Modern medicine aims to add to quality of human life. As we know, while we are afflicted by diseases, there is pain associated with them. Therefore, an incidental aim of modern medicine is to manage pain, and make life pain-free as far as possible.

There are many pain killer medicines used by doctors. The most commonly used is acetyl salicylic acid or aspirin. As it causes acidity, many more products were developed. Paracetamol or acetaminophen is a preferred pain killer.

In some conditions, the intensity of pain is much more, say post-surgery. There are also injuries which cause immense pain, say a soldier hurt by bullets. There are cancer patients who experience unbearable pain.

For such severe pain, in past morphine was used as a painkiller. These days morphine derivatives are used, e.g. pethidine and tramadol. As we know, these are very, these are very potent medicines, and are CNS depressants. An overdose causes depression of vaso-motor centre, and the patient may die. Besides, these pain killers could be taken habitually, and can cause addiction.

There were 6.45 lac deaths in the US due to overdose of pain medications between 1999 and 2021. It has been called opioid epidemic.

Media covered this tragedy in great detail. It highlighted the role of the Sackler family who ran a pharma company called Purdue Pharma which marketed OxyContin, a pain killer drug based on Oxycodone. In fact, there were three Sacklers — Arthur, Mortimer and Raymond. Arthur, the oldest brother pioneered medical advertising. He roped in physicians to prescribe Purdue products. He expired in 1987. His stake in the company was given to the surviving two brothers.

OxyContin was heavily promoted. In fact, it became a key drug that contributed to opioid epidemic.

Many states filed suits against the Sacklers for their involvement in opioid crisis.

The Sacklers were not alone in causing the epidemic. John Kapoor introduced a more powerful pain killer than OxyContin called Fentanyl which is a synthetic opioid. It was cleared by the FDA for cancer patients in hospital settings. It was not a new molecule, but its novel administration — sub-lingual — was patented. It was introduced as a spray to be used under the tongue. It was called Subsys. Pliable doctors prescribed it for all sorts of patients.

By the time Mr. Kapoor and his team was caught and prosecuted, many lines were lost or destroyed. All members of Kapoor’s team and he himself, were punished.