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A Hard Pill to Swallow


Design by Rachel Wolf.

Yale cell biology professor Yongli Zhang conducts his research using tiny tweezers. These aren’t tweezers you’d find hanging in the CVS beauty section. They’re far too small to pluck your eyebrows: about one hundred of them, bunched up, are as thick as a single human hair. With the aid of a microscope, you’d see that the tweezers are used to manipulate tiny glass beads. Together, one or two beads work to trap and apply force onto a single molecule. Using these optical tweezers, Zhang, who joined Yale’s faculty in 2009, studies protein molecules called SNARE complexes, which are key to understanding serious diseases such as epilepsy.

Zhang’s potentially groundbreaking research relies on a steady stream of funding, and graduate students who study both biology and physics. That’s where the Raymond and Beverly Sackler Institute of Biological, Engineering, and Physical Sciences comes in.

Founded in 2008 to strengthen collaboration between biology, physics, and engineering researchers at Yale, the Sackler Institute currently facilitates research by Zhang and 50 other faculty members. Donations from the Sackler family fund a wide range of research at Yale, Tufts, Harvard, and Princeton. The family has also endowed Yale’s David A. Sackler Professorship of Pharmacology with $3 billion. This post is currently held by Professor Mark Lemmon at the Yale Cancer Biology Institute. A spokesperson for the Sackler Foundation declined to comment on how much money Yale receives each year, as did the Yale Development Office.

But the Sacklers’ $13 billion fortune comes at a cost: their company, Purdue Pharma, a massive pharmaceutical conglomerate and the creator of OxyContin, has been blamed by activists, government officials, and medical experts for fueling the opioid crisis raging across America.

***

In 1952, Arthur, Mortimer, and Raymond Sackler bought Purdue Frederick, a small private medical company. Together, the three brothers from Brooklyn built a pharmaceutical empire out of circular white pills no larger than the tip of an index finger. OxyContin comes in doses of 10, 80, or 160 milligrams and, unlike other prescription painkillers, has a patented slow-release technology that allows patients to take only two doses every twenty-four hours. The main ingredient of this ‘miracle drug’ is oxycodone, a close cousin of heroin.

When OxyContin appeared on pharmacy shelves in 1995, doctors generally believed that opioids only belonged in hospice care centers. Terminally ill patients were frequently prescribed opioids like morphine, because at that point in their illnesses, addiction was no longer a concern. The Sacklers worked tirelessly to overturn these perceptions, according to an exposé by Patrick Radden Keefe published in The New Yorker in 2017.

“We are aware of it, but it’s like the Rockefellers and Carnegies and how they got their money,” said Holley. “The world is not black and white.”

Purdue’s marketing campaign was a massive operation. The company employed over 1,000 sales representatives armed with graphs and statistics designed to convince doctors that opioids were a casual and safe solution to even minor arthritic pain and muscle strains. Representatives offered smiling OxyContin pill plushies colored white, pink, and blue. There were OxyContin tote bags, baseball caps, picture books, and clocks. In 1997, Arthur Sackler was posthumously inducted into the Medical Advertising Hall of Fame.

“The initial marketing of OxyContin was very aggressive,” said Dr. Lynn Madden, the CEO and Director of the APT Foundation, which provides free walk-in addiction treatment to New Haven residents. “Yes, I do think that the marketing campaign did result in lots of powerful medication being prescribed and ultimately being abused.”

When asked to comment on their ties to the opioid crisis, representatives of Purdue Pharma responded with the following statement: “Since its approval, OxyContin has been and continues to be appropriately prescribed by doctors to bring needed relief to thousands suffering from severe pain, including those with cancer and terminal illnesses.” Purdue also stressed in its statement that the company has been developing programs to create “meaningful solutions to help stem the tide of opioid-related overdose deaths,” such as providing funds for state prescription drug monitoring programs and spearheading educational initiatives about the dangers of opioids for teenagers.

According to Radden Keefe, Purdue Pharma paid off respected scientific authorities to distort the addictive effects of OxyContin. Russell Portenoy, the pain specialist at the Memorial Sloan Kettering Cancer Center in New York, claimed that opioids should be destigmatized and used as an effective, safe painkiller with few side effects. He received regular payments from Purdue Pharma. Dr. Curtis Wright of the Food and Drug Administration approved an insert in each OxyContin bottle that reassured users that the drug was safer than rival painkillers due to the delayed-absorption mechanism. He quit the FDA and landed a job at Purdue Pharma two years later. Scientific research, in this case, was crudely manhandled for personal profit at the expense of the common good.

In 2007, Purdue Pharma pled guilty in federal court to accusations of deliberate misadvertisement, and agreed to pay $600 million in fines. This, however, was just a sliver of the $13 billion that Purdue earned by selling OxyContin.

***

The name “Raymond and Beverly Sackler Institute” calls to mind high, austere stone walls and gold-emblazoned plates. But no such building exists on Yale’s campus. Instead, the Sackler Institute is a forum for researchers. During monthly lunch discussions in lecture halls on Science Hill, Sackler-affiliated professors share their latest research, and participants from a variety of scientific backgrounds meet and chat with their colleagues. Neuroscience Professor Alex Kwan, whose lab is located at Yale’s medical campus, said that the Institute has helped him solidify his connections with associates a fifteen-minute walk away at the main campus.

Additionally, the Sackler Institute’s partnership with Yale’s Integrated Graduate Program in Physical and Engineering Biology, or PEB, channels graduate students into research positions with Sackler faculty and connects them to various interdisciplinary lecture courses. Sackler professors, in turn, can recruit from a pool of talented graduate students across multiple disciplines.

“Interdisciplinary studies can really drive a field forward rather than just focusing on one field,” said Milind Singh, a PEB graduate student studying glycolysis, the process by which cells convert sugar into energy. “Just expanding on one field alone probably won’t result in many advances.”

Members of the Sackler Institute enjoy access to annual seed grants of $50,000, enough to either start a lab or take on a risky new research venture, according to Kwan.

All five Sackler-affiliated professors I interviewed expressed strong enthusiasm for the Sackler Institute. When asked about the controversial Sackler name, Zhang said that the opioid epidemic has never come up during the weekly discussions, and that he had only “heard about it recently, maybe in a conversation.”

I asked Professor Scott Holley, head of a biology lab conducting research on the spinal column, whether he had any ethical qualms about the origins of the Sackler Institute’s funds.

“Not necessarily,” said Holley. “We are aware of it, but it’s like the Rockefellers and Carnegies and how they got their money. The world is not black and white. I think it’s a good thing that they are supporting scientific research and that’s something that benefits society.”

Singh, the PEB student, said he had never heard about the Sacklers’ connection to the opioid crisis prior to our conversation. He said that if he had a position of authority in the Sackler Institute, he would focus on the future and the current scientific research conducted by Sackler-affiliated professors. “There’s always a possibility that if the company really tries to improve… it’s always possible to move on,” he said.

***

Some people, however, find it difficult to move on. Matthew Jeffrey Abrams, who received a Ph.D in History of Art from Yale in 2017, led a double life. He spent his teenage years in the suburbs shooting Ketamine and OxyContin, and once smuggled drugs across the Mexican border. By 19, he had reclaimed sobriety and reentered school; he went on to receive a PhD at Yale. Now, Abrams is a writer and art historian living in New York City. In a personal essay published in The Guardian this May, he wrote, “Only last week, during a visit to my alma mater, did I begin to understand the role that Yale played in my own addiction.”

In the essay, Abrams wrote, he saw the traces of addiction creeping onto Yale’s campus. From Skull & Bones, whose founder, William Russell, had familial ties to the Indo-Chinese opium trade, to Yale’s sprawling medical campus, whose Sackler Institute lives on a yearly injection of Purdue money, Yale’s connections to the opioid epidemic are omnipresent—and the aftershock is far from over.

Dr. Madden, the founder and CEO of the APT Foundation, said the opioid crisis continues to grow in Connecticut. According to Madden, in 2017, 1,038 people in the state died of an opioid overdose. Nationwide, she estimated, upwards of 110 people are dying per day relative to opioid use disorders.
While the opioid crisis rages throughout Connecticut and the rest of the country, with 2.3 million Americans suffering from addiction, the scientific researchers at Yale have yet to interrogate the name looming over the Sackler Institute.

When I asked Professor Kwan about the Sackler funds, he responded much like the other professors.

“I have not put much thought into it.”

— Candice Wang is a sophomore in Berkeley College.

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