A new book reveals how Big Pharma’s brazen behavior fueled medical mistrust.
“Five years before Purdue Pharma received FDA approval to begin selling OxyContin, an oxycodone pill that Purdue claimed was less prone to abuse, J&J [Johnson & Johnson] received the agency’s sign-off on its own opioid-based painkiller. Duragesic was a fentanyl patch that was initially given primarily to cancer patients who struggled with swallowing—a relatively limited market. As [investigative journalist and author of “No More Tears” Gardiner] Harris writes, doctors already knew that opioids were highly addictive; few of them “were willing to prescribe them in anything but the most extreme circumstances.”
Harris reports that J&J deployed aggressive sales tactics and offered knowingly false assurances that Duragesic was less likely to be abused than other opioids. In fact, he notes, J&J had been making these arguments to doctors for years, even before Purdue began selling OxyContin, “laying the groundwork” for the epidemic that followed. As Purdue began attracting national scrutiny in the early 2000s when the scale of the opioid crisis was emerging, J&J watched Duragesic sales surge. Harris attributes this growth in part to the fact that Purdue and OxyContin attracted much of the public’s outrage and fear, which helped J&J sell its own drug.
“I believe Johnson & Johnson was a major cause of our opioid crisis,” Andrew Kolodny, an opioid expert at Brandeis University, testified in an ultimately unsuccessful 2019 lawsuit filed by Oklahoma’s attorney general. (In a separate action by a coalition of state attorneys general, J&J agreed, along with three pharmaceutical distributors, to pay a settlement of $26 billion.) Owing in part to the fact that J&J actually owned poppy fields that grew the opiate, which the company used in its products and also sold to other manufacturers, including Purdue, Kolodny called J&J “the kingpin in our opioid crisis.”
J&J has had few better friends than its regulator: the FDA. Harris’s condemnation of the agency is relentless; he details the ways he believes it’s been captured by the industry it should be overseeing. In 1992, Congress passed a law shifting a large portion of the agency’s funding source from taxpayers to health-care companies, leaving the FDA, as Harris puts it, “financially dependent on the drug industry.” In 2011, J&J swooped in to coordinate new industry funding for the FDA, which preserved hundreds of agency jobs. Meanwhile, the revolving door between regulators and the companies they are supposed to monitor spins freely under both Democratic and Republican administrations.
A similarly searing critique of the FDA echoes throughout another recent book. The science journalist Charles Piller’s Doctored details the yearslong dominance of a strain of Alzheimer’s research that has turned out to be less promising than its reputation would suggest. The “amyloid cascade hypothesis,” so named in a landmark 1992 paper published in Science, proposes that the accumulation in the brain of a protein called amyloid-beta causes Alzheimer’s disease. For decades, the majority of Alzheimer’s research has centered on this hypothesis, Piller writes, drawing billions of dollars in funding, enrolling thousands of patients in amyloid-related drug trials, and preventing other theories from gaining traction.
It turns out, however, that some of the foundational research linking amyloid buildup to Alzheimer’s relies on possibly fraudulent work. A central thread of Doctored is the story of Matthew Schrag, a Vanderbilt University neuroscientist who in 2021 began collecting indications that the research supporting simufilam, a new Alzheimer’s drug developed by the biotech start-up Cassava Sciences, was based in part on manipulated images. [..]
Piller’s investigation vividly captures the risks borne by whistleblowers like Schrag, not just for calling out apparent fraud but also for challenging conventional wisdom. Yet in an era of rising distrust in experts, Schrag and his fellow scientists face a broader conundrum. In Doctored, Piller considers whether overly publicizing scientific misconduct without offering solutions “creates a risk of people throwing up their hands and thinking ‘the whole scientific enterprise is a cesspool of corruption,’” as a friend worries to him.
[..] To witness how Johnson & Johnson has pushed expensive and sometimes dangerous products is to understand why people might feel so betrayed by the health-care establishment that they’d roll the dice on a vaccine skeptic and conspiracy theorist. To discover that billions of dollars in Alzheimer’s funding, and numerous clinical trials that recruited vulnerable human beings and their families, could have been based on fraudulent research is to see that Americans are right to be angry. Long before Donald Trump and DOGE and RFK Jr. came for scientists and health-care workers, too much of their work was already being undermined by a system that prioritized profit over care.
Together, Doctored and No More Tears offer a sweeping indictment of the status quo. Neither the actions of companies such as Johnson & Johnson nor their influence over regulators and politicians created a movement like “Make America healthy again.” But they helped create space for it. In their relentless pursuit of profit, they helped break the faith that held dangerous alternatives at bay.”
Full article, AM Lowentstein, The Atlantic, 2025.5.21