Drug Deals

BY BOB WHITBY
1/29/2004
Orlando Weekly

First came the e-mail hinting at dirt on the Orlando Sentinel. And I bit. Then came the phone call, and I bit again. Then came the documents, and I continued to chomp. Who can resist the tantalizing allure of afflicting the afflicters? Most people, probably, but I do not count myself among them. I know how journalism is made -- news, like hot dogs, is a product you should not inspect closely if you wish to keep consuming it. And I am well versed in the haughty, insular nature of monopoly dailies. It's all polish, professionalism and public editors on the outside, but there are bones in the closet.

In retrospect I see that I was played. By the best, in fact, but that's little consolation. The only way to salvage this ugly affair is to turn it into a short (I promise) tutorial on corporate protectionism.

In October, the Sentinel published a five-day series on the dangers of OxyContin, a potent prescription painkiller with a troubling history of overdoses. Reporter Doris Bloodsworth did nine months of the requisite legwork, examining 500 autopsy reports from around the state, 5,000 pages of documents from a state inquiry into the marketing of OxyContin, and scores of interviews with doctors and families. Bloodsworth was able to link some 200 deaths in 2001 and 2002 to the painkiller, the same stuff that Rush Limbaugh was hooked on. (Why oh why ... never mind.)

In the past, OxyContin has been criticized as being the prescription drug of choice for abusers, who crush the pill and snort it, bypassing its time-release mechanism. Doing so sometimes has the unpleasant side effect of death. Of course Purdue Pharma, the makers of OxyContin, can't be held responsible for the misbehavior of addicts. You are supposed to take the pills whole; it says so right on the label.

But Bloodsworth was interested in deaths among people taking OxyContin correctly, under the supervision of a physician. That kind of publicity can seriously cut into a company's bottom line.

So Purdue got busy picking the series apart, and Orlando Weekly got a phone call from their PR agency in Tampa (red flag there). Would I be interested in debunking this "harmful and misleading" series of articles, wondered Robin Hogen, Purdue Pharma's vice president for public affairs? A deal with the devil, but why not hear what Old Scratch has to say?

After two months of high-priced lawyers scrutinizing the series, here's what Purdue Pharma came up with: David Rokisky, one of the innocent "victims" Bloodsworth wrote about, has a history of drug abuse; and Gerry Cover, a Kissimmee man who died of an overdose, had drugs besides oxycodone (the active ingredient in OxyContin) in his system.

Both are quasi-legitimate concerns. And both are indicative of how far Purdue will go to protect the franchise.

Bloodsworth interviewed Rokisky, who told her that until a doctor prescribed OxyContin, "Life was perfect." She also wrote that, "He didn't even drink or smoke." Purdue Pharma's lawyers, however, did a little background check on Rokisky and learned that he's also an ex-cop from Albuquerque who pled guilty to one count of distributing cocaine in April 2000, and who, according to his lawyer, "had problems" with cocaine and steroids.

Regarding Cover's death, Bloodsworth wrote, "An autopsy determined that he had a lethal dose of oxycodone." The autopsy actually says "toxic" instead of "lethal." It also notes the presence of several other prescription drugs in Cover's blood, and pegs "multidrug overdose" as the cause of death.

Purdue lawyers are also trying to make hay out of the idea that the Sentinel's analysis of autopsy reports doesn't conform to scientific standards, which is ridiculous. Reporting isn't analyzing, and the Sentinel isn't JAMA.

Said inaccuracies aside, what's interesting is what Purdue isn't contesting about the series. Bloodsworth wrote about the company's aggressive marketing campaign, which recently came under fire from the General Accounting Office, an investigative arm of congress. She also wrote about doctors who didn't fully understand what they were prescribing, the incredible profits Purdue made from OxyContin and the company's attack-dog tactics when criticized in the press.

"We found out very quickly that this wasn't about truth or facts or science," she quotes Hogen saying at public-relations seminar in 2002. "It was really about politics, and we had to think politically

"Including playing journalists to do their bidding. I feel so dirty.

A chilling attempt at damage control Wednesday

March 05, 2003
BY BOB BRAUN Star-Ledger Staff

Chilling.

The word for the day at a conference last week at Columbia University's National Center for Addiction and Substance Abuse in New York City.

Most participants were doctors and what "chilled" -- scared -- them were fears of running afoul of the law for prescribing pain medications. Heard it a lot. Doctors who knew doctors who were arrested because, it turns out, the guy who asked for relief for his backache was really collecting prescriptions for addictive drugs that could be sold on the street. Drugs like "hillbilly heroin."

That's what Laura Nagle, a Drug Enforcement Administration agent, calls OxyContin, a powerful opioid, potentially as addictive as morphine. In some states, especially in Appalachia, it's a bigger problem than heroin.

Oh-oh. Did I say "addictive"?

Well, Nagle did. But a guy named Robin Hogen gets upset if you use the word "addictive" -- although he accidentally used it himself to describe OxyContin. He quickly corrected himself to say it has the "same potential for abuse as morphine."

He is vice president for public affairs for Purdue Pharma, maker of OxyContin.

He is soft-spoken and amiable. He wears a bow tie and a pinstriped suit. He corrects misimpressions about OxyContin and warns you -- nicely -- to watch your words.

But something he said struck me as chilling indeed. He spoke of Jill Skolek, a 29-year-old mother from Phillipsburg who, last year, died after taking OxyContin for back pain. That led her mother,

Marianne, of Whitehouse Station, to crusade against the drug. Marianne, a nurse, wants the Food and Drug Administration to force Purdue to admit OxyContin is addictive. She also wants the FDA to stop Purdue from marketing the drug widely. She said Jill should never have been given so powerful a drug -- initially developed for cancer patients -- but doctors are not adequately warned.

After months of letters and complaints from Skolek, the FDA in January did issue a stern "warning letter" to Purdue Pharma LP. In part, it read:

"Your journal advertisements omit and minimize the serious safety risks associated with OxyContin, and promote it for uses beyond which have been proven safe and effective."

The FDA had issued an earlier letter, in May of 2000, saying advertising for OxyContin was misleading. Nearly 200 lawsuits have been filed against Purdue, including some by states. So far, about 20 have been dismissed.

This is what Hogen said about Jill Skolek: "We think she abused drugs."

The medical examiner didn't say that. Hogen admits he really doesn't know.

That's a pretty heavy charge to make against a young woman who died, leaving behind a 6-year-old son, Brian. Because Jill can't defend herself.

And, especially because it might lead journalists -- like me -- to avoid writing about her mother's efforts to hold a big pharmaceutical house accountable. No one wants to create sympathy for a junkie. But Jill was no junkie.

The stakes are high. For Purdue, which had $1.2 billion in OxyContin sales last year. And for thousands of people who may have died or become addicted after using it.

But that wasn't the only chilling thing Hogen said.

The conference featured a panel discussion that included Richard Blumenthal, the Connecticut attorney general, who described his efforts to get information about Purdue.

After the discussion, I spoke to Blumenthal. Off to the side. I asked him to clarify whether his efforts constituted an "investigation."

He had called it "an ongoing inquiry," but I didn't want to say he was investigating Purdue, a Stamford company, if he wasn't.

"Well, yes, you can call it an investigation," he said. "It might not be a criminal investigation, but it's an investigation."

That's right from the mouth of the attorney general.

Hours later, a message was left on my voice-mail. By Hogen. He said:

"I couldn't help but overhear your conversation with Attorney General Blumenthal at the end of the CASA conference and I'm concerned that you may misrepresent something he said tomorrow which involves the correspondence between Purdue and the attorney general's office.

"There is no investigation under way. I think what he told you was that there was an investigative effort, and what that means is that he has written a letter and asked us for some documents and our marketing plans for the last few years, samples of ads and marketing plans, which we're of course providing to him. We've already provided these to several newspapers in Florida. We're happy to provide them to our attorney general.

"But that does not constitute an investigation, and that would be inaccurate for you to report tomorrow that the attorney general of Connecticut has launched an investigation of Purdue Pharma.

"I do not think that's what he meant. I heard him say it, but I also heard him withdraw it and I think we've asked him point-blank about this and he has told us and I think he would tell you, if you gave him a moment to think about it, that Purdue is not, there is no investigation. There is an exchange of documents that does not constitute an investigation and I did want to clarify that and I would encourage you to call the attorney general and ask for a clarification because we do not want (sic), we've asked him the same question, and he has told us that this is not an investigation.

"It's a request for documents and there's a big difference."

A few notes: Hogen, of course, had no business listening in on my conversation.

I did ask Blumenthal for a clarification and he did say it was an "investigation."

A court, not Purdue, released those marketing documents in Florida after two newspapers sued the state, which had collected them in its own investigation.

And I had to think about how easily this man judged Jill Skolek and carelessly talked about her to a newsman. Jill can't leave a message clarifying what he said.

This was the public relations man's sign-off to me on my tape:

"Bob, I hope you take this in the spirit in which it is offered."

I sure did.

It was chilling.