Professor Michael Malamy has been at Tufts long enough to remember when the medical school shared space with the old garment factories in Chinatown. He also remembers the first time the name of the Sackler School of Biomedical Sciences was challenged in April 1980. Now, over the past year, Tufts has come under scrutiny for its connections to the Sackler family, which is credited with developing the aggressive marketing strategies that encouraged the over-prescription of OxyContin that eventually propelled America into an opioid crisis. “Everybody thinks of OxyContin and the opioid epidemic,” Malamy said, sitting in his office in the Sackler School across from the Sackler Medical Education Building. “But our objection to the Sacklers went back to the donation that founded the [biomedical] school.”

       Last month, TCU Senate, the students of Tufts University School of Medicine (TUSM), and the Sack Sackler Campaign (organized by an inter-campus group of students and alumni), all submitted demands to remove the Sackler name from Tufts’ Biomedical School and the Sackler building at 145 Harrison Ave. In a resolution on the Sackler ties to Tufts, the Faculty Senate has also advised the University to “seek new opportunities to improve terminology for how we refer to Tufts activities and buildings.” All of these groups have cited the harm caused by the opioid epidemic in their demands.

In response to questions about the presence of the Sackler name at Tufts, Patrick Collins, Executive Director of Public Relations, has repeatedly stated that the Sackler donation was made “more than a decade before OxyContin was introduced to the marketplace.” But as Professor Malamy noted, “[OxyContin] is not our first bad encounter with the Sackler family.” Tufts had cause to scrutinize the Sackler name for several decades before 400,000 Americans died by opioid overdose between 1997 and 2017 and before Massachusetts Attorney General Maura Healey released a 274-page memorandum in January describing the “marketing benefits Purdue Pharma reaped from Tufts.”

       In reality, the story began 60 years ago in Washington DC, with Tennessee Senator Estes Kefauver. Kefauver was famous for conducting high-profile investigations, including the Kefauver Committee on organized crime, in which Frank Costello, the iconic New York mafia boss, testified. In 1959, Kefauver began congressional hearings on a more ambiguous sort of organized crime—the business of pharmaceuticals. Initially, Kefauver sought to investigate the high prices of prescription drugs. But as the hearings continued, a number of new concerns arose about aggressive marketing, deceptive advertising, and questionable testing methods being employed by the pharmaceutical industry.

In 1962, Arthur M. Sackler testified before Kefauver. Sackler was raised in a working-class family in Brooklyn, graduated with an MD from the NYU School of Medicine, and then pursued his residency in psychiatry. By the time of his testimony, he had already become a prominent figure in the pharmaceutical industry as the head of the country’s largest pharmaceutical-focused advertising firm, William Douglas McAdams.

According to Barry Meier, author of Pain Killer: A “Wonder” Drug’s Trail of Addiction and Death, Sackler edited the Journal of Clinical and Experimental Psychology, founded the Medical Tribune, a free bi-weekly newsletter sent directly to doctors, bought a pharmaceutical company with his brothers, and planted pro-opioid stories in newspapers. As one of Kefauver’s staff memos put it, “The Sackler empire [was] a completely integrated operation” that could develop drugs, create favorable testing results, ghostwrite scientific journal articles, and directly advertise to doctors and the public. Sackler managed to leave the 1962 hearing unscathed, but Kefauver had already noticed the concerns that would rise to the public eye years later, over the drug we now associate with the Sackler name: OxyContin.

Throughout the 1970s and ‘80s, Arthur Sackler made a number of large donations to art museums and medical institutions, including Tufts. In 1979, Tufts President Jean Mayer began seeking private funding to renovate research facilities. Mayer had an ambitious vision of what he called “one medicine,” which included a single graduate school that would coordinate research efforts in the biomedical sciences and across the medical, dental, and veterinary schools.

       In 1980, Arthur, along with his brothers Raymond and Mortimer, signed a contract to donate a total of $1.5 million to Tufts. In return, the contract stipulated that the University “agrees that the name, ‘The Sackler School of Graduate Biomedical Sciences,’ shall be displayed prominently on the building [housing the school]… in any official and scholarly publication, catalogue, invitation or announcement… [and] on all diplomas received by its graduate students.” Apart from delineating the terms of Sackler brand placement on buildings, publications, and diplomas, the naming contract also stated that this condition would be effective in perpetuity.

        On March 25, 2019, in response to the Attorney General’s memorandum, Tufts President Anthony Monaco announced an internal review of the possible influence of the Sacklers and Purdue Pharma on the research and training at Tufts. His university-wide message said that while many members of the Tufts community are calling for the removal of the Sackler name, the University “will await the results of the review… prior to making any final decisions.” But whatever the results of the review might be, according to the terms of the 1980 contract, the name cannot be legally changed without the written permission of the Sacklers.

Professor Michael Malamy reminds us that the Sackler name was opposed even when that contract was first written. This forgotten history can be traced in the Tufts Archive. In the minutes from a faculty meeting on April 7, 1980, faculty members raised concerns pertaining to the formation of the Sackler School, including:

“1) If it costs $1,000,000 to endow a professorship, how can the Trustees and administration consider developing a school on a $1,500,000 donation?

2) How much of the total donation will actually go toward the Sackler School?

3) Professors Shaffer and Slapikoff would like to have the question of ethics addressed in light of recent allegations as to how Sackler funds were amassed.”

Given what the Kefauver subcommittee had briefly revealed about the ethically-questionable practices of the Sacklers, Malamy said that many faculty members felt that “taking the money was an issue, but naming it the Sackler School––we didn’t think the Sackler name should be associated with an academic institution doing biomedical research.”

Professor Malamy appears in the archive as well, in the minutes of a special meeting on April 29, 1980, during a  discussion of the proposed Sackler School. The minutes summarized, “[Professor Malamy] urged the faculty in their deliberations to be cautious… to move slowly, to define the goals of graduate education, to see what is being proposed and then [to] do something positive about it.” President Mayer is then quoted as saying this was a “damned if you do and damned if you don’t situation.”

Malamy said that discussions about the ethics of the Sackler donation continued in medical school faculty discussions after this meeting, but due to a 75 year embargo on those  documents, the Observer was unable to corroborate the records. The few available documents, though, clearly indicate that ethical concerns were raised about the Sackler funds in 1980, long before OxyContin even hit the market.

Like the dissenting faculty members almost four decades ago, many Tufts community members today have challenged the power wielded by the Sackler name. Sarah Hemphill, a first-year student and organizer at the medical school, said that “Tufts has a huge opportunity here to lead the charge in becoming the first academic institution that cuts ties with the Sacklers.” She sees removing the Sackler name as “a symbolic gesture of solidarity with the hundreds of thousands of people who have been affected by the opioid crisis.”

Professor Malamy also feels “it would be appropriate to take the name away, especially in light of the student protests.” Sonia Das, an alumnus of the Sackler School who now works as a researcher in cancer drug development, affirmed that “[The Sacklers] need to be held accountable,” expressing her “support for everyone still at Tufts who is trying to remove the name.”

Hemphill said that there is “widespread acceptance” among students, faculty, and administrators of unofficially referring to the building at 145 Harrison Street as Med Ed, or the Medical Education building. A university-wide email from the Provost’s office on March 28 also referred to the building by this name. Yet both Professor Malamy and Professor Wortis, a Sackler School representative within the university-wide Faculty Senate, had not been made aware of this unofficial name change.

Malamy and Wortis both recognized the value of removing the Sackler name, while still expressing other concerns about changing it. “I would be happy to be rid of it,” Wortis said, “but I think we have bigger problems.”

“Even more concerning is the possible influence on the curriculum,” Malamy continued. But Hemphill said that the medical students have been reassured repeatedly by the Deans that their MD curriculum has not been influenced by the Sacklers in any way. “We are pretty confident that is true,” she told the Observer. Professor Emmanuel Pothos, Director of Addiction Medicine at TUSM, also emphatically stated that the course incurs no industry influence.

But the Attorney General’s report examines a specific Tufts Masters program in Pain Research, Education, and Policy (MS-PREP) at TUSM that was established by a gift from the Sackler family in 1999. The report unequivocally reveals that “The Sacklers got a lot for their money” through MS-PREP. Both Professor Pothos and Professor Malamy confirmed that the administration, including TUSM Dean Harris Berman, have announced to faculty that the MS-PREP program will be shut down. Pothos attributed this decision to low enrollment. However, President Monaco, Dean Berman, Patrick Collins, and the Director of the MS-PREP program declined to verify this. They also declined to comment on any of the Observer’s questions pertaining to the Sackler issue, out of respect for the ongoing internal investigation of the program by Donald K. Stern.

This opaque response epitomizes the most vehemently emphasized concern of the student organizers advocating to rename the Sackler school: the lack of transparency from the Tufts administration. This opacity is perpetuated by the restrictions placed on the archival documents the Observer sought to consult in reconstructing the history of Sackler ties at Tufts. Daniel Fritz, a PhD student at Sackler involved in drafting the petition for the Sack Sackler campaign said, “I understand they can’t take action until the process is concluded, but I don’t think they should close off discussion.”

Sophomore Connor Goggins was one of four authors on TCU Senate’s “Resolution Calling for Tufts University to Explain their Complicity in the Opioid Crisis and Clarify the Oversight of Trustees and Advisors.” His motivation for working on the resolution was to “expose the opacity, which is only continuing with this investigation.”

Hemphill said that while she feels the administration is “on [their] same team,” she and other medical students were “disappointed” by President Monaco’s announcement regarding  the internal investigation, especially because of his lack of commitment to eventually share the investigation results in full. “We are worried that Tufts will take an action and we will never have any transparency on how that decision was made,” she said. Likewise, Fritz expressed that the Sack Sackler group’s biggest concern at present is that President Monaco’s announcement contained “no real assurances.”

But the Sackler issue has also been a site of deeper fissures and wider tensions within the University. Eric Rizzotti, a graduate student in the history department, was not surprised when he learnt of Tufts’ connection to the opioid crisis. “There is just such a distance between Tufts and the broader community, especially where I’m coming from—and where a lot of people are coming from.”

Rizzotti grew up in Berkley, Massachusetts, a small town of fewer than 7,000 residents. Between 2013 and 2017, Berkley saw 11 opioid overdose deaths. Rizzotti explained that growing up, “there was a ton of Oxy and Percocet floating around.” In high school, a classmate on the football team got an injury and was prescribed OxyContin. He started selling the opioids at school, and soon “a ton of people got addicted to painkillers, and then became heroin addicts,” Rizzotti recalled. He described the alienation he felt coming to an “elite” institution like Tufts, “where the world is just so abstract to people.”

“Changing the Sackler name is really nothing,” Rizzotti said, reflecting on the losses of those in his hometown. “The way funding is set up, there are all kinds of interests like the Sacklers coming into schools like Tufts.” Like Rizzotti, a number of students expressed concern about what the particular case of the Sacklers might reveal about how institutions are structured with hidden pockets of opacity. Fritz said that one of his primary concerns in drafting the Sack Sackler petition was “to encourage the University to be more transparent in the future,” particularly regarding financial information. The TCU Senate resolution also asked the administration to “apply more thoughtful, rigorous, and critical criteria when evaluating board members in the future.”

“The Sacklers are just the tip of the iceberg,” Hemphill said, referring to pharmaceutical fraud, the entanglements of ethically problematic donors with universities, and the way those institutions can become tangled within themselves. Professor Malamy’s memory of the Kefauver hearings draws us back to a strange knot of history, which reveals how the boundaries between profit-seeking corporations, state regulations, and universities can be unevenly and unknowingly stitched together.

Thus, the paragons of pharmaceutical regulation and pharmaceutical recklessness moved through the same spheres—from a congressional hearing to a university. History asks us to take consequences of institutional amnesia seriously. “Nobody remembers anything,” Professor Malamy laments. “It’s as if every time a new dean or new president takes over, everything that came before is erased.” If Malamy is one of the few faculty members who still remembers the original questions raised about the Sackler name decades ago, what other forms of exploitation receive forgotten sanctuary within institutions of higher learning?

“I don’t believe the Sacklers are at fault,” Malamy said. “It’s the doctors who are prescribing these things.” Hemphill disagreed, countering, “The blame falls on the drug companies and the government’s failure to regulate them, it doesn’t fall on the doctors.” But to Malamy’s point, Professor Pothos said, “We should have the sincerity to discuss the role of the healthcare community itself.” Finally, on the subject of the University’s complicity, Goggins said, “So many levels of Tufts administration let this happen.” The answer is perhaps more challenging than any single donor, doctor, or institution.

Even as we respond to the damage done by OxyContin overprescription and the ethical challenges of responsibility that it raises, Pothos is also skeptical about the future of opioid addiction. “The opioid crisis has been with us for a few hundred years, is here with us to stay, and will probably evolve into another opioid crisis in the future,” he said. As he pointed out, the American opioid crisis is neither particularly “American,” nor is it unique to this moment, even if it has just recently landed on Tufts’ doorstep.

Ben Siegel is a Professor of History at Boston University studying the opium trade. The structure of the current opioid crisis, he explained, is similar to opioid panics and crises we have seen from the nineteenth century onwards, including mass addictions to the once over-the-counter opioid, heroin, and to the cure-all of the American Civil War, morphine. Like OxyContin, both heroin and morphine were initially marketed as non-addictive.

“The case of Sackler and Oxy is less singular than we might think,” Siegel offered. “Against the narrative of American exceptionalism, there are opioid crises in every corner of the world right now, and they are all interlinked by a complex global market.” As the Tufts community grapples with how to respond to the Sacklers and the American opioid crisis at large, will we be willing to see the complex networks that tie the ills of the here and now to the suffering of the faraway and long-ago? “Even though Tufts likes to talk about its global reach, this is a moment of reckoning,” Goggins said.

Sitting in his office across from the Medical Education Building, Professor Malamy reminds us that “coming to simple conclusions is a mistake, because it gives us a way out.” Even if removing the Sackler name were easy, the Tufts community must face that as “active citizens” and “global citizens,” we may have no easy way out of the global opioid crisis that has arrived at 145 Harrison Ave, Boston, MA.