Tuesday, January 17, 2023

the last book I ever read (Empire of Pain: The Secret History of the Sackler Family, excerpt five)

from Empire of Pain: The Secret History of the Sackler Family by Patrick Radden Keefe:

In 1965, the federal government started to investigate Librium and Valium. An advisory committee of the Food and Drug Administration recommended that the tranquilizers be treated as controlled substances—a move that would make it much harder for consumers to get them. Both Roche and Arthur Sackler perceived this prospect as a major threat. As a general rule, Arthur was skeptical of government regulation when it came to medicine, and he recognized that new controls on the minor tranquilizers could be devastating for his bottom line. For nearly a decade, the company resisted efforts by the FDA to control Librium and Valium, a period in which Roche sold hundreds of millions of dollars of the drugs. It was only in 1973 that Roche agreed to “voluntarily” submit to the controls. But one FDA adviser would speculate that the timing of this reversal was no accident: at the point when Roche conceded defeat, its patents on the drugs were set to expire, meaning that Roche would no longer enjoy the exclusive right to manufacture them and would be forced to lower its prices in the face of generic competition. As Arthur’s friend and secret business partner Bill Frohlich had observed, the commercial life span of a branded drug is the short interval between the point when you start marketing it and the point when you lose patent exclusivity. Roche and Arthur didn’t need to fight off regulation forever; they just needed to hold it off until the patents had run out.

By the time Roche allowed its tranquilizers to be controlled, Valium had become part of the lives of some twenty million Americans, the most widely consumed—and most widely abused—prescription drug in the world. It had taken time for the country to wake up to the negative impact of Valium, in part because there was some novelty, for average consumers, in the idea of a drug that could be dangerous even though it was prescribed by a doctor. Moral panics over drugs in America had tended to focus on street drugs and to play on fears about minority groups, immigrants, and illicit influences; the idea that you could get hooked on a pill that was prescribed to you by a physician in a white coat with a stethoscope around his neck and a diploma on the wall was somewhat new. But, eventually, establishment figures like the former first lady Betty Ford would acknowledge having struggled with Valium, and Senator Edward Kennedy would blame tranquilizers for producing “a nightmare of dependence and addiction.” Roche stood accused of “overpromoting” the drug. The Rolling Stones even wrote a song about Valium, “Mother’s Little Helper,” whose lyrics evoked the McAdams campaign aimed at women. “Mother needs something today to calm her down,” Mick Jagger sang. “And though she’s not really ill, there’s a little yellow pill.”

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