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Deadlier Than Cyanide

Johnson & Johnson’s Response to the Opioid Crisis

By Hannah Landers

No more tears.

For more than half a century, Johnson & Johnson has made this promise to families across America. The tagline is specifically for its baby shampoo, but it’s a commitment that could apply to any of the products that have become synonymous with the brand.

Johnson & Johnson manufacturers health and wellness products for some of the most precious populations in society, such as the Band-Aids that soothe a child’s skinned knees, or the aforementioned “no tears” promise of its baby shampoo. These products are built on trust that the company is behaving in a way that puts the customers that need it first, and that everything else, including profits, will come after.

That promise can be boiled down to a handful of words: the Johnson & Johnson Credo. This foundational document was created in 1943, and describes the company’s responsibility to its customers, employees, communities, and stockholders. Despite this clearly articulated promise, however, Johnson & Johnson is one of many companies that has played a part in the ongoing opioid epidemic that has caused the death of nearly 400,000 Americans in a decade.

The opioid epidemic isn’t the first time that Johnson & Johnson has had to reckon with the death of its customers; in the early 1980s, seven people in the Chicago area died after ingesting Tylenol pills that had been laced with cyanide. Marketers at the time predicted the best-selling Tylenol brand would never bounce back from such a tragedy, but its current ubiquity has long since disproven this.

What differs between the ways in which the Johnson & Johnson of yore handled concerns over consumer safety, and the pharmaceutical giant’s actions as of late?  Where the Credo clearly guided the ways in which Johnson & Johnson reacted to the news of the tainted Tylenol, the company’s response to its role in opioid crisis has not been consistent with the Credo’s “values that guide our decision-making.

Effective organizations build their brand around a clearly articulated ethos like the Johnson & Johnson Credo for a reason. Not only does such a narrative communicate core values, establish a brand’s personality, and provide a framework in which a brand must operate; the brand promises laid out in the Credo—and in similar brand stories—create an authentic connection between a brand and all of its stakeholders. The story provides direction, and audiences expect the brand to behave in a way that aligns with it. When a brand does not, it leaves a promise unfulfilled with enormous consequences.

Johnson & Johnson was founded in 1886 by three brothers looking to create a line of easily useable surgical dressings. From developing the first commercial first aid kits to the first mass-produced sanitary products for menstruating women, Johnson & Johnson has spent decades building a history of serving the most basic, health-related needs of its customers in order to help them live healthier, more well-rounded lives.

This promise was formalized with the creation of the Credo shortly before the company became publicly traded. As the brand prepared to leave the control of its founding family, the Credo cemented a century of history by articulating the company’s commitment to its various stakeholders. Notably, the Johnson & Johnson brand story ranks its responsibility to consumers as first and most important:

“We believe our first responsibility is to the patients, doctors and nurses, to mothers and fathers and all others who use our products and services. In meeting their needs everything we do must be of high quality. We must constantly strive to provide value, reduce our costs and maintain reasonable prices. Customers’ orders must be serviced promptly and accurately. Our business partners must have an opportunity to make a fair profit.”

While brand stories provide a framework for growth, they also become a company’s “North Star” in turbulent times. Following the Credo guided Johnson & Johnson’s actions in the face of its then-largest tragedy: the aforementioned Tylenol incident.

The mysterious string of poisonings unfolded in the Chicago suburbs over a series of just a few days, beginning with the death of 12-year-old Mary Kellerman on September 29, 1982 due to cyanide poisoning. As the death toll rose into the first few days of October, investigators tracked the cyanide to Tylenol; all of the victims had taken the popular painkiller shortly before they passed away.

At the time, Tylenol was Johnson & Johnson’s most successful product. It accounted for 17 percent of the company’s net income, and 37 percent of the $1.2 billion analgesic market. Tylenol was vital to Johnson & Johnson’s financial performance, and the crisis created competing priorities between what was best for business, and the Credo. Ultimately, the company chose the one best for those to whom it had pledged its responsibility: consumers.

Almost immediately, the company recalled 31 million bottles of Tylenol from shelves across America—a move that seems all too common today, but was relatively unheard of at the time. “Before 1982, nobody ever recalled anything,” the managing director of a public relations firm told The New York Times in a 2002 article looking back at the recall. “Companies often fiddle while Rome burns.”

For Johnson & Johnson, the choice between profit and the safety of consumers was not a choice at all: following the Credo would not permit anything else. When it was clear the “high quality” the document calls for was missing, the company wasted no time in aligning behind its guiding brand narrative. Johnson & Johnson not only recalled every single bottle of medication, poisoned or not; it put processes in place to ensure something like this never happened to its customers again.

Even when investigators learned that the pills had been altered following the manufacturing phase, effectively exonerating the company from direct responsibility for the deaths, Johnson & Johnson followed its Credo in making its products safer. The company worked with the FDA to develop tamper-proof packaging that has since become industry-standard. Johnson & Johnson also went back to the drawing board for its product design, ditching the one that allowed someone to pry open the capsule and alter the medication, and instead opting to coat the drug with gelatin to ensure the pill could still be easily swallowed, but not easily tainted. The company also ran ads explaining how to exchange Tylenol capsules for a bottle of pills with the improved design, and issued coupons to reimburse consumers for any Tylenol they may have trashed following the incident.

While the recall and subsequent re-launch of Tylenol cost the company more than $100 million, the return on investment for following through on its brand promise was priceless: A year after the incident, the brand’s share of the analgesic market—which had tanked to 7 percent after the poisonings—bounced back to 30 percent; only five months after the poisonings, Tylenol sales were 96 percent of what they were before the incident.

More than 30 years later the brand is facing a similar crisis: its role in the mounting deaths of those addicted to opioids. Today’s Johnson & Johnson is struggling to follow through on the brand promises outlined in its Credo, and the impact is life-or-death.

The opioid epidemic began in the late 1990s and early 2000s when doctors started prescribing opioids to more and more individuals suffering from chronic pain despite little scientific study of the potential effects. The problem snowballed as the prescribed became addicted, and then moved on to the better, cheaper high provided by illicit drugs like heroin and fentanyl, and furthermore as medicine cabinets were raided for those who looked to buy prescription drugs illicitly.

Purdue Pharma, maker of the bestselling OxyContin, has (rightfully) taken much of the blame for destroying countless lives throughout this crisis. Recently, however, other pharmaceutical companies—including Johnson & Johnson—have come under fire for the role they played in not just making these highly destructive drugs more widely accessible, but in marketing that opioids were a safe, reliable solution to doctors and patients alike. In JAMA Network Open, a medical journal published by the American Medical Association, researchers revealed that geographic areas across the United States with a high level of opioid marketing experienced a higher rate of overdose deaths from opioid painkillers. A research letter published in the same journal pointed to the aggressive marketing tactics of one company in particular, Janssen Pharmaceuticals—a subsidiary of Johnson & Johnson.

In an Oklahoman civil trial that tried Johnson & Johnson for its role in the state’s opioid epidemic, a woman who lost her son to an overdose (after he was prescribed them for a back injury) placed the blame firmly on the healthcare giant. “My problem with Johnson & Johnson is that they did not give appropriate information with regard to the opioids they were distributing,” she told The Guardian. “They said possibly 1 percent of people taking opioids would become addicted, when they knew the number was far greater.”

Johnson & Johnson has been forced into the courtroom to face 2,300 lawsuits in state and federal courts related to its involvement with opioid products. And, in some cases, even litigation was not enough to push the company to try to resolve its mistakes: When a judge in the aforementioned Oklahoma case ordered Johnson & Johnson to pay more than $570 million to the state—a far lighter penalty than the company’s investors had expected—the company swiftly announced it would appeal the decision.

Unlike its swift and proactive moves to protect the lives of its customers in accordance with its Credo during the Tylenol crisis, Johnson & Johnson has abandoned its longstanding brand message in its response to its role in the opioid epidemic.

Hewing to a brand promise can be difficult, because it puts emphasis on authenticity and the long-term value of the brand over immediate concerns. In ignoring the Credo—and responsibility for its mistakes—Johnson & Johnson seems determined to prioritize its own results, rather than preserve its trust-based relationship with consumers. The results have been meaningful. One study revealed that, in a ranking of the 58 leading pharmaceutical companies, Johnson & Johnson had fallen from 9th to 57th place. This loss of faith led to the same study finding that use of terms like “danger,” “harm,” “mislead,” and “unethical” have more than doubled in public conversations tied to the brand.

Johnson & Johnson’s profits over purpose strategy has paid off so far; annual revenue has steadily risen from 2016 onward. But the ramifications for its inability to deliver on its brand promises are only beginning to be felt as the public understands the role that the company has played in facilitating widespread opioid addiction. The Johnson & Johnson name has been further tarnished by concerns over whether its flagship baby powder product contains asbestos. Although the company has denied this fact, it has not done much else to assuage consumers’ concerns; actually, it has done the contrary, squashing credible scientific reports about the contamination despite evidence that the company had known about these concerns for decades.

Much has been said over whether or not the legacy brand can survive the onslaught; Johnson & Johnson’s full reckoning with its recklessness may be yet to come. When a brand invests in developing and codifying a strategic brand story, it makes a commitment to customers, employees, partners, and investors about the type of company it will be. Using it as a document to align those stakeholders and guide action builds a resilient organization, as Johnson & Johnson saw with the Credo during the Tylenol crisis. In the shadow of the opioid epidemic, modern-day Johnson & Johnson has struggled to keep its promises. Although not every customer knows about the Credo, all of them can tell when the brand is being anything less than authentic—and will flee if what they’re promised is sacrificed in order to turn a profit.

Hannah Landers is an associate at Woden. Whatever your storytelling needs may be, Woden can help. Read our extensive guide on how to craft your organization’s narrative, or send us an email at connect@wodenworks.com to discuss how we can help tell your story.