OxyContin was the “tip of the spear,” in the words of one Purdue chemist who worked on the drug. Richard Sackler and his team in the 1990s had recognized a significant market barrier—the widespread stigma associated with strong opioids in the medical establishment—and executed a brilliant strategy to remove that barrier and clear the way. Purdue itself acknowledged, in 2001, that the company’s promotional efforts helped to bring about a “paradigm shift.” Rival drugmakers might have come to supplant Purdue in the marketplace. But they were the followers, not the leader.
