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The Sacklers have profited handsomely from the highly addictive painkiller, according to Forbes.

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Weighing in at a conservative $14 billion, theSackler familyentered Forbes Top-20 List of Americas Richest Families. How did this family generate such a lofty sum? In short, Raymond and Mortimer Sackler manufactured, aggressively marketed, and sold themost notorious painkillerever created, OxyContin.

Nearly four out of five new drug addictssaythey started out abusing painkillers such as OxyContin. Prescription painkillers, according to NIDA, are the most commonly abused drug in the United States.

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Its easy to get rich when healthcare providers write 259 million prescriptions for painkillers, enough for every American adult to have a bottle full of pills. We can thank these prescribers for generating much of the Sacklers fortune. While were at it, we can also thank them for the 46 people who die from prescription painkiller overdoses each and everyday.

It wasnt just ignorant doctors that perpetuated OxyContins abuse. The Sacklers success hinged on Purdue Pharma convincing the medical community their drug was safe to prescribe for any and all pain, thanks to its time-released properties. In 1996, OxyContin was raking in $48 million. By 2002, OxyContins sales hit $1.5 billion.

The key to this skyrocket in sales was their marketing plan. Purdue targeted physicians, mostly in the South, Appalachia, and the Rust Belt, who liberally prescribed opioids. These were mostly primary care physicians who did not have training in pain management. Furthermore, Purdue had an advanced system of bonuses and incentives put in place for sales representatives. In 2001, Purdue paid out $40 million in incentive bonuses to its sales representatives.

Purdue sales representatives were coached extensively to lie about the drugs potential for addiction,claimingthat addiction occurred in less than 1% of patients.

This statistical misrepresentation eventually cost Purdue Pharma $635 million in criminal fines, when in 2007 the company wasforced to plead guiltyto false marketing charges brought on by the Department of Justice. Sackler family members were never charged.

Years later, Purdue is still entangled in pricey court cases. The state of Kentucky also alleges false marketingagainst Purdue. Its likely damages from this case could exceed $1 billion.

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A company spokesperson says Purdue Pharma denies any wrongdoing in this case due to lack of evidence linking them to have caused any of the alleged harm.

Raymond Sackler, 94, is the last living co-founder of Purdue Pharma. Chelsea Laliberte, an overdose prevention activist wholost her brotherto an opiate overdose, had strong words when I asked what the Sacklers could do to right the wrong.

Were all working tirelessly to fix the mess you made, help us, she toldThe Fix. Every day I wake up without a brother. Every day tens of millions of others wake up in fear that theyre going to lose someone they love. Others wake up in anger because theyve already lost someone.

Zachary Siegelis a freelance journalist specializing in science, health and drug policy. His reporting has also appeared inSlate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary onLinkedinor follow him onTwitter.

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