Empire of Pain: The Secret History of the Sackler Dynasty

man what a deep, detailed dive into the sackler dynasty. really well reported and well written. super long, but warranted and does not miss a note.

I really admire the author for writing this novel and trying to not be bias towards either aspect in such a strong emotional case. Having watched Dopesick and Painkiller (TV series), I received interesting perspectives on the opioid crisis and how it affected the patients, the doctors, the police, the media, the pharmaceutical salesmen, and the dark creepy big Pharma. BUT this book, gives another light into Purdue Pharma and the Sackler family. I wouldn't say you read it to humanize them or feel any sympathy, but more as a business case study or as a psychology trial session. It will definitely bring feelings of triggered emotions to see what they get away with, especially as this is a drug and drug effects still occurring today.

A thorough, well-researched history of the Sackler family and their role in the opioid epidemic. At times the book felt long-winded (it's almost 700 pages) and I was impatient to get to the more recent history that I was already familiar with, but upon conclusion of the book, it's evident that all of the background builds a well-rounded picture of the family and its dynamics.

Wow. This book was so many things for me - compelling, fascinating, educational, depressing, and unsatisfying... I hate not having a happy ending, and there is no happy ending with this book and the situation created by the Sacklers and oxycodone. I am normally a fiction reader, but my book club picked this book based on rave reviews by one of the book club members who promised it read more like a fiction book. I wholeheartedly agree with this, as I couldn't put the book down. (discussion questions are at the end of my review) The author starts at the very beginning of the dynasty creation, with three brothers who grew up in the depression from immigrant parents who wanted their kids to be MORE, to make something of themselves and make their name mean something. They become doctors and while working at a horrible mental institution, decide they want to find better ways to treat pain and illness through medicine. Ironically, they experiment on patients at the institute without asking for permission, but naturally they justify this through ground breaking treatments for the mentally disturbed. The most active brother, Arthur, creates valium and a brilliant marketing plan for pushing the drug. This template is used through three generations of Sacklers, and allows the Sacklers to hide behind shell companies and take no responsibility for the opioid crisis they created when they unleashed Oxycontin in the US, then the world. The author does a great job bringing these people to life, and explaining possible motivations and viewpoints of multiple people involved in this story. I had only a vague understanding of the opioid crisis when i started this book, so it was fascinating how the author tied together how one family - the Sacklers - used underhanded marketing tactics, politics, and money to become powerful and wealthy philanthropists while creating a deadly and addictive narcotic that caused so much death and pain. Using fake propaganda, bribery, the promise of money and future high paying jobs, the brothers convinced the country the drugs were safe to use with no chance of addiction. Paraphrasing the family line, they claimed that "we are helping people in pain. We can't help it if some predisposed addicts abuse the drug because it is SAFE for people in pain". The author connected how oxycontin led to the heroin and then fentanyl crisis of the last couple of decades. To read about how many people in government positions, medical fields and lawyers were able to twist the law and bribe / lie / deny what was going on for centuries is very depressing and makes one's stomach sour. SPOILER: Worse, even though the Sacklers and the Perdue Pharma company go to court and the company goes bankrupt, it leaves a bitter tasting ending because it feels like the family got away with everything. They never had to be accountable to the health crisis they created, and they never lost their personal family money. Their "good" name disappeared, but that, to me was cold satisfaction. It certainly will make me question "expert" opinions more - and I thought i was already cynical enough. "The opioid crisis is, among other things a parable about the awesome capability of private industry to subvert public institutions. " (pg 364) This should be a very meaty book club discussion. 1. At the beginning of the story it talks about Arthur, Raymond and Mortimers childhood. How do you think this impacted the path they took? 2. What do you think the brother’s purpose of starting a research facility with a focus on the chemicals of the brain? 3. The Sackler money came from advertising pharmaceuticals for Pfizer—this was a start of something new? How do you think this has changed the industry? What are the positives and the negatives? 4. Mortimer worked for a company in England who developed the time release— Do you feel it is safe to create such drugs for people to take on their own? 5. Getting FDA approval for most people means it, the product, is safe. How does this book change your opinion on the FDA’s approval? 6. Do you think all drugs should undergo a drug trial before released? If so for how long? 7. There was a suggestion in the book that the FDA rep who approved the “new label” type for oxycontin was promised a job with Purdue—Do you consider this appropriate? If not how is this preventable? 8. Creating an LLC makes all member only partially liable for their actions they take in their business. Purdue Pharma was an LP and unlike an LLC it only protects limited partners. What is your opinion on this type of federal classification? Why do you think Purdue opted for only an LP instead of an LLC? 9. This book discussed the attorneys and the ability for them to flip frequently from private practice to state or government practice. Why do you feel the author places emphasis on this fact? 10. Do you feel Oxycontin should be removed from production? Explain your answer. 11. Should the Sackler name be removed from the schools, museums etc.… 12. What type of punishment should each of the Sackler’s face? Who do you feel is the most to blame?

Narrative nonfiction at its best.