You’ve probably seen the name Sackler on the walls of the Met, or maybe at Oxford or the Louvre. For decades, that name was synonymous with the kind of high-society philanthropy that buys a certain brand of immortality. But then Patrick Radden Keefe released Empire of Pain, and the gilded mask didn’t just slip—it shattered.
This isn't a dry business history. It’s a multi-generational Greek tragedy with more villains than heroes. Honestly, if you pick up the Empire of Pain book, you aren't just reading about a pharmaceutical company. You are reading about how three brothers—Arthur, Mortimer, and Raymond—built a dynasty on the back of aggressive marketing and a pill that changed the world for all the wrong reasons. It’s a story about greed, sure. But more than that, it’s about the terrifying power of a family that refused to admit they were wrong, even as the bodies started piling up.
The Man Who Invented the Playbook
The story starts way before OxyContin. We have to talk about Arthur Sackler. He was the eldest. A psychiatrist by trade but a marketing genius by instinct, Arthur basically invented the way drugs are sold to doctors today.
He didn't just want doctors to know about a drug; he wanted to saturate their reality. He bought medical journals. He created "impartial" institutes that were actually just mouthpieces for his products. When Valium became the first $100 million drug, that was Arthur’s handiwork. He realized that if you could convince a doctor that a drug was the solution to a specific "syndrome"—like, say, "psychic tension"—you could sell it to everyone. He was a polymath, a collector of Chinese art, and a man who believed his own hype.
Arthur died before OxyContin was even a glimmer in a chemist's eye, but his fingerprints are all over the disaster. He left behind a blueprint for his brothers and their children: sell the solution, minimize the risk, and never, ever put your own name on the product.
The Birth of the "Blockbuster" Narcotic
By the 1990s, Purdue Pharma (the family business) was looking for a hit. They had MS Contin, a morphine pill for cancer patients, but the patent was running out. They needed something new. Something big.
Enter OxyContin.
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The brilliance—and the horror—of OxyContin was the marketing claim that it was less addictive than other painkillers because of its "time-release" coating. Keefe details this beautifully in the Empire of Pain book. The Sacklers and Purdue executives knew that the "delayed absorption" was their golden ticket. They told doctors that the risk of addiction was "less than one percent."
They didn't have a study to prove that. They just said it.
And doctors, overworked and desperate to help patients in pain, believed them. Purdue sent out a literal army of sales reps. These weren't scientists; they were charismatic recruiters armed with swag, steak dinners, and charts that looked official but were often misleading. They targeted "high prescribers"—doctors in rural areas where manual labor led to chronic back pain. They turned a niche medication for terminal cancer into a daily pill for a twisted ankle.
Richard Sackler and the Culture of Denial
If Arthur was the architect, Richard Sackler was the general. Richard is the central figure of the middle section of the book, and he is a fascinatingly cold character. He was obsessed with the success of OxyContin. He pushed the sales team to be more aggressive, more relentless.
When reports started coming in from places like Maine and West Virginia that people were crushing the pills to get high, Richard’s response wasn't concern. It was blame.
He wrote in internal emails that the "abusers" were the problem. They were "criminals." To the Sacklers, the drug was perfect; the people were broken. This refusal to acknowledge the reality of the pill's formulation is what makes the Empire of Pain book so infuriating to read. Even when the FDA started sniffing around, Purdue managed to navigate the bureaucracy with the help of former regulators who they later hired. It was a revolving door of influence that kept the money flowing while the opioid crisis began to swallow entire communities.
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Why This Book Hits Differently Than a News Report
You can read a Wikipedia entry about the opioid crisis, but Keefe does something different. He gets into the rooms. He uses internal memos, depositions, and private letters to show the sheer banality of the evil involved.
There’s a specific kind of chilling detail in the book—like the family's obsession with their "legacy" and their name being etched in stone at the world's finest museums, even as they fought tooth and nail in court to avoid paying settlements. They weren't just protecting their money; they were protecting their myth.
The Breakdown of the Sackler Strategy
- Infiltration: They didn't just sell drugs; they funded the chairs at universities that taught how to treat pain.
- The "Special" FDA Label: They got a unique label from the FDA that suggested the time-release formula reduced abuse potential. This was the "holy grail" of their marketing.
- Aggressive Litigation: Anyone who sued them was met with a scorched-earth legal defense. They had the best lawyers money could buy, and they used them to bully journalists and whistleblowers.
The Fall (Sort Of)
The later chapters of the book cover the reckoning. We see the rise of activists like Nan Goldin, a famous photographer and survivor of OxyContin addiction, who led protests inside the very museums that displayed the Sackler name.
These weren't just "protests." They were theatrical shaming rituals. They threw pill bottles into the reflecting pools of the Temple of Dendur. They made the Sackler name toxic.
Eventually, the legal walls closed in. Purdue Pharma filed for bankruptcy. The family was forced to give up the company and pay billions. But here is the kicker, and why Keefe's work is so vital: the Sacklers themselves remains fabulously wealthy. They moved money into offshore accounts years before the hammer fell. They traded the company for legal immunity.
What Most People Get Wrong About the Story
A lot of folks think this is just a story about "drug dealers in suits." That’s too simple.
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It’s actually a story about the failure of American institutions. The FDA failed. Congress failed. The medical establishment failed. The Sacklers didn't just break the rules; they used the rules to build a fortress. They found the loopholes, they bought the influence, and they stayed within the "legal" lines for an incredibly long time.
The Empire of Pain book forces you to confront the fact that our system is remarkably easy to game if you have enough capital and a complete lack of shame.
The Lasting Impact of the Empire of Pain Book
If you're looking for a happy ending, you won't find it here. The opioid crisis is still happening. Fentanyl has taken the place of prescription pills, but the path was paved by OxyContin.
However, the book did achieve something massive. It changed the public record. The Sackler name has been removed from the Met, from the Louvre, and from dozens of other institutions. They are no longer "great philanthropists." They are the family behind the worst public health crisis in a generation.
Actionable Takeaways for the Conscious Reader
Reading this book shouldn't just leave you angry. It should make you a more critical consumer of healthcare and information.
- Question "New" Medical Narratives: When a drug is marketed as having "no side effects" or being "non-addictive," look for the independent data. If the studies are funded by the manufacturer, take them with a massive grain of salt.
- Follow the Money in Philanthropy: We often celebrate large donations without asking where the money came from. Support investigative journalism like Keefe's, which digs into the origins of "prestige" wealth.
- Advocate for Regulatory Reform: The "revolving door" between the FDA and big pharma is a documented issue. Supporting policies that create a "cooling off" period for regulators before they can work for the companies they used to oversee is a practical step toward preventing the next Purdue.
- Support Local Recovery Efforts: Since the Sackler settlements are often tied up in complex bankruptcy courts, local addiction services remain underfunded. Direct your own charitable giving to grassroots organizations dealing with the fallout of the opioid epidemic in your own town.
The story of the Sacklers is a reminder that history isn't just a list of dates. It's a series of choices made by people in rooms. And as long as those people believe they can hide behind a name, books like this will be the only way to hold them to account.