old weedsle
When Emblem Cannabis Corp was cleared by the federal government to sell medical marijuana in August, the company set out to attract new investors, vowing to "change the face" of the industry.
In company materials, Emblem touted the wealth of experience its top executives brought to the fold, particularly in its pharmaceutical division.
The man in charge of that business, John H. Stewart, was a veteran of the drug industry, having spent close to 40 years in key roles at one of the world's biggest pharmaceutical companies.
His successes, Emblem said, included launching 11 new products, in particular one blockbuster drug that made his former employer billions of dollars – OxyContin.
Mr. Stewart was now bringing that expertise to Emblem, which planned on "revolutionizing" cannabis consumption with prescription tablets and capsules that "would dramatically expand Emblem's sales."
However, there were a few details Emblem glossed over in its promotional efforts.
A decade ago, when Mr. Stewart was president of Purdue Pharma Canada, coroners and public-health officials were beginning to ring alarm bells over abuse of OxyContin, a highly addictive painkiller.
When he later became chief executive officer and president of Purdue's U.S. parent in 2007, it was only a month after the U.S. company agreed to pay the U.S. government more than $634-million (U.S.) to settle allegations that it "fraudulently misbranded OxyContin" as being less dangerous than it was.
OxyContin is now seen as the flashpoint of an opioid crisis that has swept across the continent, killing hundreds of thousands of people in Canada and the United States and touching off a chain reaction of addictions to other drugs, such as fentanyl.
Many of those killed after taking OxyContin were not initially addicts or abusers, but became dependent on opioids after being prescribed the drug by their doctor upon complaining of pain.
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In 2013, law makers began asking new questions about what the company, based in Stamford, Conn., knew about the growing opioid crisis and how its own marketing tactics directed toward doctors may have fuelled the problem.
Wealthy from his days at Purdue, where he retired three years ago, Mr. Stewart has invested $1-million of his own money into his new company, one of 36 medical-marijuana producers licensed by the federal government. Emblem is now seeking to promote cannabis as an alternative to prescription painkillers – and profit from the opioid crisis Purdue was instrumental in creating.
Soon after receiving its licence from Health Canada, Emblem took to its Twitter account to extoll the virtues of cannabis over the prescription opioids that made Purdue one of the richest drug companies in the world.
"Medical cannabis," Mr. Stewart's new company said, "could save us from painkillers."
****
The opioid explosion began with a phone call.
Mr. Stewart joined Purdue as a sales representative in 1974, but was promoted to clinical research just two years later. By the early 1980s, he was put in charge of research and development at Purdue's Canadian division.
Back then, Purdue wasn't involved in analgesics, or pain-relief medications. The company's British division had, however, developed a controlled-release technology for pills that allowed medication to last longer by dispersing the active ingredient slower. It called this invention Contin.
One day, a senior physician phoned the company and suggested its researchers marry Contin with morphine, since hospitals required a painkiller that lasted longer but traditional morphine only provided about four hours of relief.
"He said, 'you've got this controlled-release system that you're currently using for respiratory medicines and potassium. You ought to think about putting morphine in that,'" Mr. Stewart said in an interview in October.
"So we in Purdue Canada, and I was head of R&D at the time, started the process for saying 'OK,' let's make a long-acting formulation of morphine.
"Myself and three other people are the ones that ran the program."
MS Contin, as it was dubbed, hit the market in 1986 and, seeing the reception it got from hospitals, researchers at Purdue got to work on developing other kinds of long-lasting painkillers. Finding one that could be used on a broader spectrum of pain would be a gold mine.
Purdue's U.S. division soon combined the opioid oxycodone with the company's patented extended-release technology and OxyContin was born. The new product was approved by the U.S. Food and Drug Administration in 1995, and by Health Canada the following year.
"The U.S. developed it and we brought it to Canada," Mr. Stewart said.
The pills sold well, with close to $50-million worth of OxyContin moving in its first year on the market in North America.
Opioids can be deceptive and dangerous drugs, though, since they are highly addictive. Oxycodone was created in 1916 by German scientists who were the first to synthesize opiates. The drug is chemically similar to heroin.
However, Purdue's sales pitch to doctors was that OxyContin was less risky because of the proprietary slow-release formula. In an informational video distributed to doctors' offices by Purdue sales representatives in the United States, the company claimed opioid analgesics had been shown to cause addiction in less than one per cent of patients, according to court documents obtained by The Globe and Mail. The video, titled From One Pain Patient to Another: Advice from Patients Who Have Found Relief, was to be used as an educational tool for clinic staff, and made available for patients to take home.
OxyContin use flourished, and by 2001, Purdue was selling more than $1-billion worth of the drug in North America. By 2002, that number climbed to more than $1.5-billion and the pills accounted for roughly 75 per cent of Purdue's revenue. By every pharmaceutical-industry standard, OxyContin was a blockbuster drug.
A key driver of this growth was Purdue's ability to persuade doctors that OxyContin could be used for more than just severe pain. When first introduced, the drug was mostly used to treat late-stage cancer patients and patients who had undergone major operations. But Purdue expanded its marketing efforts, promoting OxyContin for a wider range of ailments from arthritis and fibromyalgia to back pain.
Central to the company's sales strategy was to get more doctors to prescribe the drug. This meant expanding its marketing beyond oncologists and surgeons, who had been the primary market, to a larger pool of doctors – including general practitioners – by persuading them that OxyContin was effective for less severe pain and useful for ongoing pain management.
In another educational video produced by the company, Purdue targeted doctors with the message that OxyContin was a drug "to start and stay with," meaning that physicians should prescribe it for initial moderate and severe pain, and for extended treatment. Doctors, however, began to notice patients were developing a tolerance to the drug and, soon, a dependence.
By 2002, primary-care doctors in the United States represented nearly half of OxyContin's prescribers as the drug was increasingly promoted to physicians "who were not adequately trained in pain management," according to a report by the U.S. Government Accountability Office (GAO), a congressional watchdog that investigated the company's marketing of the drug in 2003.
Meanwhile, documents show that Purdue doubled its sales force for OxyContin. In 1996, the company employed 318 sales representatives to promote the drug to doctors' offices and hospitals and another 300 people contracted through a pharmaceutical sales company called Abbott Laboratories. By 2002, that total figure had climbed to 1,067, including 767 sales reps inside Purdue.
Each salesperson was given a list of 140 physicians to call on and was expected to make between 35 and 50 visits a week. To incentivize the sales force, Purdue expanded its bonus pool from $1-million in 1996 to $40-million by 2001. While an average sales representative made $55,000 in base salary, the bonuses for persuading doctors to prescribe OxyContin climbed as high as $240,000 a year per person.
Sales representatives were coached not to talk about OxyContin abuse unless a physician brought it up, according to a report by the medical-industry publication STAT, citing documents from a U.S. lawsuit settled in 2004 that were unsealed this year.
When Emblem Cannabis Corp was cleared by the federal government to sell medical marijuana in August, the company set out to attract new investors, vowing to "change the face" of the industry.
In company materials, Emblem touted the wealth of experience its top executives brought to the fold, particularly in its pharmaceutical division.
The man in charge of that business, John H. Stewart, was a veteran of the drug industry, having spent close to 40 years in key roles at one of the world's biggest pharmaceutical companies.
His successes, Emblem said, included launching 11 new products, in particular one blockbuster drug that made his former employer billions of dollars – OxyContin.
Mr. Stewart was now bringing that expertise to Emblem, which planned on "revolutionizing" cannabis consumption with prescription tablets and capsules that "would dramatically expand Emblem's sales."
However, there were a few details Emblem glossed over in its promotional efforts.
A decade ago, when Mr. Stewart was president of Purdue Pharma Canada, coroners and public-health officials were beginning to ring alarm bells over abuse of OxyContin, a highly addictive painkiller.
When he later became chief executive officer and president of Purdue's U.S. parent in 2007, it was only a month after the U.S. company agreed to pay the U.S. government more than $634-million (U.S.) to settle allegations that it "fraudulently misbranded OxyContin" as being less dangerous than it was.
OxyContin is now seen as the flashpoint of an opioid crisis that has swept across the continent, killing hundreds of thousands of people in Canada and the United States and touching off a chain reaction of addictions to other drugs, such as fentanyl.
Many of those killed after taking OxyContin were not initially addicts or abusers, but became dependent on opioids after being prescribed the drug by their doctor upon complaining of pain.
STORY CONTINUES BELOW ADVERTISEMENT
In 2013, law makers began asking new questions about what the company, based in Stamford, Conn., knew about the growing opioid crisis and how its own marketing tactics directed toward doctors may have fuelled the problem.
Wealthy from his days at Purdue, where he retired three years ago, Mr. Stewart has invested $1-million of his own money into his new company, one of 36 medical-marijuana producers licensed by the federal government. Emblem is now seeking to promote cannabis as an alternative to prescription painkillers – and profit from the opioid crisis Purdue was instrumental in creating.
Soon after receiving its licence from Health Canada, Emblem took to its Twitter account to extoll the virtues of cannabis over the prescription opioids that made Purdue one of the richest drug companies in the world.
"Medical cannabis," Mr. Stewart's new company said, "could save us from painkillers."
****
The opioid explosion began with a phone call.
Mr. Stewart joined Purdue as a sales representative in 1974, but was promoted to clinical research just two years later. By the early 1980s, he was put in charge of research and development at Purdue's Canadian division.
Back then, Purdue wasn't involved in analgesics, or pain-relief medications. The company's British division had, however, developed a controlled-release technology for pills that allowed medication to last longer by dispersing the active ingredient slower. It called this invention Contin.
One day, a senior physician phoned the company and suggested its researchers marry Contin with morphine, since hospitals required a painkiller that lasted longer but traditional morphine only provided about four hours of relief.
"He said, 'you've got this controlled-release system that you're currently using for respiratory medicines and potassium. You ought to think about putting morphine in that,'" Mr. Stewart said in an interview in October.
"So we in Purdue Canada, and I was head of R&D at the time, started the process for saying 'OK,' let's make a long-acting formulation of morphine.
"Myself and three other people are the ones that ran the program."
MS Contin, as it was dubbed, hit the market in 1986 and, seeing the reception it got from hospitals, researchers at Purdue got to work on developing other kinds of long-lasting painkillers. Finding one that could be used on a broader spectrum of pain would be a gold mine.
Purdue's U.S. division soon combined the opioid oxycodone with the company's patented extended-release technology and OxyContin was born. The new product was approved by the U.S. Food and Drug Administration in 1995, and by Health Canada the following year.
"The U.S. developed it and we brought it to Canada," Mr. Stewart said.
The pills sold well, with close to $50-million worth of OxyContin moving in its first year on the market in North America.
Opioids can be deceptive and dangerous drugs, though, since they are highly addictive. Oxycodone was created in 1916 by German scientists who were the first to synthesize opiates. The drug is chemically similar to heroin.
However, Purdue's sales pitch to doctors was that OxyContin was less risky because of the proprietary slow-release formula. In an informational video distributed to doctors' offices by Purdue sales representatives in the United States, the company claimed opioid analgesics had been shown to cause addiction in less than one per cent of patients, according to court documents obtained by The Globe and Mail. The video, titled From One Pain Patient to Another: Advice from Patients Who Have Found Relief, was to be used as an educational tool for clinic staff, and made available for patients to take home.
OxyContin use flourished, and by 2001, Purdue was selling more than $1-billion worth of the drug in North America. By 2002, that number climbed to more than $1.5-billion and the pills accounted for roughly 75 per cent of Purdue's revenue. By every pharmaceutical-industry standard, OxyContin was a blockbuster drug.
A key driver of this growth was Purdue's ability to persuade doctors that OxyContin could be used for more than just severe pain. When first introduced, the drug was mostly used to treat late-stage cancer patients and patients who had undergone major operations. But Purdue expanded its marketing efforts, promoting OxyContin for a wider range of ailments from arthritis and fibromyalgia to back pain.
Central to the company's sales strategy was to get more doctors to prescribe the drug. This meant expanding its marketing beyond oncologists and surgeons, who had been the primary market, to a larger pool of doctors – including general practitioners – by persuading them that OxyContin was effective for less severe pain and useful for ongoing pain management.
In another educational video produced by the company, Purdue targeted doctors with the message that OxyContin was a drug "to start and stay with," meaning that physicians should prescribe it for initial moderate and severe pain, and for extended treatment. Doctors, however, began to notice patients were developing a tolerance to the drug and, soon, a dependence.
By 2002, primary-care doctors in the United States represented nearly half of OxyContin's prescribers as the drug was increasingly promoted to physicians "who were not adequately trained in pain management," according to a report by the U.S. Government Accountability Office (GAO), a congressional watchdog that investigated the company's marketing of the drug in 2003.
Meanwhile, documents show that Purdue doubled its sales force for OxyContin. In 1996, the company employed 318 sales representatives to promote the drug to doctors' offices and hospitals and another 300 people contracted through a pharmaceutical sales company called Abbott Laboratories. By 2002, that total figure had climbed to 1,067, including 767 sales reps inside Purdue.
Each salesperson was given a list of 140 physicians to call on and was expected to make between 35 and 50 visits a week. To incentivize the sales force, Purdue expanded its bonus pool from $1-million in 1996 to $40-million by 2001. While an average sales representative made $55,000 in base salary, the bonuses for persuading doctors to prescribe OxyContin climbed as high as $240,000 a year per person.
Sales representatives were coached not to talk about OxyContin abuse unless a physician brought it up, according to a report by the medical-industry publication STAT, citing documents from a U.S. lawsuit settled in 2004 that were unsealed this year.
