Empire of Pain: The Secret History of the Sackler Dynasty

Empire of Pain: The Secret History of the Sackler Dynasty

by Patrick Radden Keefe

Narrated by Patrick Radden Keefe

Unabridged — 18 hours, 6 minutes

Empire of Pain: The Secret History of the Sackler Dynasty

Empire of Pain: The Secret History of the Sackler Dynasty

by Patrick Radden Keefe

Narrated by Patrick Radden Keefe

Unabridged — 18 hours, 6 minutes

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Overview

Notes From Your Bookseller

Arthur Sackler, physician, CEO, quasi-journalist and patriarch of Purdue Pharma, by dint of personality, drive and the desire for “having it all,” spawned a pharmaceutical empire — and global scourge — built on greed, indifference, obfuscation and, cloaking it all, privacy. With Say Nothing, Patrick Radden Keefe proved a storyteller extraordinaire.  And, no less, in Empire of Pain, in which Keefe opens a Pandora’s box, a tangle of lies and silence, a cast of vividly memorable characters and a narrative as riveting as any thriller. Unputdownable!

NATIONAL BOOK CRITICS CIRCLE NOMINEE ¿ A NEW YORK TIMES NOTABLE BOOK OF THE YEAR ¿ NEW YORK TIMES BEST SELLER ¿ A grand, devastating portrait of three generations of the Sackler family, famed for their philanthropy, whose fortune was built by Valium and whose reputation was destroyed by OxyContin. From the prize-winning and bestselling author of Say Nothing

The history of the Sackler dynasty is rife with drama-baroque personal lives; bitter disputes over estates; fistfights in boardrooms; glittering art collections; Machiavellian courtroom maneuvers; and the calculated use of money to burnish reputations and crush the less powerful. The Sackler name has adorned the walls of many storied institutions-Harvard, the Metropolitan Museum of Art, Oxford, the Louvre. They are one of the richest families in the world, known for their lavish donations to the arts and the sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing a blockbuster painkiller that was the catalyst for the opioid crisis.

Empire of Pain
begins with the story of three doctor brothers, Raymond, Mortimer and the incalculably energetic Arthur, who weathered the poverty of the Great Depression and appalling anti-Semitism. Working at a barbaric mental institution, Arthur saw a better way and conducted groundbreaking research into drug treatments. He also had a genius for marketing, especially for pharmaceuticals, and bought a small ad firm.

Arthur devised the marketing for Valium, and built the first great Sackler fortune. He purchased a drug manufacturer, Purdue Frederick, which would be run by Raymond and Mortimer. The brothers began collecting art, and wives, and grand residences in exotic locales. Their children and grandchildren grew up in luxury.

Forty years later, Raymond's son Richard ran the family-owned Purdue. The template Arthur Sackler created to sell Valium-co-opting doctors, influencing the FDA, downplaying the drug's addictiveness-was employed to launch a far more potent product: OxyContin. The drug went on to generate some thirty-five billion dollars in revenue, and to launch a public health crisis in which hundreds of thousands would die.

This is the saga of three generations of a single family and the mark they would leave on the world, a tale that moves from the bustling streets of early twentieth-century Brooklyn to the seaside palaces of Greenwich, Connecticut, and Cap d'Antibes to the corridors of power in Washington, D.C.  Empire of Pain chronicles the multiple investigations of the Sacklers and their company, and the scorched-earth legal tactics that the family has used to evade accountability. 

Empire of Pain
is a masterpiece of narrative reporting and writing, exhaustively documented and ferociously compelling. It is a portrait of the excesses of America's second Gilded Age, a study of impunity among the super elite and a relentless investigation of the naked greed and indifference to human suffering that built one of the world's great fortunes.

Editorial Reviews

JUNE 2021 - AudioFile

Accomplished author Patrick Radden Keefe narrates his well-researched and authoritative examination of several generations of the Sackler family and their business affairs. The family is well known both for being philanthropists and for their notoriety in the pharmaceutical industry, specifically with respect to the development and widespread abuse of the prescription pain relievers Valium and OxyContin. Keefe’s narration—measured, evocative, and consistent—employs just the slightest bit of indignation and irony over the health-care crises that have plagued the U.S. due to the potency and powerful addictiveness of these medications. The highly detailed work casts a spotlight on the Sackler-invented approach, begun in the 1950s, of aggressively marketing medications directly to physicians. Keefe’s polished presentation adds to this eye-opening listen. W.A.G. © AudioFile 2021, Portland, Maine

From the Publisher

New York Times Book Review 100 Notable Books of the Year • One of The Washington Post's 10 Best Books of the Year TIME Magazine 100 Must Read Books of 2021 One the Best Books of the Year: NPR, Slate, EW, Boston Globe, Goodreads, The Guardian, Town & Country, BuzzFeed, LitHub, Vulture, and more

Winner of the Baillie Gifford Prize for Non-Fiction
and Finalist for the Baillie Gifford Winner of Winners Award

One of President Obama's Favorite Books of the Year


“An engrossing (and frequently enraging) tale of striving, secrecy and self-delusion….Keefe nimbly guides us through the thicket of family intrigues and betrayals… Even when detailing the most sordid episodes, Keefe’s narrative voice is calm and admirably restrained, allowing his prodigious reporting to speak for itself. His portrait of the family is all the more damning for its stark lucidity.” —Jennifer Szalai, The New York Times
 
“I read everything he writes. Every time he writes a book, I read it. Every time he writes an article, I read it … he’s a national treasure.” —Rachel Maddow, host of MSNBC’s “The Rachel Maddow Show” and author of the #1 New York Times bestselling Blowout

“A true tragedy in multiple acts. It is the story of a family that lost its moorings and its morals… Written with novelistic family-dynasty and family-dynamic sweep, EMPIRE OF PAIN is a pharmaceutical FORSYTHE SAGA, a book that in its way is addictive, with a page-turning forward momentum.”  —David M. Shribman, The Boston Globe
 
“A brutal, multigenerational treatment of the Sackler family… Keefe deepens the narrative by tracing the family's ambitions and ruthless methods back to the founding patriarch, Arthur Sackler…His life might be a model for the American dream, if it hadn't arguably laid the foundations for a still-unfolding national tragedy.”  —Brian Mann, NPR.org
 
“The opioid epidemic has killed nearly half a million Americans over the past two decades. Many of their loved ones, along with public health advocates and experts, believe that one very rich, very famous family has never fully faced the consequences for its role in those deaths. EMPIRE OF PAIN, the explosive new book by journalist Patrick Radden Keefe, is an attempt to change that — to hold the family accountable in a way that nobody has quite done before, by telling its story as the saga of a dynasty driven by arrogance, avarice and indifference to mass suffering…. Keefe marshals a large pile of evidence and deploys it with prosecutorial precision.   Keefe is a gifted storyteller who excels at capturing personalities.” —Jonathan Cohn, The Washington Post

"Keefe has a way of making the inaccessible incredibly digestible, of morphing complex stories into page-turning thrillers, and he's done it again with Empire of Pain…A scathing — but meticulously reported — takedown of the extended family behind OxyContin, widely believed to be at the root cause of our nation's opioid crisis.  It's equal parts juicy society gossip and historical record of how they built their dynasty and eventually pushed Oxy onto the market.”  —Seija Rankin, Entertainment Weekly
 
 “An air-tight indictment of the family behind the opioid crisis….[an] impressive exposé.” —Harriet Ryan, The Los Angeles Times

“A damning portrait of the Sacklers, the billionaire clan behind the OxyContin epidemic. If you are someone who engages in this kind of sneaky conduct, the last person you want reporting on you is Keefe….[He] has a knack for crafting lucid, readable descriptions of the sort of arcane business arrangements the Sacklers favored. He is also indefatigable….The Sackler infighting described in Empire of Pain will surely prompt many comparisons to the HBO series Succession.”Laura Miller, Slate

"One of the Ten Best Books of 2021"
Laura Miller, Slate

“Put simply, this book will make your blood boil….a devastating portrait of a family consumed by greed and unwilling to take the slightest responsibility or show the least sympathy for what it wrought….a highly readable and disturbing narrative.” —John Carreyrou, The New York Times Book Review (cover)
 
“Rigorously reported and brilliantly executed Empire of Pain hones in on the family whose company developed, unleashed, and pushed the drug on Americans, pulling in billions of dollars for themselves in the process….This is an important, necessary book.” - Hillary Kelly, New York magazine

“A shocking saga… [a]tour-de-force account… [Keefe] brings to life the obsessive personalities and ferocious energy of some members…The Sacklers emerge as a shameless bunch, but Empire of Pain also poses troubling questions about the US healthcare system that permitted them to flourish.” —John Gapper, The Financial Times

"Empire of Pain reads like a real-life thriller, a page-turner, a deeply shocking dissection of avarice and calculated callousness… It is the measure of great and fearless investigative writing that it achieves retribution where the law could not….Exhaustively researched and written with grace and gravity, Empire of Pain unpeels a most terrible American scandal. You feel almost guilty for enjoying it so much."  —The Times (London)

"Indefatigable investigative journalist Keefe crafts a page-turning corporate biography and jaw-dropping condemnation of the Sacklers’ amoral disregard for anything save the acquisition of power, privilege, and influence. In Keefe’s expert hands, the Sackler family saga becomes an enraging exposé of what happens when utter devotion to the accumulation of wealth is paired with an unscrupulous disregard for human health." — Carol Haggas, Booklist

“An engrossing and deeply reported book about the Sackler family, the owners of Purdue Pharma. Their company created Oxycontin, the opioid introduced in the mid-90s that sent a wave of addiction and death across the country. Unlike previous books on the epidemic, Empire of Pain is focused on the wildly rich, ambitious and cutthroat family that built its empire first on medical advertising and later on painkillers. In his hands, their story becomes a great American morality tale about unvarnished greed dressed in ostentatious philanthropy.” —Time Magazine, The Best Books of 2021 So Far

JUNE 2021 - AudioFile

Accomplished author Patrick Radden Keefe narrates his well-researched and authoritative examination of several generations of the Sackler family and their business affairs. The family is well known both for being philanthropists and for their notoriety in the pharmaceutical industry, specifically with respect to the development and widespread abuse of the prescription pain relievers Valium and OxyContin. Keefe’s narration—measured, evocative, and consistent—employs just the slightest bit of indignation and irony over the health-care crises that have plagued the U.S. due to the potency and powerful addictiveness of these medications. The highly detailed work casts a spotlight on the Sackler-invented approach, begun in the 1950s, of aggressively marketing medications directly to physicians. Keefe’s polished presentation adds to this eye-opening listen. W.A.G. © AudioFile 2021, Portland, Maine

Kirkus Reviews

★ 2021-04-13
Richly researched account of the Sackler pharmaceutical dynasty, agents of the opioid-addiction epidemic that plagues us today.

In his latest excellent book, Keefe opens in a conference room packed with lawyers, all there to depose “a woman in her early seventies, a medical doctor, though she had never actually practiced medicine.” Kathe Sackler, thanks to the invention of a drug called OxyContin, was a member of one of the wealthiest families in the world, holding some $14 billion. The founder of that dynasty had established numerous patterns that held for generations. Though he had insisted that family philanthropy be prominently credited “through elaborate ‘naming rights’ contracts,” the family name would not extend to their pharmaceutical company, Purdue Pharma. The family would also not accept responsibility for any untoward effects that its products might have. Thus, when asked whether she acknowledged that hundreds of thousands of Americans had become addicted to OxyContin, Kathe answered, “I don’t know the answer to that.” Keefe turns up plenty of answers, including the details of how the Sacklers—the first generation of three brothers, followed by their children and grandchildren—marketed their goods, beginning with “ethical drugs” (as distinct from illegal ones) to treat mental illness, Librium and then Valium, which were effectively the same thing but were advertised as treating different maladies: “If Librium was the cure for ‘anxiety,’ Valium should be prescribed for ‘psychic tension.’ ” By Keefe’s reckoning, by the mid-1970s, Valium was being prescribed 60 million times per year, resulting in fantastic profits for Purdue. OxyContin followed in 1996—and then the opioid crisis, responsibility for which has been heavily litigated and for which the Sacklers finally filed bankruptcy even though they “remained one of the wealthiest families in the United States.” Of particular interest is the book-closing account of the Sacklers’ legal efforts to intimidate the author as he tried to make his way through the “fog of collective denial” that shrouded them.

A definitive, damning, urgent tale of overweening avarice at tremendous cost to society.

Product Details

BN ID: 2940172791130
Publisher: Penguin Random House
Publication date: 04/13/2021
Edition description: Unabridged
Sales rank: 689,325

Read an Excerpt

Chapter 1

A Good Name

Arthur Sackler was born in Brooklyn, in the summer of 1913, at a moment when Brooklyn was burgeoning with wave upon wave of immigrants from the Old World, new faces every day, the unfamiliar music of new tongues on the street corners, new buildings going up left and right to house and employ these new arrivals, and everywhere this giddy, bounding sense of becoming. As the firstborn child of immigrants himself, Arthur came to share the dreams and ambitions of that generation of new Americans, to understand their energy and their hunger. He vibrated with it, practically from the cradle. He was born Abraham but would cast off that old-world name in favor of the more squarely American-sounding Arthur. There’s a photo, taken in 1915 or 1916, of Arthur as a toddler, sitting upright in a patch of grass while his mother, Sophie, reclines behind him like a lioness. Sophie is dark-haired, dark-eyed, and formidable. Arthur stares straight at the camera, a cherub in short pants, his ears sticking out, his eyes steady and preternaturally serious, as though he already knows the score.

Sophie Greenberg had emigrated from Poland just a few years earlier. She was a teenager when she arrived in Brooklyn in 1906 and met a mild-mannered man nearly twenty years her senior named Isaac Sackler. Isaac was an immigrant himself, from Galicia, in what was then still the Austrian Empire; he had come to New York with his parents and siblings, arriving on a ship in 1904. Isaac was a proud man. He was descended from a line of rabbis who had fled Spain for central Europe during the Inquisition, and now he and his young bride would build a new beachhead in New York. Isaac went into business with his brother, operating a small grocery store at 83 Montrose Avenue in Williamsburg. They called it Sackler Bros. The family lived in an apartment in the building. Three years after Arthur was born, Isaac and Sophie had a second boy, Mortimer, and four years after that, a third, Raymond. Arthur was devoted to his little brothers and fiercely protective of them. For a time, when they were small, all three brothers shared a bed.

Isaac did well enough in the grocery business that the family soon moved to Flatbush. A bustling neighborhood that felt like the heart of the borough, Flatbush was considered middle class, even upper middle class, compared with the far reaches of immigrant Brooklyn, like Brownsville and Canarsie. Real estate was the great benchmark in New York, even then, and the new address signified that Isaac Sackler had made something of himself in the New World, achieving a degree of stability. Flatbush felt like a place you graduated to, with tree-lined streets and solid, spacious apartments. One of Arthur’s contemporaries went so far as to remark that to Brooklyn Jews of that era it could seem that other Jews who lived in Flatbush were “practically Gentiles.” With his earnings from the grocery business, Isaac invested in real estate, purchasing tenement buildings and renting out apartments. But Isaac and Sophie had dreams for Arthur and his brothers, dreams that stretched beyond Flatbush, beyond even Brooklyn. They had a sense of providence. They wanted the Sackler brothers to leave their mark on the world.

If Arthur would later seem to have lived more lives than anyone else could possibly squeeze into one lifetime, it helped that he had an early start. He began working when he was still a boy, assisting his father in the grocery store. From an early age, he evinced a set of qualities that would propel and shape his life—​a singular vigor, a roving intelligence, an inexhaustible ambition. Sophie was clever, but not educated. At seventeen she had gone to work in a garment factory, and she would never fully master written English. Isaac and Sophie spoke Yiddish at home, but they encouraged their sons to assimilate. They kept kosher, but rarely attended synagogue. Sophie’s parents lived with the family, and there was a sense, not uncommon in any immigrant enclave, that all the accumulated hopes and aspirations of the older generations would now be invested in these American-born kids. Arthur in particular felt the weight of those expectations: he was the pioneer, the firstborn American son, and everyone staked their dreams on him.

The vehicle for achieving those dreams would be education. One fall day in 1925, Artie Sackler (he went by Artie) arrived at Erasmus Hall High School on Flatbush Avenue. He was young for his class—​he had just turned twelve—having tested into a special accelerated program for bright students. Artie was not one to be easily cowed, but Erasmus was an intimidating institution. Built by the Dutch in the eighteenth century, the original structure was a two-story wooden schoolhouse. In the first years of the twentieth century, the school expanded, around that ancient schoolhouse, to include a quadrangle in the style of Oxford University with castle-like neo-Gothic buildings clad in ivy and adorned with gargoyles. This expansion was designed to accommodate the great surge of immigrant children in Brooklyn. The faculty and students at Erasmus saw themselves as occupying the vanguard of the American experiment and took the notion of upward mobility and assimilation seriously, providing a first-class public education. The school had science labs and taught Latin and Greek. Some of the teachers had PhDs.

But Erasmus was also enormous. With some eight thousand students, it was one of the biggest high schools in the country, and most of the students were just like Arthur Sackler—the eager offspring of recent immigrants, children of the Roaring Twenties, their eyes bright, their hair pomaded to a sheen. They surged into the corridors, the boys dressed in suits and red ties, the girls in dresses with red ribbons in their hair. When they met under the great vaulted entrance arch during the lunch hour, it looked, in the words of one of Arthur’s classmates, like a “Hollywood cocktail party.”

Arthur loved it. In history class, he found that he admired and related to the Founding Fathers, and particularly Thomas Jefferson. Like Jefferson, Artie had eclectic interests—art, science, literature, history, sports, business; he wanted to do everything—and Erasmus put a great emphasis on extracurriculars. There must have been a hundred clubs, a club for practically everything. On a late afternoon in winter, when classes had ended for the day and dark had fallen, the whole school was lit up, windows blazing around the quad, and as you walked the corridors, you would hear the sounds of one club or another being convened: “Mr. Chairman! Point of order!”

In later life, when he spoke of these early years at Erasmus, Arthur would talk about “the big dream.” Erasmus was a great stone temple to American meritocracy, and most of the time it seemed that the only practical limitation on what he could expect to get out of life would be what he was personally prepared to put into it. Sophie would prod him about school: “Did you ask a good question today?” Arthur had grown up to be gangly and broad-shouldered, with a square face, blond hair, and eyes that were blue and nearsighted. He had tremendous stamina, and he needed it. In addition to his studies, he joined the student newspaper as an editor and found an opening in the school’s publishing office, selling advertising for school publications. Rather than accept a standard pay arrangement, Arthur proposed that he receive a small commission on any ad sale he made. The administration agreed, and soon Arthur was making money.

This was a lesson he learned early, one that would inform his later life in important ways: Arthur Sackler liked to bet on himself, going to great lengths in order to devise a scheme in which his own formidable energies might be rewarded. Nor was he content with the one job. He set up a business to handle photography for the school yearbook. After selling advertising space to Drake Business Schools, a chain specializing in postsecondary clerical education, he proposed to the company that they make him—​a high school student—their advertising manager. And they did.

His inexhaustible gusto and restless creativity were such that he always seemed to be fizzing with new innovations and ideas. Erasmus issued “program cards” and other pieces of humdrum curricular paperwork to its eight thousand students. Why not sell advertising on the back of them? What if Drake Business Schools paid for rulers branded with the company name and issued them to Erasmus students for free? By the time Arthur was fifteen, he was bringing in enough money from these various hustles to help support his family. He was accumulating new jobs more quickly than he could work them, so he started to hand some of them off to his brother Morty. Initially, Arthur felt that Ray, as the youngest, shouldn’t have to work. “Let the kid enjoy himself,” he would say. But eventually, Ray took jobs, too. Arthur arranged for his brothers to sell advertising for The Dutchman, the student magazine at Erasmus. They persuaded Chesterfield cigarettes to run ads aimed at their fellow students. This generated a nice commission.

For all of its orientation toward the future, Erasmus also had a vivid connection to the past. Some of the Founding Fathers whom Artie Sackler so revered had been supporters of the school he now attended: Alexander Hamilton, Aaron Burr, and John Jay had contributed funds to Erasmus. The school was named after the fifteenth-century Dutch scholar Desiderius Erasmus, and in the library a stained-glass window celebrated scenes from his life. The window had been completed just a few years before Arthur arrived, dedicated to “the great man whose name we have carried for a hundred and twenty-four years.” Each day, Arthur and his fellow students were inculcated with the idea that they would eventually take their place in a long line of great Americans, a continuous line that stretched back to the country’s founding. It didn’t matter that they lived in cramped quarters or wore the same threadbare suit every day, or that their parents spoke a different language. This country was theirs for the taking, and in the span of a single lifetime true greatness could be achieved. They spent their days at Erasmus surrounded by traces of great men who had come before, images and names, legacies etched in stone.

In the center of the quad, the ramshackle old Dutch schoolhouse still stood, a relic of a time when this part of Brooklyn had all been farmland. When the wind blew in the wintertime, the wooden beams of the old building would creak, and Arthur’s classmates joked that it was the ghost of Virgil, groaning at the sound of his beautiful Latin verses being recited in a Brooklyn accent.

Arthur’s hyperactive productivity in these years might have stemmed in part from anxiety: while he was at Erasmus, his father’s fortunes began to slip. Some of the real estate investments went bad, and the Sacklers were forced to move into cheaper lodging. Isaac bought a shoe shop on Grand Street, but it failed and ended up closing. Having sold the grocery in order to finance his real estate investments, Isaac was now reduced to taking a low-paying job behind the counter at someone else’s grocery store, just to pay the bills.

Arthur would later recall that during these years, he was often cold but never hungry. Erasmus had an employment agency to help students find work outside school, and Arthur began to take on additional jobs to support the family. He got a newspaper route. He delivered flowers. He didn’t have time to date or attend summer camp or go to parties. He worked. It would become a point of pride for him that he never took a holiday until he was twenty-five years old.

Even so, in stray moments, Arthur glimpsed another world—​a life beyond his existence in Brooklyn, a different life, which seemed close enough to touch. From time to time, he would take a break from his frenetic schedule and trot up the stone steps of the Brooklyn Museum, through the grove of Ionic columns and into the vast halls, where he would marvel at the artworks on display. Sometimes, his delivery jobs would take him into Manhattan, all the way uptown to the gilded palaces of Park Avenue. At Christmas, he would deliver great bouquets of flowers, and as he walked along the broad avenues, he would peer through brightly lit windows into the apartments and see the twinkle of Christmas lights inside. He loved the sensation, as he entered a big doorman building, his arms full of flowers, of stepping off the frigid sidewalk and getting enveloped in the velvet warmth of the lobby.

When the Great Depression hit in 1929, Isaac Sackler’s misfortune intensified. All of his money had been tied up in his tenement properties, and now they were worthless: he lost what little he had. On the streets of Flatbush, forlorn-looking men and women joined breadlines. The employment agency at Erasmus started accepting applications not just from students but from their parents. One day, Isaac called his three sons together. With a defiant flash of the old family pride, he informed them that he would not be going bankrupt. He had marshaled his meager resources responsibly and had at least been able to pay his bills. But he had nothing left. Isaac and Sophie desperately wanted their sons to continue their education—​to go to college, to keep climbing the ladder, to do everything that a young man with ambition in America was supposed to do. But Isaac did not have the money to pay for it. If the Sackler boys were going to get an education, they would have to finance it themselves.

It must have been painful for Isaac to say this. But he insisted that he had not given his children nothing. On the contrary, he had bestowed upon them something more valuable than money. “What I have given you is the most important thing a father can give,” Isaac told Arthur, Mortimer, and Raymond. What he had given them, he said, was “a good name.”

When Arthur and his brothers were children, Sophie Sackler would check to see if they were sick by kissing them on the forehead to take their temperature with her lips. Sophie had a more dynamic and assertive personality than her husband and a very clear sense, from the time that her children were little, of what she wanted for them in life: she wanted them to be doctors.

“By the time I was four, I knew that I was going to be a physician,” Arthur later said. “My parents brainwashed me about being a doctor.” Both Sophie and Isaac regarded medicine as a noble profession. During the nineteenth century, many doctors had been perceived as snake oil salesmen or quacks.

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