Empire of Pain: The Secret History of the Sackler Dynasty

by Patrick Radden Keefe

“it would be extremely dangerous at this early stage in the life of the product to tamper with this ‘personality’ to make physicians think the drug is stronger or equal to morphine.” Of course, OxyContin was stronger than morphine. That was a simple fact of chemistry—but one that the company would need to carefully obscure.

Prior to the launch of the drug, they had conducted focus groups in which doctors expressed concerns about the potentially addictive properties of strong opioids. But the sales reps were issued explicit instructions to challenge such concerns. In training sessions, they did role-playing exercises in “overcoming objections.” If clinicians expressed concerns about the danger of abuse and addiction, the reps would parrot the language from the package insert, which Curtis Wright, of the FDA, had approved: “The delivery system is believed to reduce the abuse liability of the drug.” They memorized the line and recited it like a catechism.