Empire of Pain: The Secret History of the Sackler Dynasty

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.

I am learning so much and the writer makes it interesting.

It was kind of slow going for me when I started this book. Had a hard time really getting into it at first. By about mid way through it really started picking up and got very interesting. The unbridled GREED shown by the Sacklers and their " sales reps" is sickening. I do have to add, though, that when I had stage 3 uterine cancer and went through chemo. radiation, internal radiation, etc. Hydrocodone actually probably kept me from committing suicide. I was so sick and the only thing that relieved my pain and suffering was hydrocodone. They even gave me a fentanyl patch which gave me no relief but the hydrocodone did. I'm not trying to publish an ad for the drug but just telling what happened in my case. 5 months after completing my treatments and surgeries I was able to stop the drug when my pain was gone. Yeah I guess I was addicted for a while but addicted to not being in pain all the time. Hope I never have to do it again.

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.

“I started reading Patrick Radden Keefe due to the book ‘Say Nothing’ about IRA activities in Northern Ireland. Subsequently, I read ‘Empire of Pain,’ detailing how the Sackler family, posing as philanthropists, contributed to the opioid epidemic in the USA. They aggressively promoted OxyContin through Purdue Pharma reps, encouraging doctors to prescribe this highly addictive painkiller, containing oxycodone, a semi-synthetic derivative of opium. The book reveals the deceptive promotion, leading to widespread addiction and the destruction of lives and families over the past 30 years in the USA and beyond. Engaging read, a truly deserving 5-star book!”

Excelente prosa e investigación. Se lee como novela.Habla del 1) origen de la epidemia de opiáceos con un fármaco autorizado el OXYCONTIN,2) del margen en el sistema regulador estaudinense que permitió la venta de un medicamento altamente ADICTIVO y3) de un sistema de justicia deficiente que no ha podido llevar ante la justicia a la familia responsable de esa epidemia. Imponiendo tan sólo multas que aunque billonarias están tan espaciadas en el tiempo que no afectan en nada la fortuna de esos empresarios

This book made me furious. How did the Sackler family make so much money on powerful drugs that addicted or killed people without being held accountable? How could they hold themselves out as innocent, despite the mounting evidence, and never give interviews or express any sorrow for the victims?The author makes the same points again and again, using examples of other large U.S. companies that got away with the same legal manoeuvres. But the Sacklers did it for three generations!Their continued lying and blaming overdose deaths on the “junkies” who misused the medication — and their false claims of having nothing to do with Purdue’s operations, even though eight family members sat on the board at one time and micromanaged every move that executives made — becomes excruciatingly hard to stomach as a reader.This book is the first to pin down the Sacklers’ culpability for crimes committed over the years without any consequences except a penalty payment of $225 million, despite their removal of billions of dollars from Purdue before its bankruptcy.You may need a Valium (a drug launched by Arthur Sackler, the patriarch and master pill pusher) to soldier through to the end of this incendiary story. I had to take many breaks.But I’m grateful to Patrick Raden Keefe for telling the world how this unrepentant family hurt so many sick people by using high pressure and lucrative incentives to persuade doctors to prescribe OxyContin. They did so without a shred of concern for those who died while taking it according to the written instructions.Not only did Purdue keep committing the same crimes with impunity, but it taught other drug makers to use the same marketing tactics geared to excessive profits. And, alas, the death count of the opioid crisis will continue.

Very interesting story about the family business that helped fuel the opioid epidemic in the USA. Very well researched, very informative and also a great read.

Fascinating and complete story about the Sackler family and how they lay the roots of the American opioids crisis. With it aggressive marketing strategy the family got rich they succeeded in spreading opioid use in an unseen way. Unfortunately the Sacklers got away with it and kept most of the profits they reaped from their drug business. Apparently the rich can get away with it....