Gottstein was instrumental making alternatives to psychiatric drugs available in Alaska, through organizations he founded or helped lead, including Soteria-Alaska[2] and CHOICES, Inc.
In furtherance of this mission PsychRights won five Alaska Supreme Court cases establishing that the state was violating people's rights and then lost one that undid much of the gains.
Much of this progress was lost in 2019, when the Alaska Supreme Court decided In the Matter of: Linda M.,[9] holding the state could avoid the constitutional prohibition against locking someone up for being diagnosed as mentally ill and dangerous if there is a less restrictive alternative available by causing Soteria-Alaska to close due to insufficient funding, thereby making it unavailable.
[11] However, upon realizing the magnitude of Lilly's off-label marketing effort, Gottstein took the information to the New York Times, which published several articles quoting from the documents.
[11] Gottstein further wrote to Lilly's attorneys requesting that the company issue a "Dear doctor" letter to "all health care providers in the United States advising them Zyprexa should not be prescribed to anyone who is not already taking it," noting however that the drug should not be withheld from patients who were currently using it because abrupt withdrawal could cause neuroleptic induced discontinuation syndrome.
[11] At the time of the disclosures, Zyprexa had become Lilly's top selling drug despite having been approved only to treat adults with schizophrenia or bipolar disorder.
In 2009, four sales representatives for Eli Lilly filed separate qui tam lawsuits against the company for illegally marketing Zyprexa for uses not approved by the Food and Drug Administration.
In early 2009, Eli Lilly paid $1.415 Billion to the United States Government in False Claims Act (whistleblower) lawsuits over its illegal marketing of Zyprexa.