Sunday, May 19, 2019
INVESTIGATIVE
Inside the Purdue Pharma-Tufts relationship by Joe Walsh and Daniel Nelson
News Editor and Executive Investigations Editor
Tufts Medical School’s master’s degree in Pain, Research, Education and Policy (PREP) program was taught by doctors, nurses, dentists, health administrators and psychologists — experts in the multi-faceted world of treating pain. In 2006, the PREP program began featuring another expert: anesthesiologist J. David Haddox, then an executive at Purdue Pharma, the embattled drugmaker that has sold and marketed the painkiller OxyContin, a powerful drug that can often lead to physical dependency. Haddox’s recurring presence in the classroom — and his status as an adjunct associate professor — was one manifestation of Purdue’s close relationship with PREP, a program founded in 1999 after a six-figure gift from the Sackler family, owners of Purdue Pharma. Tufts is currently phasing the program out due to declining student interest, according to Tufts’ Executive Director of Public Relations Patrick Collins. In a lawsuit filed earlier this year against Purdue and the Sackler family, Massachusetts Attorney General Maura Healey alleges that the company’s support for the PREP program was part of a deceptive OxyContin marketing campaign that she says de-emphasized the drug’s addiction potential and bolstered prescriptions, helping to spark a statewide epidemic of opioid abuse. Before his time at Tufts, Haddox spent the bulk of his career arguing that pain is undertreated, opioid painkillers are effective and abuse is exaggerated. From his arrival at the university, Haddox began guest-lecturing on topics intimately connected with opioid use and the regulations surrounding their prescription, at times using Purdue-branded material. The Daily’s investigation of the PREP program uncovered course notes, lecture slides and readings — accumulated during one student’s track through the program nearly a decade ago. A number of these notes, alongside the Daily’s other reporting for this story, shine a partial light on Haddox’s time at Tufts. Tufts and the Sacklers Tufts’ relationship with the Sackler family extends well before the PREP program or the rollout of OxyContin. The university created the Sackler School of Graduate Biomedical Sciences in 1980 after sizable donations from a trio of now-deceased Sackler siblings. Though the PREP program did not bear the Sackler family name, its connections to the family were not a secret. On the program’s 10th anniversary in 2009, Professor of Public Health and PREP Program Director Daniel Carr lauded the Sacklers for their “indispensable” support. Following the PREP program’s establishment, Purdue redoubled its connection to Tufts, regularly dispatching its staff to the school and meeting with program leaders to discuss potential collaborations, Healey’s filing claims. “The Sacklers got a lot for their money,” the filing alleges. “The [PREP] Program bought Purdue name recognition, goodwill in the local and medical communities, and access to doctors at Massachusetts hospitals.” Sometimes this collaboration took the form of damage control. Donning a white lab coat, Carr lauded Purdue in a 2002 Boston Globe advertisement, noting the company’s efforts to control a then-nascent spike in prescription drug abuse. The ad included the company’s logo, acknowledged the abuse issue and declared that “Purdue Pharma is doing something about it.”
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Carr referred a request for comment to Collins. The Sacklers also served as the namesake for a Tufts lecture series that featured pain management experts. Purdue’s targeting of Tufts is not unique. Other universities were also awash with Sackler gifts, but the company’s work at Tufts was extensive enough to earn its sales team praise for — according to Healey’s filing — “penetrating this account.” According to Collins, though the PREP program initially had some financial support from Purdue, Tufts has funded the program through other sources in recent years. Purdue spokesperson Robert Josephson said the company’s financial support for the program ended in 2008. Josephson said Healey’s lawsuit “grossly distorts and mischaracterizes” the company’s relationship with Tufts, citing a motion to dismiss filed by the company. “Purdue has a long history of supporting pain research at Tufts University. Such collaborations between industry participants and research universities are common and widely viewed as appropriate,” Josephson told the Daily in a statement. “Purdue acted properly at all times in its interactions with Tufts.” Tufts has begun an independent review of PREP and other Sackler- and Purdueconnected programs at the university led by former U.S. Attorney for Massachusetts Donald Stern, the school announced in March. Collins declined to comment on the nature of Purdue’s ties to the PREP program, citing Stern’s ongoing review. One facet of this relationship, Healey’s filing notes, was the 2011 appointment of an unnamed Purdue employee to the rank of adjunct associate professor at Tufts. Former Purdue Vice President of Health Policy J. David Haddox held the same title. Collins confirmed that Haddox became an adjunct professor in July 2006, and was later promoted to adjunct associate professor, though his teaching role was limited to a few lectures per year. He no longer teaches at the school. Haddox’s History Bearing an M.D. and a doctorate of dental surgery (DDS), Haddox worked as a clinician through the 1980s and 1990s before moving to Purdue in 1999. Haddox served as Purdue’s defender in the press, arguing that OxyContin abuse was less dire than media reports claimed. Haddox’s public statements occasionally ran counter to Purdue’s private knowledge of the problems mounting for its marquee drug. Haddox spent the years before and after OxyContin’s 1996 rollout doubling down on his support for opioid painkillers. He helped prepare a 1996 statement from the American Pain Society and the American Academy of Pain Management — for which he later served as president — asserting that opioids are often useful for chronic pain and the risk of abuse in patients without a history of addiction was low. Haddox knew Purdue had a problem by 1999, when the arrest of several doctors for illegal prescriptions led Haddox to send an email recommending a company crisis-response plan, according to a confidential Justice Department report cited by The New York Times. In the same year, Purdue’s sales staff heard reports of abuse from doctors, and the sales staff toned down unsubstantiated claims about OxyContin’s low abuse potential two years later, according to a 2015 deposition of ex-Purdue President Richard Sackler that was unsealed in February. The company’s research into abuse was limited following the drug’s release, however. Purdue’s counsel confirmed in 2015 that the company never retained anyone to study
VIA BOSTON GLOBE
A Purdue Pharma advertisement from the March 7, 2002 Boston Globe is pictured. The advertisement was run at least three times in the Globe. addiction in the drug’s early years, according to the deposition. Despite Purdue’s lack of studies as well as the anecdotes about abuse, Haddox disputed a 2001 New York Times article that documented opioid addiction, OxyContin overdose risk and Purdue sales reps’ aggressive practices. Haddox responded to the charges in a 2001 Times letter to the editor that did not cite any formal research, relying instead on “discussions with medical examiners in several states” to argue that abuse is oversimplified. “The media frenzy about OxyContin abuse is interfering with good pain management,” Haddox, Purdue’s senior medical director for
health policy at the time, wrote in his letter. “In fighting drug abuse, we must not limit patients’ access to strong analgesics to manage pain and preserve quality of life.” Throughout 2001, Haddox repeated this claim that opioid abuse is less dire than pain under-treatment. Even more starkly, Haddox insisted at a 2003 conference that OxyContin is not addictive as prescribed, according to The New Yorker. He had instead attributed OxyContin’s widespread misuse to — according to The New York Times — ‘bad guys’ who are illegally trafficking the drug, affirming that
see PURDUE PHARMA, page 5