Opioid Safety

Where’s the J&J that Managed the Tylenol Crisis? The Opioid Crisis, A Story of Corporate Mismanagement

Editor’s note: In this editorial from the desk of PPAHS’s Executive Director,  Johnson & Johnson could have taken a lead in the opioid crisis, but has chosen not to.

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

Recently, Johnson & Johnson (J&J), a company that “believe(s) good health is the foundation of vibrant lives, thriving communities and forward progress,” was ordered to pay $572 million by Judge Thad Balkman of Cleveland County District Court in Oklahoma. Reported The New York Times about the judgment:

Judge Balkman was harsh in his assessment of a company that has built its reputation as a responsible and family-friendly maker of soap, baby powder and Band-Aids.

In his ruling, he wrote that Johnson & Johnson had promulgated “false, misleading, and dangerous marketing campaigns” that had “caused exponentially increasing rates of addiction, overdose deaths” and babies born exposed to opioids.

Source: CDC

The Opioid Epidemic has touched everyone’s lives – if we don’t have a family member or friend who has died or had an overdose, then chances are each of us knows of someone who has. Reports the CDC about the extent of the Opioid Epidemic:

Drug overdose deaths continue to increase in the United States. From 1999 to 2017, more than 702,000 people have died from a drug overdose. In 2017, more than 70,000 people died from drug overdoses, making it a leading cause of injury-related death in the United States. Of those deaths, almost 68% involved a prescription or illicit opioid.

Almost 40 years ago, another crisis hit J&J – seven people died after taking cyanide-laced capsules of Extra-Strength Tylenol, which was at the time J&J’s best-selling product. How J&J responded to the Tylenol deaths, an event that threatened to ruin its bottom line and reputation, is featured in business schools as a case study in how a company should best respond to a crisis.

As Time reports in “How Poisoned Tylenol Became a Crisis-Management Teaching Model”:

Without a suspect to revile, public outrage could have fallen squarely on Tylenol — the nation’s leading painkiller, with a market share greater than the next four top painkillers combined — and its parent corporation, Johnson & Johnson. Instead, by quickly recalling all of its products from store shelves, a move that cost Johnson & Johnson millions of dollars, the company emerged as another victim of the crime and one that put customer safety above profit. It even issued national warnings urging the public not to take Tylenol and established a hotline for worried customers to call.

Tylenol relatively quickly reestablished its brand, recovering the entire market share it lost during the cyanide scare. Though things could have gone very differently, the episode’s most lasting legacy has been in the annals of public relations, not poison control: the case has since become a model for effective corporate crisis management.

Fast forward 40 years after the Tylenol deaths, how J&J has responded – or, rather, not responded – should also be a business school study; however, this time on what not to do. 

Rather than show how the opioid epidemic could be managed and deaths averted, J&J has denied responsibility and failed to take any meaningful action. Right after the judgment was given, J&J’s lawyers said that the company would appeal, saying, “Johnson & Johnson did not cause the opioid abuse crisis here in Oklahoma or anywhere in this country.”

 

Several years ago, as the Executive Director of the Physician-Patient Alliance for Health & Safety, I contacted the major opioid manufacturers in the US, including J&J, and asked them to partner with us in showing clinicians how they can prescribe opioids to their patients safely, ensure their patients are taking their prescribed opioids appropriately, and help their patients get weaned from opioids to ensure non-addictive behavior. The answer provided by the opioid manufacturers was almost singularly the same – “the use of opioids is an issue that we will not discuss”.

However, they could have discussed the opioid crisis and they should have taken the lead in this issue – and they could be doing so even now. Pharmaceuticals like J&J, Purdue, and others could be helping to educate clinicians on:

  • Prescribing opioids appropriately.
  • Using opioid-sparing alternatives to manage patients’ pain.

Instead, they chose to do nothing. 

Our clinicians told us in a survey that we ran amongst our clinician followers in 2016 that clinicians are agreed with the Surgeon General’s call to play an active role in stemming the opioid epidemic. Partnering with clinicians, J&J and other opioid manufacturers and distributors could have taken the lead in helping to end the opioid epidemic and in promoting the responsible use of opioids. 

J&J has not done anything about the opioid epidemic. J&J has not taken lead, but, instead, chosen to bury its head in the sand and deny responsibility. Now, they face consequences – not unlike that which befell tobacco manufacturers – legal payments and a loss in reputation. Where’s the J&J that managed the Tylenol crisis and served as an example of what business should do in a crisis? Where is the courage of leaders to stand up and do the right thing, instead of hiding and hoping that events will not find them and hold accountable?

 

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