dr. Campbell testified. He said that he had been initially skeptical of some of Dr. Hurwitz’s high-dose treatments, but was then impressed by the results in patients he sent to Dr. Hurwitz....

“I felt that I had a duty to the patients,” he said. “I hated the idea of inflicting the pain of withdrawal on them.” After the closure of his practice in 2002, he said, two of his patients committed suicide because they gave up hope of finding pain relief.

The most moving testimony came from Mrs. Lohrey and other patients who described their despondency before finding Dr. Hurwitz. They said they were amazed not just at the pain relief he provided but at the way he listened to them, and gave them his cellphone number with instructions to call whenever they wanted.

“I felt like I was his only patient,” Mrs. Lohrey testified. “I think he truly understood the nature of what I was going through.” When she lost her health insurance, she said, Dr. Hurwitz continued treating her at no charge, and helped her enroll in a program that paid for her opioid prescriptions. After Dr. Hurwitz’s practice was shut down, she could not find anyone to treat her for seven months.

From the Drug Policy Alliance:

"While we are saddened that Dr. Hurwitz was not entirely exonerated, we are heartened that the court and the jury rejected the most outrageous and dangerous claims of the federal prosecutors, which, had they gained traction, would have threatened the entire practice of pain medicine across the country," said Daniel Abrahamson, DPA's Director of Legal Affairs. "Hopefully, the Department of Justice will be chastened by this experience and will not willy-nilly target pain doctors who valiantly fight for their patients' well-being."