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The American dynasty behind OxyContin

Patrick Radden Keefe in Larchmont, New York, March 24, 2021. (Photo: NYTimes)
What’s in a name? Apparently plenty for the members of the Sackler family, who plastered their surname on prestigious galleries and institutions while taking care to keep the source of their riches under wraps.اضافة اعلان

For years, their company Purdue Pharma had been in the news for creating OxyContin — the powerful painkiller whose introduction in 1996 ushered in a new era of both pain management and opioid addiction — while the Sackler name remained better known for philanthropy than for pharmaceuticals.

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.”

Many books about the opioid crisis have been published in recent years, including Beth Macy’s “Dopesick” and Sam Quinones’ “Dreamland.” Back in 2003, New York Times reporter Barry Meier released “Pain Killer,” a meticulous indictment of Purdue Pharma that compared the narcotic power of OxyContin to a “nuclear weapon.”

In “Empire of Pain,” Keefe sets out to do something different, tracing the fortunes of the family dynasty at the center of it all. What starts out as a humble origin story in 1913 — the year of Arthur Sackler’s birth in Brooklyn, New York, to immigrants from Central Europe — becomes an engrossing (and frequently enraging) tale of striving, secrecy and self-delusion.

Keefe is a staff writer for The New Yorker whose previous book, “Say Nothing,” depicted the code of silence that clung to the Troubles in Northern Ireland. “Empire of Pain” recounts how another code of silence did its work, obscuring complicity and deflecting guilt.

The first third of the book revolves around Arthur, who fulfilled his immigrant parents’ dreams by becoming a doctor. But as someone who had juggled multiple jobs in high school, Arthur was never content to just practice medicine. He tried his hand at pharmaceutical advertising and turned out to be extremely good at it. One of his inspired creations was a weekly paper for doctors called The Medical Tribune, which featured articles that were favorable to his advertising clients. He liked to stay behind the scenes and “do things the way I want to do them.” Arthur’s imprint on the paper was everywhere, Keefe writes, but initially “his name could not be found anywhere on the masthead.”

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.

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.

It was Raymond’s son Richard who would push Purdue into the field of pain management. Keefe portrays Richard as ambitious, arrogant and almost comically impatient. One of Purdue’s reliable if unglamorous bestsellers was a laxative; a restless Richard leaned on his staff to “get it to work more quickly.”

But OxyContin was different. Its innovation resided in its time-release coating, intended to slow down delivery of its chief ingredient, oxycodone — an opioid twice as potent as morphine, even if physicians back then were mostly unfamiliar with the name and assumed it was weaker. Purdue decided it wouldn’t correct this misapprehension; instead, the company instructed its salespeople to target family physicians, whom the company called “opioid naïve.”

Last month, the Sacklers offered to pay $4.275 billion from their personal fortune in an attempt to end thousands of lawsuits that have been filed against the company. Whether their bid is accepted remains to be seen.

Needless to say, Keefe, who wrote about the Sacklers for The New Yorker in 2017, didn’t get the family to cooperate with this book, but in a note he recalls receiving a thumb drive that was mailed to him anonymously and included thousands of pages of documents.

He sifted through 40 boxes of files from congressional investigations into the pharmaceuticals industry in the late 50s and early 60s. He interviewed dozens of former Purdue employees.