Empire of Pain by Patrick Radden Keefe

Book Review

Wow wow wow. This book is truly a masterpiece of investigative journalism.

Empire of Pain chronicles three generations of the Sackler family and their legacy. From Arthur Sackler revolutionizing the marketing of pharmaceuticals and founding Purdue Fredrick (later renamed Purdue Pharma), to Richard Sackler introducing OxyContin and effectively starting to opioid crisis, to the most recent generation struggling to escape the stigma attached to their family name after countless lawsuits, hundreds of thousands of overdose deaths attributed to the drug created by their family’s company and the continued refusal to admit any wrongdoing… This book packs a serious punch.

The book is split into three parts based on the three generations. While I enjoyed learning about Arthur Sackler and his generation, I found the second generation the most fascinating (and evil).

A few interesting takeaways from the book:

—Prior to the release of OxyContin, opioids were only used in extreme pain circumstances (like cancer and end of life treatment). However, with the introduction of OxyContin, which Purdue Pharma (fraudulently) claimed was far addictive than traditional opioids (one of their main selling points was that only 1% of users become addicted…which was based on no actual evidence), physicians began prescribing OxyContin for moderate pain - thereby leading to whole communities becoming addicted to the drug.

—Despite the more than 450,000 opioid overdose deaths, the Sackler family has managed to evade any personal legal repercussions. How? By employing high powered attorneys, lobbying/bribing government agencies/officials and funneling all liability through their company, Purdue Pharma (which has since declared bankruptcy).

—The heroin epidemic, which began in 2010, started largely due to the reformulation of OxyContin (making it harder to abuse). 4 out of 5 heroin users started on prescription painkillers.

—More Americans have died of opioid overdoses than in all the wars since WW2.

While this is a long and dense read, it’s also thrilling, infuriating, educational and incredibly well-done. This is a book I will no doubt be recommending for years to come.

⭐️⭐️⭐️⭐️⭐️/5