You’ve probably seen the name on the walls of the Met, or maybe carved into the stone at Yale or Oxford. For decades, the Sackler name was synonymous with the kind of high-society philanthropy that buys a certain brand of immortality. But that changed. Fast. Now, when people talk about the Empire of Pain, they aren't talking about a dynasty of art collectors; they’re talking about the architectural blueprint of the American opioid crisis.
It’s a story about a family that figured out how to market a pill like it was a soft drink.
Most people think the opioid epidemic started because of "bad actors" or street dealers. That’s a massive oversimplification. To really understand what happened, you have to look at the intersection of aggressive pharmaceutical marketing and a systemic failure of oversight. Patrick Radden Keefe’s exhaustive reporting on this subject basically stripped away the veneer of the Sackler family’s "legitimate" business, Purdue Pharma, and showed the world how the machinery actually worked. It wasn't just a mistake. It was a strategy.
The Marketing Machine Behind OxyContin
Let’s be real: before 1996, doctors were terrified of prescribing strong opioids for anything other than terminal cancer or end-of-life care. They knew the history. They knew about morphine. They knew about the potential for addiction.
Then came OxyContin.
Arthur Sackler, the patriarch who actually died before OxyContin was released, was the one who pioneered the medical advertising techniques that would later be used to sell it. He realized that to sell a drug, you don't just pitch the medicine; you pitch the idea of the medicine to the people writing the checks. Purdue Pharma took this and ran with it. They didn't just tell doctors the drug was good. They flooded the zone. They hired thousands of sales reps. They gave out branded fishing hats and swing-o-meters. They even created "educational" videos that claimed the risk of addiction was "less than one percent."
That statistic? It was based on a single, five-sentence letter to the editor in the New England Journal of Medicine from 1980. It wasn't a peer-reviewed study. It wasn't a clinical trial. But Purdue’s sales force used it as the gospel truth.
The brilliance—if you can call it that—was in the "delayed absorption" claim. Because the pill was designed to release the oxycodone over twelve hours, the company argued it wouldn't create a "high." But users quickly figured out that if you just crushed the pill, you could bypass the time-release mechanism entirely. It became a concentrated dose of pure narcotics. Internal documents later showed that Purdue knew about this "vulnerability" almost immediately, yet they kept pushing the "less addictive" narrative for years.
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More Than Just a Business Move
Why did it work so well?
Money. Obviously. But also, it was about data. Purdue Pharma was one of the first companies to use sophisticated "prescriber profiles." They knew exactly which doctors were prescribing the most painkillers in every zip code in America. They targeted the "whales." They focused on primary care physicians who didn't have the specialized training of pain management experts but were dealing with patients complaining of chronic back pain or arthritis.
It’s honestly chilling to look back at the memos. Richard Sackler, at one point, suggested that the company should "hammer on the abusers" to deflect blame from the drug itself. The strategy was simple: blame the "addicts" for being weak, rather than the drug for being inherently dangerous or the company for misrepresenting its safety.
The Breakdown of Regulation
You might be wondering: where was the FDA?
This is the part that drives people crazy. Curtis Wright, the FDA examiner who oversaw the approval of OxyContin, left the agency shortly after and, within two years, took a high-paying job at Purdue Pharma. While there’s no "smoking gun" prove a quid pro quo, the optics are, to put it mildly, terrible. It highlights the "revolving door" between regulators and the industries they are supposed to police.
The label for OxyContin was unique. It actually stated that the delayed absorption "is believed to reduce the abuse liability of a drug." That phrasing—"is believed to"—is doing a lot of heavy lifting. It wasn't a fact. It was a belief. And that belief paved the way for billions of dollars in sales while a public health catastrophe brewed in the background.
The Legal Fallback and the Bankruptcy Shield
Eventually, the chickens came home to roost. Thousands of lawsuits were filed by states, cities, and tribes. But the Empire of Pain didn't just crumble; it tried to restructure itself out of existence.
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Purdue Pharma filed for Chapter 11 bankruptcy. This is where the story gets legally dense and incredibly frustrating for the victims. The Sacklers themselves—the individuals—didn't file for bankruptcy. Only the company did. However, as part of the settlement, the family sought "third-party releases." Basically, they wanted to pay a few billion dollars in exchange for permanent immunity from all future civil lawsuits related to the opioid crisis.
For a long time, it looked like they were going to get away with it.
The Supreme Court eventually stepped in. In June 2024, in a 5-4 decision, the court ruled that the bankruptcy code does not allow for this kind of "non-consensual" release of claims against non-debtors (the family members). It was a massive blow to the Sackler strategy. It meant that while the $6 billion settlement was put on ice, the shield of immunity was also gone.
Why We Are Still Talking About This
The damage is done. You can't undo the last 20 years.
Since the late 90s, over half a million people in the U.S. have died from opioid-related overdoses. While the crisis has shifted toward illicit fentanyl, the "on-ramp" for many was a prescription bottle. When the government finally cracked down on "pill mills" and over-prescribing, people who were already physically dependent on opioids didn't just stop. They turned to the black market.
It’s a cycle.
The legacy of the Empire of Pain isn't just a legal case or a book title. It’s the total erosion of trust in the medical establishment. It’s why people are skeptical of new drugs. It’s why doctors are now, in some cases, so afraid to prescribe pain medication that patients with legitimate, agonizing conditions can’t get the help they need. The pendulum swung from "pills for everyone" to "pills for almost no one," and both extremes have victims.
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Real-World Accountability
If you want to see the impact, look at the "Sackler" name being scrubbed from buildings.
- The Louvre was one of the first to remove the name from its galleries.
- The British Museum followed suit.
- The Metropolitan Museum of Art in New York finally took the name off the Sackler Wing in 2021.
This "reputational laundering" through art was a core part of the family strategy for generations. By giving away a fraction of their profits to prestigious institutions, they bought a level of social immunity that lasted for decades. Seeing those names come down is a form of justice, even if it doesn't bring anyone back.
Practical Takeaways and Moving Forward
So, what do we actually do with this information? Understanding the history of the Empire of Pain isn't just about being angry at a wealthy family. It’s about recognizing the systemic flaws that allowed it to happen so we can stop the next one.
- Question the "Non-Addictive" Label: Whenever a new class of drugs is marketed as a "miracle" with no side effects, be skeptical. History shows that pharma companies often downplay risks to capture market share.
- Advocate for Transparency: The "revolving door" between the FDA and big pharma needs more than just a side-eye; it needs legislative reform. Support policies that require a "cooling off" period for regulators before they can work for the companies they used to oversee.
- Support Harm Reduction: The crisis is here. We need to focus on things like Naloxone (Narcan) access, Medication-Assisted Treatment (MAT), and destigmatizing addiction. The "blame the addict" strategy from the 90s didn't work then, and it doesn't work now.
- Monitor the Legal Precedents: The Supreme Court ruling on the Purdue bankruptcy is a landmark. It prevents wealthy individuals from using corporate bankruptcy as a personal get-out-of-jail-free card. Keep an eye on how this affects other mass tort cases, like those involving talc or forever chemicals.
The story of the Sacklers is a reminder that in the world of big business, "pain" is a commodity. And when profit is tied to the volume of a drug sold rather than the health of the patient, the results are predictably devastating.
Stay informed about the medications you are prescribed. Ask your doctor about the long-term dependency risks of any new treatment. Look into the data yourself on sites like ProPublica’s "Dollars for Docs" to see if your physician is receiving payments from pharmaceutical companies. Knowledge is the only real defense against a system designed to prioritize the bottom line over the person.
To keep up with the ongoing litigation and the distribution of settlement funds to affected communities, follow the updates from the National Association of Attorneys General (NAAG). They track how the billions in settlement money are being spent—ensuring it actually goes toward treatment and prevention rather than just filling state budget holes. This is the final chapter of the saga: making sure the money from the Empire of Pain is actually used to heal it.
The most important step is recognizing that this wasn't an accident of nature. It was a man-made disaster. By understanding the mechanics of how it happened—the marketing, the lobbying, and the regulatory failures—we are better equipped to protect our families and our communities from the next "miracle" drug that seems a little too good to be true.
Demand better from the agencies that are supposed to protect us. Support the journalists who dig through the archives to find the truth. And most importantly, remember that behind every statistic in this crisis is a human being whose life was changed by a pill that was sold as a solution but became a prison. Through vigilance and continued pressure on the legal system, we can ensure that the legacy of this era is one of reform rather than just more pain.