Senator Gaylord Nelson’s 1970 hearings about the dangers of the Pill had attracted the most intensive press coverage for a pharmaceutical story since the thalidomide scare eight years earlier. At the same time as the hearings, however, there was scant media interest in the Nixon administration’s promise to introduce sweeping legislation to eliminate the duplication and confusion that hampered federal agencies tasked with enforcing the nation’s drug laws. Nixon, who said that “America’s Public Enemy No. 1 is drug abuse,” had converted his battle on illegal drugs into a larger one about law and order. Some political analysts thought it was “arguably the decisive factor in his narrow triumph.”1
The issue resonated with voters. Law and order had been the top worry in most preelection polls. The national violent crime rate doubled since 1960 and many middle-class voters were uneasy about increasing political and social unrest.2 Nixon attacked the counterculture for embracing illegal drugs. He contended that antiwar activists, the Weather Underground radicals, hippies, and those who championed mind expansion with LSD or dropping out with marijuana, were behind the surge in crime as well as a spike in lethal overdoses. Heroin overdoses in New York City had quintupled over a decade to a record one thousand. Almost a quarter of arrests in big cities were drug-related. And as GIs returned from Vietnam, thousands were addicted to China White, a heroin so pure it was smokable. A year into his presidency (1971), Nixon called for a “war on drugs.”3 (Nixon was big on “wars” to fight public health issues; in 1971 he also declared a “war on cancer” and signed the National Cancer Act into law.)4
The idea that the existing hodgepodge of federal laws and regulations of drugs were ineffective and fragmented was not new. Lyndon Johnson had concluded during his last year as president that the “growing problem of narcotics and dangerous drugs… threaten[s] our Nation’s health, vitality and self-respect.” He urged Congress to reform federal drug laws that were “a crazy quilt of inconsistent approaches and widely disparate criminal sanctions.”5 Congress responded by folding the Treasury’s Federal Bureau of Narcotics and HEW’s Bureau of Drug Abuse Control into a newly created Bureau of Narcotics and Dangerous Drugs (BNDD) at the Justice Department. While that consolidated some enforcement duties in the federal bureaucracy, it fell far short of what Nixon envisioned.6
Not only did Nixon want to curb the importation and use of illegal drugs—he also wanted to strengthen the regulations over widely abused prescription medications. Previous crackdowns had focused on amphetamines and barbiturates and a rash of tough state laws had limited refills and dosing. Yet both classes of drugs remained popular. Their recreational availability seemed as widespread as ever. Stimulants and downers would undoubtedly get another review. The unanswered question when Nixon took office in January 1969 was whether his administration would take on mild tranquilizers, including the country’s runaway best-selling drug, Valium. Arthur Sackler and Roche’s top executives were disturbed at that possibility and held strategy meetings through the spring of 1969 to discuss how to prevent that from happening.7
Roche was Sackler’s most important client and he made certain he was available whenever needed. That commitment put him under considerable stress because at the same time he was developing one of his greatest marketing ideas, one that could be transformative for his brothers and their drug company, Purdue Frederick. It revolved around Betadine, a distinctive orange-brownish liquid that combined a synthetic polymer (povidone) with iodine and killed bacteria on contact. The Sacklers had added Betadine to Purdue’s offerings in 1966 when they bought Pittsburgh’s Physician Products, a family-run drug company that held patents on several antiseptic products.8 Arthur then had the clever idea of marketing Betadine to hospitals as an inexpensive disinfectant that doctors and nurses could use to clean their hands before all surgical procedures or contact with patients in intensive care, emergency, and recovery rooms. In 1968, the Sacklers won a lucrative Army contract to supply Betadine in bulk for wounded troops in Vietnam.9
Even Arthur, however, realized that his new idea was a long shot. He had learned a month after Nixon’s election that NASA had an unusual concern about its planned summer space flight. If successful, two of the astronauts, Neil Armstrong and Buzz Aldrin, would become the first humans on the moon. The scientist worried that they might carry back to earth an extraterrestrial pathogen that could unleash an end-of-days pandemic. NASA planned to decontaminate the returning spaceship and all gear with a super bleach, as well as quarantining the astronauts for three weeks.10 In a sealed room adjacent to the isolated astronauts, a group of germ-free mice would be exposed to moon soil. If the mice got ill or died, NASA expected the same would probably happen to the astronauts.11
Were those precautions enough? The answer to that might have been influenced by a book published only a few months before the Apollo 11 mission. It was the first best-seller by a doctor who had started writing fiction. Michael Crichton’s Andromeda Strain was a terrifying tale of a deadly microorganism unwittingly brought back to earth by a military satellite. NASA decided it needed additional safeguards. Arthur Sackler managed to get Betadine before the space agency’s senior scientists. They thought it was the ideal disinfectant.
When the astronauts splashed down in the Pacific on July 24, 1969, they put on biological isolation suits constructed from an innovative new nylon designed to prevent foreign microorganisms from attaching to their skin or hair. The history-making Apollo 11 team sprayed Purdue’s Betadine on their space suits, the module’s hatch, and their inflated rubber raft. NASA was confident that Betadine would kill alien microbes that hitched a ride to earth on any thin layer of moon dust that clung to the spacecraft or the men.
Anyone remotely familiar with Arthur Sackler’s genius at promoting and selling drugs could have predicted what was next. Purdue ran dramatic full-age ads in the country’s leading medical journals. “Apollo 11 Splashdown!” was the bold headline. “NASA Selects Betadine Antiseptic to Help Guard Against Possible Moon Germ Contamination.”12
NASA had given Purdue a priceless sales pitch. Following the Apollo moon mission, the government increased its bulk purchases for the medical corps deployed in Vietnam.13 The number of American hospitals relying on Betadine tripled, making it the country’s most commonly used disinfectant. Better yet for the Sacklers, Betadine was cheap to make, pennies a gallon. Although the price to doctors and hospitals seemed reasonable, no one realized its enormous profit margins. Betadine was instantly Purdue’s most lucrative product.
Mortimer and Raymond were ecstatic over Betadine’s success, although they knew that since it had been Arthur’s idea, they would have to endure him reminding them of why it was such a big hit. Seventeen years after they had bought Purdue, Mortimer and Raymond still worked under their brother’s shadow. Marietta had observed that Arthur enjoyed turning everything into a competition, especially when it came to family.14 He pushed himself, always taking on more work than anyone else, then insisting he did so because he did it better than anyone else. Once it was over, he goaded others by what he had achieved.
Mortimer and Raymond, for instance, had stopped conducting research studies and writing articles for medical journals (they had published almost all theirs with Arthur, between 1949 to 1959). Arthur, on the other hand, had continued his laboratory research and writing.15 He never knew, he told them, when it might lead to a new Purdue product. And, in any case, it kept him grounded in the science he loved. Arthur had created the Laboratories for Therapeutic Research in 1957, and as its director pursued private and government research grants.16 He had later hired Dr. A. Stanley Weltman as his senior research investigator.17 Throughout the 1960s they not only got funding for ambitious clinical trials but the duo published their results in prominent medical journals. Many followed up on Sackler’s earlier studies of how alterations in behavioral and endocrine levels affected mental illness.18 Before the Betadine-moon project, Arthur became chairman of the International Task Force on World Health Manpower for the World Health Organization. The WHO expected he would concentrate on “advances in the drug therapy of mental illness.” The author discovered that the WHO badly underestimated how broadly Arthur interpreted his mandate. He conducted studies to determine which workplace disturbances might negatively affect a worker’s psyche and therefore their productivity. Sackler got funding from the Environmental Protection Agency to study the effect of loud noises in the workplace.19 His conclusion in another study, delivered to the United Nations, was that a shortage of trained medical personnel led to the death or disability of 100 million people annually. It put Arthur back in The New York Times.20 And he regaled in great detail to Mortimer and Raymond his annual keynote addresses in Geneva at the World Health Organization’s World Workplace Health Day.21
The Laboratories for Therapeutic Research received about $800,000 in government or private foundation grants for clinical trials. There are no records available for how Sackler used the funding. Arthur did not get everything he applied for, however (he was particularly irked later by a failure to get a generous grant in 1971 from the Association for the Aid of Crippled Children).22
There was a certain prestige attached to a research scientist, especially one who chaired an international task force for the WHO. And Arthur never let Mortimer and Raymond forget it. He often needled them by recounting the details of what project was under way at the lab. On a later study, he told his brothers and Marietta about how he had chosen fifty rats, a “special breed that spontaneously develops high blood pressure.” Then, twice a day, Arthur and Weltman strapped half the rats into a breadbox-sized plastic cage, attached them to a motorized shaker, and jolted them side to side 150 times a minute for half an hour. All the while, the rats were bombarded with sounds recorded from the New York subway system. After four months, four of those subjected to the shaking were dead. Autopsies revealed they had enlarged adrenals, the body’s glands for generating hormones in response to stress.23
The results did not surprise Mortimer or Raymond, who thought it a waste of time. But Arthur had a knack of knowing when and how to promote something that seemed ordinary to others. He had gotten a grant from the Office of Noise Abatement and Control of the Environmental Protection Agency to study “transportation (rail and other), Urban Noise Problems and Social Behavior—Physiological and Psychological Effects.”24 Eventually, Weltman present their findings to the Federation of American Societies for Experimental Biology. The New York Times ran a prominent article because Arthur had figured out how to make the results interesting to the public. The Times headline was: “Scientists Advising Rats to Avoid Subway Rides.”25 It led with “Rats with high blood pressure should not ride the subways too often or too long. The stress of noise, vibration and crowding may kill some of them before their time. And, according to the scientists who tested the rats, similar studies should be conducted on human beings with high blood pressure to see whether they face the same hazard.” Sackler was quoted, including his observation that “I don’t think man was constructed to ride subway trains.”26
Arthur did not need to say “I told you so” when he gave copies of the Times article to Mortimer and Raymond. It was not just about continuing clinical research that he kept haranguing them. He even prodded the two about why they were not filing more drug patents. He had several approved, all related to innovative and improved anatomical models for the brain and central nervous system, inventions that would be useful for medical students and researchers. Mortimer and Raymond did file for a series of patents, all related to Purdue products. Even then, Arthur lectured one or both about how they could have done it better. When Raymond had filed in 1966 for a chemical base that allowed for a considerably faster absorption rate for suppositories, Arthur lectured him about why it was smart to assign those rights to a Sackler company abroad. It might afford more legal protections and even a better tax rate should that patent become valuable. Raymond did assign “Novel Hydrogen Bonded Compounds and Pharmaceutical Compositions” to Mundipharma AG, the Swiss company the brothers had created in 1957.27 Although Raymond made the transfer mostly to stop Arthur explaining why he should do so, it would turn out to have significant consequences when it later played a role in the development of Purdue’s extended release coating for its narcotic painkiller, OxyContin. Putting trademarks, patents, designs, and copyrights—so-called IP, intangible or intellectual property—in a tax haven was an idea that not only became widespread in the pharmaceutical industry, but later allowed the Sacklers to save hundreds of millions in taxes when OxyContin became a blockbuster success.28