THE BURNED OVER DISTRICT

Ever since its heyday as the drug of choice for that fat junkie Rush Limbaugh, the sales of Oxy-Contin have been falling off as doctors cease prescribing it and their old users die off. To maintain their flow of sweet, sweet profits, the owners of Purdue Pharma are seeking to exploit fresh markets around the world.

With the nation in the grip of an opioid epidemic that has claimed more than 200,000 lives, the U.S. medical establishment is turning away from painkillers. Top health officials are discouraging primary care doctors from prescribing them for chronic pain, saying there is no proof they work long-term and substantial evidence they put patients at risk.

Prescriptions for OxyContin have fallen nearly 40% since 2010, meaning billions in lost revenue for its Connecticut manufacturer, Purdue Pharma.

So the company’s owners, the Sackler family, are pursuing a new strategy: Put the painkiller that set off the U.S. opioid crisis into medicine cabinets around the world.

A network of international companies owned by the family is moving rapidly into Latin America, Asia, the Middle East, Africa and other regions, and pushing for broad use of painkillers in places ill-prepared to deal with the ravages of opioid abuse and addiction.

In this global drive, the companies, known as Mundipharma, are using some of the same controversial marketing practices that made OxyContin a pharmaceutical blockbuster in the U.S.

In Brazil, China and elsewhere, the companies are running training seminars where doctors are urged to overcome “opiophobia” and prescribe painkillers. They are sponsoring public awareness campaigns that encourage people to seek medical treatment for chronic pain. They are even offering patient discounts to make prescription opioids more affordable.

U.S. Surgeon General Vivek H. Murthy said he would advise his peers abroad “to be very careful” with opioid medications and to learn from American “missteps.”

Obviously Purdue has identified large markets in South America and Asia where there are masses of people just waiting for the chance to kill themselves and they live in countries that aren't too squeamish to walk around the bodies of dead junkies in the street. This move should elevate the Sackler family from filthy rich to disgustingly rich in no time.