Living in the UK, there are certain things about the USA which are very alien to me – non-socialized medicine, for example. I was also unaware of the opioid crisis in the States which has led to thousands of deaths from overdoses and the misery of addiction. Much of this can be laid firmly at the door of Purdue Pharmaceutical, inventor and manufacturer of a proprietary version of oxycodone (an opioid narcotic used for pain relief, which is more powerful than morphine), OxyContin. Other drug companies have made and sold powerful pain relieving medication, and maybe also lied about how addictive their products were, but Purdue took it to a whole new level, actively encouraging the prescription of the most powerful versions of their drug, rewarding physicians for promoting its use, and gaslighting patients about how addictive it was.
Empire of Pain, by Patrick Radden Keefe, is the history of the Sackler family, who bought Purdue when it was merely a maker of remedies such as Senokot, and which made them only ordinarily wealthy. The Sackler dynasty started with Arthur, eldest of three brothers, who qualified as a doctor and achieved excellent results treating mental illness before getting into selling ads for other people’s drugs, such as Valium. It’s here that the Purdue traits of lying about how safe and non-addictive drugs are began. Arthur was no longer involved in Purdue when the company began development of OxyContin, having died some years earlier, but Keefe examines his role as influence on the two younger brothers, Mortimer and Raymond, who were, and who became hugely rich from the sales of a drug which was causing such misery to those who took it. None of the Sacklers, in Keefe’s riveting account, took any responsibility for their product, and in fact, while donating hugely to cultural institutions around the world where their name was written large – there are Sackler wings, and Sackler collections, and Sacklers in assorted galleries and museums – were extremely secretive about their ownership and management of the company which made them all so wealthy. They all sound like venal, utterly selfish, corrupt narcissists. At one point, Purdue was worth billions, before the Sacklers started taking all the money out of the business and salting it away overseas to avoid the massive penalties they knew were coming once all the lawsuits against the firm finally succeeded; when the company was declared bankrupt, it was worth only millions.
This was an utterly fascinating book, very readable; horrifying and infuriating in turn: the Sacklers essentially acted like a drug cartel, except their product was legal, and they were enabled by the same sorts of people. You end it hoping for justice, for the Sacklers to lose everything they gained in their dirty business, but all they seems to have lost is their status as philanthropic grandees, with so many of the institutions refusing further gifts and taking down the prominent signage. There were a couple of points where I wished Keefe had gone into a bit more detail – talked to Denise Sackler, for example, Arthur’s daughter, who was alone in disowning the family long before OxyContin, or followed up about the disastrous fire at one of their manufacturing plants – but the whole book is comprehensive and (apparently) rigorously sourced and checked.
It confirms my belief that no-one gets to be a billionaire by being nice: the Sacklers didn’t even try.