nadia's review against another edition

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informative reflective slow-paced

4.5

My second Patrick Radden Keefe of the year — after Say Nothing — and he didn't disappoint.

What I love about Radden Keefe's books is how they read like fiction at times but are packed with so much detail. You can see that he cuts no corners with his research.

I knew nothing about the Sacklers going into this, which added to the intrigue. However, I do think the fact that I could only pick up the book in small bursts, and often when I was feeling tired, impacted my enjoyment. I found it harder to stay focused.

A fantastic book to read if you want to know more about the opioid crisis or the Sackler family, or if you're into narrative nonfiction books that feature multiple generations of one family or themes of corporate fraud/corruption or medicine/pharmaceuticals.

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rosa_inverno's review against another edition

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challenging dark informative sad tense medium-paced

4.75

Would you like to feel angry? Or perhaps deeply frustrated?
Would you like to stare at a page in utter disbelief at the callousness of your fellow human beings toward other fellow human beings?
Would you like to be so angered so much by something you read that you slam a book shut and have to walk away for awhile before you finish reading?
Would you like to feel sympathy and then a hundred pages later feel so guilty for feeling that sympathy that you are forced to confront the complexities of reality and the true nature of good and evil?

Well then do I have a book for you!

I truly believe this to be a must read when it comes to understanding the last quarter century, the story of which is heavily entwined with the opioid crisis. That said, it is not a easy read. That is not because of Keefe's writing, which is thoughtful and engaging, but because the subject at hand is a gut punch.

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dancingdugongs's review against another edition

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dark informative medium-paced

4.5


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hilaryreadsbooks's review against another edition

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5.0

[Thank you Anchor Books for the gifted copy] 

Many of us know that powerful people are capable of terrible things, but many of us do not know what those terrible things often are. Patrick Radden Keefe’s EMPIRE OF PAIN: THE SECRET HISTORY OF THE SACKLER DYNASTY is an incredible tome of research and investigation that exposes just a part of this terrible world. Focused less on the actual opioid epidemic, EMPIRE OF PAIN hones in on this powerful family and how greed, ambition, and power led to this crisis. Keefe writes with empathy and clarity, and his storytelling, as it was with SAY NOTHING, was phenomenal. Even at 500 pages, I finished this book in just two nights. 

What stood out to me the most was the Sackler family and Purdue Pharma’s manipulation of pain patients (and I appreciate Keefe’s note at the end explaining his intention to not contribute to stigmatization of those who use opioids, but rather to demonstrate that the Sacklers and Purdue “have for decades invoked the interests of pain patients as a fig leaf for their own avarice.” The facts that Keefe presents behind this are sobering—there were multiple instances where the Sacklers and other Purdue executives ignored addiction data that foresaw the crisis; instead, they would deny any links and continue to sell Oxy, even using pain patients as examples of Oxy’s effectiveness in their ads. There was, as well, Purdue Pharma’s intention to start selling addiction treatment drugs that target the very market of addiction they created (a business model used by many big pharma companies). 

EMPIRE OF PAIN will stay with me for a long time. 

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mc235's review against another edition

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dark informative sad medium-paced

5.0

I listened to the audiobook of this and was gripped throughout. I think I might have struggled with the first section of the book had I been reading it, but overall for such an enormous book it was very well paced. Incredibly thorough indictment of the Sacklers and the pharmaceutical industry. 

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kdsmoove's review against another edition

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dark informative sad slow-paced

5.0

“It is a peculiar hallmark of the American economy that you can produce a dangerous product and effectively off-load any legal liability for whatever destruction that product may cause by pointing to the individual responsibility of the consumer.”

*insert annie screaming gif”

the amount of times i screamed at the radio or texted someone “just when i thought these people couldn’t get any worse, they fucking do!” throughout reading this is not a low number. when i tell you i was HOOKED from the beginning and somehow not intimidated by the length. 

i knew some about the opioid crisis, even enough to associate the sackler name with it but i had *no idea* just how deep the rot went. i didn’t realize that arthur sackler was the mastermind behind the way the entire pharmaceutical marketing schemes work now. that he basically invented sales and created his own fucking sources and oh my GOD. it was a solid five or six hours in before we even got to Reagan and i did the whole *leo pointing at the tv gif* thing to the stereo. 

and of course today to tidy it up it HAD to be the fucking trump administration willing to let them off with a slap on the wrist. i am so mad, i will be staying mad. you should read this. but beware, there’s a lot of trigger warnings to check and it will make you very mad. One of the lines he used was “rip shit pissed” which sounds a lot funnier out loud than it does written down but i will be using it moving forward.

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_fallinglight_'s review against another edition

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challenging dark informative sad tense medium-paced

4.5

Surreal, insightful, albeit and clinical deep dive into the depraved and unhinged Sackler criminal billionaire family. This book is one of many definitive proofs that the billionaire is incompatible with humanity at this point and greed is an addiction as equally destructive and demoralizing as any substance addiction if not more or worse. The lengths the rotting rich go to to keep their corrosive money are so twisted but it's also morbidly impressive how they weave the web of connections and buy their way into getting the results they want. Particularly this family who honestly wouldn't have made it without ass kissers and enablers and unscrupulous people making their perversity possible bc most of them are so offensively insensitive and stupid.

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____emily____'s review against another edition

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informative reflective sad medium-paced

4.75


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samarakroeger's review against another edition

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challenging dark informative slow-paced

4.25

fascinating and extensive look at the villain origin story behind the opioid epidemic.  as addicting to read as oxy (although this is certainly a slow release). 

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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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