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Empire of Pain: The Secret History of the Sackler Dynasty-Patrick Radden Keefe

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NEW YORK TIMES BEST SELLER • A grand, devastating portrait of three generations of the Sackler family, famed for their philanthropy, whose fortune was built by Valium and whose reputation was destroyed by OxyContin. From the prize-winning and bestselling author of Say Nothing, as featured in the HBO documentary Crime of the Century.ON PRESIDENT OBAMA’S SUMMER 2021 READING LIST   The Sackler name adorns the walls of many storied institutions—Harvard, the Metropolitan Museum of Art, Oxford, the Louvre. They are one of the richest families in the world, known for their lavish donations to the arts and the sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing a blockbuster painkiller that was the catalyst for the opioid crisis. Empire of Pain begins with the story of three doctor brothers, Raymond, Mortimer and the incalculably energetic Arthur, who weathered the poverty of the Great Depression and appalling anti-Semitism. Working at a barbaric mental institution, Arthur saw a better way and conducted groundbreaking research into drug treatments. He also had a genius for marketing, especially for pharmaceuticals, and bought a small ad firm.Arthur devised the marketing for Valium, and built the first great Sackler fortune. He purchased a drug manufacturer, Purdue Frederick, which would be run by Raymond and Mortimer. The brothers began collecting art, and wives, and grand residences in exotic locales. Their children and grandchildren grew up in luxury.Forty years later, Raymond’s son Richard ran the family-owned Purdue. The template Arthur Sackler created to sell Valium—co-opting doctors, influencing the FDA, downplaying the drug’s addictiveness—was employed to launch a far more potent product: OxyContin. The drug went on to generate some thirty-five billion dollars in revenue, and to launch a public health crisis in which hundreds of thousands would die. This is the saga of three generations of a single family and the mark they would leave on the world, a tale that moves from the bustling streets of early twentieth-century Brooklyn to the seaside palaces of Greenwich, Connecticut, and Cap d’Antibes to the corridors of power in Washington, D.C.  Empire of Pain chronicles the multiple investigations of the Sacklers and their company, and the scorched-earth legal tactics that the family has used to evade accountability. The history of the Sackler dynasty is rife with drama—baroque personal lives; bitter disputes over estates; fistfights in boardrooms; glittering art collections; Machiavellian courtroom maneuvers; and the calculated use of money to burnish reputations and crush the less powerful.Empire of Pain is a masterpiece of narrative reporting and writing, exhaustively documented and ferociously compelling. It is a portrait of the excesses of America’s second Gilded Age, a study of impunity among the super elite and a relentless investigation of the naked greed and indifference to human suffering that built one of the world’s great fortunes.

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I knew the general outlines of the story, but the book still kept me up till three a.m. reading it! Opioids, and their marketing, were the slipperiest of slopes and the nation skidded down the hill.As a doc, I knew of the overprescribing in the late 1990's and wondered how a "controlled substance" could make it from the factory to the streets with such ease. Now I know. At least I never wrote a script for it and never took a single dose of this poison.Evil. Pure, homegrown, evil. Aided and abetted by lawyers, and even McKinsey. NO ONE bothered to say what everyone knew: there was no excuse for the flood of opioids. No excuse except the addiction to money.
The overdoses and deaths came early. Having been introduced to medical doctors in the mid to late 1990’s, the super strong pain medicine, OxyContin, quickly became the drug of choice to give those dying in great pain from cancer. But OxyContin soon led to chronic abuse among those seeking the highs of street drugs. What was OxyContin and who was behind the mounting death toll? In his new book, “Empire of Pain”, author Patrick Radden Keefe, takes the reader behind the scenes to the ultra-secretive Sackler family.When (and if) you to the Smithsonian Museum, you’ll see huge Sackler Gallery, dedicated to Asian Art. There are similar rooms filled with donations at prestigious colleges and museums, mostly in the northeast. They were gifts given by members of the Sackler family. The three brothers, Arthur, Mortimer, and Raymond, were sons of a Jewish immigrant family. The brothers all became doctors and were primarily interested in psychiatry. But they ended up leaving the treatment of patients for the more lucrative business of...business. The three - but in particular, Arthur - founded drug advertising agencies, and then drug companies. They produced some good sellers, like Senokot, but hit the big time with the development of the incredibly strong pain killer, OxyContin. It was sold as specifically “non addictive”. But, it was addictive and large swathes of the United States were soon hotspots in the distribution and use of the drug.Patrick Radden Keefe looks at both the family and company behind the OxyContin debacle. He’s an excellent writer and makes the medical and business details easy to understand. There have been books about the drug, but mainly on how it’s introduction to the steel towns of Pennsylvania and the “hollers” of West Virginia and Kentucky and how it’s use has affected millions of people who became addicted to the supposedly “non addictive” drug. Keefe’s book puts it all together.

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