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How a manipulative graph started the opioide crisis in the US

Recently, in one of my keynotes I have been asked a very good question: how do I spot any attempts of manipulation or misleading data graphs? My first advice is always: check the axis! If there is any irregularity, ask yourself, why might that be? 🧐

This brings me to the series of types of manipulative data visualizations.

First off: the change of scale.

A prominent example of how manipulative this can be misused is the scandal around OxyContin, a pain killer drug produced by Purdue in the USA. Allegedly, this triggered the opioid crisis in the mid/end 90’s. Still today, this crisis causes 100.000 deaths every year due to drug abuse that is more than 270 per day!

Purdue Pharma has been accused of using manipulative tactics in their marketing and representation of the drug's safety and effectiveness. One such tactic was the manipulation of the y-axis in graphs showing the plasma concentration over a 12-hour period of time.

Highly addictive drugs have a huge plasma concentration spike once ingested, that rapidly reduces leaving the patient behind with a craving for more.

In Purdue’s graphs, the y-axis was often adjusted in a way that made it appear as though OxyContin had a much flatter plasma curve compared to other opioids, implying that it had a lower risk of abuse and addiction. However, by using a logarithmic scale on the y-axis, the spike was flattened. (see graph’s below)

This manipulation was used to downplay the extent to which OxyContin was addictive, and to mislead healthcare providers and the public into thinking that OxyContin was a safer option than other opioids. As a result, the drug became widely prescribed, leading to a nationwide opioid epidemic.

(BTW: Watch the series “Dopesick” to find out more Purdue’s sales strategies.)

In a nutshell: to spot manipulative graphs check that the axis starts at 0 and has a linear scale. If not, ask why! (Cui bono?)

And in case YOU want to manipulate your audience: don’t! If you do and your audience finds out, your trustworthiness is out of the window and will it be very hard to redeem yourself.

Remember the wise words of Benjamin Parker: “With great power there must also come great responsibility!” 🕷️🦸🏽‍♂️

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