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PaperclipPerfector  4mo ago (text post)   28466 thread views

Culture War Roundup for the week of June 24, 2024

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you didn't read the links contained within it.

I did, indeed, read the links contained within it. I'm a legal nerd, and a voracious consumer of text.

They were, in fact using aggressive marketing techniques and deception to convince doctors to prescribe higher doses when their patient responsibly wanted a lower dose.

The bolded part is nowhere in there. Not in your block quote, either.

There's nothing magic about the opinion of a medical professional. There's nothing unknown or mysterious about the idea that a trained medical professional or doctor would know the appropriate amount of painkillers to give to their patient.

Ok, great! Quick question, though... how come Scott talks about adjusting the dose of various medications up/down, depending on how it's going? He's a doctor, and a trained medical professional to boot. Shouldn't he like, just "know" the appropriate amount of whatever drug to give to his patients?

Purdue Pharma interfered with this

I mean, no? Did they, like, jump into the exam room, and when doc was "just knowing" the "appropriate" amount, they interfered and somehow made him increase it?

produced fraudulent research

I mean, also no? They produced (maybe just promoted?) a concept that may, indeed, be wrong. I don't actually know if it's wrong, and there's not enough information in the indictment to know, either. But they didn't actually produce any fraudulent research. It needs to be a hell of a lot closer to "we made up fake data to put in a paper that we submitted for publication" to be considered 'fraudulent research'.

which gave both large financial incentives

What large financial incentives? Come on, man. Stop hiding the ball.

And remember, the thing you're trying to show is that they "were ultimately responsible for and made substantial profits from a legal and corporate structure that heavily encouraged and even induced addiction in cases where it wasn't necessary". So, I'd definitely like to hear some things about their legal and corporate structure.

Ok, great! Quick question, though... how come Scott talks about adjusting the dose of various medications up/down, depending on how it's going? He's a doctor, and a trained medical professional to boot. Shouldn't he like, just "know" the appropriate amount of whatever drug to give to his patients?

No? Regular supervision and adjustment of the dosage is part and parcel of responsible medical care. If he gets it right on the first go, great, and if he doesn't part of his job is adjusting the dosage or even pulling the patient off the drug. Sometimes the patient's condition can change as a result of medication and they don't need as much of it as they recover - a patient recovering and thus not needing as much of a certain medicine as they did before is not evidence that they were never sick and never needed medication.

I mean, no? Did they, like, jump into the exam room, and when doc was "just knowing" the "appropriate" amount, they interfered and somehow made him increase it?

And because it covers the same ground...

What large financial incentives? Come on, man. Stop hiding the ball.

There's no need for scare quotes. Doctors are in fact legitimate medical professionals, and making decisions about dosage is part of their professional responsibility and skillset. There's nothing magical about an anaesthesiologist determining the appropriate level of painkillers for someone based on sex/weight/pre-existing conditions. But yes, they did actually interfere. To quote from one of the legal documents involved...

Purdue’s most powerful tool of deception was sending sales representatives to promote opioids to Massachusetts doctors, nurses, and pharmacists face to face. During sales visits, Purdue reps made false and misleading claims directly to the professionals who care for Massachusetts patients. Purdue assigned reps to specific territories in Massachusetts and gave them lists of Massachusetts doctors to visit.

They sent people out to lie to medical professionals in order to encourage them to sell more Purdue pharmaceuticals.

Each of these in-person sales visits cost Purdue money — on average more than $200 per visit. But Purdue made that money back many times over, because it convinced doctors to prescribe its addictive drugs. When Purdue identified a doctor as a profitable target, Purdue visited the doctor frequently: often weekly, sometimes almost every day. Purdue salespeople asked doctors to list specific patients they were scheduled to see and pressed the doctors to commit to put the patients on Purdue opioids. By the time a patient walked into a clinic, the doctor, in Purdue’s words, had already “guaranteed” that he would prescribe Purdue’s drugs. Purdue rewarded high-prescribing doctors with coffee, ice cream, catered lunches, and cash. Purdue has given meals, money, or other gifts to more than 2,000 Massachusetts prescribers.

And they were actually just paying and bribing doctors who prescribed large doses of opioids. Literal kickbacks! They actually made up fake case profiles and patients in order to convince doctors to hand out oxycontin even when it wasn't necessary or dangerous.

Purdue trained its reps to show doctors charts emphasizing Medicare coverage for its opioids and use profiles of fake elderly patients, complete with staged photographs, to convince doctors to prescribe opioids. As a Massachusetts sales rep observed, a fake patient profile “brings the heart into it” and helps get the doctor to say: “Yes, they need this medication.”

I mean, also no? They produced (maybe just promoted?) a concept that may, indeed, be wrong.

Could it be possible that they made an accurate and true scientific discovery while faking data in order to sell more of their product? I doubt it. The core idea of their marketing was that drug addiction was actually just something that happens to "untrustworthy" people when exposed to drugs, and that "trustworthy" people can be prescribed whatever dose of painkillers you want without any risks. They created numerous bodies to create the misleading impression that pseudoaddiction was a real concept and convince doctors to ignore their actual training. Furthermore, they knew they were lying!

Purdue knew its campaign to push higher doses of opioids was wrong. Doctors on Purdue’s payroll admitted in writing that pseudoaddiction was used to describe “behaviors that are clearly characterized as drug abuse” and put Purdue at risk of “ignoring” addiction and “sanctioning abuse.” But Purdue nevertheless urged doctors to respond to signs of addiction by prescribing higher doses of Purdue’s drugs.

And remember, the thing you're trying to show is that they "were ultimately responsible for and made substantial profits from a legal and corporate structure that heavily encouraged and even induced addiction in cases where it wasn't necessary". So, I'd definitely like to hear some things about their legal and corporate structure.

The Massachusetts document is the best source for that.

Regular supervision and adjustment of the dosage is part and parcel of responsible medical care.

Ok, great. So you agree with Purdue's materials.

During sales visits, Purdue reps made false and misleading claims directly to the professionals who care for Massachusetts patients.

What false and misleading claims?

in-person sales visits

...like what is done for literally every other drug out there? You say that this is 'literal kickbacks'. Prosecute that shit for any of the hundreds of other drugs where they do similar in-person sales visits, and then I'll think about believing you.

show doctors charts emphasizing Medicare coverage for its opioids and use profiles of fake elderly patients, complete with staged photographs

So, like, a training mock-up?

Could it be possible that they made an accurate and true scientific discovery while faking data in order to sell more of their product?

Dawg, you skipped the part where you were supposed to show that they faked data in research.

Ok, great. So you agree with Purdue's materials.

This doesn't even reach the level of a bad faith attempt to understand my position or argue with the ideas I actually hold. If you think that's an honest estimation of my views on the topic then I don't think there's any point talking anymore because we clearly aren't communicating with each other.

I think it's an honest estimation of the words that you are saying and how they map to the materials in question, mostly because it doesn't seem like you've actually read the materials in question. It's supposed to invoke the idea that there is a wide gulf between what your position is/the ideas you actually hold and the words that you are using/what is in evidence. Like, the narrative you think you have going on in your head is just totally disconnected.

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