“We have to hammer on abusers in every way possible. They are the culprits and the problem. They are reckless criminals.”

This is what Richard Sackler, part of the family that runs Purdue Pharma, said about people who become addicted to OxyContin, the prescription painkiller his company distributes. It’s just one email uncovered by investigators working on a lawsuit filed against Purdue Pharma for its role in the opioid epidemic that has cost hundreds of thousands of lives across the country. In these documents, the Sacklers — a large, secretive family of billionaires who own and run Purdue Pharma — appear to double down on blaming “addicts” for the devastating crisis caused in part by their company’s product.

In 2007, Purdue pleaded guilty to misleading medical professionals and the public about the addictive potential of their drugs. But this new lawsuit, brought by the Attorney Generals of New York and Massachusetts, brings forward allegations that, since then, the company not only continued to aggressively distribute opioids, but also set their sights on addiction treatment, attempting to profit from a life-threatening disease they helped spread.

There’s so much to be angry about in what’s been exposed by this lawsuit. But to read that Richard Sackler called those battling addiction “reckless criminals, culprits,” and “the problem” made my blood boil.

I am one of those “problem” people whom Sackler targets. I don’t have a criminal record, and the only crime I would ever have committed would have been directly caused by my addiction.

I began using opioids and became addicted in 2010 after developing post-traumatic stress disorder (PTSD) in response to several years of physical and sexual abuse. Trauma and opioid addiction are closely linked, with some estimates saying as many as two out of three people with PTSD may also have a substance use disorder. This population is much more likely to be comprised of hurt, traumatized people in need of compassionate care than “reckless criminals.”

Addiction itself is a medical condition, caused by a mix of genetic and environmental triggers — such as an opioid prescription — that requires and deserves treatment. So for a pharmaceutical executive heading up one of the biggest opioid distributors to reportedly place blame on people with the disorder is particularly absurd.

“We don’t treat someone with a life-threatening, chronic relapsing illness as a criminal; we treat them with compassion and respect and get them the best care possible as quickly as possible,” said Justine Waldman, the medical director of the REACH Project, a harm-reduction-oriented health hub headquartered in Ithaca, New York. “Any derogatory term to describe someone with opioid use disorder is not only unhelpful, it’s stigmatizing and hurtful and contributes to increased loss of life.”

Environmental triggers go beyond opioid prescriptions. They can also include sexual trauma, the stress of extreme poverty, or exposure to the gang violence and street drugs that often flood low-income neighborhoods. It’s one reason why many experts say that hyperfocusing on companies like Purdue can be problematic if it leads to conversations that exclude populations that were not exposed through legitimate prescriptions. But that doesn’t leave Sackler off the hook for his derogatory and medically unsound statements.

Purdue and other pharmaceutical companies are currently facing a cluster of lawsuits, but the ones filed by New York and Massachusetts appear especially poised to make Purdue face its actions. For the company to significantly contribute to an addiction crisis, campaign to demonize its sufferers, and then plot to profit from treatment is hypocritical at best and potentially criminal at worst. (The Sackler family released a statement to the New York Times claiming that the investigation is full of false information.)

But the case is not clear cut, even if most people agree that an ethical line was certainly crossed. Leo Beletsky, an associate professor of law and health sciences at Northeastern University and the faculty director of the Health in Justice Action Lab, explains, “That’s the fundamental model of the US pharmaceutical industry: They oftentimes treat the disease and then treat the side effects of their own medication.” In this context, the question becomes not one of whether the Sacklers manipulated the public’s trust— which the evidence so far appears to affirm — but whether they did it in a way that deviates from the for-profit pharmaceutical model we all tacitly accept.

Regardless of the outcome of these lawsuits, one point bears repeating, as many times as it takes to make people understand: Richard Sackler’s comment about the blameworthiness of people with substance use disorders is totally off the mark. It reflects an attitude fueled by stigma, one that pervades nearly every system in our nation and which allowed the Sackler family to flourish for decades.

We see this myth in our drug court systems, which frequently deny clients access to evidence-based pharmacotherapies like methadone or buprenorphine, encouraging them to rely on willpower and morals, not medicine, to resolve their condition. We see that in jails, where pretrial inmates are dying from preventable, withdrawal-related complications, usually rooted in a guard dismissing an inmate’s complaint as “drug seeking.” People with this condition are viewed as criminals without ever seeing a day in court, and are blamed for any negative outcome that results from the addiction.

While it is important to hold the Sacklers accountable for their alleged predatory profiteering, there is a larger lesson to be learned from this debacle. Widespread misinformation about addiction has left so many of us floundering without care, often in jails and prisons simply for being symptomatic. At the same time, the Sacklers and others looking to profit from our pain have done so nearly unchecked. It’s time to put the War on Drugs to rest and start celebrating compassionate care and medical science.

Elizabeth Brico is a writer from the Pacific Northwest whose work often focuses on drug policy, treatment, and social justice. She is a 2019 Reimagining Communities fellow with the National Council for Incarcerated and Formerly Incarcerated Women and Girls, and a 2019 reporting fellow with Talk Poverty. Follow her on Twitter @elizabethbrico.

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