Empire of Pain: The Secret History of the Sackler Dynasty

This is the third such book that I have read in the last couple of years, the other two being “The Billion Dollar Loser” on WeWork and on Adam Neumann and “Bad Blood” on Theranos and on Elizabeth Holmes. While the first is about a business built on hubris and the second about a complete fraud, “The Empire of Pain” was the most shocking of the three. It is about a legitimate business that was extremely successful but one that was built using several unethical means and one that ultimately caused the death of thousands of Americans.The book traces the history of the Sackler family and of Purdue Pharma, starting with the early years of Arthur , Mortimer and Raymond Sackler, children of an immigrant family in New York. Their parents desired their sons to become doctors, given the perceived nobleness of the profession, which turns out ironic given the later history of the family. The first section traces the lives and the initial wealth creation of the three brothers, especially that of Arthur. It gives an insight into their ambiguous views on integrity around medical products and conflicts of interest and their desire to be recognised as a leading family in the country. The second section is about the rise of OxyContin as a majorly profitable drug for Purdue, the issue of widespread addiction caused by it and Purdue’s attempts to fight the hundreds of legal cases. The final session is about the third generation and the eventual fall of the company. The book is extremely well-researched and written in a way that makes it interesting reading despite the subject matter and the length of the book.The Sackler empire was built on Roche’s Librium and Valium, especially the latter. By the time Valium was controlled, it was used by 20 million Americans and became the most widely consumed — and abused — prescription drug. The second generation of Sacklers multiplied that wealth with OxyContin.It could be argued that OxyContin was a legal drug, approved by the FDA, but the fact was that America did not have an opioid crisis before the drug’s introduction. It is also clear that the company was aware of the problem for a long time but chose to ignore it for selfish reasons. And its usage of its legal teams, influential government representatives, threats and otherwise Machiavellian methods to thwart any attempts to stop it is simply shocking. The lack of oversight by government institutions is particularly galling — as Keefe puts it, “the opioid industry is, among other things, a parable about the awesome capability of private industry to subvert public institutions”.As I write this review, the Sackler family appears to have got away with it. They have had to pay billions of dollars as penalties, have had to give up their stake in Purdue Pharma and have to bear the ignominy of seeing their family name stripped away from many of their philanthropic attempts. However, they still have several billions of dollars of wealth created by the opioid crisis, have had no criminal charges against them and seem to have procured immunity against future legal liabilities. And that’s indeed a pity!Pros: Extremely well researched, the narrative style makes it an interesting read despite its lengthCons: The length of the book to some extent

Hats off to the author for pulling this off! The book is marvelous in all respects, fantastic research, great narration and most importantly, for having the spine to call out the extent to which greed can take over. It's a pity that the Sackler family got away without losing anything (more or less).And in general, history will make us shamefully look back at how we allow(ed) large scale white collar crimes and criminals to go scot free..

This *outstanding* book by Patrick Keefe is special for me 'coz it amplifies:- the moral challenge entrepreneurs have to 'do right' at the cost of losing millions and alternatively succumbing to self-satisfying excuses that eventually harm people. (In my case, the resolve is NOT to build "real money mobile games" that addict people).This book is a masterpiece! Why:- Apart from "Red Notice" (reviewed by me), it's the only other book I've read that mentions real-life threats to the author's life (implying the deep impact).- An critical story to learn - as a business grows, the hard choice becomes choosing between morals or profits. In this case, the sheer immorality of the entrepreneurs is staggering.- Deep entrepreneurial insights. How a 'right and left brain' combination (knowledge of medicine and marketing acumen) help companies scale. An ability we must all inculcate.- A deep, important lesson - what is 'legally' right does not mean it's good to go. What is 'morally' right is more important.- How money can buy anything (fame, status, prestige). Indicating that the most glorified institutions of the world are always up for sale.- Life can turn at any moment. "during the Depression, there were doctors in Brooklyn who were reduced to selling apples on the street."- Case study of the birth of 'native' advertising- The dark world of vested interests - 'Philanthropy wasn’t charity, as his lawyer Michael Sonnenreich insisted. It was a business deal."- Chronicles of obsessive behaviour to control outcomes “They were putting pressure on the White House,” the executive said."- The business of professional bribery - "A 2016 study found that purchasing even a single meal with a value of $20 for a physician can be enough to change the way that he prescribes."A MUST Buy and read.

Total must-read for everyone who enjoys non-fiction books and even remotely interested in the opioid crisis of USA. Fantastic writing!

The book chronicles the wrong doings of Sackler family, how they escaped the law by hiring powerful attorneys, in the end they have blood on their hands.

Lengthy but worth a read. Tell you about opioid epidemic. As a doctor it’s very eye opening to know how Pharma works

Read this and Dreamland by Sam Quinone to get a complete picture of Opioid menace Human Greed, High level corruption in US underestimating the intelligence of poor in developing countries, perils of Capitalism

very well researched and written bookEnjoyed reading itGo for itIt is worth the money

Best book I have read for ages, not much to add to the five stars reviews here. Investigative journalism and stylish writing of the highest order.

I first read “Chatter” several years ago so when I came across “Say Nothing” I was keen to read more by this author. Several other reads later I searched to find the author again. Having read about the opioid epidemic and the Sackler family in the news, I was pleased to find this book. Once again I was impressed not only with the writing but with the thoroughness of the research!

This was a fascinating read on a subjectI had looked at in a minor way before.This book is super detailed about the Oxy-Contin/Opioid scandal in the USA and beyond. Clever marketing by the Sackler family made them billions in a comparitively short time, whilst killing more 'pain sufferers' than all post WW11casualties..

Having previously read, "Say Nothing: A True Story of Murder and Memory in Northern ireland," by Patrick Radden Keefe, and having seen that this title, "Empire of Pain," had won the Baillie Gifford Prize for Non-Fiction (my favourite book award), this was a must-read for me.I had read, and seen, various news stories on the opiod crisis in the US, but I knew very little of the Sackler family. This book combines the story of the the opiod crisis, the history of pain management, the mass marketing of opiods and a family history of the Sackler family. However, Patrick Radden Keefe is an excellent writer and so do not be put off by thinking this will be overly complicated or rely too much on medical jargon. The author makes this easy to understand, without dumbing down his writing, and tells a fascinating story of the three generations of the Sackler family, through ambition, philanthropy, and huge wealth, into greed, shame, seemingly endless litigation and blaming the family personally and naming them in Court.Although I found the entire book gripping, I must admit that I was most fascinated by the first generation, that of three brothers, Arthur, Montgomery and Raymond Sackler. Arthur's ambition, his desire for wealth and respectability, his drive for success, no matter what the cost, was a portrait of utter greed and naked ambition. The shameless marketing of drugs, with no thought of the cost to users, the later blaming of patients for becoming addicted was utterly shocking. The author compares this blaming of those addicted to drugs by the company, by those who insist that individuals should be able to own guns. It is not the gun who kills people, it is people who kill people. It is not the painkiller that kills people, it is people misusing the drug that kills people. Perhaps, anyone reading this, will be inspired to now tackle the horrific amount of gun crime in the US and realise that this spurious argument is nothing less than a lie in both cases.

The history of this family and their disregard for anyone but themselves left me speechless