Book Review: "Empire of Pain" by Patrick Redden Keefe
"Empire of Pain" by Patrick Redden Keefe
Synopsis: The Sackler name adorns the walls of many storied institutions—Harvard, the Metropolitan Museum of Art, Oxford, the Louvre. They are one of the richest families in the world, known for their lavish donations to the arts and the sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing a blockbuster painkiller that was the catalyst for the opioid crisis.
Empire of Pain begins with the story of three doctor brothers, Raymond, Mortimer and the incalculably energetic Arthur, who weathered the poverty of the Great Depression and appalling anti-Semitism. Working at a barbaric mental institution, Arthur saw a better way and conducted groundbreaking research into drug treatments. He also had a genius for marketing, especially for pharmaceuticals, and bought a small ad firm.
Arthur devised the marketing for Valium, and built the first great Sackler fortune. He purchased a drug manufacturer, Purdue Frederick, which would be run by Raymond and Mortimer. The brothers began collecting art, and wives, and grand residences in exotic locales. Their children and grandchildren grew up in luxury.
Forty years later, Raymond’s son Richard ran the family-owned Purdue. The template Arthur Sackler created to sell Valium—co-opting doctors, influencing the FDA, downplaying the drug’s addictiveness—was employed to launch a far more potent product: OxyContin. The drug went on to generate some thirty-five billion dollars in revenue, and to launch a public health crisis in which hundreds of thousands would die.
This is the saga of three generations of a single family and the mark they would leave on the world, a tale that moves from the bustling streets of early twentieth-century Brooklyn to the seaside palaces of Greenwich, Connecticut, and Cap d’Antibes to the corridors of power in Washington, D.C. Empire of Pain chronicles the multiple investigations of the Sacklers and their company, and the scorched-earth legal tactics that the family has used to evade accountability. The history of the Sackler dynasty is rife with drama—baroque personal lives; bitter disputes over estates; fistfights in boardrooms; glittering art collections; Machiavellian courtroom maneuvers; and the calculated use of money to burnish reputations and crush the less powerful.
Empire of Pain is a masterpiece of narrative reporting and writing, exhaustively documented and ferociously compelling. It is a portrait of the excesses of America’s second Gilded Age, a study of impunity among the super elite and a relentless investigation of the naked greed and indifference to human suffering that built one of the world’s great fortunes.
Rating: 4.5
Trigger Warnings: suicide, drug use and overdose, corporate malevolence
Review: Before I started my current job, one of my consulting projects was working on the massive opioid litigation (on the side of the plaintiffs, duh) for about 18 months. , and I only tell you this so that when I tell you the next two things, you’ll believe me:
I know a lot about the Sackler family and their various misdeeds.
I learned so much more in the course of reading this book.
While there have been several (incredible) works written about the opioid epidemic in the United States, this is the first that focuses solely on the private Sackler family — the ones who kicked off the Oxycontin craze that’s now a seemingly unending public health emergency, and like the tobacco executives of the 1960s and 1970s, knew exactly the harm they were causing.
“Empire of Pain” starts at the very beginning — as the three Sackler brothers, Arthur, Mortimer, and Raymond, grew up in Brooklyn in the early twentieth century. We attend secondary school and medical school with the three of them, we hear about how they fell in love, had children, and set lofty goals in the quest to do justice to their family name. For the first portion of the novel, we spend the most time with Arthur, the eldest and most ambitious of the Sacklers, who set them on their path by being a revolutionary MD/advertising executive. His work in the 1960s laid the groundwork for the advertising and marketing campaign around OxyContin, which kicked off the current opioid epidemic.
The book goes from Arthur’s birth to late 2020, so it is epic in it’s scope (and requires a list of characters as these men were prolific fathers), but I personally enjoyed reading about Arthur, Mortimer, and Raymond’s early years. That is likely because I’ve read…a lot…about their world after the introduction of 1996, but it was fascinating to me to get a look at their early years, and how that played a role in shaping Purdue Pharma. I’ve talked a lot about how I enjoy a good grifter novel, and I’d have to lump this epic-in-scope work into that category; in many ways, the Sackler family are some of the biggest (and most dangerous) grifters the world has ever seen.
It’s dense, and it’s complicated, but it’s also compulsively readable. I wanted to see exactly how the Sacklers spent their money, how they built their massive art collections and put their names on the side of buildings, all while having some cognitive dissonance as to how their wealth was built on human suffering. Even more ironically, many of them are doctors — how is this not against their Hippocratic oath? I know way too much about this subject area, and I’m not going to litigate the morality of the Sacklers and their activities. I will say, however, that if you are at all interested in scammers, grifters, or understanding the how behind one of the biggest crises of our times, this book is a great read for you.
As you can probably tell by the photo, I listened to this one via Libro.fm (my preferred vendor for audiobooks), and I really enjoyed the experience. It’s narrated by the author, who has a lovely speaking voice, and it’s engaging enough that I went for regular 90 minute walks in June in DC — even before the puppy arrived. If that’s not an endorsement, I’m not sure what is. I actually find it easier to listen to non-fiction than to read it sometimes — for me, there’s less of a chance to get distracted by an internt rabbit hole — and this is one I would wholeheartedly recommend if you’re in that position.
TL;DR: An engrossing, thought-provoking, and in-depth look at the rise and (quasi) fall of the Sackler family — and the high wire they straddle between being the world’s most dangerous drug dealers and some of the biggest philanthropists in history.
If You Liked This, Try These:
“American Overdose” by Chris McGreal (Bookshop | Kindle | Shannon’s Review)
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