(collectively “Janssen”), Endo Health Solutions Inc., and Endo Pharmaceuticals Inc. They are derived from and possess properties similar to opium and heroin, and they are regulated as controlled substances.(collectively “Endo”) manufacture, market, and sell prescription opioid pain medications, including the brand-name drugs Oxy Contin, Butrans, Hysingla ER, Actiq, Fentora, Opana/Opana ER, Percodan, Percocet, Zydone and Duragesic. While opioids can dampen the perception of pain, they also can create an addictive, euphoric high.Defendants deceptively marketed opioids to prescribers and consumers through advertising, websites, and in-person sales calls.Defendants also relied upon continuing medical education (“CME”) seminars, non-credit education programs, treatment guidelines, and other publications and programs by patient advocacy groups, professional associations, and physicians that were flawed and misleading, but seemed independent and therefore credible. Through these efforts, Defendants were able to persuade doctors and consumers that opioids were not addictive, despite the previous medical consensus and scientific evidence to the contrary.Defendants continued to tell doctors and consumers that opioids could be taken in higher and higher doses without disclosing the ensuing risk to the patient.e.
Part of Defendants’ message was that doctors should treat the right patients: legitimate patients who took the drugs as directed (orally) to treat their pain, rather than abusers seeking to snort or inject the drugs for recreation.
When using opioids continuously, patients grow tolerant to their analgesic effects—requiring progressively higher doses and increasing the risks of withdrawal, addiction, and overdose. Because the medical community recognized the dangers of opioid use, they originally used opioids cautiously and sparingly, typically only for short-term acute pain—where brief use limited the need for escalating doses and the risk of addiction—or for palliative (end-of-life) care. Consequently, the market for prescription opioids was sharply restricted.5.
As Purdue developed Oxy Contin in the mid-1990s, it knew that to expand its market and profits, it needed to change the perception of opioids to permit and encourage the use of opioids long-term for widespread chronic conditions, like back pain, migraines, and arthritis.
Purdue, together with the other Defendants, helped cultivate a narrative that pain was undertreated and that pain treatment should be a higher priority for health care providers.
This effort paved the way for increased prescribing of opioids for chronic pain.