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He broke up bar fights and street brawls. During a torrential rainstorm in 1980, he waded into a flooded intersection to rescue two motorists. He had several surgeries and tried various pain medications over the next two decades.

By 2012, he was on OxyContin. His parents and siblings watched and worried as the strong, fastidiously neat man they knew became wobbly on his feet and unkempt. He spent much of his day sleeping. A toxicology test showed lethal levels of oxycodone in his blood. Based on the date Gallego filled the prescription, there should have been 44 pills left. By the late 1980s, the patent on its main source of revenue, a morphine pill for cancer patients called MS Contin, was running out. Executives anticipated a massive loss of revenue as generic versions drove down the price of MS Contin, according to internal company correspondence from the period.

The company was focused on finding a new moneymaker. In a 1990 memo, Robert F. Kaiko, vice president for clinical research, laid out why it was important to develop a second painkiller.

In this 1990 memo, Robert Kaiko, the scientist who would go on to help invent OxyContin, explains why Purdue needs another painkiller. In MS Contin, the technique made morphine last eight to 12 hours. Kaiko and his colleagues decided to use it on an old, cheap narcotic, oxycodone. Sold under several names and formulations, including Percocet and Roxicodone, oxycodone controls pain for up to six hours.

Goldenheim,then-vice president of scientific and medical affairs, wrote in a 2003 court declaration. At a 1995 meeting, Purdue executives described how OxyContin could "cure" the "vulnerability" of generic competition and laid out how they planned to market the drug. The first patients to use OxyContin were women recuperating from abdominal and gynecological surgery at two hospitals in Puerto Rico in 1989.

In the clinical study, designed and overseen by Purdue scientists and paid for by the company, 90 women were given a single dose of the drug while other patients were given short-acting painkillers or placebos. None of the women were regular users of painkillers, so they were more susceptible to the effects of narcotics. Even so, more than a third of the women given OxyContin started complaining about pain in the first eight hours and about half required more medication before the 12-hour mark, according to an FDA analysis of the study.

The study found that OxyContin was safe, relieved pain and lasted longer than the short-acting painkillers. Purdue moved ahead on two paths: seeking patents for its new drug and running additional clinical trials to secure FDA approval. In study after study, many patients given OxyContin every 12 hours would ask for more medication before their next scheduled dose. A Tennessee pain specialist whom Purdue selected to field-test the drug in 1995 as part of the FDA approval process eventually moved 8 of 15 chronic pain patients to 8-hour dosing because they were not getting adequate relief taking the drug twice a day.

Robert Reder wrote to the Memphis physician, using medical shorthand for 12-hour dosing. Some drug companies discuss that variability on their product labels and recommend that doctors adjust the frequency with which patients take the drugs, depending on their individual response. The morphine tablet, Kadian, manufactured by Actavis, is designed to be taken once a day, but the label states that some patients may need a dose every 12 hours.

It did not test OxyContin at more frequent intervals. To obtain FDA approval, Purdue had to demonstrate that OxyContin was safe and as effective as other pain drugs on the market. Under agency guidelines for establishing duration, the company had to show that OxyContin lasted 12 hours for at least half of patients.