Empire of Pain by Patrick Radden Keefe

A spoon overflowing with pills, one of them red, sits above the title where "Empire of Pain" appears in bold red lettering.

By Rebecca W.

According to the U.S. Department of Health and Human Services, in 2019 roughly 48,000 deaths were attributed to synthetic opioid overdose, and more than 10 million people reported abusing prescription opioids. While many of us have heard, for years, reports of the devastating consequences of opioid abuse, one side of this story only recently hitting the media revolves around the Sackler family. In his book Empire of Pain: The Secret History of the Sackler Dynasty, Patrick Radden Keefe takes a pointed look at the Sackler family and their role in the current opioid epidemic. While this book is not the first of its kind, Keefe reports on the family at a time when numerous lawsuits against the family’s company, Purdue Pharma, have brought to light compelling and abundant evidence of the direct impact the family had on the current epidemic and the lack of responsibility the family has taken.

What I found most interesting about this book was Keefe’s decision to devote nearly a third of the book to Arthur Sackler. While the family patriarch could be considered the father of pharmaceutical marketing, he is very much removed, if related at all, to the modern Sackler family and Purdue Pharma. Arthur Sackler, the eldest of three brothers born to immigrant parents in early 20th-century Brooklyn, made a name for himself through his pharmaceutical ad agency’s marketing of the tranquilizing drug Valium (also know as Diazepam). Valium’s creator, Roche, and Sackler made Valium one of the most-prescribed drugs to date, earning a fortune well into the hundreds of thousands in the process. Today, there is a well-established history of abuse and over-prescription of the drug.

While this portion of the book is certainly an interesting read, it does not directly pertain to the current Sackler family machinations, with Arthur’s heir selling shares of the original company to other family members well before the development of the company’s flagship drug, Oxycontin. While an argument can be made that Arthur more or less created the playbook that future Sacklers would use to enhance their empire, I feel there was another reason Keefe devoted such length to Arthur’s story. When reading the story of Arthur’s life, I saw blatant ethical missteps fueled by greed. However, when I began reading about the modern-day Sacklers, I found myself looking back on Arthur’s story, suddenly seeming like a tip-toe over the line of ethical practice. When looking at corruption that deals with billions of dollars, millions of people, and high-level corporate practices, keeping your perspective can be challenging. For me, the knowledge of Arthur’s story, and how my thoughts changed around it throughout the book, helped me maintain my perspective when trying to follow a story with details at a higher level then my understanding.

If you are someone who has followed the story of the Sackler family, recently finished watching ‘Dopesick’, or just learned of the Sacklers, I would highly recommended reading (or, like me, listening) to this book.

Learn more about the Opioid Epidemic in the US and MD here.

Becky is an Adult Instructor and Research Specialist at the HCLS East Columbia Branch who enjoys art and everything science.

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