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Empire of Pain summary

Name: Empire of Pain
Rating: 4.6 (53 reviews)
Author: Patrick Radden Keefe

Patrick Radden Keefe

The Secret History of the Sackler Dynasty

4.6 (53 ratings)

19 mins

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Empire of Pain
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What’s in it for me? Discover the rise and fall of America’s most controversial family.

On his deathbed, Isaac Sackler apologized to his three sons for not leaving them much inheritance. But there was one thing he was proud to pass on: his good name. You can always rebuild your fortune, he liked to say, but lose your good name and you cannot get it back.

His sons–Arthur, Mortimer and Raymond Sackler–would go on to build a vast fortune, making them one of the richest families in America. Their name adorned some of the world’s finest institutions: Harvard and Oxford Universities, the Guggenheim, the Louvre.

What eluded so many, even friends and associates, was how the family built all that wealth. But in due course, the public would come to understand.

In 1996, a new opiate painkiller entered the market called OxyContin. Its manufacturer, Purdue Pharma, claimed that it not only relieved pain, but was also safe.

Then reports began to surface of communities in devastation. Thousands had become addicted to OxyContin. On the black market, an 80 mg pill was selling for as much as $80. Lives were upended. Some turned to other opiates like heroin. Many people died.

Purdue Pharma was owned by the Sacklers. As OxyContin made the family billions of dollars each year, it was catalyzing an unprecedented opioid crisis.

Documents later revealed that the Sacklers knew about the drug’s addictive qualities, and yet aggressively marketed encouraging physicians to prescribe OxyContin for mild pain, and to increase the dosage.

Eventually, many institutions started to remove the Sackler name from their buildings. This is the story of how the family lost their good name, while managing to keep billions.

Chapter 1: Arthur and his kid brothers.

From a young age, Arthur Sackler was a hustler. In high school he worked for the school paper where he sold ads on commission. He had so many side gigs that he had to give some over to his younger brothers, Mortimer and Raymond.

He kept it up in college, too, graduating in the middle of the Great Depression with enough money to buy his parents a grocery store in Brooklyn. He then enrolled in medical school at NYU and took a full course load while maintaining extracurriculars and several jobs.

After med school, Arthur would work all day at a state psychiatric hospital, and then spend evenings and weekends working for a medical advertising agency, called William McAdams. Arthur quickly scaled the ranks there. He was named President after just two years, and eventually bought the firm.

Being a doctor himself, Arthur’s ad campaigns appealed directly to physicians. He placed them in medical journals, and sent literature to doctors’ offices. He also enlisted prominent doctors, and sometimes fake ones, to sell his products. Over his career, Arthur would transform pharmaceutical advertising–colleagues claimed he really invented the wheel.

One drug in particular helped make Arthur rich. His advertising campaigns for Valium, a minor tranquilizer produced by the company Roche, focused on convincing physicians to prescribe it for just about any ailment, major or minor. For years it was the most prescribed drug in America.

Mortimer and Raymond would also become doctors. Still, Arthur couldn’t stop thinking of them as his kid brothers.

He would get them both jobs at the psychiatric hospital (where he continued to work). The three of them would eventually start a research center there that explored drug treatment options that could replace shock therapy and lobotomies, which were standard practices at the time.

Then in 1952, Arthur decided to purchase a pharmaceutical company for his kid brothers. It was a tiny company, but it had a good, patrician name: Purdue Frederick.

Chapter 2: The Sacklers build a dynasty.

Purdue Frederick’s mainstay products–a laxative, and an ear wax remover–were by no means glamorous. But by the mid-1960s, the company was making the Sackler brothers very rich.

The three owned equal shares, but Arthur had his advertising agency to run, so he left Mortimer and Raymond in charge of day-to-day management.

Chapter 3: What’s in a name?

The Met in New York City is one of the most important institutions of art in the world. To have your name adorned there, say on a collection or a room, is to enter a new strata of New York high society. But Arthur Sackler already had his massive personal collection of Chinese art sitting in the Met’s Sackler Gallery. He wanted something bigger, more befitting of his name.

The Sackler Wing opened in 1978, and it was an impressive space. One wall was a tower of glass, and there was a large reflecting pool surrounding the relocated ruins of an ancient Egyptian temple.

Chapter 4: The next generation assumes the mantle.

Arthur Sackler died in 1987. Given his many heirs (two ex-wives, a widow, and four children), as well as his secrecy, and the brothers’ entangled business affairs, settling the estate was a nasty and long process. His heirs eventually sold their third of Purdue Frederick. But after Arthur’s death, a large rift opened between all three families.

Within Purdue, Mortimer’s side represented the A shares, and Raymond’s the B shares. The two families would sit at opposite ends of the boardroom table, and many meetings erupted into shouting matches and the occasional brawl.

Chapter 5: The painkiller to start with and stay with.

The first hurdle Purdue had to overcome was the FDA. They skirted around the regulator before with the release of MS Contin. This time, the man to target was Curtis Wright, who oversaw pain medication approvals. While Purdue and the FDA went back and forth on the details of the label for months, Purdue developed a cozy relationship with Wright.

Just how cozy? Not long after OxyContin was approved in record time, Wright left the FDA and secured a $400,000 annual salary working at Purdue Pharma.

Chapter 6: The making of a crisis.

In 2000, the federal prosecutor for Maine, Jay McCloskey, sent out thousands of letters to physicians across the state warning them about the dangers of OxyContin. At that point, Maine was in a full blown opioid crisis. And it wasn’t the only state.

Purdue’s lawyer, Howard Udell, would later argue in court that McCloskey’s letter was the first time they’d heard about widespread abuse of the drug. But this was a lie.

Chapter 7: The tarnished billionaires.

It was quiet in the Guggenheim Museum that evening. The large, spiraled atrium was filled with its usual whispers and foot steps. Then suddenly, squares of paper started raining down from the top floor. Banners unfolded along the balconies that read, “Shame on Sackler.”

The protest was organized by famed photographer Nan Goldin, whose own works hung in the museum. It was the beginning of massive public pressure on institutions to remove the Sackler name from their walls.

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What is Empire of Pain about?

Empire of Pain (2021) follows the rise and fall of the elusive Sacklers, the billionaire family behind Purdue Pharma. Its blockbuster drug, OxyContin, was aggressively marketed as safe, but would go on to spur a devastating opioid crisis that claimed hundreds of thousands of lives. Yet the Sacklers’ fortress of lawyers, political connections and a philanthropic name would, time and again, protect them from responsibility.

Who should read Empire of Pain?

Current affairs enthusiasts
Lovers of family dynasty dramas
Anyone wanting to understand the opioid crisis

About the Author

Patrick Radden Keefe is an award winning journalist and staff writer at The New Yorker. In 2014 he received the National Magazine Award for Feature Writing. He has written several books, including the previous bestseller Say Nothing (2018).

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