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 length
Cons: The length of the book to some extent
