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TEACHING NOTE
Profiting from Pain: Business and the U.S. Opioid Epidemic
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This case illustrates the following themes and concepts discussed in the chapters listed:
Theme/Concept Chapter
Stakeholder analysis 1
Corporate social responsibility and citizenship 3
Government regulation of business 7
Consumer protection 14
Case Synopsis
This case describes the U.S. opioid epidemic and explores its causes. The case addresses the role
played by prescription drug companies, including Purdue Pharma, the maker of OxyContin; drug
TEACHING TIP: WHERE TO USE THE CASE IN THE COURSE
This case is integrative, in that it draws on many themes of the text. It may be used at the end of
the course as a final, integrative assignment, or with the study of Chapter 14 (consumer
protection). If used with Chapter 14, the instructor should refer to earlier work on social
responsibility and government regulation.
TEACHING TIP: VIDEOS
Several videos may be used in conjunction with this case.
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class, but the instructor may wish to assign it for outside viewing or show in class a short
Fox News aired a segment in a series called “Drugged” (3:34, May 31, 2018) in which host
Tucker Carlson interviews journalist Barry Meier, author of Pain Killer, about the role of Purdue
Pharma in the opioid epidemic. It is available here:
www.youtube.com/watch?v=juthG7JgS5I
Discussion Questions and Answers
1. How would you define the opioid epidemic referenced in the title of the case?
2. an outbreak or product of sudden rapid spread, growth, or development
Instructor prompt: Does opioid use in America fit this definition?
Yes. The opioid epidemic in the title refers to the rapid spread of addiction, injury, and death
associated with prescription opioids in the United States since the late 1990s. The CDC
called it “the worst drug overdose epidemic in [U.S.] history.”
Instructor prompt: What groups were most affected by the epidemic?
2. List the various businesses mentioned in this case, including drug manufacturers,
distributors, clinics, and illegal drug dealers. Do you believe they acted in an ethical
and socially responsible way, and why or why not?
Business
No, did not act responsibly:
Yes, acted responsibly:
Drug manufacturers
• Purdue Pharma
• Also: Teva, Johnson
& Johnson, Endo,
Allergan
• Aggressively
marketed Oxycontin,
causing its use to soar
• Downplayed potential
for addiction, without
solid scientific basis
• Found to have
misbranded
OxyContin “with
intent to defraud and
mislead”
• Did not properly
formulate first-
generation
OxyContin, allowing
for abuse
• Close correlation
between number of
opioids prescribed and
overdose deaths
• Brought to market a
drug that treated
severe pain
• In 2010, changed
formulation of
OxyContin so it could
not be crushed or
dissolved
• Lobbied for hard-to-
abuse formulations of
opioids
Distributors
• McKesson
• Also: Amerisource
Bergen, Cardinal
Health
• Paid $170 million in
fines for failure to
implement effective
controls to prevent
diversion for
nonlegitimate uses
• Shipped only FDA-
approved drugs
• Did not manufacture
or prescribe opioids
Pain clinics
• American Pain
• Prescribed almost 2
who had been patients
at AP died in Florida,
and more in other
states
Drug dealers
other drug dealers
directly to addicts
3. What stakeholders were impacted by the actions of these businesses? Which were
helped, and which were hurt, and how?
The instructor can add a column to the right, continuing the board work in dialogue with
students, as follows. (Alternately, instructors might wish to distribute a blank handout and ask
students to work in small groups to fill in the cells.)
Business
Stakeholders helped
Stakeholders hurt
Drug manufacturers
• Purdue Pharma
• Also: Teva, Johnson
& Johnson, Endo,
Allergan
• Some patients with
chronic pain had
access to pain
medication who might
not have had access
previously
• Shareholders and
owners (e.g., Sackler
family) made a lot of
money
• Addicts: tens of
thousands of deaths
due to opioid
overdose
• Communities and
government: increased
costs for law
enforcement, health
care, public welfare,
child services
• Victims of crime (e.g.,
theft to support
addiction)
• Other businesses: loss
of economic
productivity,
difficulty hiring
Distributors
• McKesson
• Also: Amerisource
Bergen, Cardinal
Health
• Efficient delivery of
medication,
benefitting
pharmacies, hospitals,
and patients
• Shareholders made a
lot of money
• Failure to divert drugs
that were used
inappropriately led to
all the outcomes listed
above
Pain clinics
• American Pain
• Owners and doctors
• Inappropriate
to all the outcomes
listed above
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4. Do you believe that drug companies fraudulently marketed their products? Why or
why not?
5. In what ways did the government regulate the production and distribution of opioids?
Do you believe the government acted appropriately in doing so, and why or why not?
6. Looking at the case as whole, what organizations or individuals do you believe bear the
greatest responsibility for the opioid epidemic, and why? What should be the
consequences for those responsible?
• Counter argument: Opioids are highly addictive. Addiction causes changes in the brain,
making it almost impossible to quit without medical assistance. Individuals who attempt
• Counter argument: Purdue properly obtained FDA approval for OxyContin, for which
there was a legitimate medical use. It was not responsible for individuals who abused the
Teaching Tip: This argument raises the fascinating question: Why did the government keep
raising the quota? There is no public information about the negotiations that occurred between
