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EMPIRE OF PAIN

The secret history of the sackler dynasty.

by Patrick Radden Keefe ‧ RELEASE DATE: April 13, 2021

A definitive, damning, urgent tale of overweening avarice at tremendous cost to society.

Richly researched account of the Sackler pharmaceutical dynasty, agents of the opioid-addiction epidemic that plagues us today.

In his latest excellent book, Keefe opens in a conference room packed with lawyers, all there to depose “a woman in her early seventies, a medical doctor, though she had never actually practiced medicine.” Kathe Sackler, thanks to the invention of a drug called OxyContin, was a member of one of the wealthiest families in the world, holding some $14 billion. The founder of that dynasty had established numerous patterns that held for generations. Though he had insisted that family philanthropy be prominently credited “through elaborate ‘naming rights’ contracts,” the family name would not extend to their pharmaceutical company, Purdue Pharma. The family would also not accept responsibility for any untoward effects that its products might have. Thus, when asked whether she acknowledged that hundreds of thousands of Americans had become addicted to OxyContin, Kathe answered, “I don’t know the answer to that.” Keefe turns up plenty of answers, including the details of how the Sacklers—the first generation of three brothers, followed by their children and grandchildren—marketed their goods, beginning with “ethical drugs” (as distinct from illegal ones) to treat mental illness, Librium and then Valium, which were effectively the same thing but were advertised as treating different maladies: “If Librium was the cure for ‘anxiety,’ Valium should be prescribed for ‘psychic tension.’ ” By Keefe’s reckoning, by the mid-1970s, Valium was being prescribed 60 million times per year, resulting in fantastic profits for Purdue. OxyContin followed in 1996—and then the opioid crisis, responsibility for which has been heavily litigated and for which the Sacklers finally filed bankruptcy even though they “remained one of the wealthiest families in the United States.” Of particular interest is the book-closing account of the Sacklers’ legal efforts to intimidate the author as he tried to make his way through the “fog of collective denial” that shrouded them.

Pub Date: April 13, 2021

ISBN: 978-0-385-54568-6

Page Count: 560

Publisher: Doubleday

Review Posted Online: April 12, 2021

Kirkus Reviews Issue: May 15, 2021

CURRENT EVENTS & SOCIAL ISSUES | HEALTH & FITNESS | TRUE CRIME | BUSINESS | PUBLIC POLICY | ISSUES & CONTROVERSIES | GENERAL BUSINESS | GENERAL CURRENT EVENTS & SOCIAL ISSUES

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KILLERS OF THE FLOWER MOON

The osage murders and the birth of the fbi.

by David Grann ‧ RELEASE DATE: April 18, 2017

Dogged original research and superb narrative skills come together in this gripping account of pitiless evil.

Greed, depravity, and serial murder in 1920s Oklahoma.

During that time, enrolled members of the Osage Indian nation were among the wealthiest people per capita in the world. The rich oil fields beneath their reservation brought millions of dollars into the tribe annually, distributed to tribal members holding "headrights" that could not be bought or sold but only inherited. This vast wealth attracted the attention of unscrupulous whites who found ways to divert it to themselves by marrying Osage women or by having Osage declared legally incompetent so the whites could fleece them through the administration of their estates. For some, however, these deceptive tactics were not enough, and a plague of violent death—by shooting, poison, orchestrated automobile accident, and bombing—began to decimate the Osage in what they came to call the "Reign of Terror." Corrupt and incompetent law enforcement and judicial systems ensured that the perpetrators were never found or punished until the young J. Edgar Hoover saw cracking these cases as a means of burnishing the reputation of the newly professionalized FBI. Bestselling New Yorker staff writer Grann ( The Devil and Sherlock Holmes: Tales of Murder, Madness, and Obsession , 2010, etc.) follows Special Agent Tom White and his assistants as they track the killers of one extended Osage family through a closed local culture of greed, bigotry, and lies in pursuit of protection for the survivors and justice for the dead. But he doesn't stop there; relying almost entirely on primary and unpublished sources, the author goes on to expose a web of conspiracy and corruption that extended far wider than even the FBI ever suspected. This page-turner surges forward with the pacing of a true-crime thriller, elevated by Grann's crisp and evocative prose and enhanced by dozens of period photographs.

Pub Date: April 18, 2017

ISBN: 978-0-385-53424-6

Page Count: 352

Review Posted Online: Feb. 1, 2017

Kirkus Reviews Issue: Feb. 15, 2017

GENERAL HISTORY | TRUE CRIME | UNITED STATES | FIRST/NATIVE NATIONS | HISTORY

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BOOK TO SCREEN

IN COLD BLOOD

by Truman Capote ‧ RELEASE DATE: Jan. 7, 1965

"There's got to be something wrong with somebody who'd do a thing like that." This is Perry Edward Smith, talking about himself. "Deal me out, baby...I'm a normal." This is Richard Eugene Hickock, talking about himself. They're as sick a pair as Leopold and Loeb and together they killed a mother, a father, a pretty 17-year-old and her brother, none of whom they'd seen before, in cold blood. A couple of days before they had bought a 100 foot rope to garrote them—enough for ten people if necessary. This small pogrom took place in Holcomb, Kansas, a lonesome town on a flat, limitless landscape: a depot, a store, a cafe, two filling stations, 270 inhabitants. The natives refer to it as "out there." It occurred in 1959 and Capote has spent five years, almost all of the time which has since elapsed, in following up this crime which made no sense, had no motive, left few clues—just a footprint and a remembered conversation. Capote's alternating dossier Shifts from the victims, the Clutter family, to the boy who had loved Nancy Clutter, and her best friend, to the neighbors, and to the recently paroled perpetrators: Perry, with a stunted child's legs and a changeling's face, and Dick, who had one squinting eye but a "smile that works." They had been cellmates at the Kansas State Penitentiary where another prisoner had told them about the Clutters—he'd hired out once on Mr. Clutter's farm and thought that Mr. Clutter was perhaps rich. And this is the lead which finally broke the case after Perry and Dick had drifted down to Mexico, back to the midwest, been seen in Kansas City, and were finally picked up in Las Vegas. The last, even more terrible chapters, deal with their confessions, the law man who wanted to see them hanged, back to back, the trial begun in 1960, the post-ponements of the execution, and finally the walk to "The Corner" and Perry's soft-spoken words—"It would be meaningless to apologize for what I did. Even inappropriate. But I do. I apologize." It's a magnificent job—this American tragedy—with the incomparable Capote touches throughout. There may never have been a perfect crime, but if there ever has been a perfect reconstruction of one, surely this must be it.

Pub Date: Jan. 7, 1965

ISBN: 0375507906

Page Count: 343

Publisher: Random House

Review Posted Online: Oct. 10, 2011

Kirkus Reviews Issue: Jan. 1, 1965

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by Truman Capote

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Empire of Pain: The Shocking Story Behind the Opioid Crisis

The secret history of the sackler dynasty: empire of pain ( 5 / 5).

Patrick Radden's Empire of Pain The rise and fall of the Sackler family—a dynasty associated with charity, art patronage, and—most controversially—the American opiate crisis—is expertly explored in Keefe. Keefe painstakingly reveals the tale of the Sacklers' enormous wealth and the disastrous effects of their main drug, OxyContin. This book provides a critical examination of public health policy and business ethics, in addition to being a historical record.

Plot Summary  

The book is divided into three parts, each chronicling a different era of the Sackler family's saga.

1. Part One: The Dynasty's Foundation

Arthur Sackler, the witty and controversial father who transformed pharmaceutical advertising in the middle of the 20th century, is introduced in the first section. Arthur's aggressive advertising techniques and creative marketing approaches created the foundation for the family's enormous wealth. His groundbreaking work in medical advertising for medications such as Valium and other pharmaceuticals revolutionized the pharmaceutical industry by fusing science, art, and business in ways never seen before.

2. Part Two: The Rise of OxyContin

The second section explores the development and aggressive promotion of OxyContin by Purdue Pharma, a business owned by the Sackler family and run by Richard, Raymond, and Mortimer Sackler, Arthur's nephews. In spite of the acknowledged hazards of addiction, OxyContin was advertised as a revolutionary painkiller; this section goes into great depth about how this happened. The story tracks the creation, approval, and novel sales techniques of OxyContin, emphasizing the dishonest business methods and the exaggerated claims of minimal danger of addiction that contributed to the drug's widespread usage and eventual abuse.

3. Part Three: The Opioid Epidemic and Legal Reckoning

The final section explores the terrible consequences of the opioid crisis and how it has affected American communities. The stories of people and families impacted by opioid addiction are included in this section, which powerfully and heartbreakingly illustrates the human cost of corporate avarice. It also describes the court cases and public protests that ultimately compelled the Sackler's to answer for their actions both morally and legally, even if the results of these cases frequently seemed insufficient given the scope of the pandemic.

1. Corporate Malfeasance

Keefe reveals Purdue Pharma's unscrupulous business methods and aggressive marketing tactics, illuminating how corporate avarice and a disdain for public safety can result in disastrous public health emergencies. He provides examples of how the chase of business may eclipse morality and have disastrous effects on society.

2. Philanthropy vs. Accountability

The Sacklers' involvement in the opioid crisis and their charitable initiatives are contrasted in the book, which raises ethical concerns regarding the duties of affluent donors. Given their involvement in the opioid crisis, the Sacklers' donations to museums, universities, and other cultural organizations are under investigation. This raises more questions about the morality of taking "tainted" money.

3. Family Legacy

Keefe paints a complex picture of the Sackler family, emphasizing their goals, internal tensions, and the effects of their decisions on subsequent generations. He provides a nuanced portrait of the people hiding behind the corporate façade as he looks at how the family's quest of wealth and success influenced their choices and ultimately brought about their demise.

Radden, Patrick In Empire of Pain, Keefe's skill as a storyteller is evident. His thorough investigation and captivating narrative offer a thorough and engrossing portrayal of the Sackler dynasty. The substantial material and first-hand anecdotes Keefe provides demonstrate his investigative thoroughness, which makes the book both fascinating and educational. Particularly fascinating is Keefe's characterization of Arthur Sackler, who is shown as a visionary but profoundly flawed person whose contributions to pharmaceutical advertising had a significant impact. The industry was revolutionized by Arthur's ability to combine medical and marketing, but his legacy has been marred by his family's continuous use of aggressive techniques and unethical behavior. The book's later sections, which describe the toll the opioid crisis has taken on both communities and individuals, are horrifying and frustrating. Keefe's aptitude as a journalist and storyteller is demonstrated by his ability to relate the micro-level suffering of people to the macro-level corporate actions. He highlights the real-world effects of the Sacklers' activities and gives a human face to the data by highlighting the perspectives of individuals impacted by the situation. Keefe also examines the legal and regulatory shortcomings that contributed to the opioid crisis's exacerbation, criticizing the FDA, the medical community, and the political establishment for their involvement in the epidemic's continuation. His research goes beyond the Sackler's to look at broader systemic problems in governance and healthcare that fueled the disaster.

“Empire of Pain” is a compelling and necessary read for anybody hoping to comprehend the workings of corporate America and the nuances behind the opioid crisis. In addition to providing a historical account, Patrick Radden Keefe's painstaking and engrossing narrative serves as a warning about the dangers of unbridled greed and the moral obligations of individuals in positions of authority. A wide readership should read this book because it makes a substantial contribution to the literature on corporate ethics, public health, and American history. Keefe's art serves as a sobering reminder of the significant influence that business decisions can have on society and the necessity of holding influential people and organizations responsible.

  By  Dr. Pallavi Saxena

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'empire of pain: the secret history of the sackler dynasty' profiles pharma family.

Ailsa Chang

Noah Caldwell

Christopher Intagliata

NPR's Ailsa Chang speaks with Patrick Radden Keefe about his book Empire of Pain: The Secret History of the Sackler Dynasty. The book profiles the family that founded oxycontin maker Purdue Pharma.

Copyright © 2021 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

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Empire of pain: the secret history of the sackler dynasty, by patrick radden keefe.

🏆 Winner of the 2021 Baillie Gifford Prize for Non-Fiction

☆ Shortlisted for the 2023 Winner of Winners Prize, which aims to pick out the best nonfiction book of the past 25 years

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“It’s a brilliantly told story and, again, fits into the compelling and enjoyable category very, very well. It’s also enraging for the reader. Radden Keefe has done a great job of maintaining objectivity while painting a picture of the way in which people connected to Purdue seemingly evaded responsibility for the problems it allegedly triggered.” Read more...

The Best Business Books: the 2021 FT & McKinsey Book Award

Andrew Hill , Journalist

“It’s an extraordinary book. He’s writing of extraordinary things, but that alone won’t make it a good book. There’s incredible artistry in putting this story together. And because he has a very transparent style—he’s a New Yorker staff writer—and it’s not fancy, it’s very easy to say, ‘Well, he just had to research it and write it down.’ But no, it’s incredibly beautifully done. It’s about the Sackler scandal, this family that’s made a fortune out of Oxycontin, this very, very addictive opioid that’s killed more Americans than have died in all the wars the country has fought since the Second World War. What he does is go back and look at the origins of the company, Purdue Pharma. It’s a fascinating story. It’s an immigrant family, Russian Jewish. The father has a grocer’s shop. They work incredibly hard. Against all the odds the three boys, the first generation, all become doctors. It is the American dream. They’re doing something extraordinary and it’s admirable at the start.” Read more...

The Best Nonfiction Books: The 2021 Baillie Gifford Prize Shortlist

Kathryn Hughes , Literary Scholar

“It’s a perfect blending of family history, dynastic shenanigans on a par with the Borgias, combined with a story that has just ruined so many people’s lives.”

Narrator: Patrick Radden Keefe

Length: 18 hours and 6 minutes

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Other books by Patrick Radden Keefe

Say nothing: a true story of murder and memory in northern ireland by patrick radden keefe, our most recommended books, red memory: the afterlives of china's cultural revolution by tania branigan, the living mountain by nan shepherd, my fourth time, we drowned by sally hayden, revolutionary spring: europe aflame and the fight for a new world, 1848-1849 by christopher clark, chip war: the fight for the world’s most critical technology by chris miller, as i walked out one midsummer morning by laurie lee.

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Protect the Family at All Costs

A damning portrait of the sacklers, the billionaire clan behind the oxycontin epidemic..

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In the late 2000s, an employee of Purdue Pharma was stunned by the words of the corporation’s in-house counsel. At a meeting, the company’s lawyer, Stuart Baker, had been praising three former members of the leadership team, including his own predecessor. Those three men had pleaded guilty in 2007 to making fraudulent claims about the harmlessness of Purdue’s cash cow product, OxyContin, and had been forced to resign. “Those people had to take the fall to protect the family,” Baker said, as quoted in Empire of Pain , Patrick Radden Keefe’s masterfully damning new book about that family, the billionaire Sacklers, who owned Purdue . The company’s foremost priority, Baker went on to remind all present, was “to protect the family at all costs.” The unnamed (and now former) Purdue employee who witnessed this little speech told Keefe, “I remember going home and saying, ‘Where the fuck am I working? ’ ”

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Empire of Pain, Keefe explains in his afterword, is a dynastic saga. Like Purdue, it is all about the Sackler family: how it transformed American medicine, the key role it played in the opioid crisis that now costs tens of thousands of Americans their lives every year , and the family’s belated and incomplete downfall. The Sacklers went from an esteemed clan known primarily for their philanthropy on behalf of cultural, educational, and scientific institutions—including, most famously, the spectacular Sackler wing of the Metropolitan Museum of Art, which houses the Temple of Dendur—to public disgrace and repudiation. Among the final scenes in Empire of Pain is a student activist happily watching the Sackler name being chipped off the facade of a building at Tufts University. The family threatened to sue, claiming that the university was violating an agreement it had made when it received donations from one of its members. Keefe calls this “a graphic measure of the Sacklers’ vanity, and of their pathological denial, that the family was prepared to debase itself by trying to force its name back onto a university where the student body had said, quite explicitly, that they found it morally repugnant.” It’s also an illustration of how much the very rich, when crossed, operate like the Mafia, though they reinforce their power with shell companies and lawyers rather than omertà and violence.

Keefe is no stranger to covering gangster tactics. His previous book, 2019’s Say Nothing , was an acclaimed bestseller about the abduction and murder of a widowed mother of 10 by the Irish Republican Army, and for the New York Times Magazine , he wrote about the financial management of the Sinaloa drug cartel in Mexico . In fact, it was Keefe’s interest in how the cartels function as businesses that piqued his curiosity about Big Pharma, and specifically the Sackler family, which he wrote about for the New Yorker in the article that became the basis for Empire of Pain . Keefe doesn’t lean too hard on the Mafia comparison in this book, but when he refers to Howard Udell—Purdue’s ultraloyal longtime staff attorney, and one of the three men who took the fall in 2007—as the Sacklers’ “consigliere,” the dart hits home.

The Sackler story begins with three striving brothers, Arthur, Mortimer, and Raymond, born to a Jewish immigrant grocer and his wife in early 20 th century Brooklyn. All three became doctors. Arthur, the eldest and a superhuman dynamo, seemed to start a new enterprise every week; after his death from a stroke in 1987, one of the greatest challenges facing his heirs was the task of locating all of his assets and paying off unexpected debts. Arthur Sackler didn’t like people knowing his business—literally—so no one had a grasp of the entire financial picture of his estate. This was partly because some of his dealings were ethically dubious. He secretly owned a controlling share in the chief competitor of one of his own firms, for example, and he kept his name out of medical newsletters that he published to conceal a self-interested editorial bias in favor of pharmaceuticals. When Arthur became obsessed with both collecting art and donating to cultural institutions in exchange for having galleries and wings named after himself and his family, he faced a challenge, as Keefe writes, to “reconcile this ardent desire for recognition of the Sackler name with his equally strong preference for personal anonymity.” He balanced this skillfully. In the art and philanthropy world, Arthur was known to have lots of money, but no one seemed to know where he’d gotten it.

The answer was Valium, the first $100 million drug in history. Arthur didn’t own F. Hoffmann-La Roche, the company that manufactured the tranquilizer (although he swanned around the headquarters so often that there were rumors he ran it). Though Arthur was an early proponent of psychopharmaceuticals, his greatest expertise lay in advertising and marketing, services provided by his agency, McAdams. The first inductee into the Medical Advertising Hall of Fame, Arthur Sackler was credited by that august institution with pioneering the field and bringing “the full power of advertising and promotion to pharmaceutical marketing.” Some of his innovations included making unfounded claims for the nonaddictive nature of Valium, producing the first promotional insert designed to look like editorial content (in the New York Times , no less), and creating ads filled with the testimonials of practicing MDs who, upon investigation, turned out to be entirely fictional.

Arthur died before OxyContin was developed, and his widow and children, according to Keefe, energetically strive to distance themselves from that most notorious of Sackler-associated products. Purdue, which the brothers bought in 1952, was run by Mortimer and Raymond’s children and grandchildren. But Empire of Pain amply demonstrates that Arthur created the playbook used to make OxyContin a blockbuster drug, from incentives for sales reps to speakers, publications, and “grassroots” advocacy groups that are secretly funded by the manufacturer. Opioids are powerful and addictive painkillers, but not necessarily dangerous if used carefully and properly. Purdue Pharma, however, did nothing to ensure that OxyContin was used that way, and in fact encouraged its misuse. Internal documents and correspondence quoted in Empire of Pain prove that Purdue’s staff and leadership, including several of Arthur’s nephews and nieces, knew full well that many doctors were operating illegal pill mills. Yet the company refrained from reporting them because it made money from every bogus prescription.

If you are someone who engages in this kind of sneaky conduct, the last person you want reporting on you is Keefe. Although the material in Empire of Pain is more complex and less action-packed than the crimes and terrorism of Say Nothing, the narrative is just as involving. Keefe has a knack for crafting lucid, readable descriptions of the sort of arcane business arrangements the Sacklers favored. He is also indefatigable. He will interview the yoga teacher you brought to Turks a few times to help with your bad back and who knows your wife ordered two butlers to escort you everywhere as “human crutches.” He will find the doorman who was standing outside your aunt’s apartment building when your cousin jumped out the window to his death. And he will not only dig up the third grade classmate who remembers you as “innocent and mocked and friendless and rich,” he’ll quote that classmate adding that “to be ostracized on that basis” at such a tony private school, “you had to be pretty fucking rich.”

Empire of Pain: The Secret History of the Sackler Dynasty

By Patrick Radden Keefe. Doubleday.

The Sackler infighting described in Empire of Pain will surely prompt many comparisons to the HBO series Succession , but a real-world parallel also comes into focus. Around this time last year, I was knee-deep in memoirs by Trump staffers and associates , and while the Sacklers may be more housebroken than the former president, there are some significant similarities. The Sacklers who ran Purdue surrounded themselves with yes men and interfered with the more prudent employees who sought to curb their excessive demands for more and more OxyContin sales. They considered only their own enrichment when making any business decision. They lack basic empathy for other people, or any understanding of the difficulties life presents to those less fortunate than themselves. Richard Sackler—Arthur’s nephew and the driving force behind the OxyContin campaign—adamantly insisted that neither Purdue nor OxyContin was to blame for the abuse of the drug, and pointed his finger at the addicts themselves. They consider themselves victimized whenever they don’t get what they want or anyone criticizes them. The Sacklers are prone to feuds and tantrums and, finally, as Keefe puts it, there is their “reluctance to concede, even hypothetically, the possibility of error or wrongdoing.”

Held up to the Sacklers, Trump seems less outrageous and sui generis, his awful behavior less a manifestation of his dysfunctional individual upbringing than typical of his kind—the mediocre children of the rich. Only worse, of course—or is he? Cosmetically, Trump is certainly the more appalling, but when it comes to the deaths that can be chalked up to his heedless selfishness … well, Keefe’s book makes clear, the Sacklers can give him a run for his money.

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Patrick Radden Keefe’s Empire of Pain is another dizzying, provocative investigation: Review

The author of Say Nothing turns his sights on the Sackler family and Purdue Pharma.

Patrick Radden Keefe's body of work doesn't seem, at first glance, the most accessible. An investigative journalist by trade, he reports on many manners of corruption, and his last book, 2019's Say Nothing , had an elevator pitch that sounded anything but mainstream. It dove into The Troubles in Ireland, using the decades-past disappearance of a 38-year-old mother of 10 to detail the human effect of that very specific time in I.R.A. history. It also became a New York Times bestseller — and was one of EW's best books of the year. Keefe has a way of making the inaccessible incredibly digestible, of morphing complex stories into page-turning thrillers, and he's done it again with Empire of Pain: The Secret History of the Sackler Dynasty.

The behemoth (450 pages, plus 80 more of notes and indices) is a scathing — but meticulously reported — takedown of the extended family behind OxyContin, widely believed to be at the root cause of our nation's opioid crisis. It's equal parts juicy society gossip (the Sackler name has been plastered across museums and foundations in New York and London, they attend society events with the likes of Michael Bloomberg) and historical record of how they built their dynasty and eventually pushed Oxy onto the market. It's not likely to flip-flop anyone's opinion over who is to blame for the addiction epidemic: If you've made it this far with your belief of the Sacklers' innocence intact, there's likely nothing that can be said to sway you. But for the rest of the reading public, it lives out every promise inherent in the word exposé.

Empire is divided into three parts: Patriarch, which chronicles the life and career of Arthur Sackler, who built the family's wealth and launched their foray into pharmaceuticals in the first place; Dynasty, which deals mostly in the invention of OxyContin (which grew out of the pain remedy MS Contin); and Legacy, which details not only the start of the family's downfall but drives home Keefe's portrait of just how careless, money-hungry, and conniving the Sacklers were in their push to dominate the painkiller market.

Keefe, as a journalist, is measured in his delivery. He never shies away from including his deeply disturbing evidence of ways that Purdue lied about OxyContin's addictive properties, say, or ways that the Sacklers ignored how their product was killing people en masse. But he doesn't editorialize. As a reader, there are moments in which we want more from him; it would occasionally be a more satisfying read if he couched the reporting in his personal stories or reactions. It's clear why he, as a reporter, didn't do that; it's clear to the book critics and readers that these people are monsters.

What he does do is weave in stories of people that he met through his reporting that have had their own brushes with this disastrous drug. The photographer Nan Goldin is one: after decades in and out of addiction (Oxy and heroin) she became an anti-Purdue and anti-Sackler activist, staging protests at museums like the Met, where the family donated the wing that houses the Temple of Dendur. Martha West served as the secretary to Purdue general counsel Howard Udell — she was encouraged by Udell to seek out an Oxy prescription after he saw her limping in the office and quickly found herself taking more than the recommended dose, crushing and snorting pills before work.

Say Nothing , Keefe's previous book, was news-breaking: He essentially solved the crime of his subject's disappearance in his reporting. His current subject matter doesn't offer the same opportunities to wrap up the story in a tidy bow, so there's a chance that fans of his may feel less closure than they hoped for after reading Empire . But what he has done is provide a record of this disaster and a terrific starting ground for other journalists and authors who'd like to pick up the torch (he also does break plenty of news, releasing WhatsApp conversations and emails between Sacklers that show the family members portraying themselves as victims of an anti-OxyContin news cycle, among other items). The tome also serves as yet another reminder of the humanity behind the addiction crisis: Every time he reports on the ways that the Sacklers vilify addicts as "criminals" or bad people is a reminder that it's really quite the opposite. If you're lucky enough not to have been personally touched by this epidemic, it feels like required empathy reading; if you're less fortunate, it could be a rallying cry.

The author closes with several afterwords, where he describes his reporting process in depth, opens up about intimidation tactics that he says the Sacklers employed against him, and goes into further details of their constant denials even in the face of wildly obvious evidence. He also explains that a large portion of the depositions, law enforcement files, and internal Purdue records he used to report the story arrived in his mailbox via an anonymous thumb drive (he was in the process of a Freedom of Information Act suit against the FDA at the time). The envelope arrived with a note that quoted The Great Gatsby , capturing the exact Eat the Rich sentiment that feels like it's bubbling underneath the surface of every page of Empire of Pain. " They were careless people," the anonymous whistleblower wrote, quoting Fitzgerald. "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." B+

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Empire of Pain: The Secret History of the Sackler Dynasty

By Patrick Radden Keefe Doubleday: 560 pages, $33 If you buy books linked on our site, The Times may earn a commission from Bookshop.org , whose fees support independent bookstores.

Liberals have spent a lot of time recently puzzling over the behavior and attitudes of working-class Americans . Why have they cast off civic values and embraced conspiracy theories? Why do they flock to candidates who offer little beyond a middle finger raised at elites? What is behind their seething rage?

There are any number of credible explanations, mostly based in economics and race, but one often overlooked factor is the opioid epidemic. Since the late 1990s, nearly 500,000 Americans have died, with white working people in places like Appalachia, the Rust Belt and Florida particularly hard hit. The death toll, grievous as it is, attests only to a fraction of the suffering inflicted on tens of millions of citizens.

A factory job exported to China is a crushing loss, but it cannot compare to the ravages of an addicted relative: the years of stealing and lying, the arrests, the destroyed marriages, the homes mortgaged and remortgaged and then lost to pay for rehab, the children born addicted and then thrown into foster care or the arms of stunned grandparents.

Compounding this heartbreak is the fact that the well-off and well-educated created this crisis — the scientists who developed the painkiller OxyContin, the government regulators who approved it, the sales reps who flogged the pills with lies and the doctors who prescribed them in outrageous quantities.

In his impressive exposé, “ Empire of Pain : The Secret History of the Sackler Dynasty,” the journalist Patrick Radden Keefe lays the blame directly at the feet of one elite family, the billionaire owners of Purdue Pharma. The decisions that birthed and perpetuated the epidemic were not made by employees or a management team, he reveals, but by members of this cultured clan of physicians, long acclaimed for their arts philanthropy.

World & Nation

More than 1 million OxyContin pills ended up in the hands of criminals and addicts. What the drugmaker knew

April 18, 2017

As Keefe ably demonstrates, it was the Sacklers who dreamed up OxyContin as a solution to an anticipated revenue decline, and it was the Sacklers who insisted their powerful narcotic, the sort of drug previously reserved for terminal patients, be marketed aggressively and widely. That decision to push the drug as a treatment for common aches and pains kicked open a door. OxyContin rushed in first, but competitors followed; eventually they were joined by Mexican cartels dealing heroin and Chinese traffickers of fentanyl .

The Sacklers’ motivation, Keefe suggests, was simple greed, and they were aided in this project by a pair of noxious family traits: the refusal to admit error and a shocking inability to empathize.

“These are criminals,” Richard Sackler, a physician and then president of the company, emailed a friend in 2001 after news reports of patients becoming addicted in West Virginia. “Why should they be entitled to our sympathies?”

The Sacklers’ attitude scarcely changed over the next two decades, despite the mounting proof that their pill was destroying legions of families — albeit ones that lived far from their mansions in Greenwich, Conn.; Amagansett, N.Y.; and Gstaad, Switzerland. Keefe quotes a 2019 email exchange among relatives in which a second-generation Sackler, Mortimer D.A., refers to “the so called ‘opioid crisis.’”

A staff writer at the New Yorker, Keefe is known for tackling mysteries. His book “ Say Nothing ” took on a notorious and unsolved murder during the Irish Troubles. In last year’s podcast “Wind of Change,” he tried to get to the bottom of a rumor that the CIA orchestrated a Cold War pop hit.

When it comes to the Sacklers, the mystery he sets out to solve seems to be: how could they?

A possible answer emerges in the first third of the book, an extended portrait of Arthur Sackler, the oldest brother and paterfamilias. At first glance it seemed odd to delve so deeply into a man who died nine years before OxyContin debuted, but it proves an inspired choice and the best part of the book.

Arthur Sackler climbed from an impoverished childhood in Brooklyn, where his immigrant parents had a grocery, to the Upper East Side, as Keefe observes, by always betting on himself. Whether it was selling ads on commission for his high school yearbook or marketing a new tranquilizer called Valium in exchange for a cut of sales, Arthur Sackler went “to great lengths in order to devise a scheme in which his own formidable energies might be rewarded.” Trained as a physician, he became an entrepreneur who pioneered the marketing of pharmaceuticals directly to doctors and purchased the company that would become Purdue in 1952 for $50,000.

It was Arthur Sackler’s unshakable confidence in his own abilities that made him very rich and propelled him past competitors, congressional investigators, the FDA and, it seems, any type of moral reflection.

OxyContin goes global: ‘We’re only just getting started’

OxyContin is a dying business in America.

Dec. 18, 2016

His younger brothers Raymond and Mortimer, along with their offspring, modeled this approach as they sold OxyContin and confronted — or refused to confront — its damage. Using internal company emails, Keefe lays out how the family micromanaged the company and demanded ever higher revenues. Executives outside the family seemed to serve primarily as fall guys and yes men who espoused the view, as Keefe writes of one official, that OxyContin was “a magnificent gift the Sacklers had bestowed upon humanity that was now being sullied by a nihilistic breed of hillbilly pill poppers.”

The book’s final part is less powerful, perhaps inevitably, as it covers the fits and starts of pending litigation against the company and its ongoing bankruptcy proceedings. Still, it is a compelling chronicle of the lengths to which the rich will go to avoid accountability and the sterling-resuméd lawyers and spin doctors eager to help.

Though Purdue had been the subject of decades of investigative journalism , the family had remained largely unscathed, with many in high society or in philanthropic circles unaware the source of their money was nicknamed “hillbilly heroin.” When my colleagues and I published several hard-hitting pieces in 2016, Richard Sackler felt insulated enough from responsibility (and infamy) to maintain a public Facebook page where he listed his relationship status as “It’s complicated.”

But after Keefe wrote about the family in 2017 in the New Yorker, essentially the hometown newspaper of the elite, the tide turned. Museums and universities started rejecting their donations and removing the family name from gallery walls and research buildings.

I wish Keefe made space in this very long book — more than 500 pages with footnotes — to describe the effect of opioids on a family that wasn’t named Sackler. He finds room for the founding brothers’ romantic conquests, Arthur Sackler’s cringey dealings with the Metropolitan Museum of Art and even a ditzy daughter-in-law’s ghastly attempts at fame. But the shattered lives remain for the most part on the margins.

That is a shame because Keefe is such a talented researcher and storyteller, and a sustained portrait of one of the multitude of families ruined by the Sacklers’ drug would have presented their callousness in even starker relief.

‘You want a description of hell?’ OxyContin’s 12-hour problem

May 27, 2016

As it is, “Empire of Pain” seems an air-tight indictment of the family. There seems little chance any of the Sacklers will learn from it, but perhaps others striving for wealth and status will take its lessons and remember that when you bet on yourself, there is always someone — sometimes millions of someones — on the other side of the wager.

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Harriet Ryan is an investigative reporter for the Los Angeles Times. Since joining the paper in 2008, she has written about high-profile people, including Phil Spector, Michael Jackson and Tom Girardi, and institutions, including USC, the State Bar of California, the Catholic Church, the Kabbalah Centre and Purdue Pharma, the manufacturer of OxyContin. Ryan won the Pulitzer Prize for Investigative Reporting with colleagues Matt Hamilton and Paul Pringle in 2019. She and Hamilton won the Collier Prize for State Government Accountability in 2023. She previously worked at Court TV and the Asbury Park Press. She is a graduate of Columbia University.

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What Did the Sacklers Know?

Patrick radden keefe’s new book provides the fullest accounting so far of purdue pharma’s role in the opioid crisis..

What did they know, and when did they know it? That is, when did the Sackler family know that OxyContin, the drug responsible for their vast fortune, was also partly responsible for the opioid crisis? Such questions are no abstraction to the family of billionaires currently fending off some 3,000 lawsuits filed by nearly every state, as well as many cities, counties, and tribal governments, in America. The lawsuits allege, among other crimes, that the privately owned Sackler family business, Purdue Pharma, downplayed the risks of its blockbuster drug while illegally boosting its sales, and that this scheme to profit led to unfathomable destruction.  

Discovering anything about the Sackler family, let alone the innermost workings of its privately owned companies, is not easy. The earliest investigations into OxyContin and the emerging overdose crisis did not mention the Sackler family by name at all. Even a front-page story in The New York Times, “ Cancer Painkillers Pose New Abuse Threat ,” did not use the Sackler family name. This gets to a paradox at the heart of their story. The Sacklers donated lavishly to art museums and galleries, insisting in return that the family name be plastered prominently on the walls of institutions like the Guggenheim and New York’s Metropolitan Museum of Art. But their name appeared nowhere near any of their pharmaceutical businesses.

In his new book, Empire of Pain: The Secret History of the Sackler Dynasty , New Yorker writer and investigative journalist Patrick Radden Keefe has provided the fullest picture of Sackler family dynamics so far, including what the family knew about OxyContin’s dark side and when. The book unfolds in three parts, with the first focusing on Sackler brothers Arthur, Raymond, and Mortimer, all doctors who grew up in Brooklyn in the early twentieth century. It was Arthur Sackler who mastered both medicine and marketing. Arthur was the brains behind the advertising campaign for Valium, which was  the  top-selling drug in the United States from 1968 until 1982, solidifying Arthur and the Sackler family as major players in the pharmaceutical business. But it was under a new generation of Sacklers—led by Richard Sackler (Raymond’s son) and Kathe Sackler (Mortimer’s daughter)—that the family’s fortune grew significantly more, thanks to OxyContin, which since 1996 has netted about $35 billion in sales for their company Purdue Pharma .

There have been numerous lawsuits and investigations into Purdue and OxyContin over the years, including a $600 million  fine for false marketing in 2007, but none presented such rich insight into the family that’s been quietly reaping profits this whole time. A huge trove of court filings in 2019 laid the groundwork for Keefe’s exposé; he later also received a mysterious thumb drive by mail . Empire of Pain is ultimately a multigenerational tale of an American dynasty and its rocky tumble from the peaks of high society to the status of social pariah. Moving alongside the history of how the Sacklers accumulated their wealth is Keefe’s lucid, unrelenting portrayal of how the Sacklers, especially Richard, were fully aware of alarming reports of overdose deaths related to their product but continued to press and press for more sales. It’s also the story of how America’s government and regulatory agencies gladly furthered the Sackler family’s corporate interests.

If Arthur Sackler flew close to the sun selling Valium, it was Richard Sackler’s campaign to sell as much OxyContin as humanly possible, and then some, that set the whole family, and possibly a chunk of their vast fortune, ablaze. 

Whatever your feelings on the excesses of American wealth in today’s gilded age, the Sackler clan featured in Empire of Pain come across as a petty, cold, and perpetually aggrieved bunch, despite their enormous wealth. Keefe’s reporting on the Sacklers, a mammoth undertaking that draws on discovery documents, internal company memos, and emails displaying Succession -level bickering among Sackler family members, is a window into their bunker mentality, reinforced by impenetrable walls of denial.

The book’s prologue sees Kathe Sackler casually answering questions during a deposition for a massive lawsuit against her and her family in 2019. “Some measure of defensiveness was to be expected from a corporate official being deposed in a multibillion-dollar lawsuit,” Keefe writes. “But this was something else. This was pride. The truth is, she said, that she, Kathe, deserved credit for coming up with ‘the idea’ for OxyContin.” (In fact, oxycodone, the sole ingredient in OxyContin, was invented in 1916 by a group of German scientists; the Sacklers simply added a delayed-release mechanism to it that was supposed to make each dose last 12 hours but didn’t .) While being deposed, Kathe is asked a simple yes or no question: “Do you recognize that hundreds of thousands of Americans have become addicted to OxyContin?” Her lawyers blurt out “Objection!” and all Kathe can say is, “I don’t know the answer to that.”

America’s poor system of public health surveillance, as demonstrated by the Covid-19 pandemic, makes it hard to figure out exactly how many people in this country are addicted to opioids, and which opioids they’re addicted to. But as a company, Purdue knew early on that OxyContin was a hit, especially in illegal markets. Two senior Purdue executives testified to Congress that it was not until the year 2000 that the company first learned of OxyContin’s popularity among recreational drug users. Yet Keefe’s reporting shows that Purdue and the Sacklers knew about the drug’s rampant “misuse” before then. In 1999, under the sardonic pseudonym “Ann Hedonia” (a play on the condition anhedonia, the inability to feel pleasure), one of Purdue’s legal secretaries, whose identity remains anonymous in the book, logged onto online forums and message boards devoted to recreational drug use. The purpose of her online mission was to prepare a memo cataloging the ways in which people were using OxyContin and becoming addicted to it.  

Ann Hedonia found that people were easily bypassing the drug’s supposed time-release coating and either snorting or injecting the pure oxycodone underneath. By this time, OxyContin sales were generating $20 million per week, which somehow for Purdue’s then-president, Richard Sackler, wasn’t enough. According to emails obtained by Keefe, Richard Sackler’s response to news of the sales was, “not so great.… Blah, humbug. Yawn.”

According to a 2004 deposition, Ann Hedonia circulated her findings in a memo to “all the Sacklers” involved in running the company, a memo that Keefe reports later went missing from Purdue’s files. OxyContin was approved by the Food and Drug Administration in 1996, and Keefe documents that as early as 1997, reports of OxyContin’s misuse around the country flooded into Purdue from its sprawling sales force. With so much OxyContin flowing through the medical system, significant amounts of the drug spilled over onto the street. At one point, OxyContin was selling for $1 per milligram (an 80 milligram pill could sell for $80 or more). While plenty of patients found pain relief with OxyContin, many others found the drug numbed the pain of trauma, economic precarity, and isolation.  

How did Richard Sackler respond to news of growing addiction to OxyContin? He doubled down, and cranked up the sales.

By far the most enraging detail, for me, in Empire of Pain is how Richard Sackler decided to handle the risks of the drug. In emails that were either leaked to Keefe or appeared in court filings, Richard Sackler shows outright contempt for people who struggle with substance use disorders. He and Purdue capitalized on the long-standing stigma toward people who use drugs that is central to American drug policy, and made it a go-to feature of their overall defense strategy, as Keefe explains:

What Purdue should do, [Richard] decreed, was “hammer on the abusers in every way possible.” They are “the culprits,” he declared. “They are reckless criminals.”

Keefe writes that this became the company line “promoted to the outside world, and also to its own workforce.” In an email dated February 1, 2001, Richard Sackler says, “ Abusers aren’t victims. They are the victimizers.” Purdue’s defense has consistently been that the company simply manufactured and sold a legal drug approved by the FDA, and that if anyone is a criminal, it is those who became addicted and “abused” their drug.

The story of Ann Hedonia, the legal secretary at Purdue who researched the memo about recreational OxyContin use, is a study in how the company demeans and discredits those with substance use disorders. In the book, Keefe gives Ann Hedonia the pseudonym Martha West. One day at Purdue’s headquarters in Connecticut, a top lawyer, Howard Udell, noticed West walking around the office with a limp. She told Udell that she suffered from back pain stemming from a car accident. “We got to get you on OxyContin,” Udell told her. Through a referral from Purdue’s medical department, West was connected to a local pain specialist in Connecticut. Eventually, she became addicted to OxyContin, and just as she’d read in the online drug forums, she crushed and snorted her medication for a concentrated dose of oxycodone. 

After 21 years at the company, West was fired for “poor work performance,” and she was escorted out of the building by Security. West tried to sue Purdue, but Purdue fought back, dirty. Purdue lawyers got hold of her medical records and exploited what they viewed as her main weakness: a substance use disorder diagnosis. Purdue lawyers asked, “Was OxyContin not just the latest entry in a litany of substances she had abused?” She was characterized as an unhinged “drug abuser” with no moral or legal ground to stand on.

In press for Empire of Pain, Keefe told The New York Times that he did not set out to write an “opioid crisis book, per se.” After all, the Sacklers are just one family, and a type of family that American capitalism seems routinely to cook up these days. The opioid crisis is a story about the Sacklers, but it is also much bigger than them. It’s not only a story about people overdosing, dying, or becoming addicted to drugs. It’s also a story of how pain is treated in America, and how the American way of government caters to rich corporations while screwing over individuals.

Up until the 1990s, opioids were rarely prescribed long-term for chronic “non-malignant pain.” That is, pain that isn’t caused by cancer. There are a few reasons for this—one is that doctors were correctly being taught that opioids cause physiological dependency in their patients. Another is that the federal government once operated under a spirit of robust regulatory enforcement that did not let pharmaceutical companies release new opioids on the market very easily. Enter the so-called Reagan Revolution, and the fervor for small government that transformed the country. Both parties proceeded to cut budgets and hollow out regulatory agencies across critical sectors, especially pharma and health care. Now free enterprise could flourish, and the rising tide would lift all boats, etc. At the same time, there really was a problem with the undertreatment of pain in this country, though the Sacklers and their drug were maybe the worst solution to it.                                                              

At first, Purdue’s team of scientists and lawyers were aware that the FDA would probably restrict OxyContin solely to the cancer pain market. But Keefe dug up an internal company memo that shows a hidden plan “to expand the use of OxyContin beyond Cancer patients to chronic non-malignant pain.” After its courtship of a former FDA official named Dr. Curtis Wright, Purdue got what it wanted from the federal government: approval of its drug for “moderate to severe pain,” which dramatically expanded the market and reach of OxyContin.  

“This didn’t just ‘happen.’ It was a deftly coordinated, planned event,” Keefe reports Richard Sackler telling his staff after the drug flew through the FDA’s approval process. Whereas other filings can linger for years at the FDA, “this product was approved in eleven months, fourteen days.” Shortly after the approval of OxyContin, Curtis Wright left the FDA and went to work for Purdue Pharma with a first-year compensation package of $400,000.

This story is much bigger than the Sacklers indeed. Without government regulators all too willing to cave to corporate interests, or an industry norm of putting profits ahead of patient health and safety, the Sacklers never would have gotten this far.

Finally, there’s the tragic story of pain patients. While the volume of opioid prescriptions has dropped by 60 percent from their peak in 2011, the number of overdose deaths continues to soar, and not from OxyContin but from much more potent, illicitly manufactured opioids like fentanyl. Just as the Sacklers scapegoated people who suffered addiction, the screws have been tightening on patients suffering from intractable pain. Efforts to dial back opioid prescribing have put pain patients who actually need relief in the crossfire. Things are so bad that academics are now studying a rash of patient suicides related to rapid, often mandatory, opioid tapers. After a Veterans Affairs doctor abruptly cut off a military veteran from opioids he was using to manage chronic pain, the vet shot himself in the VA parking lot . As in many projects about the opioid crisis, stories of pain patients tend to be an afterthought. Empire of Pain focuses much more on Sackler family dirt and addiction than the plight of pain patients today who, as Brian Goldstone reported in Harper’s , view themselves as “refugees” of the opioid crisis.

Keefe’s book is ultimately an important record of private greed facilitated by a corrupted government. The book’s conclusion is somewhat open-ended. The Sacklers have proposed to settle all pending litigation against them by coughing up some $4 billion . It remains unclear if that deal will be the end of their story. But one thing that’s certain after reading Keefe’s book is that between an ever-growing death toll from overdose deaths and a generation of pain patients left to fend for themselves, much more than lawsuits and money is needed to get America out of this painful nightmare.

Zachary Siegel is a writer based in Chicago. His work has appeared in The New York Times Magazine, The Atlantic, Slate, and Wired, among others.

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Book review: Scathing chronicle of the Sackler family, opioids and greed

"Empire of Pain: The Secret History of the Sackler Dynasty"

Author: Rodrick Radden Keefe

Doubleday, 452 pages, $32.50

If you think this story is simply about drugs the Sackler family foisted upon the public, you are wrong. It’s also about insatiable greed and lies on many fronts. Long before Mortimer and Raymond Sackler came up with OxyContin — older brother Arthur had died by then, they were involved with the tranquilizers Valium, Librium and many other meds. They assured users none had any side effects. There were plenty. Side effects were reported by 27 percent of the users.

The brothers Sackler, mostly Arthur, the oldest, controlled the drugs from beginning to end, including the advertising. In the early 1900s, the family, father Isaac (from the Austrian Empire), and mother Sophie, (from Poland), landed in New York City, set up a modest grocery store and dabbled unsuccessfully in real estate. They eventually had three sons who went through medical school. Years later, in 1996, OxyContin became known as an opioid pain killer connected with Purdue Pharma, a drug manufacturing company. The pain relief drug brought in $35 billion dollars in the late '90s. It also caused more than 450 million deaths. To date people have filed in excess of 2,500 lawsuits.

In “Empire of Pain,” author Rodrick Keefe has written a fascinating, scrupulously researched biography of this family. Even though there are no photographs, the author, who won awards for “Say Nothing,” his true story about “Murder and Memory in Northern Ireland,” lets you visualize the family through his deft writing. You feel you know these brothers: Arthur, the entrepreneurial workaholic, Mortimer, the philanderer and extroverted middle child with a mania for travel, and Raymond, the youngest and perhaps least ambitious, but still fascinating. The aggressive sales reps were making fortunes and enjoying vacations. They were told they were helping people combat chronic pain of all types, not just cancer. Purdue touted it as a “revolutionary” drug.

The launch of OxyContin in 1996 occurred during a blizzard in the Northeast, an interesting coincidence with the blizzard of prescriptions that followed. (The initial celebration was actually in the West.)

Keefe’s style of writing makes this narrative nonfiction easy to read as the author zooms in on the business side of a story, and then swivels to a profile or two of the more charismatic characters.

As early as the 1960s investigators probed the Sackler headquarters in New York City. The brothers cleverly handled their own public relations and Arthur did not disclose that he was at the head of 20 medical publications. “Sackler” was emblazoned on buildings everywhere. The name has been on dozens of art museums, medical corporations and other buildings in cities around the world, but they somehow managed to be somewhat secretive about their connection with the drugs they created.

Keefe mesmerizes the reader as he recounts the men’s lives. But beyond the profiles of the brothers, you come to know the marketing firms that, in the 1950s, had Librium and Valium head-butting one another to be pronounced the best tranquilizer. Valium was called “Penicillin for the Blues.” Arthur Sackler marketed Valium to parents whose youngsters who were afraid of the dark and the adults let the drugs work its magic on their children.

Of the three brothers, it was Arthur, the eldest who amazes. He was juggling many lives and ignoring his children. When one of Arthur’s wives (Marietta) attempts suicide, the event takes on elements of grand opera. When she woke up in the hospital, his first words to her were “How could you do this to me?” Keefe’s attention to detail is impressive.

Forbes listed the Sackler family, at one point, as one of the 20 wealthiest in the U.S., with a net worth of more than $14 billion. Lately, the family name is being chipped off the buildings because of the scandal; some corporations do not want the name associated with their company. Students at Tufts successfully badgered the administration to remove the Sackler name, saying it was offensive with that name on five of its buildings.

Most notably, in the mid-'60s they donated $3.5 million to rebuild the Temple of Dendur at the Metropolitan Museum of Art. It arrived in millions of pieces and was reconstructed from the rubble.

The family was clearly addicted to money. Their father had often warned them their name was more important than money. So far they have lost not only their name, but $225 million of their more than $10 billion. We know the Hippocratic Oath is “First, do no harm.” Keefe tells us a contributor to this book added something to the effect of, “Unless you can make a lot of money.” The family Sackler might consider adopting this as their slogan.

Mims Cushing lives in Ponte Vedra Beach and has written three books.

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Empire of Pain: The Secret History of the Sackler Dynasty Hardcover – April 13, 2021

• Print length 560 pages
• Language English
• Publisher Doubleday
• Publication date April 13, 2021
• Dimensions 6.3 x 1.5 x 9.3 inches
• ISBN-10 0385545681
• ISBN-13 978-0385545686
• See all details

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• Publisher ‏ : ‎ Doubleday; First Edition (April 13, 2021)
• Language ‏ : ‎ English
• Hardcover ‏ : ‎ 560 pages
• ISBN-10 ‏ : ‎ 0385545681
• ISBN-13 ‏ : ‎ 978-0385545686
• Item Weight ‏ : ‎ 1.95 pounds
• Dimensions ‏ : ‎ 6.3 x 1.5 x 9.3 inches
• #6 in Pharmaceutical & Biotechnology Industry (Books)
• #12 in White Collar Crime True Accounts
• #49 in Criminology (Books)

About the author

Patrick radden keefe.

Patrick Radden Keefe is an award-winning staff writer at The New Yorker and the bestselling author of five books, including Empire of Pain: The Secret History of the Sackler Dynasty, which received the Baillie Gifford Prize for Nonfiction and was a finalist for the FT Business Book of the Year, and Say Nothing: A True Story of Murder and Memory in Northern Ireland, which received the National Book Critics Circle Award. His most recent book is Rogues: True Stories of Grifters, Killers, Rebels and Crooks. The recipient of the National Magazine Award for Feature Writing and the Orwell Prize for Political Writing, he is also the creator and host of the 8-part podcast "Wind of Change," about the strange intersection of Cold War espionage and heavy metal music, which was named the #1 podcast of 2020 by Entertainment Weekly and the Guardian and has been downloaded more than 10 million times. He grew up in Boston and now lives in New York.

Customer reviews

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Customers say

Customers find the book very interesting, with important implications for the medical field. They also describe the content as factual, frightening, and distressing. Readers praise the research as incredibly and thoroughly researched. They say the book is well written and easy to follow.

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Customers find the content interesting, amazing, and provides context for actions and decisions. They also say the book provides a thorough account of the Sackler family and the unfortunate fact that the more money you have, the more you lose.

"...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-..." Read more

"...By about mid way through it really started picking up and got very interesting ...." Read more

"...So… interesting and well researched but the author’s bias, and intention to tar the greedy, unlikeable Sacklers with *everything* feels a little too..." Read more

"...so on, but he synthesizes what he’s learned and is thus able to create a strong narrative ...." Read more

Customers find the book well-written, using exactly the right words to tell a story full of sorrow, death, and anger. They also say the events are easy to follow, and the work is well organized and researched.

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

"...It is a long history and a lot of details that the author did a good job summarizing . I would recommend this book to anyone that has a conscious...." Read more

"Very interesting read. Be prepared to learn some new words!!! A very well written , well researched saga of a sad but true telling of how much..." Read more

"...The author does a great job on showing how the family changed overtime and was warped by wealth...." Read more

Customers find the book incredibly and thoroughly researched, detailed, and readable. They also appreciate the smart, resourceful, and energetic person. Readers also mention the book is fantastic journalism that is rare these days.

"...(Arthur, Raymond, and Mortimer), especially Arthur, are admirable in how hardworking they were and how innovative in terms of diversifying into many..." Read more

"...Three Jewish brothers, sons of immigrants, are intelligent , enterprising, and devoted...." Read more

"...This is an incredibly well documented book showing the true damage that unchecked Pharma companies can do on the American populace...." Read more

"...Be prepared to learn some new words!!! A very well written, well researched saga of a sad but true telling of how much power the all might dollar..." Read more

Customers find the emotional tone superb, enlightening, riveting, and well researched. They also say the ending is disturbing but satisfying. Overall, readers describe the book as informative and a thriller that reads like a novel.

"...A heartbreaking read by an amazing author that went above and beyond in researching every aspect of this horrible story of evil all in the pursuit..." Read more

"Informative book that reads like a thriller . Incredible story and informative on the opioid issue in the United States...." Read more

"...how unfettered capitalism contains the seeds of its own destruction: sorrowful ." Read more

"...Extremely informative and well written. And depressing ...." Read more

Customers find the plot riveting, with fascinating arcs woven throughout. They also appreciate the great insights on pharma.

"...This book makes for gripping reading , but even more importantly it highlights the need for criminal prosecution for drug company execs who flout the..." Read more

" Absolutely riveting . I loved it from beginning to end. I would recommend taking a weekend or a day off because I could not put it down" Read more

"I’ve never been a fan of non-fiction, but this book was captivating and surprises you at every turn of the page. I will recommend this book to anyone." Read more

"Absolutely worth reading, fascinating arcs woven throughout , great insights on pharma marketing and addiction, of course, but also on the many good..." Read more

Customers have mixed opinions about the detail level of the book. Some find it has just the right amount of detail, while others say it has too much detail.

"...The records are also pretty clear that they lied in their aggressive marketing knowing the pills were addictive..." Read more

"Way too long. Too many extraneous sections and passages . Needs to be culled of at least 150 pages...." Read more

"Great book, read like a novel with just the right amount of detail ...." Read more

"...His biased approach made this book less interesting and less reliable resource of facts about the Sackler family or opioid crisis...." Read more

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Ayesha’s Reviews

Book Review: Empire of Pain by Patrick Radden Keefe

A wonderful tale of a chilling saga that tracks the multi-generational story of the Sackler family, starting with three brothers, Arthur, Raymond and Mortimer, who founded and acquired a group of businesses including Purdue Pharma, the company that created and sells OxyContin - basically, oxycodone - a close relative to heroin. The Sacklers are largely responsible for initiating the opioid crisis in the US that has spread to other countries as well. 

Arthur Sackler began in advertising, working to make Pfizer a household name by getting prominent doctors to hawk their pill as the best. The methods he put in place are commonplace today - the disturbing nexus between advertising, pharmaceutical sales, greed and money.

The family worked hard to ensure that their name became synonymous with philanthropy but was not directly associated with their actual businesses. This obfuscation is at the heart of everything they do. They marketed OxyContin as a painkiller for not just serious pain like cancer, but for “non-malignant” pain and general use, completely failing to publicise the fact that the drug was addictive.

Even the artist, Nan Goldin, became addicted . After rehab, she takes a stand, staging protests with fellow artists and activists at the Sackler Enclave at the Met. Her activism is the seed that got the art and educational institutions to take the Sackler name off their doors and stop accepting their donations.

The book spans rise in sales of OxyContin, the growth of the family’s wealth, the fall of millions of Americans into drug addiction, the revolving doors between FDA officials who should have put the brakes this and the executives at drug companies, how states slowly came together to take the Sacklers to court and how the family has denied all culpability and spared no expense in defending themselves. 

Keefe makes you feel like you’re there in the room as events unfold. He manages timelines beautifully so that even though we’re going back and forth across generations, characters and aspects of this subject, you always know exactly where you are in the story. It’s an eye-opening, thorough and absorbing read.

Currently, the Sacklers look like they will get away with all of this. 

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Patrick Radden Keefe on ‘Empire of Pain’

Keefe discusses his new book about the sackler family and oxycontin, and elisabeth egan talks about joanne tompkins’s debut novel, “what comes after.”.

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Patrick Radden Keefe’s new book, “Empire of Pain,” is a history of the Sacklers, the family behind Purdue Pharma, the creator of the powerful painkiller OxyContin, which became the root of the opioid crisis in the United States. One of the subjects covered in Keefe’s investigative work is what the company knew, and when, as the crisis began to unfold.

“One thing I was able to establish very definitively in the book is that, in fact, there is this paper trail, really starting in 1997, so just a year after the drug is released, of sales reps sending messages back saying, ‘Hey, we’ve got a problem here. People are abusing this drug,’” Keefe says. “And there’s very high-level discussion by senior executives at the company, some of whom subsequently testified under oath that they didn’t know anything about this until early 2000. In terms of the timeline, it’s very hard to reconcile what they have always said publicly and what I was able to substantiate with internal documents.”

Elisabeth Egan, an editor at the Book Review, is on the podcast this week to discuss “What Comes After,” by JoAnne Tompkins, the latest pick for Group Text, our monthly column for readers and book clubs. The novel starts with the deaths of two high school students, and becomes a mystery when we meet Evangeline McKensey, a pregnant 16-year-old with a connection to the dead boys.

“I am the mother of three teenagers, and I’m constantly looking for the book that makes me feel a little better about how little I know about what’s running through my kids’ heads at any given time,” Egan says. “There was something about this book that felt reassuring to me, as strange as that sounds because it begins with this terrible tragedy. But it’s really, actually a book about life.”

Also on this week’s episode, Tina Jordan looks back at Book Review history during this year of its 125th anniversary, and Lauren Christensen and John Williams talk about what they’ve been reading. Pamela Paul is the host.

Here are the books discussed in this week’s “What We’re Reading”:

“Crusoe’s Daughter” by Jane Gardam

“The Secret Lives of Church Ladies” by Deesha Philyaw

“True Grit” by Charles Portis

“Klara and the Sun” by Kazuo Ishiguro

We would love to hear your thoughts about this episode, and about the Book Review’s podcast in general. You can send them to [email protected] .

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Book summary and reviews of Empire of Pain by Patrick Radden Keefe

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Empire of Pain

The Secret History of the Sackler Dynasty

by Patrick Radden Keefe

• Critics' Consensus:
• Genre: History, Current Affairs and Religion
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About this book

Book summary.

A grand, devastating portrait of three generations of the Sackler family, famed for their philanthropy, whose fortune was built by Valium and whose reputation was destroyed by OxyContin.

The history of the Sackler dynasty is rife with drama—baroque personal lives; bitter disputes over estates; fistfights in boardrooms; glittering art collections; Machiavellian courtroom maneuvers; and the calculated use of money to burnish reputations and crush the less powerful. The Sackler name has adorned the walls of many storied institutions—Harvard, the Metropolitan Museum of Art, Oxford, the Louvre. They are one of the richest families in the world, known for their lavish donations to the arts and the sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing a blockbuster painkiller that was the catalyst for the opioid crisis. Empire of Pain begins with the story of three doctor brothers, Raymond, Mortimer and the incalculably energetic Arthur, who weathered the poverty of the Great Depression and appalling anti-Semitism. Working at a barbaric mental institution, Arthur saw a better way and conducted groundbreaking research into drug treatments. He also had a genius for marketing, especially for pharmaceuticals, and bought a small ad firm. Arthur devised the marketing for Valium, and built the first great Sackler fortune. He purchased a drug manufacturer, Purdue Frederick, which would be run by Raymond and Mortimer. The brothers began collecting art, 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. 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.

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Media Reviews

Reader reviews.

"[A] page-turning corporate biography and jaw-dropping condemnation of the Sacklers' amoral disregard for anything save the acquisition of power, privilege, and influence. In Keefe's expert hands, the Sackler family saga becomes an enraging exposé of what happens when utter devotion to the accumulation of wealth is paired with an unscrupulous disregard for human health." - Booklist "An engrossing (and frequently enraging) tale of striving, secrecy and self-delusion….Keefe nimbly guides us through the thicket of family intrigues and betrayals… Even when detailing the most sordid episodes, Keefe's narrative voice is calm and admirably restrained, allowing his prodigious reporting to speak for itself. His portrait of the family is all the more damning for its stark lucidity." - The New York Times "A true tragedy in multiple acts. It is the story of a family that lost its moorings and its morals… Written with novelistic family-dynasty and family-dynamic sweep, Empire of Pain is a pharmaceutical Forsythe Saga , a book that in its way is addictive, with a page-turning forward momentum." -The Boston Globe "A brutal, multigenerational treatment of the Sackler family… Keefe deepens the narrative by tracing the family's ambitions and ruthless methods back to the founding patriarch, Arthur Sackler…His life might be a model for the American dream, if it hadn't arguably laid the foundations for a still-unfolding national tragedy." - NPR.org "[Keefe holds] the family accountable in a way that nobody has quite done before, by telling its story as the saga of a dynasty driven by arrogance, avarice and indifference to mass suffering…. Keefe marshals a large pile of evidence and deploys it with prosecutorial precision. Keefe is a gifted storyteller who excels at capturing personalities." - The Washington Post " Empire of Pain reads like a real-life thriller, a page-turner, a deeply shocking dissection of avarice and calculated callousness… It is the measure of great and fearless investigative writing that it achieves retribution where the law could not….Exhaustively researched and written with grace and gravity, Empire of Pain unpeels a most terrible American scandal. You feel almost guilty for enjoying it so much." - The Times (London) "A scathing — but meticulously reported — takedown of the extended family behind OxyContin, widely believed to be at the root cause of our nation's opioid crisis. It's equal parts juicy society gossip and historical record of how they built their dynasty and eventually pushed Oxy onto the market." - Entertainment Weekly "An air-tight indictment of the family behind the opioid crisis….[an] impressive exposé." - The Los Angeles Times "A damning portrait of the Sacklers, the billionaire clan behind the OxyContin epidemic. If you are someone who engages in this kind of sneaky conduct, the last person you want reporting on you is Keefe….[He] has a knack for crafting lucid, readable descriptions of the sort of arcane business arrangements the Sacklers favored. He is also indefatigable….The Sackler infighting described in Empire of Pain will surely prompt many comparisons to the HBO series Succession." - Slate (One of the Ten Best Books of 2021) "Put simply, this book will make your blood boil…a devastating portrait of a family consumed by greed and unwilling to take the slightest responsibility or show the least sympathy for what it wrought…a highly readable and disturbing narrative." - The New York Times Book Review (cover) "A shocking saga… [a]tour-de-force account… [Keefe] brings to life the obsessive personalities and ferocious energy of some members…The Sacklers emerge as a shameless bunch, but Empire of Pain also poses troubling questions about the US healthcare system that permitted them to flourish." - The Financial Times "Rigorously reported and brilliantly executed Empire of Pain hones in on the family whose company developed, unleashed, and pushed the drug on Americans, pulling in billions of dollars for themselves in the process…This is an important, necessary book." - New York magazine "An engrossing and deeply reported book about the Sackler family...Unlike previous books on the epidemic, Empire of Pain is focused on the wildly rich, ambitious and cutthroat family that built its empire first on medical advertising and later on painkillers. In his hands, their story becomes a great American morality tale about unvarnished greed dressed in ostentatious philanthropy." - Time Magazine, The Best Books of 2021 So Far "I read everything he writes. Every time he writes a book, I read it. Every time he writes an article, I read it … he's a national treasure." - Rachel Maddow, host of MSNBC's "The Rachel Maddow Show" and author of the #1 New York Times bestselling Blowout

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Author Information

Patrick radden keefe.

Patrick Radden Keefe is a staff writer at The New Yorker and the author, most recently, of the New York Times bestseller Say Nothing: A True Story of Murder and Memory in Northern Ireland , which received the National Book Critics Circle Award for Nonfiction, was selected as one of the ten best books of 2019 by The New York Times Book Review, The Washington Post, the Chicago Tribune and The Wall Street Journal, and was named one of the "10 Best Nonfiction Books of the Decade" by Entertainment Weekly. His previous books are The Snakehead and Chatter . His work has been recognized with a Guggenheim Fellowship, the National Magazine Award for Feature Writing and the Orwell Prize for Political Writing. He is also the creator and host of the eight-part podcast Wind of Change .

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