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Writer's pictureDan Spencer

The Peculiar Truth about the Letter that Sparked the Opioid Crisis


  • 1980: Dr. Herschel Jick was a professor at the Boston University School of Medicine.

  • He was in charge of the Boston Collaborative Drug Surveillance Program, which began in 1966.

  • That group, which still exists, published hundreds of data-driven studies in respected journals about the effects of pharmaceuticals.

  • One of Dr. Jick’s graduate students in 1980, Jane Porter, compiled information about opioids administered by doctors to hospitalized patients.

  • Her findings suggested that only 4 out of 11,882 patients became addicted to opioids — in a hospital setting.

  • It was not a formal study, not peer reviewed, and — given what is known today — not terribly credible.

  • Even so, Jane Porter and Dr. Jick submitted their findings to the New England Journal of Medicine.

  • The short piece was published January 10, 1980 — but merely as a letter to the editor, not as a substantial study. It ran one paragraph long with only five sentences.

  • The title read, “Addiction Rare in Patients Treated with Narcotics.” (Click to read)

  • The final sentence reads: “We conclude that despite widespread use of narcotic drugs in hospitals, the development of addiction is rare in medical patients with no history of addiction.”

  • That poorly conceived sentence, as well as the title, practically begged for misinterpretation, because the data suggested that people didn’t become addicted while hospitalized. The data never showed what happened to the opioid-treated patients after they departed the hospital.

  • The piece made no splash whatsoever in 1980 and was quickly forgotten, if anyone bothered to read it at all.

  • Many years later, though, someone did. The marketing department at Perdue Pharma found the letter to the editor. And they exploited it.

  • Purdue Pharma was, and still is, a pharmaceutical company that produced OxyContin, the most widely-prescribed opioid on the market.

  • Purdue Pharma had been established in 1892 and produced many successful pharmaceuticals.

  • Over 100 years after the company’s founding, OxyContin became their best-seller by far.

  • Their sales staff were told that OxyContin was safe and that opioid addiction rates were lower than 1%, according to a “finding” in the prestigious New England Journal of Medicine. They didn’t mention that it was merely a letter to the editor produced by a graduate student with misleading information.

  • Over the years there have been hundreds of citations of Dr. Jick’s letter in various medical articles, and they all misrepresented the findings.

  • For decades, that one retold falsehood — known in the medical establishment as ‘Porter and Jick’ — became gospel, and few doctors disputed it.

  • Physicians across the US prescribed the painkillers without being told the truth.

  • A drug crisis then gradually grew across the United States and elsewhere. Lawsuits and investigations followed.

  • Dr. Herschel Jick, who is now 91, only learned about his indirect involvement in the opioid crisis within the past 10–15 years. He claimed to be completely unaware that Purdue Pharma was citing him in their marketing campaigns, and he couldn’t even remember the letter to the editor. He now regrets sending it.

  • There have been no reports regarding Jane Porter, the graduate student from 40 years ago.

  • Purdue Pharma settled lawsuits against it for $6 billion in 2022.

  • However, though citing bankruptcy, they still manufacture OxyContin.

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