---
title: OxyContin's launch marketing:a one-paragraph letter and a "less than one percent" message
url: https://propagandaarchive.org/case-studies/oxycontin-marketing/
description: after the FDA approved OxyContin on 12 December 1995, Purdue promoted it to doctors as less addictive and less subject to abuse than other pain drugs, a…
section: Case studies
---

![Illustration: a redacted Cold War intelligence-dossier collage centred on a world map of influence operations, with the U.S. Capitol among the evidence.](https://propagandaarchive.org/static/generated/hero-home.jpg)

[Case studies](https://propagandaarchive.org/case-studies/)

# OxyContin's launch marketing:a one-paragraph letter and a "less than one percent" message

At a glance

After the FDA approved OxyContin on 12 December 1995, Purdue promoted it to doctors as less addictive and less subject to abuse than other pain drugs…

- **When:** December 12, 1995
- **Actor:** Purdue Pharma L.P. and The Purdue Frederick Company…
- **Target:** U.S. physicians and other prescribers; secondarily, patients with chronic pain
- **Source:** Identified Openly sourced: the speaker is who they say they are
- **Confidence:** **documented** Primary documents, court records, official disclosures
- **Techniques:** [Card stacking](https://propagandaarchive.org/techniques/card-stacking/) [Transfer](https://propagandaarchive.org/techniques/transfer/) [Testimonial](https://propagandaarchive.org/techniques/testimonial/) [Semantic hijacking](https://propagandaarchive.org/techniques/semantic-hijack/)

Full details

- **Actor:** Purdue Pharma L.P. and The Purdue Frederick Company (makers of OxyContin), owned by members of the Sackler family

On this page

- [What happened](https://propagandaarchive.org/case-studies/oxycontin-marketing/#what-happened)
- [How it works](https://propagandaarchive.org/case-studies/oxycontin-marketing/#how-it-works)
- [Then and now](https://propagandaarchive.org/case-studies/oxycontin-marketing/#then-and-now)
- [Positions on the record](https://propagandaarchive.org/case-studies/oxycontin-marketing/#positions-on-the-record)
- [Same-method test](https://propagandaarchive.org/case-studies/oxycontin-marketing/#same-method-test)
- [How to spot it](https://propagandaarchive.org/case-studies/oxycontin-marketing/#how-to-spot-it)
- [Images](https://propagandaarchive.org/case-studies/oxycontin-marketing/#images)
- [Sources](https://propagandaarchive.org/case-studies/oxycontin-marketing/#sources)

On this page

**In one line:** after the FDA approved OxyContin on 12 December 1995, Purdue promoted it to doctors as less addictive and less subject to abuse than other pain drugs, a claim the company admitted in a 2007 felony plea had no medical research behind it, while a five-sentence 1980 letter about hospital patients was cited widely in the medical literature, and by Purdue, as evidence that addiction was rare.

![Diagram: a 1980 one-paragraph letter about hospital patients and a 1995 label sentence on abuse liability feed a sales message that addiction risk was under one percent, carried by a patient video and training materials, ending in guilty pleas in 2007 and 2020](https://propagandaarchive.org/case-studies/images/oxycontin-marketing-diagram.svg)

## What happened

- **10 January 1980.** Jane Porter and Hershel Jick of the Boston Collaborative Drug Surveillance Program publish a one-paragraph letter in the *New England Journal of Medicine* titled "Addiction rare in patients treated with narcotics." Among 11,882 hospitalized medical patients who received at least one narcotic, they found four cases of addiction, one of them considered major. The letter concerns patients treated in hospital; Jick later said it had no bearing on long-term outpatient use.
- **12 December 1995.** The FDA approves OxyContin, a twice-daily controlled-release oxycodone tablet. The approved label says: "Delayed absorption, as provided by OxyContin tablets, is believed to reduce the abuse liability of a drug." The sentence states a belief, not a study result. The FDA medical review officer, Curtis Wright, later said in a 2018 deposition that he had early concerns about the scientific basis for Purdue's claims; he later went to work for Purdue, as reported in press coverage of that deposition.
- **1996 to 2001.** Purdue launches OxyContin and expands its sales force. The U.S. General Accounting Office (GAO) found that Purdue went from 300-plus sales representatives in 1996 to nearly 700 in 2000, and that bonuses Purdue tied to OxyContin sales grew from about $1 million in 1996 to about $40 million in 2001. Physician Art Van Zee, writing in the peer-reviewed *American Journal of Public Health* in 2009, states that "Purdue trained its sales representatives to carry the message that the risk of addiction was 'less than one percent,'" and that the company cited the Porter and Jick letter and a study of burn patients in support.
- **1998.** Purdue distributes a promotional video, *I Got My Life Back: Patients in Pain Tell Their Story*, to doctors. GAO reported in 2003 that Purdue did not submit the video to the FDA for review, as required; 15,000 copies had been distributed by 2000. In the video, a pain physician says the drugs "don't wear out" and "don't have serious medical side effects." News coverage (*The Washington Post*, NBC News) reported that the physician in the video also says fewer than 1 percent of patients become addicted, a figure the FDA said had not been substantiated.
- **July 2001.** The FDA removes the "believed to reduce the abuse liability" sentence from the label.

![DEA illustration of OxyContin tablet strengths](https://propagandaarchive.org/case-studies/images/oxycontin-marketing-dea-tablets.jpg)

*OxyContin tablets in several strengths, from a U.S. Drug Enforcement Administration "Drugs of Abuse" publication. U.S. government work, public domain.*

![Cover of the Senate hearing record OxyContin: Balancing Risks and Benefits, 2002](https://propagandaarchive.org/case-studies/images/oxycontin-marketing-senate-hearing-2002.jpg)

*Cover of the printed record of the Senate Health, Education, Labor and Pensions Committee hearing "OxyContin: Balancing Risks and Benefits," 12 February 2002. U.S. government work, public domain.*

- **10 May 2007.** In federal court in Abingdon, Virginia, The Purdue Frederick Company pleads guilty to felony misbranding of OxyContin "with the intent to defraud or mislead." The agreed statement of facts says that from about 12 December 1995 to about 30 June 2001, certain Purdue supervisors and employees marketed OxyContin "as less addictive, less subject to abuse and diversion, and less likely to cause tolerance and withdrawal than other pain medications." Three executives, Michael Friedman (president), Howard Udell (chief legal officer) and Paul Goldenheim (former chief medical officer), plead guilty to misdemeanor misbranding. Company and executives pay $634,515,475 in total.
- **February 2018.** The minority staff of the Senate Homeland Security and Governmental Affairs Committee, under Senator Claire McCaskill, publish *Fueling an Epidemic*. It reports nearly $9 million in payments from five opioid makers to 14 advocacy groups and professional societies from 2012 to 2017, with Purdue's $4,153,554.33 about half of the total.
- **21 October 2020.** The Justice Department announces an $8.3 billion resolution. On 24 November 2020 Purdue Pharma L.P. pleads guilty in federal court in Newark to three felonies: a dual-object conspiracy to defraud the United States and violate the Food, Drug, and Cosmetic Act, and two conspiracies to violate the Anti-Kickback Statute. The admitted conduct runs from May 2007 to March 2017 and concerns misleading the DEA about Purdue's anti-diversion program, payments to prescribers and to the records firm Practice Fusion, and specialty-pharmacy contracts; it is a separate period from the 1995 to 2001 launch claims. Sackler family members agree to pay $225 million to resolve civil False Claims Act liability. No individual receives a criminal release.
- **27 June 2024.** In *Harrington v. Purdue Pharma L.P.*, the Supreme Court rules 5 to 4 (Justice Gorsuch for the majority) that the Bankruptcy Code does not authorize a Chapter 11 plan to release claims against non-debtors, here Sackler family members, without the claimants' consent.

## How it works

- [Card stacking](https://propagandaarchive.org/techniques/card-stacking/): the 2007 agreed statement of facts is the core record. Purdue employees told prescribers the drug was less addictive and less subject to abuse "when there was no medical research to support these claims," in the words of the U.S. Attorney's release. Van Zee argues that the evidence Purdue did cite, the Porter and Jick letter and a burn-unit study, dealt with short-term treatment in hospital and "do not help establish the risk of iatrogenic addiction when opioids are used daily for a prolonged time in treating chronic pain." The selection left out the population the drug was being sold for.
- [Transfer](https://propagandaarchive.org/techniques/transfer/): a one-paragraph letter to the editor, not a full research report, carried the authority of the *New England Journal of Medicine*. Leung, Macdonald, Stanbrook, Dhalla and Juurlink (*NEJM*, 2017) counted 608 citing articles from 1981 to 2017. In 439 (72.2%), the letter was cited as evidence that addiction is rare in patients treated with opioids; 491 did not mention that the patients were hospitalized. The journal then added an editor's note warning that the letter had been "heavily and uncritically" cited as evidence that addiction is rare with opioid therapy. Hershel Jick told the Associated Press in 2017: "I'm essentially mortified that that letter to the editor was used as an excuse to do what these drug companies did."
- [Testimonial](https://propagandaarchive.org/techniques/testimonial/): *I Got My Life Back* put named patients and their physician on screen to vouch for the drug. The video reached doctors outside the FDA review that promotional material is required to pass, according to GAO. A patient's account of relief is real evidence about that patient; the technique is using it, together with an unreviewed addiction figure, as a substitute for population data.
- [Semantic hijacking](https://propagandaarchive.org/techniques/semantic-hijack/): "pseudoaddiction" was coined by David Weissman and J. David Haddox in a 1989 case report in *Pain* to describe drug-seeking behavior caused by under-treated pain. Haddox worked for Purdue from 1999 to 2018, latterly as a vice president for health policy. State attorneys general allege, in complaints filed from 2018 onward, that Purdue's prescriber guide *Providing Relief, Preventing Abuse* promoted pseudoaddiction and said addiction "is not caused by drugs"; these are allegations, not findings. Greene and Chambers (*Current Addiction Reports*, 2015) found 224 articles discussing pseudoaddiction by 2014 and none that tested it empirically; the 12 that supported it included all four that disclosed drug-company funding. The effect is to take signs clinicians read as addiction and relabel them as a reason to increase the dose.

## Then and now

![A Frank Statement to Cigarette Smokers (1954)](https://propagandaarchive.org/collection/images/frank-statement-1954.png)

*[A Frank Statement to Cigarette Smokers](https://propagandaarchive.org/collection/frank-statement-1954/), Tobacco Industry Research Committee, 1954. Public domain.*

Both cases use selective citation directed at the people making health decisions. The differences matter. The 1954 advertisement disputed a causal finding and spoke to the public; Purdue's message went mostly to prescribers, about an approved prescription medicine used to treat pain, and some of its key wording (the 1995 label sentence) had been approved by the FDA itself. The tobacco case turned on doubt ("no proof"); this one turned on reassurance (a low risk figure). See also [The tobacco industry's smoking-and-health doubt campaign, 1953 to 1998](https://propagandaarchive.org/case-studies/tobacco-doubt-campaign/) and [The Sugar Research Foundation and the 1967 heart disease review](https://propagandaarchive.org/case-studies/sugar-research-foundation/) for industry-funded science in other sectors.

## Positions on the record

- **Purdue's position:** Purdue pleaded guilty twice and, in doing so, admitted the conduct in each agreed statement of facts. On the 1998 video, Purdue said the failure to send it to the FDA was an oversight, as reported by NBC News. On the Senate report, Purdue said it supports organizations interested in helping patients receive appropriate care.
- **The Sackler family's position:** in a statement on 21 October 2020, family members who served on Purdue's board said they "acted ethically and lawfully" and had relied on "repeated and consistent assurances from Purdue's management team that the company was meeting all legal requirements." A website run for the Raymond Sackler branch of the family argues that the FDA reviewed and stood by the approval of OxyContin.
- **The regulator's role:** the FDA approved the "believed to reduce the abuse liability" sentence in 1995, and the sentence cites no study. The agency removed it in 2001. Marketplace and others describe the sentence as approved on belief rather than substantial evidence.
- **Critics' position:** attorneys for 25 states argued in 2020 that the evidence showed the Sacklers engaged in "pervasive fraud and crime." The 2018 Senate minority report argues that funded groups issued guidance that minimized addiction risk.
- **This archive's reading:** documented: the 1995 label text, the 2007 and 2020 guilty pleas and their agreed facts, GAO's findings on the video and sales force, Leung et al.'s citation count, and the Supreme Court ruling. Attributed but not court-found: Van Zee's account of the "less than one percent" sales message, and the state complaints about pseudoaddiction. **Not shown here:** that funded advocacy groups were fronts or were created by Purdue, or how many prescriptions or deaths any one message caused. Leung et al. counted the misuse of the Porter and Jick letter across the medical literature as a whole, not only in Purdue's material, so it was not the company's alone.

![Press conference on the Massachusetts resolution with Purdue Pharma and the Sackler family, July 2021](https://propagandaarchive.org/case-studies/images/oxycontin-marketing-massachusetts-2021.jpg)

*Massachusetts officials announce a resolution of the state's lawsuit against Purdue Pharma and the Sackler family, 8 July 2021. The governor's office said it would bring $90 million to the state. Office of Governor Charlie Baker, public domain (PD-MAGov).*

## Same-method test

A government agency or health charity that cited a short letter or a small, unrepresentative study as settled proof that a drug, diet or intervention was low-risk, dropping the population limits the authors stated, would be scored with the same tags. Such a campaign would get [Card stacking](https://propagandaarchive.org/techniques/card-stacking/) and [Transfer](https://propagandaarchive.org/techniques/transfer/) for leaning on a journal's name, and [Testimonial](https://propagandaarchive.org/techniques/testimonial/) if patient stories stood in for population data. The record here already contains non-corporate cases: the FDA approved a belief-based sentence about abuse liability, and Leung et al. show that the letter's conclusion was repeated out of context across the medical literature, not only in company material. This archive scores government health messaging by the same definitions (for example, [The Real Cost — "Your Skin"](https://propagandaarchive.org/collection/real-cost-your-skin-2014/) is tagged [Fear appeal](https://propagandaarchive.org/techniques/fear-appeal/)).

## How to spot it

- When a risk figure comes with a citation, open the citation and check the population, setting and follow-up. Hospital inpatients over days are not outpatients over years.
- Check what kind of item is cited. A letter to the editor is not a trial, whatever journal printed it.
- Watch for a new term that turns a warning sign into a reason to do more of the same thing.
- Ask whether promotional material went through the review it is required to pass, and who paid for it.
- Keep the regulator's text separate from the evidence behind it. "Believed to" in a label is a statement of belief.

## Images

| Image | Source | Licence |
| --- | --- | --- |
| Mechanism diagram (above) | Drawn for FRAME from the sourced facts on this page (`make_diagrams.py`) | CC BY 4.0, FRAME |
| OxyContin tablets, DEA illustration | [Wikimedia Commons](https://commons.wikimedia.org/wiki/File:Oxycontin_list.jpg), from U.S. DOJ/DEA *Drugs of Abuse* | Public domain (PD-USGov-DOJ) |
| *A Frank Statement to Cigarette Smokers* (1954) | FRAME gallery, from Wikimedia Commons | Public domain |
| Massachusetts press conference, 8 July 2021 | [Wikimedia Commons](https://commons.wikimedia.org/wiki/File:Press_conference_on_litigations_against_Purdue_Pharma_(E5zZ_saWYAQgMDv).jpg), Office of Governor Charlie Baker | Public domain (PD-MAGov) |
| *OxyContin: Balancing Risks and Benefits*, Senate HELP hearing record, 12 February 2002 (cover page) | [Wikimedia Commons](https://commons.wikimedia.org/wiki/File:OXYCONTIN-_BALANCING_RISKS_AND_BENEFITS_(IA_gov.gpo.fdsys.CHRG-107shrg77770).pdf), U.S. Government Publishing Office | Public domain (U.S. government work) |

### Image gaps

- **Frames from *I Got My Life Back* (1998).** Not included: the video is Purdue's copyrighted work. Copies circulate online; a court exhibit copy in the public record could fill this gap.
- **Purdue sales materials and the *Providing Relief, Preventing Abuse* guide.** Not included: copyrighted company material. Exhibits in the state complaints and the Opioid Industry Documents Archive show them.
- **The 1980 Porter and Jick letter and the 2017 editor's note.** Not included: *NEJM* copyright. Both are linked below.
- **Photos of the 2007 Abingdon plea hearing or the 2020 Newark plea.** None openly licensed was found.

## Sources

- [Porter J, Jick H. "Addiction rare in patients treated with narcotics." *NEJM* 1980;302:123](https://www.nejm.org/doi/full/10.1056/NEJM198001103020221)
- [Leung PTM, Macdonald EM, Stanbrook MB, Dhalla IA, Juurlink DN. "A 1980 Letter on the Risk of Opioid Addiction." *NEJM* 2017;376:2194-2195](https://www.nejm.org/doi/full/10.1056/NEJMc1700150)
- [Retraction Watch on the NEJM editor's note, 2 June 2017](https://retractionwatch.com/2017/06/02/nejm-issues-unusual-warning-readers-1980-letter-opioid-addiction/)
- [Van Zee A. "The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy." *AJPH* 2009;99(2):221-227](https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2007.131714)
- [GAO-04-110, *Prescription Drugs: OxyContin Abuse and Diversion and Efforts to Address the Problem*, December 2003](https://www.gao.gov/products/gao-04-110)
- [U.S. Attorney, Western District of Virginia, news release, 10 May 2007](https://media.defense.gov/2007/May/10/2001711223/-1/-1/1/purduefrederick1.pdf)
- [Senate Judiciary Committee hearing, "Evaluating the Propriety and Adequacy of the OxyContin Criminal Settlement," 31 July 2007](https://www.govinfo.gov/content/pkg/CHRG-110shrg40884/html/CHRG-110shrg40884.htm)
- [HHS Departmental Appeals Board decision CR1885 (2009), quoting the 2007 agreed facts](https://www.hhs.gov/sites/default/files/static/dab/decisions/alj-decisions/2009/CR1885.pdf)
- [Marketplace, "How one sentence helped set off the opioid crisis," 13 December 2017](https://www.marketplace.org/story/2017/12/13/opioid)
- [*The Washington Post*, "OxyContin and our opioid crisis," 2018](https://www.washingtonpost.com/graphics/2018/national/amp-stories/oxycontin-how-misleading-marketing-got-america-addicted/)
- [NBC News, "Report: OxyContin maker made false claims"](https://www.nbcnews.com/health/health-news/report-oxycontin-maker-made-false-claims-flna1c9445621)
- [CNN, "Opioid history: From 'wonder drug' to abuse epidemic," 12 May 2016](https://www.cnn.com/2016/05/12/health/opioid-addiction-history/index.html)
- [Yahoo, "Dr. Curtis Wright Took A Job At Purdue Pharma After OxyContin's Approval"](https://www.yahoo.com/lifestyle/dr-curtis-wright-took-job-161400685.html)
- [STAT, "Painful words: How a 1980 letter fueled the opioid epidemic," 31 May 2017](https://www.statnews.com/2017/05/31/opioid-epidemic-nejm-letter/)
- [Weissman DE, Haddox JD. "Opioid pseudoaddiction: an iatrogenic syndrome." *Pain* 1989](https://pubmed.ncbi.nlm.nih.gov/2710565/)
- [Greene MS, Chambers RA. "Pseudoaddiction: Fact or Fiction?" *Current Addiction Reports* 2015](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4628053/)
- [State of Connecticut v. Purdue Pharma, second amended complaint (redacted), 2019](https://portal.ct.gov/-/media/AG/Press_Releases/2019/Redacted-Second-Amended-Complaint-(2).pdf?la=en)
- [Senate HSGAC minority staff, *Fueling an Epidemic*, Report Two, February 2018](https://www.hsgac.senate.gov/wp-content/uploads/imo/media/doc/REPORT-Fueling%20an%20Epidemic-Exposing%20the%20Financial%20Ties%20Between%20Opioid%20Manufacturers%20and%20Third%20Party%20Advocacy%20Groups.pdf)
- [NPR on the Senate report and Purdue's response, 13 February 2018](https://www.npr.org/sections/thetwo-way/2018/02/13/585290752/drugmakers-spent-millions-promoting-opioids-to-patient-groups-senate-report-says)
- [DOJ, "Justice Department Announces Global Resolution of Criminal and Civil Investigations with Opioid Manufacturer Purdue Pharma and Civil Settlement with Members of the Sackler Family," 21 October 2020](https://www.justice.gov/archives/opa/pr/justice-department-announces-global-resolution-criminal-and-civil-investigations-opioid)
- [DOJ, "Opioid Manufacturer Purdue Pharma Pleads Guilty to Fraud and Kickback Conspiracies," 24 November 2020](https://www.justice.gov/archives/opa/pr/opioid-manufacturer-purdue-pharma-pleads-guilty-fraud-and-kickback-conspiracies)
- [Statement by members of the Sackler family who served on Purdue's board, Business Wire, 21 October 2020](https://www.businesswire.com/news/home/20201021005928/en/Members-of-the-Sackler-Family-Who-Served-on-Purdues-Board-Issue-Statement-about-Department-of-Justice-Announcement)
- [Judge for Yourselves (Raymond Sackler family site), "FDA Stands By Approval of OxyContin"](https://www.judgeforyourselves.info/key-points/oxycontin/fda-review/)
- [NPR, "Critics Want Sacklers To Face Criminal Charges," 25 November 2020](https://www.npr.org/2020/11/25/938801514/critics-want-sacklers-to-face-criminal-charges-for-role-in-opioid-crisis)
- [*Harrington v. Purdue Pharma L.P.*, 603 U.S. ___ (2024)](https://supreme.justia.com/cases/federal/us/603/23-124/)
- [Congressional Research Service, LSB11201, on *Harrington v. Purdue Pharma*](https://www.congress.gov/crs-product/LSB11201)