Buying Heroin Gstaad

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Buying Heroin Gstaad

Eleven thousand white porcelain tiles, inlaid like a shattered backgammon board, cover a surface the size of six tennis courts. The Sackler Courtyard is the latest addition to an impressive portfolio. A popular species of pink rose is named after a Sackler. So is an asteroid. The Sackler Institute for Nutrition Science supports research on obesity and micronutrient deficiencies. The Sackler name is everywhere, evoking automatic reverence; the Sacklers themselves, however, are rarely seen. The descendants of Mortimer and Raymond Sackler, a pair of psychiatrist brothers from Brooklyn, are members of a billionaire clan with homes scattered across Connecticut, London, Utah, Gstaad, the Hamptons, and, especially, New York City. Thousands more have died after starting on a prescription opioid and then switching to a drug with a cheaper street price, such as heroin. Not all of these deaths are related to OxyContin—dozens of other painkillers, including generics, have flooded the market in the past thirty years. Nevertheless, Purdue Pharma was the first to achieve a dominant share of the market for long-acting opioids, accounting for more than half of prescriptions by According to the Centers for Disease Control, fifty-three thousand Americans died from opioid overdoses in , more than the thirty-six thousand who died in car crashes in or the thirty-five thousand who died from gun violence that year. If you head north on I through Stamford, Connecticut, you will spot, on the left, a giant misshapen glass cube. The company was purchased in by Arthur Sackler, thirty-nine, and was run by his brothers, Mortimer, thirty- six, and Raymond, thirty-two. The Sackler brothers came from a family of Jewish immigrants in Flatbush, Brooklyn. Arthur was a headstrong and ambitious provider, setting the tone—and often choosing the path—for his younger brothers. There, they coauthored more than one hundred studies on the biochemical roots of mental illness. In the s, Arthur was contracted by Roche to develop an advertising strategy for a new antianxiety medication called Valium. This posed a challenge, because the effects of the medication were nearly indistinguishable from those of Librium, another Roche tranquilizer that was already on the market. Arthur differentiated Valium by audaciously inflating its range of indications. Arthur, whose compensation depended on the volume of pills sold, was richly rewarded, and he later became one of the first inductees into the Medical Advertising Hall of Fame. When Arthur donated his art and money to museums, he often imposed onerous terms. According to a memoir written by Thomas Hoving, the Met director from to , when Arthur established the Sackler Gallery at the Metropolitan Museum of Art to house Chinese antiquities, in , he required the museum to collaborate on a byzantine tax-avoidance maneuver. In accordance with the scheme, the museum first sold Arthur a large quantity of ancient artifacts at the deflated s prices for which they had originally been acquired. Arthur then donated back the artifacts at s prices, in the process taking a tax deduction so hefty that it likely exceeded the value of his initial donation. Three years later, in connection with another donation, Arthur negotiated an even more unusual arrangement. Hoving said that the Met hoped that Arthur would eventually donate his collection to the museum, but over time Arthur grew disgruntled over a series of rankling slights. Jillian Sackler said it was Arthur who rejected the board seat, after repeated offers by the museum. Arthur's younger brothers, Mortimer and Raymond, looked so much alike that when they worked together at Creedmoor, they fooled the staff by pretending to be one another. Their physical similarities did not extend to their personalities, however. In , he renounced his U. Like Arthur, Mortimer became a major museum donor and married three wives over the course of his life. Mortimer had his own feuds with the Met. On his seventieth birthday, in , the museum agreed to make the Temple of Dendur available to him for a party but refused to allow him to redecorate the ancient shrine: Together with other improvements, Mortimer and his interior designer, flown in from Europe, had hoped to spiff up the temple by adding extra pillars. Kind and mild-mannered, he stayed with the same woman his entire life. Lutze concluded that Raymond owed his comparatively serene nature to having missed the worst years of the Depression. The Sacklers have been millionaires for decades, but their real money—the painkiller money—is of comparatively recent vintage. In the years before it swooped into the pain-management business, Purdue had been a small industry player, specializing in over-the-counter remedies like ear-wax remover and laxatives. Its most successful product, acquired in , was Betadine, a powerful antiseptic purchased in industrial quantities by the U. The turning point, according to company lore, came in , when a London doctor working for Cicely Saunders, the Florence Nightingale of the modern hospice movement, approached Napp with the idea of creating a timed-release morphine pill. A long-acting morphine pill, the doctor reasoned, would allow dying cancer patients to sleep through the night without an IV. At the time, treatment with opioids was stigmatized in the United States, owing in part to a heroin epidemic fueled by returning Vietnam veterans. In , Napp introduced a timed-release morphine pill in the UK; six years later, Purdue brought the same drug to market in the U. MS Contin quickly became the gold standard for pain relief in cancer care. At the same time, a number of clinicians associated with the burgeoning chronic-pain movement started advocating the use of powerful opioids for noncancer conditions like back pain and neuropathic pain, afflictions that at their worst could be debilitating. In , two doctors from Memorial Sloan Kettering hospital in New York published a fateful article in a medical journal that purported to show, based on a study of thirty-eight patients, that long-term opioid treatment was safe and effective so long as patients had no history of drug abuse. Soon enough, opioid advocates dredged up a letter to the editor published in The New England Journal of Medicine in that suggested, based on a highly unrepresentative cohort, that the risk of addiction from long-term opioid use was less than 1 percent. Though ultimately disavowed by its author, the letter ended up getting cited in medical journals more than six hundred times. In the tradition of his uncle Arthur, Richard was also fascinated by sales messaging. From public records and conversations with former employees, though, a rough portrait emerges of a testy eccentric with ardent, relentless ambitions. The few publicly available pictures of him are generic and sphinxlike—a white guy with a receding hairline. He is one of the few Sacklers to consistently smile for the camera. In a photo on what appears to be his Facebook profile, Richard is wearing a tan suit and a pink tie, his right hand casually scrunched into his pocket, projecting a jaunty charm. His ex-wife, Beth Sackler, has given almost exclusively to Democrats. In , he wrote a letter to the editor of The Wall Street Journal denouncing Muslim support for suicide bombing, a concern that seems to persist: Since , his charitable organization, the Richard and Beth Sackler Foundation, has donated to several anti-Muslim groups, including three organizations classified as hate groups by the Southern Poverty Law Center. Former employees describe Richard as a man with an unnerving intelligence, alternately detached and pouncing. In meetings, his face was often glued to his laptop. Whether it was on the weekend or a holiday or a Christmas party, you could always expect the unexpected. Richard also had an appetite for micromanagement. Richard really wanted Purdue to be big—I mean really big. To effectively capitalize on the chronic-pain movement, Purdue knew it needed to move beyond MS Contin. When it came to branding, oxycodone had a key advantage: Although it was 50 percent stronger than morphine, many doctors believed—wrongly—that it was substantially less powerful. They were deceived about its potency in part because oxycodone was widely known as one of the active ingredients in Percocet, a relatively weak opioid- acetaminophen combination that doctors often prescribed for painful injuries. A common malapropism led to further advantage for Purdue. Purdue did not merely neglect to clear up confusion about the strength of OxyContin. As the company later admitted, it misleadingly promoted OxyContin as less addictive than older opioids on the market. The theory was that addicts would shy away from timed-released drugs, preferring an immediate rush. In practice, OxyContin, which crammed a huge amount of pure narcotic into a single pill, became a lusted-after target for addicts, who quickly discovered that the timed-release mechanism in OxyContin was easy to circumvent—you could simply crush a pill and snort it to get most of the narcotic payload in a single inhalation. MS Contin had contended with similar vulnerabilities, and as a result commanded a hefty premium on the street. It was removed from OxyContin in and would never be approved again for any other opioid. After a stint at another pharmaceutical company, he began working for Purdue. That was not something generated by Purdue—that was not a secret plan, that was not a plot, that was not a clever marketing ploy. Chronic pain is horrible. In the right circumstances, opioid therapy is nothing short of miraculous; you give people their lives back. Purdue did not invent the chronic-pain movement, but it used that movement to engineer a crucial shift. Wright is correct that in the nineties patients suffering from chronic pain often received inadequate treatment. But the call for clinical reforms also became a flexible alibi for overly aggressive prescribing practices. By the end of the decade, clinical proponents of opioid treatment, supported by millions in funding from Purdue and other pharmaceutical companies, had organized themselves into advocacy groups with names like the American Pain Society and the American Academy of Pain Medicine. Purdue also launched its own group, called Partners Against Pain. Sales reps were encouraged to downplay addiction risks. Why mince words about it? Greed took hold and overruled everything. They saw that potential for billions of dollars and just went after it. Wholesalers got rebates in exchange for keeping OxyContin off prior authorization lists. Pharmacists got refunds on their initial orders. Patients got coupons for thirty- day starter supplies. Academics got grants. Medical journals got millions in advertising. Senators and members of Congress on key committees got donations from Purdue and from members of the Sackler family. It was doctors, though, who received the most attention. It was graft. Between and , the number of OxyContin prescriptions in the United States surged from about three hundred thousand to nearly six million, and reports of abuse started to bubble up in places like West Virginia, Florida, and Maine. Research would later show a direct correlation between prescription volume in an area and rates of abuse and overdose. Hundreds of doctors were eventually arrested for running pill mills. As criticism of OxyContin mounted through the aughts, Purdue responded with symbolic concessions while retaining its volume-driven business model. To prevent addicts from forging prescriptions, the company gave doctors tamper-resistant prescription pads; to mollify pharmacists worried about robberies, Purdue offered to replace, free of charge, any stolen drugs; to gather data on drug abuse and diversion, the company launched a national monitoring program called RADARS. Critics were not impressed. A single dose of Percocet contains between 2. OxyContin came in , , , , and 80mg formulations and, for a time, even mg. Over the next several years, dozens of class-action lawsuits were brought against Purdue. Many were dismissed, but in some cases Purdue wrote big checks to avoid going to trial. Paul Hanly, a New York class-action lawyer who won a large settlement from Purdue in , had a similar recollection. Richard Sackler, or any other individual. When the federal government finally stepped in, in , it extracted historic terms of surrender from the company. It was one of the harshest penalties ever imposed on a pharmaceutical company. No Sacklers were named in the suit. In , STAT , an online magazine owned by Boston Globe Media that covers health and medicine, asked a court in Kentucky to unseal the deposition, which is said to have lasted several hours. STAT won a lower-court ruling in May As of press time, the matter was before an appeals court. Purdue seized the occasion to rebrand itself as an industry leader in abuse-deterrent technology. Purdue suddenly argued that the drug it had been selling for nearly fifteen years was so prone to abuse that generic manufacturers should not be allowed to copy it. The company had effectively won several additional years of patent protection for its golden goose. Opioid withdrawal, which causes aches, vomiting, and restless anxiety, is a gruesome process to experience as an adult. These infants, suddenly cut off from their supply, cry uncontrollably. Their skin is mottled. They cannot fall asleep. Their bodies are shaken by tremors and, in the worst cases, seizures. Bottles of milk leave them distraught, because they cannot maneuver their lips with enough precision to create suction. Weaning sometimes takes a week but can last as long as twelve. But the children of OxyContin, its heirs and legatees, are many and various. The second- and third-generation descendants of Raymond and Mortimer Sackler spend their money in the ways we have come to expect from the not-so-idle rich. Notably, several have made children a focus of their business and philanthropic endeavors. One Sackler heir helped start an iPhone app called RedRover, which generates ideas for child-friendly activities for urban parents; another runs a child- development center near Central Park; another is a donor to charter-school causes, as well as an investor in an education start-up called AltSchool. It was like a family acquisition. Lynne Regan, its current director, told me that neither students nor faculty have ever brought up the OxyContin connection. The controversy surrounding OxyContin shows little sign of receding. In , the CDC issued a startling warning: There was no good evidence that opioids were an effective treatment for chronic pain beyond six weeks. There was, on the other hand, an abundance of evidence that long-term treatment with opioids had harmful effects. A recent paper by Princeton economist Alan Krueger suggests that chronic opioid use may account for more than 20 percent of the decline in American labor-force participation from to Millions of opioid prescriptions for chronic pain had been written in the preceding two decades, and the CDC was calling into question whether many of them should have been written at all. At least twenty-five government entities, ranging from states to small cities, have recently filed lawsuits against Purdue to recover damages associated with the opioid epidemic. The Sacklers, though, will likely emerge untouched: Because of a sweeping non-prosecution agreement negotiated during the settlement, most new criminal litigation against Purdue can only address activity that occurred after that date. Neither Richard nor any other family members have occupied an executive position at the company since The American market for OxyContin is dwindling. According to Purdue, prescriptions fell 33 percent between and In Colombia, according to the L. Times , the company went so far as to circulate a press release suggesting that 47 percent of the population suffered from chronic pain. In May, a dozen lawmakers in Congress, inspired by the L. Times investigation, sent a bipartisan letter to the World Health Organization warning that Sackler-owned companies were preparing to flood foreign countries with legal narcotics. In some places, though, they have already left their mark. In July, Raymond, the last remaining of the original Sackler brothers, died at ninety-seven. The Sacklers had made a number of transformational donations to the university over the years—endowing, among other things, the Sackler School of Graduate Biomedical Sciences. The audience that day was limited to family members, select university officials, and a scrum of employees. Addressing the crowd of intimates, Monaco praised his benefactor. This article appears in the November '17 issue of Esquire. Subscribe Today. The Joy of the Childless Men. I Am Falling Apart. How to Talk Like a Man. The Cousin I Never Knew. Who Gets to Be a Father Figure? I Am a Wellness Asshole Now. Hearst Digital Creative. Getty Images OxyContin became a lusted-after target for addicts, who quickly discovered that its timed-release mechanism was easy to circumvent. Mundipharma is their company charged with developing new markets. Watch Next. Advertisement - Continue Reading Below. Esquire Select Exclusives.

Why Swiss cities dominate the cocaine hit parade

Buying Heroin Gstaad

In terms of European cocaine usage, half of the top ten cities are Swiss. Swiss cities take five of the top nine slots for European consumption. The cocaine comes mainly from West African networks, reports Addiction Switzerland. Heroin, meanwhile, is imported and sold mainly by Albanian groups, with the quantity in circulation estimated at 1. But even the cheap options result in high social costs. Every year problems linked to dependency — either of substances or gambling — result in more than 11, deaths and social costs of around CHF14 billion. Tobacco is responsible for almost 9, deaths a year in Switzerland, where 9. Cannabis remains the most consumed illegal substance. Given reforms of cannabis law internationally, for example in North America External link , Addiction Switzerland urged the development of regulation adapted for Switzerland. What is your experience with AI at work? Have you already used it? Has it helped you work better? Or has it caused you more stress, more work or caused you to lose your job? Tell us about your experiences! Swiss food regulations do not allow raw milk to be sold for direct consumption. However, a loophole allows raw milk vending machines to do just that. Is Swiss neutrality misunderstood? Or has the Swiss model of neutrality now become obsolete? More: SWI swissinfo. You can find an overview of ongoing debates with our journalists here. Please join us! If you want to start a conversation about a topic raised in this article or want to report factual errors, email us at english swissinfo. This content was published on Oct 21, An overview of patient statistics from shines new light on the dependency of Swiss on legal and illegal drugs. This content was published on Jul 11, Men should drink no more than two glasses of alcoholic beverages a day, the new government guidelines have recommended. During the week it is second only to Barcelona, finds a wastewater study. This content was published on Feb 4, Tens of thousands of patients in Switzerland regularly use cannabis to relieve pain and discomfort. Most of them do so illegally, however. SWI swissinfo. Swiss perspectives in 10 languages. Search Close. Menu Close. Search Search. About us. International Geneva. Foreign affairs. Swiss Politics. Multinational companies. Swiss Abroad. Switzerland: How To. Special reports. This content was published on February 6, - Other languages: 5 EN original. External Content. Popular Stories. More Swiss Abroad. Most Discussed. Next Previous More Debate. Hosted by: Sara Ibrahim. Is artificial intelligence an advantage or a disadvantage for workers? Join the discussion. Sep 11, More Debate. Hosted by: Anand Chandrasekhar. Should raw milk sales be banned or should consumers decide? Oct 8, Hosted by: Giannis Mavris. What is the future of Swiss neutrality? Sep 13, More Debates. In compliance with the JTI standards. Read more. More Swiss experts recommend lower alcohol intake This content was published on Jul 11, Men should drink no more than two glasses of alcoholic beverages a day, the new government guidelines have recommended. Read more: Swiss experts recommend lower alcohol intake. Follow us. Data Privacy Statement. Terms of Use. Rights to content and liability. Play SWI. External Content Your subscription could not be saved. Please try again. Almost finished We need to confirm your email address. To complete the subscription process, please click the link in the email we just sent you. Discover our weekly must-reads for free! Sign up to get our top stories straight into your mailbox. I consent to the use of my data for the SWI swissinfo. Subscribe See all newsletters. Manage my profile Log out Close. My Profile. Delete profile. Our data protection notice provides you additional information concerning data processing. More on our terms and conditions.

Buying Heroin Gstaad