If you have not seen it yet, I highly recommend you watch the TV miniseries Dopesick. It is about the opioid crisis in the US and how it was started by one family, the Sackler family, the owners of Purdue Pharma which is the maker of Oxycontin. Dopesick the TV show is based on Dopesick the book by Beth Macy. I decided to read Patrick Radden Keefe’s book Empire of Pain instead because it came out just last year and has been well received, and its focus is on the Sackler family rather than the opioid crisis in general. I was curious to know what has made the Sackler family so ruthlessly greedy that they do not care at all that they have caused the deaths of hundreds of thousands of people in the US alone since Oxycontin was introduced in 1996.

No members of Sackler family were interviewed for Keefe’s book; all the Sacklers have said is that everything in the book is “false”. Empire of Pain is amazingly well research, and Keefe had access to millions of documents from the lawsuits against Purdue Pharma (seriously, nearly every US state has filed suit against Purdue and some states have even filed suits against the Sacklers personally), which included personal correspondence and depositions of various Sackler family members. Keefe personally interviewed hundreds of people for this book, including people who know the Sacklers and former employees of Purdue. This is as close as we are going to get to getting into the Sacklers own minds, because they are likely to never voluntarily talk about Oxycontin and the opioid crisis.

Empire of Pain begins with the history of Arthur Sackler, who made the Sackler millions that enabled the next generation to make the Sackler billions. Arthur was hardworking and enterprising, often working multiple jobs in order to support his parents, put himself through medical school and even put his younger brothers, Mortimer and Raymond, through medical school as well. Arthur was driven to be successful like his father was (before his father failed and lost his businesses) and he was driven to prove that he was worthy in the face of anti-Semitism. Pretty inspiring stuff, until you learn that Arthur made his millions by running an advertising company for pharmaceuticals and used shady practices (which would be emulated by the next generation of Sacklers when marketing Oxycontin) like inventing fictional doctors to recommend drugs, because Arthur worked on a commission basis, so the more the drugs that were sold, the more money he made.

For a long time, people did not know where the Sacklers got their money from, they just knew that the Sacklers were rich and were generous with their money. Arthur became a millionaire off marketing Valium, and he was generous with his money, but for a price. He made donations to all kinds of institutions, in exchange for having a wing or a building named after the Sacklers. The reputation of the Sackler name was very important to him.

Arthur used his money to buy his brothers, Mortimer and Raymond, a pharmaceutical company called Purdue Frederick (later Purdue Pharma). Purdue was never a major player in the pharmaceutical industry; it made mere millions off products like Senokot (the laxative). Raymond’s son, Richard Sackler, was the one who turned Purdue into a billion-dollar company with Oxycontin (although Kathe Sackler, one of Mortimer’s daughters, argues that Oxycontin was actually her idea). Richard employed the Sackler shady business practices to market Oxycontin to doctors and pharmacies as an opioid that provided pain relief for up to twelve hours, which meant that patients would take less of it (even though Purdue knew through testing that Oxycontin did not last twelve hours for some patients), and as an opioid that was less addictive, with addiction occurring in less than one percent of patients (this was absolutely false; Purdue had no data to support this. Where they actually got this percentage from is a wild story).

The Sackler family has been described as “the most evil family in the world”. I agree with this sentiment. What kind of people continue to push sales of a drug that they know is addictive and kills people? What kind of people milk billions of dollars out of an opioid crisis to fund their lavish lifestyles and donate money to give themselves an aura of respectability? If they are so proud of their product, then why did they hide their connections to Purdue Pharma? Why hasn’t a single member of the Sackler family that was involved in Oxycontin or benefited from Oxycontin come out and admit what they did was wrong and apologize for it?

Empire of Pain is quite simply a story of a greedy family that does not give a shit about anyone but themselves, a family that leveraged their billions to escape the consequences of the opioid crisis for so long, until recent events, and even still they are trying to escape from personal liability. Empire of Pain is equal parts fascinating and infuriating. I am gleeful knowing that the Sackler name is shit now (Arthur must be rolling over in his grave). I really do recommend you read this book, but if you are not so inclined, then at least watch Dopesick.