Last week, a federal jury found executives at a large opioid manufacturer, Insys Therapeutics guilty of bribing doctors to prescribe their fentanyl-based painkiller, Subsys, among other crimes including criminal racketeering.

John Kapoor, the company’s founder, was found guilty alongside four other executives. Richard Simon, the former national director of sales; Sunrise Lee, former regional sales director, Joseph Rowan, also a former regional sales director; and Michael Gurry, former vice president of managed markets, were all found guilty of racketeering charges.

The trial focused on Insys’s often manipulative efforts to sell as much of its potent opioid painkiller, Subsys. Created to help cancer patients with severe pain, sales efforts soon moved to off-label purposes.

A New York Times expose detailed how the company used fake “educational talks” to financially reward doctors for prescribing the drug in large amounts, while misleading insurance companies about the benefits of the drug. A former employee also described how a former sales director, Sunrise Lee, had her give a doctor a lap dance to get him to persuade a doctor to prescribe the medication.

Criminal and Civil Cases Against Insys Are Still Pending

The criminal case covered the efforts that Insys made to mainstream a medication that was never meant for anything but severe pain like that kind that people suffering from cancer or a car crash might experience. Off-label uses were encouraged indirectly by the sales team, and sales were rewarded through a covert payoff system directly to doctors.

At one point, the Insys sales staff even created a rap video with the line, “I love titration, yeah it’s not a problem. I got new patients, and I got a lot of ‘em.” Titration is the medical term for when a doctor increases or decreases a patient’s dosage of prescribed medication.

The criminal charges follow a substantial financial loss for the company as well. Last December, Insys settled with the government for over $150 million in fines to pay dozens of state lawsuits across the country. Several employees, including John Kapoor, are still facing lawsuits as well.

Criminal charges are becoming a new norm for pharmaceutical companies alongside civil suits. Last month, federal prosecutors filed charges against a major drug distributor, Rochester Drug Cooperative, for their alleged role in fueling the opioid crisis.