This is an absolutely fascinating work of family history, that just happens to also be a searing indictment of that family’s contribution to the opioid crisis.
The first chunk of this book details the origins of the Sackler family. In some ways, it’s a truly American success story: the three brothers, Arthur, Mortimer, and Raymond, were the children of immigrants. All became doctors. The three brothers purchased a small pharmaceutical company in the early 1950’s (Purdue Pharma), which Mortimer and Raymond mostly ran while Arthur split time between doctoring and pharmaceutical advertising. Entrepreneurship! Bootstrapping!
But if you caught that little crossover between pharmaceuticals and pharmaceutical advertising, you’d be well on your way to discovering the rot at the center of this family. As the Sacklers made their millions, they wanted nothing more than legitimacy, entrée into the old-money circles of New York. The Sackler name was plastered on museums (the Egyptian wing of the Met, the Smithsonian’s Asian Art Museum) and Universities (the medical school at Tufts, NYU medical center). This is a family who wanted more money, and desperately wanted more status. The next generation picked up the reins and continued down the same path. Although this section of the book can feel a bit long, understanding the family dynamics and their motivations is critical for understanding what happened next.
In 1996, Perdue Pharma introduced OxyContin. Oxycodone was not new to the market, but what was new was the time-release coating. The idea is that patients could now manage their pain at home – a revolution for those suffering from chronic or severe pain. The problem comes down to one main factor: there was always the possibility of abuse (all you have to do is crush the pill to bypass the time-release mechanism), the family knew it, and they pushed it anyway, either minimizing or outright lying about the potential for abuse. As Keefe points out, in one of his most damning observations, Perdue got paid for every pill, whether or not that pill was later sold in the secondary market, or even stolen from pharmacies.
This is truly a stunning and infuriating work of investigative journalism, and should be required reading for, well, everyone.