The New Yorker Radio Hour

Episode: How OxyContin Was Sold to the Masses
Date: April 2, 2019
Host: David Remnick
Guests: Patrick Radden Keefe (The New Yorker journalist) and Stephen May (former Purdue Pharma sales rep/whistleblower)

Episode Overview

This episode delves into Purdue Pharma's aggressive and controversial marketing of OxyContin, a prescription opioid painkiller widely implicated in spurring the opioid epidemic in the United States. Host David Remnick introduces reporting from Patrick Radden Keefe, including a revealing interview with Stephen May, a former Purdue sales rep turned whistleblower. The discussion examines the drug’s origins, marketing strategies, internal pressures, personal and corporate responsibility, and the ongoing consequences of OxyContin’s proliferation.

Key Discussion Points & Insights

1. The Sackler Family and the Stigma Around Philanthropy

The Sackler name, once synonymous with philanthropy in museums and medicine, has turned controversial because of the family's ties to Purdue Pharma and OxyContin.
Many prestigious institutions have stopped accepting Sackler donations due to public scrutiny. (00:09)

2. Stephen May’s Entry to Purdue and the Sales Culture

Stephen May joined Purdue in 1999, drawn by the company’s reputation for success and high compensation in pharmaceutical sales.
Initially, sales training instilled a sense of pride and focus on treating legitimate pain patients, presenting OxyContin as a medical breakthrough.

"When there was an opportunity to join what was perceived to be the best company to work for in the industry, I basically jumped at it." — Stephen May (01:42)

3. Purdue’s Marketing Strategy: 'Start with and Stay with'

Sales reps, including May, were trained to suggest OxyContin as a first-line opiate for pain management—starting patients directly on OxyContin rather than milder opioids—touting its longer-acting formula as less habit-forming.

"Oh, I used that quite frequently. Yeah. 'Start with and stay with.'" — Stephen May (02:58)
The selling point was the steady release of the drug, allegedly reducing the risk of habit formation compared to drugs taken every few hours.

4. 'Delayed Absorption' and Claims on Addiction

Early marketing relied on FDA labeling that suggested OxyContin’s delayed absorption “was believed to reduce the abuse liability of the drug.”

“I memorized the specific line in the package insert...that delayed absorption of the OxyContin was believed to reduce the abuse liability of the drug.” — Stephen May (08:00)
The claim lost credibility as it became clear that pills could be crushed for immediate release, undermining safety assurances.

5. On-the-Ground Consequences: Early Signs of Addiction

May encountered entrenched skepticism from doctors who saw addiction and overdose in their own communities, sometimes among their own families.

"We were pulled aside and advised that a family member of that particular doctor had died over as a result of an overdose of OxyContin. So that was a pretty significant blow that we both had. So I call that the day that it really hit really close to home for me." — Stephen May (09:14)
Despite witnessing these issues, May remained at Purdue for five years, wrestling with his sense of duty and the apparent opportunity for both treating pain and personal growth.

6. Internal Pressure and Overcoming Physician Objections

Reps were trained to redirect concern about addiction toward “legitimate pain patients”, while finding ways to counter objections.

"A lot of time was spent trying to overcome the doctor's objections on that and trying to refocus them and saying, yes, there's going to be people out there that are going to abuse or divert the drug. But basically, we were trained, let's focus on treating the legitimate pain patients." — Stephen May (06:46)
Sales quotas and company pressure were relentless—reps were pushed to “turn the doctors’ minds away from the bad news… and get them focused on treating the legitimate chronic pain patients.” (11:43)

7. Whistleblower Lawsuit and Personal Reckoning

May participated in a whistleblower lawsuit (Radcliffe May v. Purdue), alleging company fraud, but it was dismissed on a technicality.
Looking back, May holds Purdue and the Sackler family “absolutely instrumental” in precipitating the opioid crisis.

“The culpability is you can’t turn a blind eye to the problems that you’re creating in the community. And that’s one of the things I want to say to the Sackler family. Stand up, be responsible… But also take some responsibility for the problems that has been caused by the way that your products are being promoted and how your products are being abused.” — Stephen May (13:14)
May expresses regret for his role:

“Looking back, it saddens me that I was a part of it. I'll say it that way.” — Stephen May (14:14)

8. Secrecy and Power Structure at Purdue

Keefe explains that Purdue is uniquely insulated from outside scrutiny, being privately held and fully controlled by the Sackler family.

“The profits all flow to the family. And what this means is when you get into some of these dicey questions... they’re just decided by the family, and we don’t know what goes into that decision making.” — Patrick Radden Keefe (15:45)

9. Industry Defenses and Broader Context

Keefe speculates the Sacklers may use a libertarian defense, likening themselves to gun manufacturers: “We put a product out there… but ultimately this is a question of individual responsibility.” (16:35)
He outlines the ancient dichotomy: opiates are effective painkillers, but always carry high addiction risk.

10. Flooding the Market and the Heroin Connection

Purdue’s success at “destigmatizing” strong opioid use led to widespread addiction; later, as prescription access tightened, many turned to heroin.

“Once that genie is out of the bottle, it gets very hard to put it back.” — Patrick Radden Keefe (17:13)

11. Sackler Philanthropy and Moral Culpability

In response to public outrage, Purdue reformulated OxyContin in 2010 to be harder to abuse, but Keefe notes this coincided with their patent expiry, raising questions about motive.
Notably, the family has funded arts and medicine widely, but “there’s nothing for the opioid crisis, nothing for addict treatment… If there is any sense in that family that they bear any moral culpability for where we are today, they’re not acting on it.” — Patrick Radden Keefe (19:06)

Notable Quotes & Memorable Moments

Stephen May on Reality vs. Training (09:14):
“I call that the day that it really hit really close to home for me.”
— after learning that a doctor’s family member died from OxyContin.
On Company Pressure (11:43):
“How do we turn the doctors minds away from the bad news of what was happening in the community and get them focused on treating the legitimate chronic pain patients?”
On Responsibility (13:14):
“The culpability is you can’t turn a blind eye to the problems that you’re creating in the community…"
Patrick Radden Keefe on the Family’s Power (15:45):
“…when you get into some of these dicey questions about selling a very addictive substance to lots and lots of people… they’re just decided by the family, and we don’t know what goes into that decision making.”
On Moral Culpability (19:06):
“…if there is any sense in that family that they bear any moral culpability for where we are today, they’re not acting on it.”

Timestamps for Key Segments

00:09: David Remnick introduces the Sackler family controversy
01:34: Patrick Radden Keefe interviews Stephen May (main interview)
02:58: "Start with and stay with"—Purdue's OxyContin marketing philosophy
06:43: Reps trained to handle objections about addiction
08:00: Package insert claim about delayed absorption and reduced abuse risk
09:14: May describes realization of OxyContin’s real-life impact
11:43: Company pressure to maintain sales amidst growing crisis
12:09: May’s experience as a whistleblower
13:14: May reflects on Purdue’s and his own responsibility
15:43: Keefe on Sackler family power and Purdue’s secrecy
16:54: Libertarian defenses and responsibility
17:13: The shift from OxyContin to heroin addiction
18:30: Purdue’s limited and strategic reformulation of OxyContin
19:06: Lack of philanthropic response to opioid crisis

Conclusion

This episode provides an intimate and critical look at the rise of OxyContin and the marketing strategies that fueled an American public health catastrophe. Through Stephen May's testimony and Patrick Radden Keefe’s analysis, listeners gain insight into the ethical blindness, corporate pressures, and downstream societal damage involved—making clear the enduring impact of Purdue Pharma and the Sackler family on the opioid epidemic.

The New Yorker Radio Hour

Episode Overview

Key Discussion Points & Insights

1. The Sackler Family and the Stigma Around Philanthropy

The Sackler name, once synonymous with philanthropy in museums and medicine, has turned controversial because of the family's ties to Purdue Pharma and OxyContin.
Many prestigious institutions have stopped accepting Sackler donations due to public scrutiny. (00:09)

2. Stephen May’s Entry to Purdue and the Sales Culture

Stephen May joined Purdue in 1999, drawn by the company’s reputation for success and high compensation in pharmaceutical sales.
Initially, sales training instilled a sense of pride and focus on treating legitimate pain patients, presenting OxyContin as a medical breakthrough.

"When there was an opportunity to join what was perceived to be the best company to work for in the industry, I basically jumped at it." — Stephen May (01:42)

3. Purdue’s Marketing Strategy: 'Start with and Stay with'

Sales reps, including May, were trained to suggest OxyContin as a first-line opiate for pain management—starting patients directly on OxyContin rather than milder opioids—touting its longer-acting formula as less habit-forming.

"Oh, I used that quite frequently. Yeah. 'Start with and stay with.'" — Stephen May (02:58)
The selling point was the steady release of the drug, allegedly reducing the risk of habit formation compared to drugs taken every few hours.

4. 'Delayed Absorption' and Claims on Addiction

Early marketing relied on FDA labeling that suggested OxyContin’s delayed absorption “was believed to reduce the abuse liability of the drug.”

“I memorized the specific line in the package insert...that delayed absorption of the OxyContin was believed to reduce the abuse liability of the drug.” — Stephen May (08:00)
The claim lost credibility as it became clear that pills could be crushed for immediate release, undermining safety assurances.

5. On-the-Ground Consequences: Early Signs of Addiction

May encountered entrenched skepticism from doctors who saw addiction and overdose in their own communities, sometimes among their own families.

"We were pulled aside and advised that a family member of that particular doctor had died over as a result of an overdose of OxyContin. So that was a pretty significant blow that we both had. So I call that the day that it really hit really close to home for me." — Stephen May (09:14)
Despite witnessing these issues, May remained at Purdue for five years, wrestling with his sense of duty and the apparent opportunity for both treating pain and personal growth.

6. Internal Pressure and Overcoming Physician Objections

Reps were trained to redirect concern about addiction toward “legitimate pain patients”, while finding ways to counter objections.

"A lot of time was spent trying to overcome the doctor's objections on that and trying to refocus them and saying, yes, there's going to be people out there that are going to abuse or divert the drug. But basically, we were trained, let's focus on treating the legitimate pain patients." — Stephen May (06:46)
Sales quotas and company pressure were relentless—reps were pushed to “turn the doctors’ minds away from the bad news… and get them focused on treating the legitimate chronic pain patients.” (11:43)

7. Whistleblower Lawsuit and Personal Reckoning

May participated in a whistleblower lawsuit (Radcliffe May v. Purdue), alleging company fraud, but it was dismissed on a technicality.
Looking back, May holds Purdue and the Sackler family “absolutely instrumental” in precipitating the opioid crisis.

“The culpability is you can’t turn a blind eye to the problems that you’re creating in the community. And that’s one of the things I want to say to the Sackler family. Stand up, be responsible… But also take some responsibility for the problems that has been caused by the way that your products are being promoted and how your products are being abused.” — Stephen May (13:14)
May expresses regret for his role:

“Looking back, it saddens me that I was a part of it. I'll say it that way.” — Stephen May (14:14)

8. Secrecy and Power Structure at Purdue

Keefe explains that Purdue is uniquely insulated from outside scrutiny, being privately held and fully controlled by the Sackler family.

“The profits all flow to the family. And what this means is when you get into some of these dicey questions... they’re just decided by the family, and we don’t know what goes into that decision making.” — Patrick Radden Keefe (15:45)

9. Industry Defenses and Broader Context

Keefe speculates the Sacklers may use a libertarian defense, likening themselves to gun manufacturers: “We put a product out there… but ultimately this is a question of individual responsibility.” (16:35)
He outlines the ancient dichotomy: opiates are effective painkillers, but always carry high addiction risk.

10. Flooding the Market and the Heroin Connection

Purdue’s success at “destigmatizing” strong opioid use led to widespread addiction; later, as prescription access tightened, many turned to heroin.

“Once that genie is out of the bottle, it gets very hard to put it back.” — Patrick Radden Keefe (17:13)

11. Sackler Philanthropy and Moral Culpability

In response to public outrage, Purdue reformulated OxyContin in 2010 to be harder to abuse, but Keefe notes this coincided with their patent expiry, raising questions about motive.
Notably, the family has funded arts and medicine widely, but “there’s nothing for the opioid crisis, nothing for addict treatment… If there is any sense in that family that they bear any moral culpability for where we are today, they’re not acting on it.” — Patrick Radden Keefe (19:06)

Notable Quotes & Memorable Moments

Stephen May on Reality vs. Training (09:14):
“I call that the day that it really hit really close to home for me.”
— after learning that a doctor’s family member died from OxyContin.
On Company Pressure (11:43):
“How do we turn the doctors minds away from the bad news of what was happening in the community and get them focused on treating the legitimate chronic pain patients?”
On Responsibility (13:14):
“The culpability is you can’t turn a blind eye to the problems that you’re creating in the community…"
Patrick Radden Keefe on the Family’s Power (15:45):
“…when you get into some of these dicey questions about selling a very addictive substance to lots and lots of people… they’re just decided by the family, and we don’t know what goes into that decision making.”
On Moral Culpability (19:06):
“…if there is any sense in that family that they bear any moral culpability for where we are today, they’re not acting on it.”

Timestamps for Key Segments

00:09: David Remnick introduces the Sackler family controversy
01:34: Patrick Radden Keefe interviews Stephen May (main interview)
02:58: "Start with and stay with"—Purdue's OxyContin marketing philosophy
06:43: Reps trained to handle objections about addiction
08:00: Package insert claim about delayed absorption and reduced abuse risk
09:14: May describes realization of OxyContin’s real-life impact
11:43: Company pressure to maintain sales amidst growing crisis
12:09: May’s experience as a whistleblower
13:14: May reflects on Purdue’s and his own responsibility
15:43: Keefe on Sackler family power and Purdue’s secrecy
16:54: Libertarian defenses and responsibility
17:13: The shift from OxyContin to heroin addiction
18:30: Purdue’s limited and strategic reformulation of OxyContin
19:06: Lack of philanthropic response to opioid crisis

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Summary

The New Yorker Radio Hour

Episode Overview

Key Discussion Points & Insights

1. The Sackler Family and the Stigma Around Philanthropy

2. Stephen May’s Entry to Purdue and the Sales Culture

3. Purdue’s Marketing Strategy: 'Start with and Stay with'

4. 'Delayed Absorption' and Claims on Addiction

5. On-the-Ground Consequences: Early Signs of Addiction

6. Internal Pressure and Overcoming Physician Objections

7. Whistleblower Lawsuit and Personal Reckoning

8. Secrecy and Power Structure at Purdue

9. Industry Defenses and Broader Context

10. Flooding the Market and the Heroin Connection

11. Sackler Philanthropy and Moral Culpability

Notable Quotes & Memorable Moments

Timestamps for Key Segments

Conclusion

Summary

The New Yorker Radio Hour

Episode Overview

Key Discussion Points & Insights

1. The Sackler Family and the Stigma Around Philanthropy

2. Stephen May’s Entry to Purdue and the Sales Culture

3. Purdue’s Marketing Strategy: 'Start with and Stay with'

4. 'Delayed Absorption' and Claims on Addiction

5. On-the-Ground Consequences: Early Signs of Addiction

6. Internal Pressure and Overcoming Physician Objections

7. Whistleblower Lawsuit and Personal Reckoning

8. Secrecy and Power Structure at Purdue

9. Industry Defenses and Broader Context

10. Flooding the Market and the Heroin Connection

11. Sackler Philanthropy and Moral Culpability

Notable Quotes & Memorable Moments

Timestamps for Key Segments

Conclusion