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

In the middle of Patrick Radden Keefe’s Empire of Pain: The Secret History of the Sackler Dynasty, there’s a pause. The author recounts how, one day, he opened his mail to find an anonymous package containing a thumb drive laden with previously private court documents, depositions, data. All that accompanied it was a small slip of paper, on which was written, by hand, this quote from The Great Gatsby: “They were careless people … they smashed up things and creatures and then retreated back into their money or their vast carelessness or whatever it was that kept them together, and let other people clean up the mess.”

And what a mess it is that the Sacklers helped make. As most everyone knows by now, the main product of the family’s company, Purdue, was the opioid OxyContin. As Radden Keefe recounts, “More Americans [have] lost their lives from opioid overdoses than had died in all of the wars the country had fought since World War II.” This is all the more notable given that, before OxyContin, there was no opioid crisis.

Arthur, the oldest of the three Sackler brothers and the mastermind of a marketing strategy for Valium, which the next generation of Sacklers used for OxyContin.

The “secret” in the title is, at this stage, a bit of a misnomer. Books and articles galore have been written about the devastation wreaked by opioids. The Sacklers have been outed, their names removed from buildings, and their money rejected by the many institutions of learning and culture that had happily looked the other way for years. But in his job as a staff writer at The New Yorker, Radden Keefe was one of the first to delve into the family behind Purdue, and about this book, he says, “My intention was to tell a different kind of story … a saga about three generations of a family dynasty and the ways in which it changed the world, a story about ambition, philanthropy, crime and impunity, the corruption of institutions, power and greed.”

Oxy’s Roots

The family’s formative character was the oldest of the three Sackler brothers, Arthur. Born in 1913 and raised in Brooklyn by Jewish immigrants at a time when anti-Semitism ran rampant, he was a polymath: a skilled doctor, ad salesman, entrepreneur, and art collector, whose unconventionality extended to the way he navigated his three marriages.

It was Arthur who helped make Valium the first $100 million drug, by devising the advertising campaign that sold it as a miracle: relief from pain and stress, without any nasty side effects! By the time Arthur died of a heart attack, at 73, he and his two brothers, Raymond and Mortimer, were barely speaking. In the bitter fight over the estate, Arthur’s heirs sold their one-third stake in the small drug company Purdue Frederick, whose best-known product was the antiseptic Betadine, to Mortimer and Raymond for a paltry $22 million.

Raymond Sackler with his wife, Beverly, in the Netherlands, where in 2004 they donated $1 million to Leiden University. Raymond’s son, meanwhile, was spearheading America’s addiction to OxyContin.

So it was that Purdue ended up being run by Raymond’s son Richard, about whom his college roommate said, “He had a hubris, a blindness to consequences and an unshakable certainty in his own convictions.” Richard Sackler seems to have viewed OxyContin as an extension of himself. “You won’t believe how committed I am to make OxyContin a huge success,” he wrote to a friend. “It is almost that I dedicated my life to it.”

“A story about ambition, philanthropy, crime and impunity, the corruption of institutions, power and greed.”

When it came to the marketing of OxyContin, Richard looked to his forebears. With Valium, Arthur had used a double game in which he argued that doctors, in their beneficent wisdom, couldn’t possibly be influenced by advertising. (Which begs the question, why advertise?)

Purdue took it one step further by paying a network of doctors to push OxyContin to other doctors. When addiction resulted (surprise!), both uncle and nephew employed the peculiarly American strategy of blaming the consumer, who had been foolish enough to believe them. Arthur argued that those who became addicted to Valium were simply “prone to abuse”; years later, Richard echoed that sentiment when he said it was OxyContin’s addicts who were the “culprits, the reckless criminals.”

Mortimer Sackler and his wife, Theresa. By the time the eldest Sackler died of a heart attack, Mortimer was barely speaking to either brother.

The question that has always hovered over the story of the Sacklers is why they refused to halt OxyContin’s sales as the warnings of addiction—and, eventually, the deaths—piled up.

One answer is obvious. OxyContin was making them very, very rich. Over the years, the family took what one member called a “fantastic amount of money out of the business,” somewhere between $4 billion and $13 billion.

But the more human, and perhaps more frightening, explanation is that we often don’t see that which we won’t allow ourselves to see. As Radden Keefe writes, “Richard was so closely invested in OxyContin that he would not abide any suggestion that the drug might be addictive.” His great gift to a world that needed to be relieved of its pain, reduced to a curse? No.

It made me understand that one kind of carelessness can be born of great wealth—but another kind can be born of great conviction.

In addition to being a Shakespearean tale of human nature, Empire of Pain offers several lessons about our world.

As Radden Keefe writes, “The opioid crisis is, among other things, a parable about the awesome capability of private industry to subvert public institutions.” From the F.D.A. to the Justice Department, to the bankruptcy courts, it does look like the Sacklers will do what they always have: use the system which they paid to prop up in order to evade any personal responsibility.

The second, more hopeful lesson is that Radden Keefe produced his work with no cooperation from the family at the center of his story. His book is a testament to the power of the deep document dive, to the importance of talking to that “category of employee who might have seemed almost invisible to the family,” from housekeepers to doormen. That kind of journalism remains the reason why even the greatest of fortunes can’t buy the one thing its heirs want most: secrecy.

Bethany McLean is a journalist and the author of several books, including The Smartest Guys in the Room: The Amazing Rise and Scandalous Fall of Enron (co-authored with Peter Elkind) and, most recently, Saudi America: The Truth About Fracking and How It’s Changing the World