Empire of Pain: The Secret History of the Sackler Dynasty

Synopsis: Buckle up for a deep dive into the story of the Sackler family and their privately held pharmaceutical company Purdue. Patrick Radden Keefe presents a rigorously researched, and meticulously reported account of the origins of the Sackler fortune and the family’s role in the opioid epidemic which has cost nearly a half million American lives. The story begins with three physician brothers, Arthur, Mortimer and Raymond. Arthur in particular had a knack for advertising and promotion, and combined ownership of an advertising agency AND the purchase of a small pharmaceutical company called Purdue Frederick. He made his first fortune on the marketing of Valium, and the brothers started collecting art, wives, and lavish homes in exotic locales. Philanthropy led to the Sackler name on the walls of many prestigious institutions: Harvard, the Metropolitan Museum of Art, and the Louvre. The Sacklers then used the template created to sell Valium to produce and market a far more potent product, Oxycontin. The family pursued a strategy of co-opting doctors, influencing the FDA and downplaying the drug’s addictiveness to create a blockbuster drug that made billions of dollars for the family. Unfortunately, it also launched a public health crisis leading to a different kind of pain—addiction, death and the destruction of hundreds of thousands of lives.

Review: This was a long book that was compelling from start to finish. It’s a credit to Radden Keefe’s reporting and writing that he takes a complicated story that could have been quite dry, and turns it into a thriller. Be prepared to feel anger, outrage, and disgust. Prior to the introduction of Oxycontin, opioids were largely restricted to the treatment of pain related to cancer. This changed with Purdue’s relentless and aggressive promotion of Oxycontin as a nonaddictive solution to chronic pain of all types. Couple this aggressive marketing with regulatory agencies that looked the other way, and Oxycontin became a juggernaut that made the Sacklers one of the richest families in America. The Sacklers were not the first people to market unsafe pharmaceuticals to vulnerable populations, but they might have been the best. There’s plenty of culpability to go around here, including unscrupulous doctors, the FDA, and a Department of Justice willing to let them off the hook. Still, what is so nauseating is the complete indifference of the Sackler family to the devastation their product was spreading across America. They had their own addiction to money, power and influence, and that trumped all. As the final insult, the family has methodically siphoned millions, if not billions of dollars out of the company into offshore accounts leaving an empty husk of a corporation to declare bankruptcy. There will likely be no accountability. This was a fascinating, well written and compulsive read. Highly recommended.

Rating: 5/5

Recipe: I’m aware that there is a cocktail called the Painkiller, but that seemed like too obvious a choice. In fact, I question whether a painkiller cocktail might actually lead to a headache! So I’m opting for a pain fighting dish incorporating salmon, ginger and turmeric, all known for their anti-inflammatory properties.

Salmon with Ginger and turmeric

1/2 pound broccoli cut into florets

1/2 pound cauliflower, cut into florets

3/4 cup water

3 tablespoons vegetable oil

1 medium onion, thinly sliced

1 1/2 tablespoons minced fresh ginger

salt and pepper

1/4 teaspoon turmeric

1/2 cup unsweetened coconut milk

4 6 ounce salmon filets

1) In a deep skillet, simmer the broccoli and cauliflower, covered in 1/2 cup of water for 3 minutes, then transfer to a bowl.

2) in the skillet, heat 3 tablespoons of oil, add the onion and ginger, season with salt and pepper. Cook over moderate heat about 8 minutes until golden. Add the turmeric and cook until fragrant. Add the coconut milk and remaining water and bring to a simmer. Stir in the vegetables, cover and remove from the heat.

3) Heat a grill pan. Season the salmon with salt and pepper and grill salmon, skin side down until crisp, about 4 minutes. Turn and grill until cooked through, 2 minutes longer.

4) Serve the salmon over a bed of vegetables.