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

Reviews tagging 'Drug abuse'

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

155 reviews

bailee_f's review against another edition

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informative reflective medium-paced

5.0

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rjansen282's review against another edition

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dark informative medium-paced

5.0

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b3thanamy's review against another edition

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challenging informative slow-paced

3.25

There was absolutely no need for this book to be so long. I really enjoyed reading it but felt that it eventually got boring and I just wanted it to end.

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albernikolauras's review against another edition

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challenging dark informative medium-paced

4.5

If you wanted an in depth book about the horrors the Sackler family has bestowed upon the world, go no farther. Keefe starts with the oldest Sackler, who revolutionized pharma by marketing directly to doctors. Then it shifts over to the younger brothers who ran Purdue Pharma and rode the painkiller train as high as they could. Oh, how far they have come from the college communist days.

As a book, it is well-written and gives excellent explanation of just how the Sacklers have made it to the position they hold today and the opiod crisis they had a large hand in creating. The book was at times a little long-winded. However, because portions of it felt like watching reality TV with the family drama, it was easy to fly through. Keefe wrapped the book up well by the end, but I felt a bit lost. Not due to any fault of his, but just the lack of punishment the family suffered, so beware of that going in.

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mmccombs's review against another edition

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informative sad medium-paced

4.5

A wow of a read! Like most people, I’m aware of the opioid crisis and have been impacted by it, but truly had no context or history or even a real understanding of what OxyContin is. This was so well researched, expertly paced, and kept me hooked the whole time. It was really digestible and I left this angry but in a good way. A case study in all of ways capitalism destroys others and then ourselves and all of the WILD legal loopholes that rich people gain access to when they need to avoid responsibility for literally anything. I think this should be a must read!

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ashlightgrayson's review against another edition

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dark informative reflective slow-paced

5.0

This provides an excellent history and background to the Sackler family, the owners of the privately owned drug company Purdue Pharma. The book takes a narrative chronological approach to the events that display the Sackler's connection to the current opioid crisis in the United States. We are given a glimpse into each pertinent Sackler family member's life. We are shown how they came from humble beginnings only to eventually become notorious for their role in the opioid crisis. The author progressively shows how the Sacklers used Purdue Pharma and the aggressive marketing of Oxycontin to build their wealth on the addiction of a nation to opioids (specifically their opioid, Oxycontin). Additionally, they used the company name to gain immunity from legal prosecution. It was incredible to see how greed drove a family to knowingly push the sale of a drug that was destroying thousands of lives. It emphasizes the human susceptibility to corruption regardless of initial well-meaning intentions. It allows the narrative to take on an eerie tone as it progresses without obscuring the facts. The narrator of the audiobook is the author himself and his voice is serious but immersive. This made every important point in the book stand out and remain engaging. I learned a lot through my journey with this book and I highly recommend the audio book for this one because it is excellent. Might be one of the best non fictions of the year for me.

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katylizg's review against another edition

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dark informative fast-paced

4.0

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arianashea's review against another edition

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challenging dark informative reflective sad medium-paced

5.0

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emilybaum's review against another edition

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dark informative reflective sad medium-paced

5.0

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just_one_more_paige's review against another edition

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challenging informative reflective medium-paced

5.0

Alright. I did it. In one of the most overwhelming #bookstagrammademedoit reading choices I've ever made, with particular shout outs to @thestackspod and @irisbooklist, I decided to give this one a go. I've never really seen a nonfiction book talked about like this one was, with so much hype. I hesitated to read it though, because I worked in youth substance youth prevention for years, in a state (NC) and county (Orange) that were part of the suits brought against Purdue Pharma, and it was in the depth of argument while I worked there. I was really enmeshed in the world of prevention and harm reduction related to opioid use (pushing patient education materials and new tracking software on prescribers and pharmacists, among other things) and I wasn't sure I wanted or was ready to jump back into that world. Also, for a few years my partner worked as a pharma rep (for a small, now bankrupt/nonexistent company, that did not, in fact, have an opioid in their repertoire) and he truly hated the role. So, for that reason as well, I was concerned about revisiting some of that, mentally. However, I am nothing if not a sucker for book hype, especially from certain readers/reviewers, so in the end, I decided to give it a go.

After that intro, this nonfiction chunk is, obviously, about the opioid crisis/epidemic in the United States. There have been many other books, both fiction and nonfiction, that address this topic from a variety of perspectives. This expose in particular focuses on the Sackler family, the family who owns Purdue Pharma, and their history and rise to financial and social prestige, and the way their marketing and business decisions were pivotal in the way the opioid crisis played out. As the author addresses in the afterward, this book touches on but doesn't delve as deeply into the affected people/communities, the consideration of prevention and treatment availability moving forwards, etc. - as other books have done that well already and otherwise this book would be too wieldy to pick up. This particular book delves into the Sackler family itself, and their internal development/issues, as well as how they managed (for so long) to keep their name disconnected from this unfolding epidemic, despite how deeply involved they actually were, in an attempt to call them to account, to responsibility, in a way that hadn't yet been done.

We begin with the "original three" Sackler brothers Arthur, Mortimer and Raymond in the early 20th century and their general rise through medical school, the first investment in the company that became (expanded into), Purdue Pharma and what was, essentially, the creation of the field of medical/pharmaceutical marketing. In addition, this beginning part chronicles the way the family put an emphasis on philanthropic giving, to arts and sciences foundations, widely and generously, but always was an obvious attachment of their name to the giving. On the other hand, we see how, from the beginning the family chose to disassociate their name from their business interests, in a dichotomy that is fascinating and does cause one to question, even before things got really shady. Anyways, we then follow the next generation, Richard Sackler in particular, as Purdue Pharma created and aggressively marketed the opioid OxyContin without real scientific evidence of its safety, and even against all (increasing) evidence that it was deeply addictive. Keefe uses court documents, company communications, employee/family friend interviews, and many other primary sources to detail the way the Sackler's ignored the actual needs of patients with a view solely on creating their "empire of pain." There are no words of the Sackler's own, at least in interviews or in response to Keefe's writing here, because they have steadfastly refused public commentary. However, even without that, this is an incredibly robust and intricately researched work of nonfiction, really bringing this family and their history to life on the page.

So, after all that background, let me just start by saying that everyone was right. This was truly a spell-binding piece of nonfiction. I listened to the audiobook (which Keefe himself reads) and it was unputdownable. The 18 hours went by so fast. I couldn't believe it. And, as a few people messaged when I posted about having started reading this, I was both astounded and infuriated, in alternating reactions, over the course of the book. I mean, with my personal/partner background in what this epidemic turned into (sales and prevention), I shouldn't have been surprised by as much as I was, but seeing the narrative unfold "in order" like this, I honestly sometimes was. To start, the amount of conflicting interest in the Sacklers' rise to fortune through monopolistic drug production/testing/medical journals/advertising, etc. is unbelievable. So many legitimate efforts to move treatment and medicine forwards were co-opted for prestige and money with no regard for anything else (like patient safety or sales/marketing regulations) and it's sickening. Also, like I knew the FDA has not always been above reproach (re: lobbying and bribing and sub-par investigation), but honestly reading about the corruption here was sickening, making one question (more than before) and lose trust in all FDA approvals and now here we sit with the shit end of that stick mid opioid crisis and COVID with no end in sight...

Anyways, this whole book was an astounding primer on willful ignorance, detachment from reality and lack of cognitive dissonance. The outmanned/over-gunned smear campaigns against individuals bringing attention to red flags, and the efforts to cast all naysayers as “addicts”/unstable. The systematic undermining, through lobbying/bribing, of Congress, the DEA, the CDC, state legislatures, federal prosecutors, and more. Basically, the way that rich white people can get away with stuff, in this case legitimate mob and drug dealing type shit is unreal to see this clearly displayed; what money can get you as far as leverage is frightening. This kind of elitist bullshit is the baseline of so many social issues now.

The Sacklers were just so blind to their own immorality, to an unbelievable degree, with an addiction to money and prestige and the lengths they went to (what they ignored and willingly misunderstood) to get and maintain it. Keefe highlights so many really fascinating insights into this family's rise and the way they were hyper-focused on philanthropy (being known for "good"), but ignored how much harm they were causing the world; the way they started out so diversified and ended so single-minded. Plus, the internal family drama was kinda unbelievable and entertaining in the way that messy families and rich people behaving badly can be. Honestly, I have no idea how Keefe made this long of a book, on such an intense, heavy topic, such a parge-turner. But damn, he sure did.

“The doctor is feted and courted by drug companies with the ardor of a spring love affair [...] The industry covets his soul and his prescription pad because he is in a unique economic position; he tells the consumer what to buy.”

“...a classic Arthur Sackler play: innovative, showy, a little bit shady...”

“…Arthur liked limbo. He thrived on it. He'd built a life around fuzzy boundaries, overlapping identities, conflicts of interest. Limbo was his element.”

“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.” (With guns, underage access to/overuse of substances like tobacco and alcohol, addiction, and more - it’s freaking infuriating.)

“He had a hubris, a blindness to consequences, and unshakable certainty in his own convictions. If there was one attribute that Richard shared with his uncle Arthur - apart from a common name, a genius at marketing, and a sense of unquenchable ambition - it was the stubborn refusal to admit doubt, even in the face of contrary evidence, and a corresponding ability to delude himself into a blinkered faith in his own virtue.” (And let me add a disgustingly nonexistent ability to accept responsibility for his own choices and actions.)

“I wondered if, for some of these people, it was just too demoralizing to take a sober measure of their own complicity, if it was simply too much for the human conscience to bear.”

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