This is the second book I've read by Keefe and so I knew it would be a good book. The story of the Sacklers is fascinating. The early Sacklers (Arthur, Raymond, and Mortimer), especially Arthur, are admirable in how hardworking they were and how innovative in terms of diversifying into many different areas. Arthur was almost manic in his pursuits and he seemed especially bright. However, as that generation became more and more successful, you could see the deterioration of ethical values. By the next generation, the deterioration continued. The son of Raymond, Richard, has some of the intensity of Arthur; however, he seemed almost on the asperger's spectrum in terms of lacking any semblance of compassion or feeling towards others. Keefe did an excellent job of synthesizing a mountain of information into a coherent book. At times, the technical details of the medical information was a little dry but the book is well-worth the read. It's also a good depiction of the unfortunate fact in America that the more money you have, the less you have to face the consequences of any wrong-doing. The Sacklers caused untold deaths in America (and maybe world-wide) and yet, because of hundreds of millions of dollars paid to squads of attorneys, they were able to get off with barely a slap on the wrist, all the while exporting billions of dollars into off-shore accounts. The unwinding of how the Sacklers took deliberate, planned actions to continually increase the sales of opioids even long after it was well known that these drugs were leading to addiction and overdoses is mind-boggling. The story is also a lesson for museums and universities, etc. to be cautious about agreeing to naming rights when accepting money.
Empire of Pain: The Secret History of the Sackler Dynasty
4.7 4.7 out of 5 stars | 12,360 ratings
Price: 21.66
Last update: 12-03-2024
About this item
National Book Critics Circle Nominee
A New York Times Notable Book of the Year
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 best-selling author of Say Nothing
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. The Sackler name has adorned 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 35 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 20th-century Brooklyn to the seaside palaces of Greenwich, Connecticut, and Cap d’Antibes to the corridors of power in Washington, DC. 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.
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.
Top reviews from the United States
Abra Smith5.0 out of 5 stars
A Lesson on Greed
Reviewed in the United States on July 10, 2021vjstravino5.0 out of 5 stars
Important, Revealing and Damning
Reviewed in the United States on April 22, 2021
Keefe has meticulously managed to package the vast vile and many purposeful dastardly tangles of the Sackler Family into a marvelous, readable work of narrative non-fiction. As a frontline healthcare provider since the early days in Appalachia, where the devastation to their deeds was utterly catastrophic, I am well aware of the Sacklers/Purdue dupe on the American public. As the author points out, there are many areas of blame and responsibility, but this may never have happened without the sheer greed of the Sackler clan.
Even if you have read the excellent works on the Oxycontin/opioid crisis that precede this work (Barry Meier's "Pain Killer," Sam Quinones', "Dreamland" and Beth Macy's "Dopesick"), Keefe's work is even more enlightening and encompassing and I recommend it without reserve.
I really thought I knew all there was to know about the Oxycontin/Opioid epidemic after being a witness to it for the past 25 years, but this book unearthed another layer to the crisis that is needed and may give pause to future regulators/legislatures/medical professionals about the folly of casually using lethal potions based upon anecdotal hearsay and scant scientific data. A powerful family, with endlessly deep pockets and a team of lawyers and admen have outwitted/paid off all the regulatory bodies and oversight infrastructures for obscene personal gain.
This book goes a long way in sullying the name of this family that they, themselves, cleverly tried to immortalize with grotesque profits at the cost of hundreds of thousands of lives.
Keefe is excellent. He is an American literary treasure. Thank you.
Even if you have read the excellent works on the Oxycontin/opioid crisis that precede this work (Barry Meier's "Pain Killer," Sam Quinones', "Dreamland" and Beth Macy's "Dopesick"), Keefe's work is even more enlightening and encompassing and I recommend it without reserve.
I really thought I knew all there was to know about the Oxycontin/Opioid epidemic after being a witness to it for the past 25 years, but this book unearthed another layer to the crisis that is needed and may give pause to future regulators/legislatures/medical professionals about the folly of casually using lethal potions based upon anecdotal hearsay and scant scientific data. A powerful family, with endlessly deep pockets and a team of lawyers and admen have outwitted/paid off all the regulatory bodies and oversight infrastructures for obscene personal gain.
This book goes a long way in sullying the name of this family that they, themselves, cleverly tried to immortalize with grotesque profits at the cost of hundreds of thousands of lives.
Keefe is excellent. He is an American literary treasure. Thank you.
Angie Schultz4.0 out of 5 stars
Will take some time to read.
Reviewed in the United States on February 12, 2024
Very interesting read. Be prepared to learn some new words!!! A very well written, well researched saga of a sad but true telling of how much power the all might dollar wields.
suzy hallock-bannigan5.0 out of 5 stars
the Opiod Crisis Exposed
Reviewed in the United States on June 6, 2021
Patrick Radden Keefe is the best writer I have read in a long time. You finish all 452 pages and you know very well the story could never have been more succinct, more tight: it’s perfect. Three Jewish brothers, sons of immigrants, are intelligent, enterprising, and devoted. One of them, Arthur Sackler, is attentive to dilemmas of mental patients and appalled at the lack of medical interventions to alleviate pain. His research led to the invention of Valium and eventually, Oxycontin. Arthur bought a pharmaceutical manufacturing company (Purdue),and brothers Mortimer and Raymond would manage it. As time evolves both the pain treatment world and the development of drugs to treat pain, Purdue folks realize that oxy condone seemed to prescribing physicians as less threatening than traditional morphine; earlier Bayer had manufactured heroin as morphogenetic without the pesky side effects—-even though heroin was more powerful and just as addictive. This is really a turning point in the narration of the opiod crisis story: Purdue executives decide to follow a similar strategy and they begin to exploit the misunderstanding that oxy was less strong, more safe. In those days, doctors knew what they knew about oxy based on Percocet in which a very small dose of oxycodone is combined with acetaminophen or aspirin. The company for reasons of profit and sales decides to enhance the product’s appeal to doctors by pushing it for non-malignant pain—-forms of chronic pain because, after all, who doesn't have some of that? So the appeal expanded far beyond cancer patients—-not only would its use become widened for all sorts of patients (even juveniles), but the dosage could be increased. And so it was. The relationships with doctors in the field, the Food and Drug Administration, and the countless museums which benefitted from Sackler generosity weaves a very tangled web of unchecked capitalism and moral poverty. Purdue decided to create a special coating which would minimize the risk of addiction—or perhaps remove that risk altogether. This unique “improvement” would eliminate the risk of serious addiction (when is addiction NOT serious?) so that the wedding of the opium poppy and pain management could be obtained without danger. The sales and marketing of the product and the wooing of doctors is the most sorrowful chapter of unfettered capitalism: people started dying from overdoses. There is something odd about “the guns-don’t- kill people; people- kill- people” thinking here—-the Sacklers claimed addicts misused the product and truly, it could not be seen as their fault nor their responsibility. Most of us would remember Big Tobacco litigation and walking a mile for a Camel or the Marlboro Man: now the Purdue company was spending millions per month on litigation, but that litigation was seen as an annoyance at best. A photographer widely recognized for her artistic expression and product, Nan Goldin, developed a painful case of tendinitis in a wrist and a doctor prescribed OxyContin. The drug felt to her “like a padding between you and the world.” For three years she took the pills, always upping the ante and taking more and more. She overdosed. She was hooked, and she knew it, so at the age of 62, she checked herself into a rehabilitation facility of great repute and began a journey to sobriety. In 2017, she read an article in the New Yorker magazine about the opiod crisis which mentioned the drug developed by the Sacklers and their company which painted a picture in stark contrast between their generosity in the world of culture and their —-well, depravity—-their source of Great Wealth. A Chair of Psychiatry at the esteemed Duke University noted that the Sackler name is known as the source of good and philanthropic work, but actually those gifts and their fortune come to us as the result of the millions of people who are addicted to their product. Phillip Radden Keefe was the writer of the magazine article. As a result of the readership of the magazine and the compelling content of the article (we all know the New Yorker doesn’t limit its writers—that the magazine tells the whole story), the Sackler family came under ever increasing scrutiny for their role in the opiod crisis. Nan Goldin arranged for protests in some of the very museums once blessed with Sackler funds and she just would not stop. Nor would Keefe: he interviewed Purdue employees and saw Denial in the lot of them; the reader of this expose will see Greed as the driving principle. This books calls into question the entire scheme—-advertisers and marketers, wholesalers, doctors who wrote the scripts, and the pharmacies who carried the drug. The only whistleblower who emerges from the entire dreadful Mess is Patrick Radden Keefe himself. Read this book if you want another example of how unfettered capitalism contains the seeds of its own destruction: sorrowful.
Bruce W5.0 out of 5 stars
I thought I knew
Reviewed in the United States on October 12, 2024
Amazing read page turner. If you thought you knew how deeply immoral, insensitive, and downright unethical the Sackler family’s business operations were as associated with OxyContin you don’t.