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Empire of Pain: The Secret History of the Sackler Dynasty

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The highly anticipated portrait of three generations of the Sackler family, by the prize-winning, bestselling author of Say Nothing. 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 sciences. The sou The highly anticipated portrait of three generations of the Sackler family, by the prize-winning, bestselling author of Say Nothing. 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 sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing OxyContin, a blockbuster painkiller that was a catalyst for the opioid crisis. Empire of Pain is a masterpiece of narrative reporting and writing, exhaustively documented and ferociously compelling.


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The highly anticipated portrait of three generations of the Sackler family, by the prize-winning, bestselling author of Say Nothing. 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 sciences. The sou The highly anticipated portrait of three generations of the Sackler family, by the prize-winning, bestselling author of Say Nothing. 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 sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing OxyContin, a blockbuster painkiller that was a catalyst for the opioid crisis. Empire of Pain is a masterpiece of narrative reporting and writing, exhaustively documented and ferociously compelling.

30 review for Empire of Pain: The Secret History of the Sackler Dynasty

  1. 4 out of 5

    Traci at The Stacks

    This is A+ reporting and storytelling. The story of the Sackler family is expertly laid out for the reader. Riveting and sickening. Investigative journalism at its best. Read this book.

  2. 5 out of 5

    K.J. Charles

    I've been reading a lot of non fiction because I haven't been able to read romance. After this I want to crawl into a hole with forty romance novels and never come out. Jesus. This is horrifying. As a Brit I didn't know about this horrendous story of greed and selfishness, which is simultaneously utterly compelling and unbearable to read. I don't know which are worse: the staggering greed monsters that are the Sacklers, the phalanx of lawyers and capos who helped them get away with it, the publi I've been reading a lot of non fiction because I haven't been able to read romance. After this I want to crawl into a hole with forty romance novels and never come out. Jesus. This is horrifying. As a Brit I didn't know about this horrendous story of greed and selfishness, which is simultaneously utterly compelling and unbearable to read. I don't know which are worse: the staggering greed monsters that are the Sacklers, the phalanx of lawyers and capos who helped them get away with it, the public officials and politicians who took bribes with both hands, the institutions (many British) who gave them a sheen of respectability in exchange for blood money, the doctors who knowingly pumped opioids into people and the salesmen who helped them do it. All of the above. Actually I think I hate the public officials and politicians most. They had a duty. This is a broken, broken society, capitalism at its finest, money creating monsters, and the only cure is the fucking guillotine because as this book makes clear, most of the people (rich white privileged people) who've lived high off the hog of legal drug-pushing, addiction and death just don't see they did anything wrong and don't intend to take any responsibility, ever. I lay awake last night because of this book and the enraging picture it presents of how greedy, selfish bastards get away with it thanks to a corrupt system that serves only the rich. I hope there's a hell. You should read it, and then let's go burn some things down.

  3. 4 out of 5

    Michael Perkins

    How it all started..... https://www.vox.com/2017/6/5/15111936... ====================== The article that the book expanded from. https://www.newyorker.com/magazine/20... ===================== New documentary.... https://www.youtube.com/watch?v=SkU75... ============ sociopaths.... https://www.npr.org/2021/06/02/100208... How it all started..... https://www.vox.com/2017/6/5/15111936... ====================== The article that the book expanded from. https://www.newyorker.com/magazine/20... ===================== New documentary.... https://www.youtube.com/watch?v=SkU75... ============ sociopaths.... https://www.npr.org/2021/06/02/100208...

  4. 4 out of 5

    Perry

    Compelling story and swirling subplots around the Sackler men and women whose billions were gained on pain and abusive practices concerning opioids, as well as of some heroes who brought the Sacklers to heel. Comprehensive history of the Sackler dynasty, the descendants of Polish Ukrainian Jewish immigrants to Brooklyn, largely hidden behind their company, Purdue Pharma and its prized Oxycontin, et al. Coherent argument for the family's primary responsibility for the North American opioid crisis Compelling story and swirling subplots around the Sackler men and women whose billions were gained on pain and abusive practices concerning opioids, as well as of some heroes who brought the Sacklers to heel. Comprehensive history of the Sackler dynasty, the descendants of Polish Ukrainian Jewish immigrants to Brooklyn, largely hidden behind their company, Purdue Pharma and its prized Oxycontin, et al. Coherent argument for the family's primary responsibility for the North American opioid crisis.

  5. 4 out of 5

    Elle

    A painstaking account of the very beginnings of the Sackler family business, starting with the founding and acquisition of several companies by Arther, Mortimer and Raymond Sackler, to present day where their name is being scraped off of the side of institutions they donated millions to, Patrick Radden Keefe has provided the ultimate guide to the people behind the pills at Purdue. Obviously they are not the first to market unsafe pharmaceuticals to a vulnerable population, or the only players in A painstaking account of the very beginnings of the Sackler family business, starting with the founding and acquisition of several companies by Arther, Mortimer and Raymond Sackler, to present day where their name is being scraped off of the side of institutions they donated millions to, Patrick Radden Keefe has provided the ultimate guide to the people behind the pills at Purdue. Obviously they are not the first to market unsafe pharmaceuticals to a vulnerable population, or the only players in this massive industry. The politicians in the pocket of big pharma, the medical providers and doctors who facilitate these massive drug schemes, the regulators who look the other way—there’s a lot of culpable parties. But I feel like Keefe draws a clear line between not just the Sacklers and Purdue taking advantage of these systems, but actively making them worse for the public. They laid the groundwork for future companies to follow, all with seemingly no consequences. Between this and COVID, I don’t know how anyone can look at our healthcare system and not be repulsed. The amazing thing to me about the ultra-wealthy is that it does not take an unattainable amount of brilliance to stay rich, just a moderate level of competence. There was one, maybe two true visionaries in this family, despite that vision being morally bankrupt, and after the companies were built there wasn’t much left to do. The rest of the family members were little more than warm bodies who coasted by on accumulated wealth, too wrapped up in their own self-importance to even attempt to care about the devastation left in their wake. What the Sacklers did have in spades was an unmatched level of egotism and callous win-at-all-costs mentality, both of which eventually contributed to the downfall of Purdue after years of being the things propping it up. A perhaps an unexpected result, but there’s nothing that gives this more credibility to me than the first few sentences of A Note on Sources at the end of the book. “The Sackler family did not cooperate with my efforts to research this book. None of the Sacklers who feature prominently agreed to grant interviews.” I would be immediately skeptical of any work that they willingly involved themselves with. I’m sure this was frustrating for a writer, but still probably anticipated by Keefe. Everything in his reporting would suggest this is a family that does not engage in anything unless they are in full control of the narrative. Lately I’ve been thinking about objectivity in journalism, as well as reading reporters share their own feelings on the subject. Much of the complaints by the Sackler clan against those who have reported on their family’s misdeeds have led with an accusation of the journalist in question being “biased” or motivated by some other self-serving desire. This premise is both ridiculous in the context of the case, but also broadly speaking. And this kind of demand for absolute neutrality from those reporting the news is unrealistic, but also sanitizes the crimes of the powerful. It’s the way we get phrases like “officer involved shooting” that exist entirely in a passive voice. And with over 800,000 Americans dead and millions left reeling in the fallout of the Sacklers’ greed, the last thing that I want in any analysis is passivity. And now I’m going to do something I rarely do, which is give credit to a publisher. I’ve criticized publishing houses for not supporting their authors, giving book deals to known liars with dubious fact-checking or possibly the worst offense: printing book club ‘stickers’ directly onto covers. But putting out a nonfiction work like this, especially one that so directly shines a light towards organizations that have used their over-powered legal forces to silence and punish critics, does take a certain level of nerve and belief in their authors’ work. Keefe directly named Bill Thomas, Daniel Novack, Kimon de Greef and Julie Tate among a dozen others for their efforts, so credit to them and the rest of the team involved. One of the refrains that David Sackler repeatedly echoed was his desire to “humanize” his family. With this book, I believe that Patrick Radden Keefe accomplished that goal for him. The author, with the help of previous efforts by journalists like Barry Meier, prosecutors like Maura Healey and activists like Nan Goldin, has fully removed the veil obscuring the Sackler name from their deadly legacy. It’s my belief that even after everything, they’re going to get away with it. But it will come at a cost, possibly the only thing they value near as much as money: their reputation. And now embossed in gold lettering, a New York Times Best Seller, their name in the subtitle The Secret History of the Sackler Dynasty will forever follow the phrase Empire of Pain . If the shame does not devour this family, I hope it perpetually shadows them. If you liked this book by Keefe, I’d also highly recommend Say Nothing: A True Story of Murder and Memory in Northern Ireland by him as well. **For more book talk & reviews, follow me on Instagram at @elle_mentbooks!

  6. 4 out of 5

    Wynne Kontos RONA READS

    Have you seen Anya Taylor-Joy in the THE WITCH? Perhaps you washed pan seared gnocchi down with a crisp French 75 at The Smith. Did you attend Columbia, NYU, Yale, Harvard, or Tufts? Have you been to the Egyptian room at the Metropolitan Museum of Art? What about an exhibit by a woman artist at the Brooklyn Museum? Ever been to the Tate Modern in London? What about the Dia Art Foundation? The National History Museum? Have you ever taken Senokot for constipation? Do you know a Vietnam war veteran Have you seen Anya Taylor-Joy in the THE WITCH? Perhaps you washed pan seared gnocchi down with a crisp French 75 at The Smith. Did you attend Columbia, NYU, Yale, Harvard, or Tufts? Have you been to the Egyptian room at the Metropolitan Museum of Art? What about an exhibit by a woman artist at the Brooklyn Museum? Ever been to the Tate Modern in London? What about the Dia Art Foundation? The National History Museum? Have you ever taken Senokot for constipation? Do you know a Vietnam war veteran treated with antiseptic while serving? Have you seen the HBO original film O.G. starring Jeffery Wright? If the answer to any of the above is yes, you can thank the Sackler family. They donated too, funded or directly created all of the above experiences. If you've lived in New York City in the past thirty years, this might not be new information. But whether it's new info or another reminder, it hurts all the same. (That pan seared gnocchi hits me especially hard.) The Sacklers are a New York family who until the last 5 or so years were mostly known for their philanthropy in the arts and sciences. Arthur, Mortimer and Raymond Sackler were all medical doctors who since the 1940s worked together to create medical and advertising businesses that made them obscenely wealthy. In 1996, after careful deliberation and deviously applied tactics from the Sackler family, Purdue Pharma released an upgrade from their time release morphine pill (MS Contin) that would make the Sacklers billionaires many times over. The drug was called OxyContin. Despite egregious ethical and medical malpractice, the Sacklers continued to work for and on the board of Purdue Pharma while OxyContin sold across the US and eventually worldwide. Due to the pill's time release coating, it could not be addictive if used correctly and opiates were safe for all kinds of pain, not just end of life treatment. Even typing those statements onto the screen seems strange, since we know they're all lies. The Sackler's campaign to market and manufacture OxyContin through Purdue Pharma helped created the opiate crisis. Once in 1996 and then again in 2010, when the drug was "reformulated" in order to make it harder to abuse. Opiate users turned to heroin. In a world where the Sackler name is so tainted, when the ravages of opiate abuse are so apparent, what else could be said? It turns out a lot. In 2017, Patrick Radden Keefe wrote a startling expose on the Sacklers and Purdue Pharma for THE NEW YORKER. This emboldened the photographer Nan Goldin and her activist group, PAIN, to protest in many of the famous galleries around NYC. Not until that article was published (several books and journalism stories had been written about the Sacklers for decades with little fanfare) did the tides seem to shift for the Sacklers. What came before and after the 2017 article will blow your LID OFF. I'm serious. I've always been fascinated by addiction research and when I was still practicing as a social worker in New York would regularly attend workshops and symposiums on my own dime in order to best stay informed. (The day I found out The Smith restaurants were Sackler funded was a dark, dark day.) But even with all I thought I knew about Purdue and the Sacklers, the behavior of this family and the influence of money across literally every single entity of our lives as Americans (and quite frankly, human beings) is startling. The FDA bribery, the corruption of the court system, marketing and advertising, state and government jurisdiction, pharmacies and insurance companies. I mean to quote THE REAL WORLD, you think you know, but you have no idea. My first recollection of opiate medication came very early, when my mother was being treated for cancer. Always a calm and collected woman, when my mother drove her forest green Jetta into the seventh grade parking lot and shouted for me to hurry out of her passenger's side window, I knew something was up. At the time, my mother was taking an experimental drug that was covered on a trial type basis through her insurance. Even a single dose was thousands of dollars, and my mother took the drug several times a week (by the end of her life she'd take it several times a day.) She'd been charged full price for the drug by accident and we had only an hour or so until the insurance office closed. Needless to say, we were in a hurry. But this wasn't the first time my mother had dealt with bureaucracy in getting her medication. The first time was a couple years prior when she'd been prescribed OxyContin. The drug was so regulated by the local pharmacies, that she could only fill the prescription through one (even though for a time, my hometown boasted three drugstores all on opposite corners of one another.) We drove in literal circles while my mother called representative after representative. No one could get her the person she needed to dispense the medication. It was a new prescription, given to her by her oncologist and the oncology team she'd seen since the onset of her illness. The regulations exhausted my mother, so finally she put a call in to her oncologist and said to scrap it. This rigamarole had set off my mother's alarm bells. What medication was warranted this type of trouble? It took me until adulthood to understand why these memories stuck out for me. In each instance, my mother's temperament was changed. She was visibly frustrated and angry, confused and combatant. She was rarely these things and typically only expressed these feelings to close friends and family. Living as she had with cancer for so long, was a long line of indignities. Driving from pharmacy to pharmacy for a schedule II narcotic was just the icing on the cake. Much later, after she had died, I saw the Oxy memory in yet another light. What if my mother didn't have an oncologist she trusted? What if he had insisted she get the medication filled that day? What if he'd prescribed her an 80 milligram dose for the foreseeable future? (This was the preferred prescription sale of the Sackler family.) What if the pharmacies in my hometown weren't regulated? What if the pharmacist on call took pity on my mother and relented, filling the prescription against protocol? By then my mom was divorced from my father, parenting me as a single mother while working a rigorous full time job. She did her upmost to shield me from her illness, but terminal cancer is a hard thing to shield someone from. I didn't have much to compare it to. It was the only life I knew and sometimes, it was a hard life. But the only thing that could've been worse than terminal cancer to a 12-year-old, is having your terminally ill mother addicted to opiates. It's laughable to think of my mother as a drug addict, I'm sure anyone who knew her would say the same. But we know enough about addiction in 2021 to know that it just doesn't discriminate. According to Keefe's reporting in EMPIRE OR PAIN, patients became physically addicted to OxyContin just from taking it regularly, even if they didn't feel the mental compulsion of addiction. The entire trajectory of my life--of my mother's life--was so fragile that cloudy day in Indiana. Keefe's writing only drove that home in a profound way. The fact that Keefe can write about this type of heavy, depressing topic and keep the pace of EMPIRE OF PAIN as breakneck as he does is proof of his talent. This reads like an inverse thriller, one where you sort of know the ending but you're racing along trying to determine how it will all unfold. Sort of a MEMENTO but...narrative fiction. I was very interested in reading this, but figured it would be dense and hard to get through. On the contrary, I was able to read a lot in single sittings. The beginning of the third section does drag a bit. At that point in the narrative we've met all our players and are sort of watching all the debauchery unfold in a big, rotting mess. This is the only time where the subject matter did indeed feel heavy and a little redundant. It's all necessary, but it slows. Other than that, I was really impressed. I tend not to do well with nonfiction. But I sped through this. Aside from my own personal reflections, there's so much EMPIRE OF PAIN can teach us about confronting authority. Not just our state and local governments, but the gigantic institutions that tell us what to think and feel. Advertising agencies, museums and scholarship funds, publications and fashion and what's "cool." Not a single slice of American cultural life went untouched by the Sacklers. How rich people (mostly white men) have corrupted our system in such inexplicable ways taught me, yet again, how to be a critical consumer and reader. Nothing we do, however altruistic in its intent, can subsist without this rigorous criticism. Without this criticism is how a doctor disgusted by electroshock therapy and determined to uncover a dignified, medical cure for mental illness becomes a blood baron of prescription opiates. It's how we can discuss a book about destruction through unregulated wealth on a website owned by Am*zon. But that's for another review. It's true that none of the Sacklers were charged with any crimes. They barely have lost a dime after all of this. They're living amongst us, selling us delicious (such delicious) gnochi, they're producing films and social media apps, they're directing films and founding fashion lines. (You won't have to wonder which, Keefe names names, hallelujah hallelay!) Since Arthur Sackler died in 1987 before the on-set of Purdue Phara and its OxyContin hey-day, many of his heirs say they do not bear the responsibility of the opiate crisis. But Arthur created (literally) big pharma as we know it. Drug salesmen? Profits for selling a particular drug? Drug advertising? The mass production of Librium and Valium (another addictive drug the Sackler marketed as safe without doing any research.) That's all Arthur. His daughter, Elizabeth, a notable benefactor of the Brooklyn Museum, is a big fan of this defense. Every single member of the Sackler family, including the grandchildren, has taken Purdue Pharma money. It's on record. Madeline Sackler and her documentaries about the unjust prison system. Michael Sackler and his initiatives into safe digital media and regulation (and producing bangers like THE WITCH,) Joss Ruggles and her athleisure clothing line...all of it is Sackler blood money. The Sacklers like to live deliciously, as Satan famously said in Michael's movie. It's the rest of us who get the bitter pill. ______ Want more book recommendations? Be sure to follow #RONAREADS on Instagram @ronareads4u or visit our digital storefront on Bookshop: https://bookshop.org/shop/ronareads

  7. 5 out of 5

    Ophelia Alderton

    “Addicts want to be addicted, they get themselves addicted over and over again.” Richard Sackler The Sackler family sold opioids as if they were selling sweets and truth be told there are probably more controls put in place over sweets than there are over highly addictive and life destroying drugs. This book reads like a thriller. From the beginnings of Arthur Sackler studying psychology to the present day indifference to human suffering and all the horrifying bits in between. I highly recommend “Addicts want to be addicted, they get themselves addicted over and over again.” Richard Sackler The Sackler family sold opioids as if they were selling sweets and truth be told there are probably more controls put in place over sweets than there are over highly addictive and life destroying drugs. This book reads like a thriller. From the beginnings of Arthur Sackler studying psychology to the present day indifference to human suffering and all the horrifying bits in between. I highly recommend this book to learn more about this family, the opioid crisis and just how pharmaceutical companies can manipulate.

  8. 4 out of 5

    Truman32

    Some families seem genetically disposed with certain traits. Take for instance the Righteous Brothers and the Ramones. These families have the genetic knack to gift the world with head-bopping tunes. The Manning family possesses the genetic gift of throwing a football really far and accurately. And then we have the Sackler family, the owners of Purdue Pharma which more than likely started the opioid crises with their aggressive (and often untruthful) strategy to hawk OxyContin pills to anyone an Some families seem genetically disposed with certain traits. Take for instance the Righteous Brothers and the Ramones. These families have the genetic knack to gift the world with head-bopping tunes. The Manning family possesses the genetic gift of throwing a football really far and accurately. And then we have the Sackler family, the owners of Purdue Pharma which more than likely started the opioid crises with their aggressive (and often untruthful) strategy to hawk OxyContin pills to anyone and everyone in the name of greed. It seems the Sacklers have some sort of programing in their DNA to be just totally awful horrible people. In Empire of Pain: The Secret History of the Sackler Dynasty, author Patrick Radden Keefe meticulously details this family from first generation immigrants doing despicable things, to the second generation working hard to complete their deplorable work, to the current third generation keeping on keeping on with their reprehensible tasks. What at first seems like an all-American tale of a family with nothing pulling themselves up through hard work quickly turns and becomes a tale of a family consumed by greed and willing to obliterate any and all ethical or moral codes simply to line their pockets with money. Of course it is impossible to talk about the Sacklers without bringing up John Wayne Gacy. Now you may say this is not a fair comparison, serial killer (and wonderfully delightful clown) Gacy has killed only 33 people while the Sacklers by fueling the deadly opioid crisis have the blood of more than 200,000 on their hands. Why do I want to do poor John Wayne like that? But stay with me. Both are driven to do what they want. They are only focused on themselves, their urges: Gacy to murder and the Sacklers to make themselves rich. Neither could care less about the toll their little hobbies take on society, or the pain they cause. I would also be remiss when discussing the Sacklers if I did not also mention garbage. Not your traditional garbage, but stinky fly covered garbage that contains the rancid bodies of several mob informants, glowing radioactive barrels, and a fair amount of canine fecal matter. Now you may say that this is a horrible comparison. The Sacklers are unremittent liars who have no qualms about killing people to make their already obscenely rich selves even richer but their hygiene is beyond reproach. Perhaps, but consider this: If Mr. Grinch, that green fellow who is always climbing into the open windows of the homes in Whoville is a bad banana with a greasy black peel, then the Sacklers can only be this large pile of rotten malodorous garbage. Empire of Pain painstakingly documents the secretive Sacklers as they go about their horrible deeds. Sometimes in too much detail; the lying, the sneakiness, the non-stop plotting to get everyone to swallow their highly addictive pain medication becomes monotonous in its repetition. It would be impossible to write anything about the Sacklers without also bringing up Cujo, the rabid Saint Bernard who terrorized Castle Rock in the summer of 1980. Like this deranged dog, foaming at the mouth and attempting to bite anyone within reach, the Sackler family is unhinged. They are unable to see the pain they cause or take any ownership of what they have done. Their breath also smells of kibble. Like a lot. What is up with that?

  9. 4 out of 5

    Tyler Hunt

    After reading "Say Nothing", which is the best non-fiction book I've ever read, I figured I would read whatever Keefe wrote next, good choice. It honestly took me a little longer to finish this because at times you'll read something that these malicious tone-deaf fucks have done to the general public that you become so furious you have to go do something else for a while. The thesis of this book is that one family had a guiding hand in the opioid epidemic, which it did, and that they (the family After reading "Say Nothing", which is the best non-fiction book I've ever read, I figured I would read whatever Keefe wrote next, good choice. It honestly took me a little longer to finish this because at times you'll read something that these malicious tone-deaf fucks have done to the general public that you become so furious you have to go do something else for a while. The thesis of this book is that one family had a guiding hand in the opioid epidemic, which it did, and that they (the family) profitied immensely from this and didn't really care what happened to anyone else. There's some major succession vibes in here, except that you know, there's no likable characters and these are real people flying to private islands in the Turks. Great book about generally terrible and dispicable people. Also a great PS here, Trump tried to help them all out. Because of fucking course he did.

  10. 5 out of 5

    SuperWendy

    Capitalism is a hell of a drug. I wasn't as obsessed with this as I was with Radden Keefe's previous book, Say Nothing, but it's still a riveting read and a dynamite listen on audiobook. The author details three generations of the Sackler family and the rise of Purdue Pharma, the drug company that unleashed OxyContin on to the world. If for some reason you were under the impression that pharmaceutical advertising isn't completely gross - this book is here to tell you otherwise. Also if you ever w Capitalism is a hell of a drug. I wasn't as obsessed with this as I was with Radden Keefe's previous book, Say Nothing, but it's still a riveting read and a dynamite listen on audiobook. The author details three generations of the Sackler family and the rise of Purdue Pharma, the drug company that unleashed OxyContin on to the world. If for some reason you were under the impression that pharmaceutical advertising isn't completely gross - this book is here to tell you otherwise. Also if you ever wondered why people hate lawyers? Yeah, this book. The Sacklers reportedly aren't happy about this book, but if anything Radden Keefe is shockingly even-handed - the blind, willful arrogance of the family and the complete lack of understanding by American medicine of addiction created a perfect storm - the author doesn't have to dress that up for shock value. And these folks reaped billions while trying to hide behind a cloak of philanthropic gifts/donations like 19th century robber barons. When I wasn't angry, I was in jaw-dropping awe of the sheer mountain of hubris. Highly recommended.

  11. 5 out of 5

    Donna Backshall

    The name Sackler is one I never knew I never wanted to know.

  12. 5 out of 5

    Jeanette

    Thorough. Researched. But to me this was the opposite of a book I couldn't put down. Weary of hearing about their womanizing lives is putting it mildly. Name, place and prestige drop of nearly infinitive variety. NYC brand in predominance. Sackler brilliance and logic. Philanthropy originated in forests of marketing. Coupled with duplicitous manevolence. I could do a very long review but I will not. Several points of analogy the author makes I would solidly disagree with in an answering argument. Thorough. Researched. But to me this was the opposite of a book I couldn't put down. Weary of hearing about their womanizing lives is putting it mildly. Name, place and prestige drop of nearly infinitive variety. NYC brand in predominance. Sackler brilliance and logic. Philanthropy originated in forests of marketing. Coupled with duplicitous manevolence. I could do a very long review but I will not. Several points of analogy the author makes I would solidly disagree with in an answering argument. I think a comparison to the media of the last decade or two would be more apt than the products he denotes. "Our values" as defined in public marketing duplicity and definitions all around just as faulty as that comparison too. He's exact in data. And unequivocal. That I like with this author. Ironic that people will always go after and desire any respite from pain. Despite costs. Still will. Sacklers are guilty but 1000's of others, including doctors are just as culpable. As is most advertising hype of lies in general. And we see them on media, tv RX ads every day. In repeating and repeating. Not to speak of the politico. I just find some other reviews of this super strange. Condemnation belongs way further into government all the way down to the medicine beggars for every earthly twinge. This same disgust is what I experienced when I worked in pharmacy during my 20's and watched as Valium took over. I left the field completely because it always takes two or three in a perverse tango. That's why this could happen. And it will again. Corrupt overseers are rich as well as the manufacturers are. All the way down the long lines to easy "empathetic" fixes in medicine's sphere.

  13. 5 out of 5

    Sheree | Keeping Up With The Penguins

    Empire Of Pain is a chunky book, but it doesn’t read like one – it’s every bit as gripping and compelling as any fictional family saga. (And don’t worry, the medical jargon is comprehensible to anyone who’s ever watched an episode of Grey’s Anatomy.) With the precision of a prosecutor, but the even-handedness of a responsible journalist, Radden Keefe picks apart the origins of this dynasty’s deadly legacy. This is one of my favourite reads of 2021 so far, a must-must-must for fans of Erin Brocko Empire Of Pain is a chunky book, but it doesn’t read like one – it’s every bit as gripping and compelling as any fictional family saga. (And don’t worry, the medical jargon is comprehensible to anyone who’s ever watched an episode of Grey’s Anatomy.) With the precision of a prosecutor, but the even-handedness of a responsible journalist, Radden Keefe picks apart the origins of this dynasty’s deadly legacy. This is one of my favourite reads of 2021 so far, a must-must-must for fans of Erin Brockovich and The Social Network. My full review of Empire Of Pain is up now on Keeping Up With The Penguins.

  14. 5 out of 5

    Sarah

    Phew. 4.5 rounded down

  15. 5 out of 5

    Hannah

    Incredible. I have so many thoughts.

  16. 4 out of 5

    Skip

    Wow. A meticulously researched profile of a private family, whose pharma company made billions of dollars by aggressive marketing tactics for Valium and then Oxycodone. Initially, an immigrant family, the three sons built a juggernaut and they become patrons of art, education, philanthropy in the U.S. and Europe. The family claimed it was not involved in the management of the company, but this was proven wrong again and again by Keefe. The marketing claimed that the pill's shell allowed for time Wow. A meticulously researched profile of a private family, whose pharma company made billions of dollars by aggressive marketing tactics for Valium and then Oxycodone. Initially, an immigrant family, the three sons built a juggernaut and they become patrons of art, education, philanthropy in the U.S. and Europe. The family claimed it was not involved in the management of the company, but this was proven wrong again and again by Keefe. The marketing claimed that the pill's shell allowed for time release of the pain relief, but the claim that 12-hour relief was possible was belied by varying strengths of the pill, necessary as users built resistance. Abusers crushed the pills, and the company defended itself by claiming that people were the problem -- that their product was not inherently additive. Eventually, class action lawsuits were filed and state attorney generals sued the company and family. A bit long, but very interesting reading. 4.5 stars.

  17. 5 out of 5

    Esther Espeland

    This rocked so hard literally couldn’t put it down. I loved say nothing and will read all of his investigative journalism/narrative nonfiction! This book was so evil and dramatic it read like a multigenerational family epic novel except it Is All Real!! Truly a nightmare of capitalist greed. Like the show succession except turned up several dials on the evil scale. He’s also pretty clear about the parameters of this book, that it’s a family history, and not broader reporting about the opioid cri This rocked so hard literally couldn’t put it down. I loved say nothing and will read all of his investigative journalism/narrative nonfiction! This book was so evil and dramatic it read like a multigenerational family epic novel except it Is All Real!! Truly a nightmare of capitalist greed. Like the show succession except turned up several dials on the evil scale. He’s also pretty clear about the parameters of this book, that it’s a family history, and not broader reporting about the opioid crises, and so it stays focused on the sacklers and not victims of the epidemic. Which makes sense, because I’ve read other really good books about the opioid crises, and this book is really successful in its narrower focus, and obviously provides so much new information bc of all the secrecy surrounding this family. He hits on the obvious evils of Richard sackler, preying on Appalachian communities to sell Oxy, but then also the granddaughter who uses her family wealth to become a filmmaker and gains notoriety making a documentary about people in prison who are incarcerated for drug crimes, but tries to distance herself from Purdue Pharma. This hit on so many marks, on nepotism, family legacy, how elite institutions sacrifice morality for money, Orientalism in the art world, I do want to peel off my skin a little bit, but I couldn’t stop until I had finished.

  18. 4 out of 5

    Kyle Erickson

    Eye-opening. Enlightening. Incredibly well researched. The Sacklers are insanely wealthy and play a large part in America's opioid crisis. This book is consistently engaging and revelatory, without a doubt my favorite non-fiction read this year so far. Recently, the Sacklers were in a court, and the judge cut through their stream of bullshit to say, "Watching you testify makes my blood boil. I can't fathom there is another family in America more evil than yours." A must-read in my book. Eye-opening. Enlightening. Incredibly well researched. The Sacklers are insanely wealthy and play a large part in America's opioid crisis. This book is consistently engaging and revelatory, without a doubt my favorite non-fiction read this year so far. Recently, the Sacklers were in a court, and the judge cut through their stream of bullshit to say, "Watching you testify makes my blood boil. I can't fathom there is another family in America more evil than yours." A must-read in my book.

  19. 4 out of 5

    Mbgirl

    This amazing investigative journalist/writer wrote this one from bed! Mhm—- he gave the office to his attorney wife during COVID, and so he got the other room:) As amazingly and impeccably researched as his previous work was( for which I will facilitate the book discussion in my book club), I was blown away at the intricacies and intimacies of the many generations that comprised the Sackler clan, many of whom are bonafide corporate criminals and inadvertent murderers. One of my favorite parts was This amazing investigative journalist/writer wrote this one from bed! Mhm—- he gave the office to his attorney wife during COVID, and so he got the other room:) As amazingly and impeccably researched as his previous work was( for which I will facilitate the book discussion in my book club), I was blown away at the intricacies and intimacies of the many generations that comprised the Sackler clan, many of whom are bonafide corporate criminals and inadvertent murderers. One of my favorite parts was the formative upbringing of Arthur and that generation. What he groomed in his brothers and the culture he perpetuated was wile in its most sophisticated form But the lengths to which the family went to distance itself from Purdue, and all the hiding in which Arthur was almost quadruple dipping—- the ruthlessness and callousness of Richard (denial much?), and all of the arguments among the various cousin at the board room table—— The billions of dollars of blood money and the trauma that Oxy has caused, borne of an insatiable greed to get as much profit as possible, was nauseating. As Keefe closes, I too hope that this book is not the finale... I too hope that there will be more dominoes to fall in the telling of what Pharma evil looks like as is said in the last line in the opening of Days of Our Lives. Shame is not so easy to erase, even if the $ punishment didn’t make a dent ($4.5 billion) in the Sackler fortune. I mean, when Madeleine can buy a $3+ MM Ca mansion in cash—- just sayin’—- PS the tidbit about OG prison HBO film Madeleine produced together with the Narcos actor was pretty cool! On my list to watch next is Crime of the Century. PPS very glad that I watched the documentaries The Pharmacist and Heroin(e), and read Bad Medicine, all of which gave me an augmented view of what oxy has done.

  20. 5 out of 5

    Siria

    An engrossing and appalling story of greed, untrammelled wealth, corporate corruption, and the continual failure of institutional and judicial oversight. The portrait Patrick Radden Keefe paints of the Sackler clan—the extended family whose deliberate shilling first of Valium and then of Oxycontin—led to hundreds of thousands of deaths and millions of lives destroyed is a damning one. The Sacklers come across as the Big Pharma version of the Trumps—every bit as tacky, greedy, self-deluded, and s An engrossing and appalling story of greed, untrammelled wealth, corporate corruption, and the continual failure of institutional and judicial oversight. The portrait Patrick Radden Keefe paints of the Sackler clan—the extended family whose deliberate shilling first of Valium and then of Oxycontin—led to hundreds of thousands of deaths and millions of lives destroyed is a damning one. The Sacklers come across as the Big Pharma version of the Trumps—every bit as tacky, greedy, self-deluded, and sociopathic, just better at earning college degrees.

  21. 4 out of 5

    Lyn Caglio

    This was one of the best nonfiction books I’ve read in a long time. Fantastic narrative reporting and great writing. If this story of the Sackler family and their great contributions to the opioid epidemic in this country doesn’t dismay and enrage you - well, you are dead inside. Meticulously researched, but not “dry” in the slightest, I highly recommend this book. 👍

  22. 5 out of 5

    Katie Long

    Get ready to be outraged! Well, you probably already are, so I guess, get ready to feel even more justified in your outrage. The Sackler Family has had their fingers in all the pharmaceutical pies for far too long, so it is long past time that we all know the truth.

  23. 5 out of 5

    Brendan Monroe

    In "Say Nothing," Patrick Radden Keefe's look into that period of bitter conflict in Northern Ireland from 1968-1998 known today as The Troubles, it's hard to say that any of the major players were truly "evil." Instead, you come away feeling that everyone involved was culpable to some degree. In "Empire of Pain," by contrast, evil exists and it has a name — Sackler. You may already know of the Sackler family, who Forbes estimated in December 2020 to have a net worth of $10.8 billion — likely an In "Say Nothing," Patrick Radden Keefe's look into that period of bitter conflict in Northern Ireland from 1968-1998 known today as The Troubles, it's hard to say that any of the major players were truly "evil." Instead, you come away feeling that everyone involved was culpable to some degree. In "Empire of Pain," by contrast, evil exists and it has a name — Sackler. You may already know of the Sackler family, who Forbes estimated in December 2020 to have a net worth of $10.8 billion — likely an underestimate, as the family almost certainly has unreported income stashed in offshore accounts. John Oliver did a blistering segment on the Sacklers in 2019 in his brilliant late-night show "Last Week Tonight" and his team was even responsible for putting up a website called the Sackler Gallery featuring famous actors reading unsealed documents from deposition hearings for the family because, in Oliver's words, "they love having their name on fucking galleries." Through their company, Purdue Pharma, the Sacklers are responsible for the infamous opioid OxyContin — and the hundreds of thousands of overdose deaths that have come with it. The Centers for Disease Control and Prevention (CDC) in Atlanta has rightly labeled these opioid-related deaths an "epidemic" and, in 2019, "2,600 lawsuits from 49 states and various territories of the U.S." were filed against the company. Perdue, under the express orders of the Sackler clan, marketed OxyContin as a cure-all for any sort of pain and assured doctors and patients that the addiction rate was "less than one percent." Lies. In their race to generate profits as quickly as possible, the Sacklers ignored testimonials from doctors, patients, and the company's own sales force that the drug was in fact highly addictive and causing overdose deaths. The warning signs came as early as 1997, shortly after the drug first went on the market. But the sales — and the deaths — only ramped up from there. The Sacklers? They just didn't care. When links between the rise in overdose deaths and the mass prescribing of OxyContin shed new light on the company, the Sacklers held firm — casting the blame not on the company but on "abusers." “We have to hammer on abusers in every way possible,” Richard Sackler wrote in an email in 2001, when he was president of Purdue Pharma. “They are the culprits and the problem. They are reckless criminals.” One would think that the mere knowledge that your drug is causing a huge upsurge in deaths and addiction across the country would be enough to perhaps take it off the market, or at least stop marketing it so heavily, but the Sacklers didn't think so. Instead, they doubled down on the pledge Richard Sackler had made following the release of the drug. “The launch of OxyContin tablets will be followed by a blizzard of prescriptions that will bury the competition. The prescription blizzard will be so deep, dense, and white." If you view your competition as human beings addicted to your product, then Richard Sackler was certainly right — it did bury them. When a federal prosecutor reported in 2001 that OxyContin had been responsible for 59 overdose deaths in just one single state, Kentucky, the Sacklers showed all the empathy expected of a family of psychopaths. “This is not too bad,” Richard Sackler wrote to company officials. “It could have been far worse.” As you can see, the Sacklers make the characters in "Succession" look like Peace Corps volunteers. And while Richard Sackler has the most disgusting quotes — his total lack of empathy is matched only by his utter naivety at the idea that his comments could ever become public — he's by no means the only bad apple on the Sackler tree. It was difficult while reading "Empire of Pain" to actually determine which family member is the worst. Madeleine Sackler makes my blood boil in a totally different way. The daughter of Jonathan Sackler, the former director of Perdue, Madeleine ostensibly has nothing to do with the family business and is instead a filmmaker who likes to tackle important topics, like mass incarceration in the American prison system. However, when confronted with questions about her family's connection to a drug that has led to the deaths of hundreds of thousands of people, Madeleine has repeatedly refused to talk about it or take any responsibility at all. Yes, she's worth many millions of dollars thanks to her family's drug dealing and has built a career making "social justice" movies (oh, the irony) with that money, but no, it's not her fault ... blood money is accepted currency too. Funny how her site's about me page mentions nothing about the family business. If I've spent this entire review talking more about the Sacklers than about Patrick Radden Keefe's spectacular book about them, it's because I still haven't gotten over my outrage — outrage at how the family has largely gotten away with it and been allowed to keep their billions while families across the country are suffering the loss of loved ones due to their product. Patrick Radden Keefe has written an absolutely riveting bildungsroman here, telling the story of the family going all the way back to the arrival of Isaac Sackler, a Jewish immigrant from Galicia — now Ukraine — to the United States. The first third of the book is centered around Isaac's son, Arthur, the most driven of the three Sackler brothers. It's like "The Godfather Part II," except Robert De Niro's Vito Corleone was an eminently more honorable figure than anyone here — that whole mafia business aside. The bigger problem "Empire of Pain" exposes is that of a capitalistic society run totally amok, without any sort of meaningful regulations or consequences. Patrick Radden Keefe shows how The Food and Drug Administration (FDA) was and still is in the pocket of the pharmaceutical industry, which has a history of offering kickbacks to government officials in exchange for approval. In 2020, the Trump Justice Department was even pursuing an investigation into the Sacklers but then, just weeks before the presidential election, the case was abruptly wrapped up without charges being pursued against the family. All this reportedly at the behest of an unnamed individual high up in the Trump administration. Because of course. "Empire of Pain" is the perfect companion piece to the equally bloodcurdling Romanian documentary "Collective" — nominated for Best Documentary and Best International Film at this year's Academy Awards. That film's tagline is just as apt when talking about the US government's failure to regulate and prosecute the Sacklers and companies like theirs as it is about corruption in the Romanian government: When government fails, we all pay the price.

  24. 5 out of 5

    Naia Pard

    I added it after watching the interview between Seth Myers and John Oliver. The latter said that he was very excited to read it. I am, too.

  25. 5 out of 5

    Leftbanker

    «Le secret des grandes fortunes sans cause apparente est un crime oublié, parce qu’il a été proprement fait.» Le Père Goriot, published in “Revue de Paris” in 1834 by Honoré de Balzac. “The secret of great fortunes without apparent cause is a forgotten crime, because it was properly done." Big pharma, and in this case the company created by the Sackler brothers chronicled in this book, make El Chapo look like a lowly street corner pusher selling dime bags. They created a drug so powerful that a sin «Le secret des grandes fortunes sans cause apparente est un crime oublié, parce qu’il a été proprement fait.» Le Père Goriot, published in “Revue de Paris” in 1834 by Honoré de Balzac. “The secret of great fortunes without apparent cause is a forgotten crime, because it was properly done." Big pharma, and in this case the company created by the Sackler brothers chronicled in this book, make El Chapo look like a lowly street corner pusher selling dime bags. They created a drug so powerful that a single pill can cause death by overdose, then they marketed their drug so shamelessly that they almost single-handedly brought about America’s current opioid crisis. “The Sackler empire is a completely integrated operation,” Blair wrote. They could develop a drug, have it clinically tested, secure favorable reports from the doctors and hospitals with which they had connections, devise an advertising campaign in their agency, publish the clinical articles and the advertisements in their own medical journals, and use their public relations muscle to place articles in newspapers and magazines. That's how the rich do it. They don't commit crimes; they change the laws to suit them. When donors gave money, they liked to see their name on the wall. But Arthur also proposed a more exotic arrangement. He suggested that he would purchase from the Met all of the artworks that would fill the new space—a series of Asian masterpieces that the Met had acquired back in the 1920s. He offered to pay the price that the Met had originally paid—the 1920s price—and then donate the works back to the museum, with the understanding that each piece would henceforth be described as a “gift of Arthur Sackler,” even though they had belonged to the museum all along. This would be a convenient way for the museum to generate some additional revenue and for Arthur to attach the Sackler name to more objects. Arthur had also become attuned to the advantages of gaming the tax code, so for tax purposes he declared each donation not at the price he paid for it but at the present market value. It was a classic Arthur Sackler play: innovative, showy, a little bit shady; a charitable gesture in which, considering the tax advantages, he would actually make money. Even in his philanthropy, he was a thief. David Kessler, who was the head of the FDA when OxyContin was approved, characterized the de-stigmatization of opioids that OxyContin helped to initiate as one of the “great mistakes of modern medicine.” This book was a tour de force of investigative journalism. I was mesmerized during the entire 500 pages.

  26. 4 out of 5

    Steven Z.

    Yesterday I decided to binge on the two part HBO series “The Crime of the Century.” It detailed the horrors inflicted on the most vulnerable of the American people – individuals who suffer from chronic pain or are about to pass away and are in extreme pain. The culprit for these horrors was and remains the Sackler family and its company Purdue Pharma which was created when its other pharmaceutical company Purdue Frederick was making a great deal of money manufacturing items like Benedine and Sen Yesterday I decided to binge on the two part HBO series “The Crime of the Century.” It detailed the horrors inflicted on the most vulnerable of the American people – individuals who suffer from chronic pain or are about to pass away and are in extreme pain. The culprit for these horrors was and remains the Sackler family and its company Purdue Pharma which was created when its other pharmaceutical company Purdue Frederick was making a great deal of money manufacturing items like Benedine and Senekot, but for the family led by Richard Sackler this did not produce enough profit, so it branched out into the “pain market” and took one of its products MS Contin and reoriented its composition to create Oxycontin. The process involved pressure on the FDA, a great deal of obfuscation concerning its components, bribery, and outright lies to cause the death of over 500,000 Americans since its release in 1996. One of the narrators for the documentary was Patrick Radden Keefe, a staff writer at The New Yorker and the author of the New York Times bestseller, SAY NOTHING: A TRUE STORY OF MURDER AND MEMORY IN NORTHERN IRELAND the winner of the 2019 National Critics Circle Award for Nonfiction. Keefe’s newest book EMPIRE OF PAIN: THE SECRET HISTORY OF THE SACKLER DYNASTY fills in some of the gaps of the HBO expose and reaffirms the despicable actions of numerous characters in the family, Purdue Pharma employees, and individuals outside the company and family who were coopted into the process because of greed and a convoluted sense of morality. EMPIRE OF PAIN is a multi-faceted biography of a family dynamic that produced individuals who seemed to lack empathy for others and were obsessed with the accumulation of wealth which allowed them to satisfy their pocketbooks and egos. Secondly, it is a study that delves into the drug empire created by the Sackler family and the lengths they would go to continue to engage in practices that would enhance and maintain their wealth while ignoring the negative and at times disastrous effects of their decisions on the American people. Some family members would argue that this accumulation of wealth is partially offset by the philanthropic ventures that the Sackler’s pursued. The name Arthur M. Sackler, the individual most responsible for beginning the creation of its “pain empire” appears on museum walls and buildings ranging from New York’s Metropolitan Museum of Art, the Smithsonian in Washington, D.C., Harvard, Tufts, Columbia Universities, the Sackler School of Medicine in Tel Aviv, among others in London, Paris, and Berlin. These gifts and/or donations were made possible by the fortune earned from developing and marketing drugs like Librium and valium in the 1960s and 70s with its negative effects on those patients whose doctors over prescribed the medication. Keefe’s narrative unfolds as he explores the origins of Sackler family wealth which is estimated at about $14 billion. He delves into the role played by three brothers; Arthur, Raymond, and Mortimer Sackler, all three physicians who developed the edifice that resulted in the hundreds of thousands of drug overdoses that have been inflicted on American society in the last few decades. The key figure is Arthur M. Sackler who after working at Creedmoor Mental Hospital in New York along with his brothers in the 1960s concluded that the care for the mentally ill was grisly and became convinced there was a better treatment solution. Arthur Sackler, trained as a Freudian concluded that one’s life experience could not fully account for mental illness – that there was a chemical component, and he would unlock the mystery to help these people. Sackler would conclude that the derangement of brain chemistry was the missing link. The brothers conducted a series of experiments on rabbits which reinforced their views of chemical changes in the brain being responsible for mental illness. Keefe lays out the early careers of the brothers, but Arthur was the key. He was a complicated individual who enjoyed multiple careers; physician, mental illness researcher, and advertising executive. His strategy was to market products/medicines directly to doctors and at first took “broad spectrum anti-biotics” and revolutionized medical marketing by convincing physicians to write prescriptions for his products. The advertising techniques used for clothing, automobiles, food, perfume etc. were now applied to medicine. Promotion and brand differentiation were key, and Arthur’s success was built upon his purchase of the William Douglas McAdams advertising agency whose major client was Pfizer. As Keefe points out, Arthur was shrewd as he owned or had a partnership with McAdams and Bill Frohlich’s ad agency. The brothers opened their medical practice in the 1950s in New York and purchased Purdue Frederick, a small company in the patent medicine business. The expansion of their wealth was predicated on developing what they termed “a minor tranquilizer” to offset the use of Thorazine. Roche, another major pharmaceutical company developed Librium to meet that market and Arthur was tasked to market the new drug. In an age of Cold War anxiety, it was the perfect time to launch a new tranquilizer. By 1963 Roche would build upon Librium and develop Valium and Arthur’s firm zeroed in on convincing doctors that it worked separately on anxiety, muscle tension and numerous other ailments. It would become the first $100 million drug in history, further little was done to determine if the new drugs were addictive – creating a Sackler family pattern. Valium would be used by 20 million Americans and was at that time the most widely consumed and abused drug in history. Even the Rolling Stones wrote a song about Valium, “Mother’s Little Helper.” Keefe encapsulates Arthur’s approach carefully correctly arguing that “he desired posterity, not publicity. The last thing Arthur wanted to do was call attention to his own wealth and holdings, and to do so in a manner that might raise questions about his overlapping careers.” It was quite clear that Arthur modus vivendi of helping develop drugs, fiercely marketing them to physicians, manipulating the FDA through the likes of Dr. Henry Welch, indirect gifts and bribery to the right individuals be they salespeople or doctors was unethical as well as illegal. As Keefe lays out his arguments it is clear the groundwork for our current drug problem was fostered by the Sackler brothers approach that drugs are not addictive, and it was the patient’s personality and needs that were responsible not the drug manufacturer or the physician. It was clear as they marketed Valium they developed the advertising approach designed to create a vast market for Oxycontin. The main culprit among the next generation of Sackler’s was Raymond’s son Richard, and Arthur’s daughter Elizabeth (Kathe). The family created a new company, Purdue Pharma to engage in developing a “pain” product that would create a new market since their patent for MS Contin, a morphine based drug was running out. The Contin process contained a time released component over a twelve hour period that they argued would prevent addiction. Kathe’s goal was to apply the Contin system to Oxycodone and Richard would micromanage its development. At first, they stressed that the new drug Oxycontin (time released Oxycodone/morphine) should be marketed just for cancer patients to gain FDA approval, but what was never mentioned was that Oxycodone was synthesized into heroine by Bayer in Germany. Once on the market for a period of time the target market would be expanded. Keefe does an excellent job recounting the mindset of Richard Sackler and his cohorts in undoing the perception that Oxycontin was addictive to enhance the profitability of the drug. This approach was implemented with a vengeance. Mitchell Freidman who had been Head of Marketing at the FDA joined Purdue Pharma a year after he left the government and he and Richard would spearhead the idea that Oxycontin could be used for a myriad of issues from back pain, arthritis, post-surgical pain etc. Keene has culled the evidence and shows how Richard and Freidman deliberately chose a marketing strategy to deceive doctors and their patients of the low addictive quality of Oxycontin and the mistaken belief held by doctors that the drug was less powerful than morphine. Curtis Wright, who oversaw pain medication at the FDA, was cultivated and he helped write the drug insert for the medication that stated, “Delayed absorption, as provided by Oxycontin tablets, is believed to reduce the abuse liability of the drug.” On December 28, 1995 the FDA approved Oxycontin. A year later Wright earned $400,000 at Purdue Pharma. The sales approach described by Keefe to market the new drug rested on the company’s catechism, “the delivery system is believed to reduce the abuse liability of the drug.” Keefe dissects the sales pitch and training of the hundreds of Pharma reps. They would target certain geographical areas like southern West Virginia and eastern Virginia and the rust belt to maximize sales as people overdosed. Keefe’s account is stunning and based on assiduous research, confidential and original documents, and interviews. The author follows the legal battle to unearth what the Sackler’s had done and its vast implications for the wealth and health of the American people. Their arrogance is clear in the words of Kathe Sackler who boasted that Oxycontin was “very good medicine” and “a safe medicine.” She also claims credit for coming up with the “idea.” Years later in reference to the hundreds of thousands of addicted Americans she claimed not be aware of that. In 2007 the Bush Justice Department only delivered a slap on the wrist after investigating Purdue Pharma. It was no coincidence that the Sackler’s were major donors to the Republican Party and Rudy Giuliani was one of their lawyers! The name Barry Meier, a New York Times reporter and author of the first major expose dealing with Purdue Pharma and the Sackler’s, PAIN KILLER: AN EMPIRE OF DECEIT AND THE ORIGIN OF AMERICA’S OPIOID EPIDEMIC became a thorn in the side of the opioid industry. Keefe relies on Meier’s early work in his research and conveys the travails that the reporter had to deal with. Purdue Pharma executives pressured the Times to block Meier’s efforts. They were successful for a period of time until the various trials against the corporation took place where he was “reinstated” on the topic and his incisive reporting reemerged. Keefe and Meier argued that it is clear that Purdue Pharma had an inside man at the FDA and Paul McNulty, the deputy attorney general during the Bush administration handcuffed the prosecution and the efforts of John Brownlee, the federal prosecutor for the western district of Virginia who went after Purdue Pharma. In 2007 Purdue would pay a $600 million fine for the $35 billion earned from Oxycontin. Two years ago, when the Sackler’s faced their harshest legal challenge, they sold their stake in Purdue Pharma, moved their money overseas and had Purdue file for bankruptcy. Once that strategy was implemented, no court could gain damages from the family’s personal funds. By 2019-20 the Trump Justice Department under William Barr gave the family a reprieve and no family members or company executives would face criminal charges. Keefe effectively traces how finally after 2013 the Sackler family name became toxic as museums, universities, medical schools, and hospitals refused their donations and, in some cases, removed their names from their properties. Keefe follows the family’s efforts to counter lawsuits brought by numerous state Attorneys General and their use of White Plains, NY Judge Robert D. Drain to protect the Sackler family wealth, in addition to the family realization that for the first time settlements might hit them personally. As a result, they began to siphon off vast amounts of cash (family wealth is estimated to be $14 billion) from the company and planting it in offshore accounts. The result is that this entitled group of “Sackler’s” had to face the fact they had become social pariahs. Samanth Subramanian’s review of May 13, 2021, in The Guardian sums up the devastation and corruption, both government and non-government very clearly and its implications for the future: Keefe’s narrative is so lush with details that only in the chinks do we spot the story behind the story: the rotting structure of American healthcare that almost wills disasters into being. Some failures are born of lethargy or neglect. A federal government official once told me that if states had simply transitioned faster to reporting their health statistics electronically, someone might have caught a pattern: “all the drug overdose deaths, the suicides, the medical examiner events” that advertised the opioid crisis. But other failures are the results of a system maintained at a level of designed corruption.

  27. 5 out of 5

    Ashley

    Best for: Those interested in how corporations and the government have failed us. Those who enjoy a little bit of schadenfreude (though, in my opinion, not nearly enough). In a nutshell: The Sackler family, obsessed with their reputation and ‘good name,’ help 400,000 people to their deaths via the opioid epidemic. Why I chose it: I loved the author’s book ‘Say Nothing’ about The Troubles in Northern Ireland and searched for other work. Saw this was being released in April so ordered it right away. Rev Best for: Those interested in how corporations and the government have failed us. Those who enjoy a little bit of schadenfreude (though, in my opinion, not nearly enough). In a nutshell: The Sackler family, obsessed with their reputation and ‘good name,’ help 400,000 people to their deaths via the opioid epidemic. Why I chose it: I loved the author’s book ‘Say Nothing’ about The Troubles in Northern Ireland and searched for other work. Saw this was being released in April so ordered it right away. Review: What is a name, really? Is philanthropy truly a gift if it comes with so many strings, including the need to have one’s name splashed across all the things? How do we hold accountable the leaders of corporations that cause pain and suffering for millions? Author Keefe explores all these themes in his excellent book that focuses on the Sackler family, the name behind the billion-dollar pain empire via one of the ventures they chose not to put their name on, Purdue Pharma. If you’re not familiar, Purdue Pharma patented OxiContin, the extraordinarily strong opioid pain reliever introduced in the 1990s. The book opens with a deposition in the late 2010s, but immediately jumps back to the early 1900s so we can follow three generations of the Sackler family, starting with boys Arthur, Raymund, and Mortimer. Arthur took the lead as the first born to take a bunch of jobs, supporting his family. He and his brothers all went to medical school, and all married (some of them multiple times). Over time Arthur especially starts to build the empire with medical marketing, then the purchase of Purdue Frederick and Purdue Pharma. Each successive generation seems to be obsessed with putting their names on EVERYTHING. It kind of reminds me of the Trump family - there’s just this deep, almost pathological, need to piss all over the place. I don’t understand obsessions with names and legacy. Maybe it’s because I’m not having kids? To my mind, one’s legacy should be doing good things because they should be done, not because one wants credit and a fancy plaque at the entrance to a museum gallery. The Sacklers do not ever get what they deserve - though the very last chapter does have a slight sense of comeuppance. They are helped in many ways by the FDA — who should have shut down OxiContin’s claims from the start — but also by the Trump DOJ, who chose not the prosecute the individual family members in addition to the privately owned company. The family made billions off of the addiction of others, essentially creating not just the opioid epidemic but, when they changed the formulation, helping push those individuals on to heroin. They are evil. And while they do get to sleep on their giant pillows of ill-gotten money, at least one thing is now true: they have completely ruined the name they hold so dear. Museums and universities they donated to have started to strip their name from it (the Louvre, most notably, as well as medical programs at NYU and Tufts), as they don’t want to be associated with such immoral, vile individuals. But it still won’t bring back the lives lost at their hands. Keep it / Pass to a Friend / Donate it / Toss it: Pass to a Friend

  28. 5 out of 5

    Mike

    Full review to come. If you want to read about and get infuriated at rich people and the systems that protect them, boy is this book for you.

  29. 4 out of 5

    Flora

    i never write reviews but i’m making myself vulnerable to the crippling fear of public judgement. anyway this is INCREDIBLY well-written; thorough, pacy, and passionate. i knew next to nothing about the sacklers’ involvement in the opioid crisis yet i was completely compelled right from the beginning. i really really really urge everyone to read this

  30. 5 out of 5

    Mian

    For the first 1/4 of this book, I thought I might actually enjoy reading about this evil family in the same morbid way that I enjoy Succession and The Godfather movies. But NOPE!! These people are so horrifically evil, particularly the second generation of Sackler parasites, characters who lets be honest even Shonda Rhimes would hesitate to write because they'd be criticized as being too cartoonishly awful to be real. Making money off of human suffering is bad enough but these pieces of human ga For the first 1/4 of this book, I thought I might actually enjoy reading about this evil family in the same morbid way that I enjoy Succession and The Godfather movies. But NOPE!! These people are so horrifically evil, particularly the second generation of Sackler parasites, characters who lets be honest even Shonda Rhimes would hesitate to write because they'd be criticized as being too cartoonishly awful to be real. Making money off of human suffering is bad enough but these pieces of human garbage refuse to even consider that they share some responsibility for peddling an addictive drug to people like candy and then they have the gall to victim blame addicts for being "weak" while at the same time enriching themselves in the order of billions from the profits of all the misery they created. With all due respect, fuck the Sacklers, everyone who enabled them and all the museums, universities and institutions that still have their name on walls/buildings. Unless you wanna turn the Sacker Wing into a particularly sadistic prison for this family to rot in, I will not be paying your optional $25 admission price @ THE MET!! Fuck off. Also fuck Pfizer and J&J. Thank you Moderna for being at least not horrible enough to make it into this book!! The bar is on the floor but you cleared it.

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