A decision has been made boxing cotton maker Purdue Pharma. To stop encouraging physicians to write the painkillers groups at. In destroying you know positive reviews from some of these experts around the country. Or rogue remind you that Purdue or privately held company based in Stamford Connecticut. Had three former executives ten years ago plead guilty in federal court. To criminal charges of misleading the public about the addictive nature of OxyContin paying more than 630. Million dollars in fines and penalties. And here we are ten years later we’re still dealing with these same issue. And it’s you know. Presented itself yet again as a whole series of lawsuits and as a result of these lawsuits this announcement recently. By Purdue Pharma and joining us on line is. Doctor Indra. Sin Dhabi. Who is the medical directors should be their residency yet commodities medical center in Brooklyn and in fellowship an addiction medicine and Bellevue hospital on New York welcome to the show doctor. I hope I got that last name pronounced right. And seen it done again thank you thank you. You know at first blush. Out I think a lot of the folks in our listening audience we say they’re not gonna promote their products. To physicians any longer. I don’t know that everybody really knows what that truly means it when you start to make a deeper if you get. An understanding of the aggressive and almost predatory marketing practices of these companies. And and you know. And I think arranged. But did not going to be marketing and maybe to do it. But. I would also be conscious about tightening prescription. Because it. Mean on. Prescriptions I mean by its actions and let the states. I practiced in the days. The worst QB litigation should only be good concerning. That need to leave. Practically. The apply in the league and deeply. Turning out more guitar called the pills I don’t have that. Yeah see you know and it might need Ike. Are linking their. On them and like. I think what went into entry here. Is the deepest. And then. After the right track field. And other. Don’t mean to me is. And like I. Mean it in the evening and he. Wants. Me. But for sure it has been done and written and killing people. They’ve been meeting could be. Happy it better and that these days like stopping the magic actually it is. Push OP being quiche and by look at the right you heard the lead the and drug dealing. Display and. But at that and I guess all things considered. The plus side as you say is that hopefully we will be able to reduced. And norm possibly restrict new entrants. Into that illicit side by not being. In a position to get addicted to these drugs were with the the legal side of it here with that restriction correct. Write the prescription litigation. Will be trying to conclude that and you know he can be. The other crisis that be have maybe. You know I would dare to challenge. It the illegal why can’t spying Carolyn run on Friday in an illegal market and giving all these. Marleau. Ignorant you really. The cardinals to actually help people order and dying from the current. You know pale. But always interesting about OxyContin though was the breadth and depth of the marketing. And kind of the the practice. Really convincing. Hundreds and thousands of positions that there were no long term. Of faxes are related to addiction. Relative to the print prescribing this medication. Yes stayed broken little room you know it’s so and a group of non X companies and people aren’t dipping purposes and I mean to get stable independent of the medication. But an old technical people. Cody an independent. But not as big communication becomes an act an increasingly different. But in the treatment I think the indication of being elected school. I’m going to independent and pain medication used. In. But long term basis that is the biggest concern. And it I have if anybody that the family is so you production. And abroad to get addicted to our back pocket not being the conviction buy crack. So you know if we’re gonna protect the consumer who’s obviously at a significant disadvantage. How do we go about doing that would we have liked this company Purdue farmer from 1996 to 2001. Conducted. Forty national pain management and speaker training conferences at resorts in Florida Arizona California. They actually touch. Over 5000. Physicians pharmacists and nurses with all expense paid symposium. You know where they recruited and trained. These folks things like trained a trainer program so that they can go out and reaches many other positions and pharmacist. To talk about. You know prescribing this medication. All under. A false message. That wasn’t true. Think in nineteen. Clooney I wouldn’t give. At happened in the mean. And see me committed in the until that rule is so deep pay and we being. It continued education at the sea me we do you know. Where all the credit. But somebody teens are gaining a big red black. What the benefits and you know. Act and should note that the Haitian born and it and it. Sure. Poll you know I don’t. Seem broad market it not been. Should be. The world. And being patient and why do medical doctors get these kind of troll from school he got pretty should be. The purpose of the description would be right and what indeed my Canon production of that but the medication. I’m going to keep. But the litigation and an art and they’d been. Quiche. This is being built and you know I wouldn’t have on the market. And doctor you know if this was really kind of a multi. Level strategy in promoting is because not only did they do the train the trainers. But even with their own internal sales people once they started scene which doctors prescribe the most toxic content. They would cause visits to be had by the air sales votes to. To conduct the in re encouraged them to keep it going. And by giving bonuses and things of that nature they paid forty million in sales incentive bonuses to those. And increase their sales staff they doubled it up from 96 to 2000 in order and started issuing coupons. Four. OxyContin. And in that period of time. Purdue. Increase. Their prescriptions. From 670000. In 19701997. Five years later six. Point two million prescriptions. Were issued. And it was at a time where you know there was a lot of science about cancer related pain. But they’re still wasn’t a consensus relative to non cancer related pain in the you support UOP origin long term treatment. So they obviously took advantage of this and you’d weighs in a brings me to this question okay great they’ve announced what they’ve gonna announce. How are we gonna re educate the physician networks across this country as to the alternatives toxic content. And I should bear that cost and who should bear that responsibility. You know and they did an important question to me. In my tour and or in. And as well you know it does not talk about. Other school in Google are. Children and our typical. It affected. The play of the night you know they think maybe there are GMT nine. The rule cat. In nobody. Comes from the fact that the of these and it actually groups and production are viewed as. I’m more. About the question is and then get in the they’re bringing that it would. Come. To a two in management after the one describing these kind of I’m content. It mean. Thinking about what the entries that end in BP lead in the pocket. Doping in the coming from shore and the group. And and he viewed as a I get etched in and it is supposed to be doing. More people are looking. At work when they did it. Expect a fuel production want to. Be adding you know if they keep. And who didn’t. Need to practice the majority of prescribing. Well I. Got there to be right. Right again and I had one of the reasons we can go to the intent. On. And then Beagle school in legal car it. Is. Scott practice Linux. Well it’s important. To. Our business. And one. Won’t need more technical ground you know after becoming a potential do. IE. That spontaneity. And it’ll in making this list. But you know as well aside you know so many independent physicians are across his country it’s going to be hard to formulate. This type of marketing. An education. To let them know there there are alternatives. To this and we have to choose. Developed and delivered treatment protocols to wean people off of of this in the interim or yet we’re gonna lose more people to this. Addiction and we’re losing 42000 people a year die and. More than a 115. Bird country. Steps taken in the right direction. This CDC. Be tempered. You know. That this guy. Could be out due to the recommendations bright eyed look at. And on top of that he’d be. Patient and media continues. Medical education on currently being missing or actor but you know. And you’ve got McCain and you. Can. Re educating doctors and taking appropriate. Mod. Gracious enough about the eagle. Prescription that begin in nordic Kristi. And chronic low ball the whole album on addressed DOP. And are based. People who are or will be built based expedient and shut it wore me. But that opiate medication to me you know keeping the thing. And you know we talked earlier about this seven day limit that’s what we have here where in Louisiana and you know were listening audiences. And the thing is is that. I wonder how much. Consultation areas between the physician and the patient as to what is available after that. Or them because it to try and for those individuals. From going to that secondary market that you talked about where they’re just pressing pills. In the bathroom I’ll leave that hotels. You know across this country and putting them out there and we don’t even know what’s in that. Had signed on definitely dead birds birds had quintuple that’s sure. Offense and all I mean it is so dangerous for little benefit listening audience when. I used to be in law enforcement when our guys came in contact with them we had a Russian to the hospital because they may die. I did it could be facing. A bed and IP. In the treatment looking for treatment. And detox we hit it relations. Ambulatory need to could be a patient these top eight identity and full well. You know and I like being patient baby in the government in the and it. And well. I needed. I only did that spill that I didn’t even know OP. Well and be confident that it that it has. It should really get. Thanks stationed on the and you know that it ended died. And guided not right in there Katrina. When we think about this I mean that we we have some other significant challenges as well. Quit we know them and treatment. And all Bjorn addiction are really only success for the most part in the short term has been to put them. The patient on another addiction whether that be methadone or some box and right. Are. Wrong you know not JT one got beyond that Barry. You know. Wife pregnant people and people get right to be key to be that addiction isn’t going. And everything. I. I know where you go with that what I am saying misses it that is one of the intermediary. Treatment modalities that are used to try and get in and and you. You surround them with other services as well to try and treat these addictive disorder. Cracked. Right so I didn’t mean to minimize it in report choice awards on my part. And then we have this development. No locks in an arcane when people actually overdosing that we are having high success rates are being able to save them. From from that over goes. And to me it really begs the question Larry music even highlights the issue even war. As it relates to this education. Warts services that we can provide to pokes. We’re saving. In an otherwise. If we don’t yet it is re education of medical doctors pharmacies this that in very holistic approach. To be able to make again this. On that should be. Should be put me. Look at that. Trade and need. To be educated. I’ll certainly. Be executed. And ghoul. The but each. Are treating The Beatles. He you’ve. Been. In law other. He. Is not. Trying to stop somebody. For. What you’ve been. Beaten a you don’t. Oh. Or there is evaluation by addiction I did. And I don’t see. And also look at the TDT I. Don’t. Oddity is the doctor Congo fatigue the patient on the medication should be. I you know I think he would. I’ll I’ll. Educated. About what Medicaid. Auditing. But the problem you know. They shall. Not cut a key shall be able. And I’ll be an all. And he used to will be not comfortable that the on it being education and meat. But. Interest does not go the alternative treatments like you. Feedback. Although they could stimulate. They don’t cover things are about to be. So you beat. Being occasion and occupancy. Indeed bite to eat. Well and didn’t finish in to a point. And say patient questioned. Why treated but did he. Are you comfortable that we will get to an adopted. National formula Larry I was made aware that the other day by a physician who treats a number of folks on workman’s compensation. And on the insurance provider to this work comp program on a formula Larry right now. As oxy code own in. In for longer than seven days in spite of the state law. Well orbiter and he and he says that does that’s a serious problem across this country. It ain’t because you know. Can protect too much and see if you look at the only. Guy it’s more comfortable smooth. Or they’ll issue of the doctor prescribes that he said. And that they have some from the doctor about apple and then apple the packet. Pick whatever they want to take. And that knee problems here what we bought. The extra will be. He made Johncke of these prescriptions are written by Pratt international and the AP and should be expecting. Non DMD can interact so we need to focus on eating. Warding. Beanie like train it should be Christian leader but light the commission would treat me. And we get we only have. I think it should be able. We’re expecting and beat the only potential Google. People. Well the level of evidence that he is not there because of the level of training is not there I mean I don’t know how. How more overt that has to be I mean that’s like stare in the obvious in the face and walk right around. On expectations prescribing it actually change. In a comfortable cutting out again in between legal and it in the baby. And more. Non medical in on. Special to Indy to go ahead in prescribing and the city quiche and yeah I think. Absolutely. Well doctor interest said Bobby thank you so much for joining us we really appreciated jury and insight denial we will be talking to you again I think because I’m not so sure that this issue is gone away any time soon. Yeah give it he appreciated that I hoped to come back on national and do more than eight PR. Listen. And happy Valentine’s to you out there in New Jersey. Think you can actually do on a few happiness and a little bit of.