Convicted or Fined

Convicted or Fined

“Mr. Becker, can you please tell the jury if you have any regrets regarding your involvement in the sale and distribution of opioids during the time that you worked for Mallinckrodt?” “No,” he said.

Steven Becker was the national sales account manager for the now bankrupt but reorganized Mallinckrodt Pharmaceuticals, once largest manufacturer of opioids in the United States. Described in 2010 by Drug Enforcement Administration as “the kingpin within the drug cartel” of legitimate companies driving the opioid epidemic.

The US has a new, dramatically undemocratic tendency these days to convict and incarcerate middlemen and foot soldiers of concerted criminal activity, leaving the ultimate perpetrators at the top free to live without material interruption, with their greatest consequences being fines, legal fees – often relegated to their corporations and not them individually. Occasionally, the worst consequence is the bankruptcy (often just a Chapter 11 reorganization) of the perpetrating corporation, but not the controlling owners. If there are criminal charges against those perps, it often attaches solely to their companies and not the controlling owners. Billionaires walk in our rising plutocracy. Nothing screams of this two-level legal system that the companies and their controlling owners that promulgated the opioid crisis.

“When Purdue Pharma filed for Chapter 11 bankruptcy protection [in 2019], the news came as no surprise. With the company staring down nearly 2,000 lawsuits from around the country related to its marketing of Oxycontin, Purdue had reportedly been floating a massive settlement plan that includes bankruptcy and restructuring. As part of the settlement, Purdue is reportedly planning to shell out $12 billion, with $3 billion coming directly from the company’s owners, the Sackler family…

“[In 2018], Insys went to trial for accusations that the company gave kickbacks to doctors who prescribed the company’s powerful fentanyl spray, Subsys, to patients who didn’t necessarily need it. During the trial, accusations emerged that Insys hired an exotic dancer to be a regional sales manager and that she gave lap dances to doctors at parties. The company also created a rap video that was designed to motivate employees to push sales of the highly addictive Subsys spray… Ultimately, the DOJ asked for $225 million and this month, and Insys filed for bankruptcy in June — making it the first company to officially sink from the weight opioid litigations.

“The company’s … chapter 11 bankruptcy plan shows that it will not be able to pay the DOJ the full settlement because the company came up short ‘by a wide margin’ when it sold off its assets.” PharmaManufacturing.com, 9/23/19. But the biggest player in the opioid epidemic is a little known company, Mallinckrodt Pharmaceuticals, the subject of a marvelous in-depth expose by Meryl Kornfield, Scott Higham and Steven Rich published in the May 10th edition of the Washington Post. Here are a few excerpts:

“Between 2006 and 2014, Mallinckrodt accounted for 27 percent of the opioid market compared with 18 percent for Purdue Pharma, measured by the potency of the pills they produced, according to an analysis by The Post. While the Sackler family, which owned Purdue, attracted intense national attention and became a cynosure of criticism after the company’s introduction of its blockbuster pill OxyContin, the Mallinckrodt brand slipped under the radar.

“Between 2000 and 2020, more than 270,000 people died of prescription opioid overdoses in the United States… ‘Everybody thinks of Purdue when they think about the opioid epidemic, but Mallinckrodt was far worse,’ said Jim Geldhof, a DEA supervisor who investigated Mallinckrodt before retiring in 2016 after four decades with the agency and now works as a consultant to cities suing the opioid industry. ‘They were up to their eyeballs in oxycodone, and they knew exactly what they were doing. Their drugs had become the most popular on the street and they jumped in with both feet.’… The largest manufacturer of opioids in the United States once cultivated a reliable stable of hundreds of doctors it could count on to write a steady stream of prescriptions for pain pills.

“[Mallinckrodt] once cultivated a reliable stable of hundreds of doctors it could count on to write a steady stream of prescriptions for pain pills… But one left the United States for Pakistan months before he was indicted on federal drug conspiracy and money laundering charges. Another was barred from practicing medicine after several of his patients died of drug overdoses. Another tried to leave the country in the face of charges that he was operating illegal pill dispensing operations, or pill mills, in two states. He was arrested and sent to prison for eight years.

“These doctors were among 239 medical professionals ranked by Mallinckrodt Pharmaceuticals as its top prescribers of opioids during the height of the pain pill epidemic, in 2013. That year, more than 14,000 Americans died of prescription opioid overdoses… More than a quarter of those prescribers — 65 — were later convicted of crimes related to their medical practices, had their medical licenses suspended or revoked, or paid state or federal fines after being accused of wrongdoing, according to a Washington Post analysis of previously confidential Mallinckrodt documents and emails, along with criminal and civil background checks of the doctors. Between April and September of that year, Mallinckrodt’s sales representatives contacted those 239 prescribers more than 7,000 times…

“Mallinckrodt paid top prescribers thousands of dollars to extol the virtues of the company’s drugs to fellow doctors at ‘speaker programs’ held at fine restaurants and resorts. All it took ‘was a speaker program to get them writing,’ one sales rep wrote… Mallinckrodt played a key role in an industry-wide effort to convince the health-care industry that addiction was rare among opioid users and marketed its drugs to specific segments of society. ‘With older adults, start dose low, go slow,’ the company wrote in marketing material for drug industry trade shows. ‘But go!!’

“‘While Mallinckrodt does not agree with the allegations regarding decade-old issues, it has spent the past three years negotiating a comprehensive, complete and final settlement that resolves the opioid litigation against it, provides $1.725 billion to a trust serving affected communities, and allows Mallinckrodt to continue to serve patients with critical health needs under an independently monitored compliance program,’ a company spokesperson said in a statement to The Post.” Yes, lots of doctors received criminal convictions, even a few Mallinckrodt executives, but after a Chapter 11 reorganization, the company still exists, and the owners remain relatively unscathed.

As we watch the minions who attacked the Capitol on January 6, 2021, face criminal charges, the inciting perpetrators at the top, with legions of highly paid lawyers, refuse to cooperate with investigators, have no problem with fines and have been the very ones to appoint and confirm sympathetic judges that enable their delays and obfuscation. Even a billionaire who should face criminal charges for using a low value on real estate in tax filings and a high value for a loan from federally insured lenders for the same holdings, both federal felonies, sits smiling, unindicted, and controlling the bulk of the Republican Party, seriously contemplating a run for the presidency in 2024. Lots of corporations, lots of lawyers, and lots of resistance seem to reinforce the notion that our legal system has a very different set of rules for those at the top.

I’m Peter Dekom, and our legal system seems to make a mockery of the notion that “no one is above the law.”