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What can we learn from internal company documents?

August 4, 2022

Today’s post has been guest authored by Jeremy Greene, Adam Koon, and Anne Seymour, all affiliated with Johns Hopkins University.

Dr. Greene is a practicing internist, a historian of medicine and directs the Institute of the History of Medicine and the Center for Medical Humanities and Social Medicine at the Johns Hopkins University School of Medicine. Dr. Koon is a social scientist in the International Health Department where he conducts research on the politics of contentious health issues, and directs the Health Systems Summer Institute. Ms. Seymour oversees library and information services for the Johns Hopkins University’s Schools of Medicine, Nursing, and Public Health, and the Johns Hopkins Health System; she has an interest in the impact of access to information on addressing global and local health disparities.

The Opioids Industry Documents Archive (OIDA), a collaboration between Johns Hopkins University (JHU) and the University of California San Francisco (UCSF), is designed to encourage meaningful use of the millions of previously-confidential documents produced by opioid industry litigation since 2015. This includes internal communications, sales and audit reports, and depositions of drug company executives. The scope of material allows for a fuller understanding of the commercial determinants of health, which include corporate political activity and regulatory failure.

The Opioids Archive is the newest collection of industry records within the UCSF Industry Documents Library. The UCSF Industry Documents Library’s Truth Tobacco Industry Documents, created in 2002 following the Master Settlement Agreement with tobacco corporations, is the best known of industry archives. In May 2022, it contained 92,555,544 pages in 15,022,505 previously confidential records of leading tobacco firms. For two decades, researchers have extensively analyzed this collection, producing more than 1000 peer-reviewed journal articles, book chapters, blogs, newspaper articles and other publications. The UCSF Industry Documents Library has subsequently expanded to include document collections of the chemical, food, fossil fuel and pharmaceutical industries.

Complex litigation against opioid manufacturers, distributors, and retailers—with thousands of lawsuits brought by individuals and local governments—underscores the value of locating all these documents in a single repository. In July 2022, the Opioid Archive contained 8,067,059 pages in 1,429,599 documents in eight collections of internal corporate records with further releases to follow (see Table below). This includes emails between sales representatives and physicians, prescribing information submitted to regulatory agencies, and other documents. In addition, the website contains elaborate data on sales visits from Purdue Pharma and Mallinckrodt representatives. Researchers can use an email tracker that categorizes the senders and authors of the 500,000 emails contained in the Mallinckrodt collection; the archive will soon have an index of visual materials from the collection as well.

This table below from a paper published in the American Journal of Public Health lays out the various documents contained in the Opioid Archive.

The Opioid Archive team has developed a number of resources, including background literature, narrative themes and hot takes to orient users. These show the various sales, marketing, regulatory, lobbying, and other tactics used by pharmaceutical corporations that fueled opioid prescribing. Like all Opioid Archive materials, these resources are dynamic and will continue to grow to better address the needs of users such as policymakers, researchers, journalists, and members of the public. To keep up-to-date on the latest developments with the Opioid Archive, subscribe to our companion blog or follow us on Twitter.

Early use of the Opioid Archive has been made by investigative journalists, with particular traction in understanding the role of consulting firms and marketing and sales decisions by manufacturers and distributors at key moments in the growth of the current opioid crisis. The Opioid Archive team is working to broaden the possible range of researchers and educators who can use these materials to make sense of this terrible crisis. Particular efforts are being made to help communities that have been affected by the opioid crisis find means to use Opioid Archive for their own purposes, to build pathways for using Opioid Archive documents for K-12 education, and build out more specialized educational projects for undergraduate, medical, public health, and health policy training.

We hope that this vital resource continues to receive the attention it deserves during subsequent litigation and thank all involved in making these valuable resources available in perpetuity. In this way, we hope the Opioid Archive helps make the politics of industry regulation more transparent and responsive to the needs of consumers moving forward.