No More Tears

1. J&J's Iconic Trust Masked a Dark Reality.

If there is a more American—quintessentially American—company than Johnson & Johnson, I do not know what it is.

A beloved brand. For generations, Johnson & Johnson cultivated an image of trust and care, deeply associated with iconic products like Johnson's Baby Powder and Tylenol. This emotional bond, particularly with the mother-baby relationship, served as a powerful protective halo, fostering consumer loyalty and admiration from professionals and regulators.

The Credo's promise. Central to this image was the J&J Credo, promising responsibility first to those who use their products, not shareholders. The company's handling of the 1982 Tylenol poisoning crisis became a legendary example of prioritizing safety over profit, taught widely as a model of ethical corporate behavior.

A stark contrast. However, beneath this pristine reputation, the author argues, lay a pattern of prioritizing profits, concealing dangers, and engaging in illegal marketing tactics. This disconnect between mythology and reality became increasingly apparent as the company grew into the world's largest healthcare conglomerate.

2. Baby Powder: Decades of Known Asbestos Contamination Concealed.

For Johnson & Johnson, virtually none of this was new.

Early warnings ignored. As early as the 1950s, J&J was aware that its talc, sourced from mines often co-located with asbestos deposits, contained asbestos impurities. Internal documents from the late 1960s explicitly discussed the presence of tremolite asbestos and the potential for litigation related to lung disease.

Discrediting science. When independent scientists in the 1970s found asbestos in J&J's Baby Powder and linked talc use to ovarian cancer, the company launched aggressive campaigns to discredit the research and influence regulatory bodies. They hired consultants who had found asbestos in their own tests but pressured them to suppress findings.

Lies and cover-ups. J&J publicly denied the presence of asbestos while privately acknowledging it. They manipulated testing standards, destroyed documents, and provided false sworn testimony for decades. This concealment continued even as evidence mounted and lawsuits accumulated, prioritizing the "sacred cow" brand over public health.

3. The Tylenol Myth: Crisis Management Hid Deeper Issues.

It was a bitter irony that the gentle, loving relationship between mother and child should somehow be a factor in the comeback phase of a crime of evil-minded brutality.

A PR triumph. J&J's swift, costly recall of Tylenol capsules in 1982 after cyanide tamperings is widely hailed as a masterclass in ethical crisis management, solidifying the company's reputation for putting people first. This response undoubtedly saved lives and led to industry-wide tamper-proof packaging.

Undermining the narrative. However, the author points to flaws in this heroic tale:

• Tylenol had experienced prior tamperings, suggesting the crisis wasn't unforeseen.
• J&J initially resisted a nationwide recall, agreeing only after a copycat poisoning became public.
• Evidence suggests the contamination may have occurred higher up the distribution chain (wholesale boxes found), not just on store shelves, potentially implicating J&J's system security.

A corrupt regulator. The FDA's response was also problematic, quickly absolving J&J and surrendering investigative roles, partly influenced by a commissioner later found to have secretly taken money from drug companies. This "love fest" between J&J and the FDA, while leading to positive packaging changes, also shielded the company from deeper scrutiny regarding its distribution vulnerabilities.

4. Risperdal: Illegally Marketing a Dangerous Drug to Vulnerable Patients.

Thus was born “Sell to the Symptoms.”

Beyond schizophrenia. Approved only for schizophrenia, Risperdal's sales goals necessitated expanding its use to other conditions. J&J implemented a strategy to market the drug based on symptoms common across many psychiatric issues (anxiety, agitation, hostility), not just the approved diagnosis.

Targeting the vulnerable. This illegal "Sell to the Symptoms" approach aggressively targeted children and the elderly, populations where Risperdal was not approved and carried significant risks:

• Children: Marketed for behavioral disorders, despite known risks of severe weight gain and gynecomastia (male breast growth). Internal studies showed one in ten boys developed permanent breast tissue.
• Elderly: Marketed for dementia-related psychosis, despite trials showing little benefit and increased risks of strokes, heart attacks, and death.

Ignoring and concealing risks. J&J executives knew of these severe side effects from their own trials but suppressed the data, manipulated study results, and lied to the FDA and doctors. Sales reps were even told to suggest diagnosing dementia patients with schizophrenia to avoid regulatory scrutiny.

5. Corrupting Doctors and Institutions Fueled Harmful Prescribing.

Every dollar given to doctors led to between $3.50 and $5.00 in additional drug sales.

The payoff machine. With the rise of data tracking, J&J and other drugmakers learned that paying doctors directly yielded massive returns. This led to a systematic effort to funnel money to physicians through speaking fees, consulting gigs, lavish gifts, and "seeding trials" disguised as research.

Undermining science. This financial influence corrupted medical practice and research:

• Doctors were incentivized to prescribe based on profit, not patient need or scientific evidence.
• Academics were paid to conduct biased studies and ghostwrite articles promoting off-label uses.
• Patient advocacy groups (like NAMI) and state officials were paid to lobby for policies favoring expensive drugs like Risperdal, even at the cost of cutting services for the poor.

FDA's complicity. The FDA, increasingly reliant on industry user fees, largely ceased policing illegal marketing and bribery. This created an environment where companies factored fines into the cost of doing business, knowing the financial rewards of illegal promotion far outweighed potential penalties.

6. J&J's Hidden Role in Driving the Opioid Epidemic.

J & J was clearly the kingpin of the opioid epidemic, not Purdue Pharma.

Supplier and marketer. While Purdue Pharma is infamous for OxyContin, J&J played a crucial, often overlooked, role in the opioid crisis. It was the largest supplier of key opioid ingredients (like oxycodone) in the U.S., achieved partly by engineering a high-yield "Norman" poppy in Tasmania.

Copying Purdue's playbook. After OxyContin's addiction crisis became public, J&J aggressively marketed its fentanyl patch, Duragesic, and later Nucynta, using the same false claims of low addiction risk that Purdue had pioneered.

• J&J sales reps cited flawed data (like DAWN) to convince doctors fentanyl was less prone to abuse than oral opioids.
• Internal plans targeted high-risk patients and aimed to extend treatment duration, directly fueling addiction.

Profit over public health. Unlike Purdue, J&J didn't need opioid sales for survival, yet it doubled down on aggressive marketing even as the death toll mounted. This demonstrated a ruthless indifference, prioritizing profits from addiction over the devastating public health consequences.

7. Medical Devices Rushed to Market Caused Widespread Injury.

Few doctors are aware that so many complex devices are approved without proof of safety or efficacy.

The 510(k) loophole. Unlike drugs, many high-risk medical devices are approved via a loophole (510(k)) by claiming similarity to devices approved before 1976, often without human testing. This allowed J&J to rush potentially dangerous devices to market.

Known dangers ignored. J&J launched devices with known, severe risks:

• Pinnacle Hip: A metal-on-metal hip implant similar to failed 1960s designs. Internal testing showed it shed toxic metal debris and failed at high rates, but J&J misrepresented data to the FDA and doctors.
• Prolift Mesh: A vaginal mesh kit for pelvic organ prolapse. Internal studies and inventor warnings before launch showed high rates of erosion, pain, and complications, yet J&J sold it without FDA approval and concealed the risks.

Profiting from failure. J&J not only sold defective devices but profited from the surgeries needed to remove and replace them. They also used payments to surgeons to encourage the use of these problematic implants and suppress reporting of complications.

8. The FDA: A Captive Regulator Failed to Protect the Public.

In truth, no major government agency has failed as fully, frequently, or consistently as the FDA.

Industry funding and influence. The FDA's increasing reliance on user fees from the industries it regulates compromised its independence. This financial dependence, coupled with a revolving door of personnel between the agency and industry, led to regulatory capture.

Failure to enforce. The FDA consistently failed to act as a tough cop:

• It ignored or delayed action on illegal marketing, known product contamination (Baby Powder, Tylenol), and dangerous side effects (Tylenol, Risperdal, Duragesic, Ortho Evra).
• It allowed devices to be approved without adequate testing and failed to mandate recalls despite mounting injuries.
• It issued statements favorable to J&J during litigation, undermining public health warnings.

A perpetuated myth. Despite its failures, the FDA maintains a public image as a rigorous, independent watchdog, a myth actively promoted by industry (including J&J) and often perpetuated by the media. This false perception shields companies from liability and lulls the public into a false sense of security about product safety.

9. J&J's Legal and Political Influence Ensured Impunity.

Johnson & Johnson has long been one of the biggest individual patrons of corporate law firms in the world.

Fighting accountability. J&J employed aggressive legal tactics to avoid responsibility for its misdeeds, including destroying documents, providing false testimony, and using maneuvers like the "Texas Two-Step" bankruptcy filing to shield assets from lawsuits.

Influence over the system. J&J's vast financial power and political connections allowed it to influence regulators, prosecutors, and the legal system:

• It lobbied successfully against stricter regulations and for laws limiting corporate liability.
• The revolving door between government agencies (FDA, DOJ) and law firms representing J&J hindered investigations and prosecutions.
• Prosecutors often declined to charge individual executives, citing lack of smoking-gun evidence or the difficulty of taking on a powerful conglomerate.

The Credo as camouflage. J&J's carefully crafted image and the widespread belief in its ethical standards served as a powerful shield, making it difficult for the public, media, and even some within the legal system to believe the extent of its misconduct.

10. The Covid Vaccine: A Failed Redemption Attempt.

Suddenly, the rarest of opportunities presented itself to the planet’s largest healthcare conglomerate—a chance to redeem itself by saving the world.

A high-profile effort. J&J's development of a single-shot Covid vaccine was presented as a chance to restore its reputation, marred by mounting lawsuits and scandals. CEO Alex Gorsky personally championed the effort, aligning his brand with the vaccine.

Manufacturing and safety failures. However, the vaccine effort was plagued by problems:

• A key manufacturing partner (Emergent BioSolutions) had severe quality control issues, leading to millions of contaminated doses being discarded.
• The vaccine was linked to rare but serious blood clots and Guillain-Barré syndrome, leading to pauses and warnings.
• Its efficacy proved lower than competitors, particularly against new variants.

Reputational damage. Despite initial hopes, the vaccine's problems and eventual withdrawal further damaged J&J's standing. The effort, intended to be a triumph, became another example of the company's struggles with quality control and transparency, ultimately becoming a "punch line."

11. J&J's History Reflects Systemic Failures in American Healthcare.

That Johnson & Johnson has gotten away with so much is a devastating indictment of the country’s for-profit healthcare model at large.

A pattern of harm. The detailed history of J&J's products reveals a consistent pattern: identifying profitable markets, rushing products to sale (often without adequate testing or approval), concealing known dangers, and using influence to evade accountability for resulting harm and deaths.

Systemic enablers. J&J's behavior was enabled by broader failures in the American system:

• A healthcare model where profit incentives often override patient well-being.
• A regulatory system (FDA) weakened by industry influence and lacking enforcement power.
• Institutions (medical societies, universities, media) compromised by financial ties to industry.
• A legal system where corporate power can overwhelm accountability.

The enduring myth. Despite evidence of widespread misconduct and significant harm, J&J's powerful brand and the complementary myth of a vigilant FDA allow it to maintain a positive public image and continue operating with relative impunity, highlighting deep flaws in American healthcare and capitalism.

Last updated: May 28, 2025