Book Review : ‘Empire of Pain,’ by Patrick Radden Keefe


  • Book Review: ‘Empire of Pain,’ by Patrick Radden Keefe - The New York Times

    Taking cover under complexity has been a common strategy for tobacco companies and big oil — entities that have profited from disaster while seeking ways to avoid any moral opprobrium and expensive accountability. But even the most elaborately complex phenomena can still have relatively simple beginnings, a kernel that requires only the ingenuity and ruthlessness of people who are ready to exploit it.

    Since 1996, 450,000 Americans have died from opioid overdoses, making them the leading cause of accidental death in the country. In “Empire of Pain,” Patrick Radden Keefe tells the story of how the Sackler family became a decisive force in a national tragedy. “Prior to the introduction of OxyContin, America did not have an opioid crisis,” Keefe writes. “After the introduction of OxyContin, it did.”

    Throughout his career, Arthur maintained that he wasn’t trying to influence physicians, just to “educate” them. Among his biggest triumphs as an adman was the marketing of the tranquilizers Librium and Valium, beginning in the 1960s. The drugs’ manufacturer, Roche, insisted they weren’t addictive — even though the company had evidence showing they were. Once the patents on the tranquilizers were about to expire, Roche finally relented to government controls. By then, 20 million Americans were taking Valium, and Arthur was rich. “The original House of Sackler was built on Valium,” Keefe writes, but Arthur would spend the rest of his life trying to downplay the connection.
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    Keefe nimbly guides us through the thicket of family intrigues and betrayals — how Arthur purchased the patent medicine company Purdue Frederick for his brothers, Mortimer and Raymond, in 1952, before he grew apart from them; and how Arthur’s heirs sold their shares to the surviving brothers after he died in 1987. Arthur’s descendants have tried to distance themselves from their cousins, protesting that they weren’t involved in the creation of OxyContin, but Keefe suggests they can’t get away from Purdue’s origin story. Arthur had created a fortune and a template.

    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.

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