'They bribed physicians at scale to boost the sales of their drug. That's the crux of the problem.'

Exactly, not only has Purdue's irresponsible pushing up sales of OxyContin led to more people consuming the narcotic but also and more importantly—as we've seen from the opioid epidemic—it means that thousands of patients who are not terminally ill have already become seriously addicted to the drug when otherwise they likely would not have been had they had proper medical care/pain management.

I mention terminally ill patents here both because others have done so and the fact that it's necessity to classify them separately from those who are not terminally ill because essentially both groups have very different opioid regimens to each other. For obvious reasons, concern about addiction in terminally ill patients is not as an acute a problem as it is for those who are not terminally ill whereas it is an extremely serious matter for the latter group.

The issue of discriminating between pain relief for terminally ill patients and for others who are NOT terminally ill has long historical roots—a fact that many, especially the regulators, (FDA et al) including those within the medical profession who have either seemed to have forgotten the facts or who never learned them in the first instance.

Excuse me for not having the exact details to hand, but when international treaties that were concerned with illicit narcotics and the illicit narcotic trade were being signed some 80 years ago, they included provisions that permitted the use of morphine for medical purposes but banned heroin (aka, diamorphine or diacetylmorphine) outright, as then it was considered too dangerous (and unmanageable) for said purpose. This was despite the fact, which was already well known at the time, that heroin is significantly better at suppressing very severe pain than is any increased amount of morphine. Thus, the inclusion of this clause in the treaty meant that heroin became illicit for any purpose.

Nevertheless, one country refused to sign the treaty in its entirety. The United Kingdom became the stand-out exception in that whilst it still signed the treaty it had clauses that banned heroin per se struck out and or had them altered to allow heroin to be used in cases of very severe pain that were unable to be adequately controlled with any quantity of morphine. Typically, these were terminally ill patients with cancer.

Whilst this enlightened and humane view put British doctors (or at least those ones who controlled policy and regulations) at odds with doctors in other countries, it meant that doctors throughout the UK could [continue] to use heroin in cases where pain was otherwise intractable (note: heroin had been in use before the treaties came into effect).

Not only did UK doctors acknowledge that heroin was essential to their pain-relieving arsenal for terminally ill patients but also they went even further in that they continued to use a combination of both heroin and cocaine (and sometimes also in combination with other drugs) in a mixture that became known as Brompton cocktail (named after the UK hospital of the same name). This combination of drugs acted synergistically to not only relieve a cancer sufferer's severe pain but it also made the patient feel substantially better and more comfortable during his or her remaining days. That doctors in other counties did not adopt this approach is, in my opinion, heartless. Whilst concoctions such as Brompton cocktail are not as relevant these days for various reasons too involved to mention here, there's still a longstanding problem with pain management that's not necessarily directly connected with opioid addiction problems. It's as if these bastards have adopted the attitude that too much pain relief is not good for one even if it has nothing to do with increasing addiction. https://en.wikipedia.org/wiki/Brompton_cocktail

Comment on my various posts to this news article: If you read my other/earlier posts here, you'll notice that I'm not only vehemently opposed to the proposed leniency that's likely to be extended to the Sacklers but also you'll see that my anger almost surges to zealot-like proportions over what both they and Purdue have done.

My reason for reacting to the extent that I have is that this Sackler/Purdue scandal is not just another instance of corporate corruption caused by the nefarious actions of bad and greedy players—rather; it goes much, much further than that. Those of us who actually understand the true extent of what has happened in this horrible saga know that the issues it crosses are those that are fundamental to underlying integrity of modern medicine.

The matter is truly that significant and the fact that so many people do not really care about it is truly tragic. Like so many other things that have gone wrong these days, it almost seems that people have willingly parted with their long-held ethical values for good.

The matter of opioid regulations was about as high as it got in international treaties. The fact that Sacklers and Purdue have completely undermined that 100-year understanding between nations is just staggering.

Moreover, as I've shown, it is not only the medical profession that was convinced of the absolute necessity to tightly control the distribution of opiates. As we can see from the universal actions of governments around the world some 80 or so years ago, in that they were all of similar minds and convinced to the extent that they were prepared to enter into international treaties that bound both them and their citizens to this effect. In addition, each government then enacted strict local drug law legislation with draconian penalties to back said treaties.

Essentially, that for the better part of a century, the regulated control and distribution of narcotic opioids and other drugs of addiction has not only been of prime concern to the medical profession worldwide but also to every government on the planet for the very reason that the unregulated distribution of these drugs would have a devastating negative affect on their citizens. Stated another way: that if the world's citizens were given unregulated and unfretted access to drugs of addiction then many of them would suffer irreparable harm and damage to themselves from having access to said drugs—is a notion upon which both the medical profession and governments almost universally agree—and they have so agreed to this notion for most of the 20th Century and they continue do so into the 21st Century.

That long-winded statement is to emphasize the universality of this position. What you have to understand is that the Sacklers and Purdue have deliberately undermined that almost universal covenant on drugs of addiction and they have done so in the most despicable, reprehensible and nefarious way possible.

The family/company combo of Sackler/Purdue, whose ethics are as equally bad as the large illegal drug cartel barons, acted outrageously and in an irresponsible manner by deliberately co-opting and undermining the ethics of many doctors by bribing them. Many of who have since acted in a greedy and disingenuous towards their patients, not to mention also having breached their Hippocratic Oath towards them.

In summary, the Sacklers and Purdue along with their complicit doctors including the irresponsible FDA have completely undermined the very foundations of present day medical 'law',
in essence they've torn away the ethical fabric from asunder, and in so doing they have effectively destroyed the universal consensus that's been built up over the past one hundred years or so between the medical profession, the regulators such as the FDA and those countries that signed the otherwise irrevocable drug treaties. The fact that Sacklers/Purdue can wield this much power is, in my view, terrifying.