Reviews with content warning for Chronic illness - Empire of Pain: The Secret History of the Sackler Dynasty

Reviews tagging 'Chronic illness'

Empire of Pain: The Secret History of the Sackler Dynasty by Patrick Radden Keefe

18 reviews

stephaniezd's review against another edition

dark informative reflective tense medium-paced

5.0

Impeccably researched and compelling in it's telling. Easily the best non-fiction I have read this year. I have already recommended to several people. Jaw-dropping at times in the unabashed ridiculousness that the focuses of the tale engaged in. Just an incredible story.

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aegagrus's review against another edition

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3.25

Empire of Pain is a smart and thorough chronicle of three generations of the notorious Sackler family. Radden Keefe may write in the dramatized language commonly found in tales of “true crime”, but his credibility is bolstered by the years he’s put into this story and the vast quantity of source material he’s able to cite. His book does many things well. It provides a fascinating case study of the ways in which ill-gotten wealth can change a family over time, altering each generation’s proclivities and character. It effectively demystifies relatively arcane fields like pharmaceutical advertising and bankruptcy law. It doesn’t spare those peripherally implicated in the Sackler saga – well-known political figures from both major parties, doctors, lawyers, consultants, and museum administrators. Most importantly, it elucidates where we stand today, unflinchingly demonstrating the insufficiency of the ways in which the Sacklers have been “held to account”.

For all its thoroughness, Empire of Pain has a fairly narrow focus. Radden Keefe readily admits that his book is not intended to be a broad sociological account of the opioid crisis. At times, this tight focus on the Sacklers leaves the reader with questions. Radden Keefe does a pretty good job separating out the impact of Purdue Pharma from that of other opioid suppliers, citing empirical studies to show the close association between Purdue’s activities and the emergence of the crisis writ large. Purdue was an early and aggressive mover; in ascribing responsibility for the crisis, to start at Purdue is entirely justified. In other instances, though, the centrality of the Sacklers to this narrative may have led Radden Keefe to overstate their centrality – on the birth of medication-based psychiatry, for instance, or even on the ideological battles over how the medical field should approach chronic non-malignant pain (which is not to say that the Sackler’s astroturfing did not have a major impact in this regard).

It is also notable that a full third of the book is spent on the activity of Arthur Sackler, the family patriarch, who was already dead by the time OxyContin was created. The ways in which Arthur shaped the family’s trajectory are certainly relevant, getting the Sacklers started in the worlds of art and philanthropy, passing down an array of corporate structures, and inculcating deeply held ideologies in the succeeding generations. Arthur’s role in creating modern pharmaceutical advertising and his aggressive profiteering off of non-opioid tranquilizers (namely Valium) are also interesting. Nonetheless, too much time is probably spent mythologizing the dynasty’s origins, time which could perhaps have been better spent providing somewhat broader context for later material about the marketing of OxyContin and the ensuing litigation.

Empire of Pain is, all in all, well worth reading. If the reader is seeking to understand the opioid crisis itself, this book is probably not a perfect starting point. If the reader already has some background in the opioid crisis, however, or is primarily interested in a case study of the corrupt abuse of corporate, legal, and political power, Empire of Pain is an excellent choice.

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megang519's review against another edition

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challenging emotional informative medium-paced

4.0

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kristin_h_reads's review against another edition

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challenging dark informative sad fast-paced

5.0

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maarsargo's review against another edition

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challenging dark emotional informative reflective sad tense medium-paced

5.0

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allisonwonderlandreads's review against another edition

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challenging dark informative reflective slow-paced

5.0

This meticulous, damning work of non-fiction is worth all the hype. The opioid epidemic was a topic completely outside my sphere of understanding before picking this book up. I was unaware of all the legal battles raging to bring a particular company and its scions to account for a public health disaster of epic proportions. I was horrified by the influence of one powerful family over an entire industry, and through that, the country at large. The Sacklers' inability to empathize, to accept any level of responsibility for the opioid crisis through the aggressive marketing of their drugs, is more astounding than it ought to be given our society, fueled by capitalistic fever dreams and cold ambition. Here, we have a family ostensibly offering a compassionate product, a drug that can help many suffering from pain of all sorts. However, the tactics revealed in this book tell a different story, the calculating minds of a family willing to do anything to increase their net worth with no concept that there could be negative, lasting consequences to answer for. That misleading the medical establishment could lead to dangerous prescription practices. That data indicating where pill mills are located could necessitate corrective action rather than representing a welcome source of income. That influencing government agencies and public perception is anything less than their right as the ultra-wealthy. That willful ignorance is somehow less harmful than intentional malice when the result is the same: over a million dead and many more affected in the US alone.

I'm not really sure how to review such an impactful work. I think everyone can benefit from a closer look at how the pharmaceutical industry works and how wealth is accrued and kept more broadly. It leaves me with a lot to ponder and with a lot more information at my disposal to see things clearly. Highly recommend.

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caseythereader's review

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challenging dark emotional informative sad slow-paced

5.0

- Pretty sure no one needs my endorsement to pick up EMPIRE OF PAIN at this point, but here it is. I don't read a ton of heavily reported nonfiction, but this is one you can't miss.
- Keefe is so good at discussing complicated people and topics in a conversational, easy to follow way.
- Even if you already know the basics of this story from news reports or other books like DOPESICK, I'm willing to bet there are still anecdotes in this book about the callousness of the people involved that will shock you. You think you know how greedy people can be, and yet.
- Also, this is a sort of irrelevant side note, but if this was fiction I would have dinged the author for seemingly transparently lifting Richard Sackler's personality from the characters in THE SECRET HISTORY, haha.

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sjanke2's review against another edition

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dark informative tense medium-paced

5.0

This is not a book about the opioid crisis. Rather, it's a book about a powerful American family that profits off of pain. Patrick Radden Keefe's investigative journalism here is dense, detailed, impressive. I wasn't sure I'd enjoy this book about rich people as much as I enjoyed Say Nothing: A True Story of Murder and Memory in Northern Ireland, but I couldn't stop listening. On top of being a talented journalist, Keefe is an engaging, urgent voice narrator.

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