Pain Killer – Barry Meier

Below are personal notes I took for the book “Pain Killer“, by Barry Meier. It’s an exciting read that goes into great detail on the origins of the opioid crisis. He goes into WAY more detail in the book, but here is what I wrote down.

Pain Killer


  • There are really two crises in “The Opioid Crisis”:
    • The use of illegal narcotics (like counterfeit Fentanyl)
    • The medical use of opioids (what this book focuses on)
  • The Sackler family built the 16th largest fortune in the country by making the most popular and controversial opioid of the 21st century, OxyContin. It was created at Purdue Pharma in CT.
    • Positives / Negatives of the company:
      • The drug itself
        • The “contin” in OxyContin stands for “continuous”, meaning it provides a steady rate of Oxycodone absorption, rather than a huge surge all at once. The company argued that this would help prevent drug addiction and abuse since most addicts prefer an instant high.
        • Addicts and abusers quickly learned to bypass the slow absorption of the drug by crushing it up and then either inhaling or injecting it.
      • The target population
        • They marketed the drug towards the relief of patients with chronic pain, since it is an effective way to mitigate it.
        • Although the drug helped those in chronic pain, the company tried to market it as an initial treatment option towards anyone in pain, no matter the condition.
      • Pre-crisis marketing strategies
        • They funded prescription-monitoring programs and informative seminars and conferences on the nature of the drug and its proper uses.
        • They frequently paid well-known, influential doctors to speak in support of the product, gave doctors false information regarding it’s ideal uses (stressing how it was not as addictive as other drugs), and had a bonus system that encouraged bigger rewards for reps who promoted and sold the strongest doses.
      • Post-crisis marketing strategies
        • They donated lots of money to areas that were affected, and helped distribute naloxone (the drug used to reverse overdoses) once they became pressured from overdose accusations taking place.
        • They didn’t stop their current marketing plan and denied any wrong-doing as compared to other drug companies.
      • Their actions
        • Once they were forced to act, they restructured their selling of it and tried to make the drug itself more abuse-resistant.
        • It took almost 2 decades of countless court-cases to elicit effective action from the company. They only altered the drug itself once the original patent expired.


  • It’s now known that long-term use of opioids causes emotional dependency, reduced sexual drive, extreme lethargy, increased falls in the elderly, and even increased sensitivity to pain. Studies show pain patients recover faster with other treatments other than opioids.

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