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

5.0

This book has an excruciating start. So slow, with tangents that seem to go nowhere and have nothing to do with the meat of the book. There are very important pieces of information that set up the rest of the book, the corruption of the FDA, the donations to philanthropic causes, the use of fake doctors to advertise, the branches of the family; but it is buried under a lot of fluff of family affairs and the Sackler interest in Asian Art (though the part about how the Sackers were the ones who helped to fund the temple from Egypt that is at the met is very interesting). PLEASE push through. The rest of the book is so good. It lays out so clearly the history of the opioid crisis and how we got to where we are. It really is pretty much just do to Perdue, and this book lays that out so incredibly well. It also goes after the family behind the company as well. It isn’t just regular corporate greed, I mean it is definitely also that, but Perdue is just the Sacklers. This isn't about a board of investors, this is a family that directly caused other families to suffer all around the country.
This book and the crazy amount of sources that Keefe so perfectly balances between what is going on around the country, what's going on in science and the FDA, and what's going on in the meeting rooms of Perdue, and eventually, what's going on in the courtroom. It is crazy to see a family so far up their own ass , who absolutely cannot comprehend being the villains even though they definitely are. One of the Sacklers ends up being a film director and, you really cannot make this stuff up, directs a film about mass incarceration and then refuses any sort of introspection as to how the war on drugs could have been in any way impacted by her family and the drugs they peddle. Though it is not the perfect ending (take these people to prison please, they should not have their wealth), it was a little gratifying to read about all of their names being taken off of museum wings etc and that they weren't able to make any donations to continue to launder their name.
The parts that discussed how the FDA failed to regulate or really do anything about Oxycontin is crazy to me, but completely predictable. The amount of blatant lies that Perdue used to sell Oxy that went completely unquestioned is so disturbing and should make us want a complete overhaul of this institution. To think that Perdue was allowed to sell Oxy knowing that it was being abused and then to make the FDA retire (so as to not become generic) it “because it was too dangerous” THE DRUG THAT THEY HAD BEEN CLAIMING WAS TOTALLY SAFE FOR YEARS only to then market a ‘safer’ version of that drug that was harder to abuse is appalling. And of course, with the pills harder to get and abuse, the switch to heroin was bound to follow, and it did. It is crazy to think that there was a time that pretty much ALL of the painkillers being abused that came from pill farms were produced and sold by Perdue, there were no street versions, it was just them. This doesn't even get into how the family directly pushed this drug, refused to invest in ‘less lucrative’ diversifications of medicines, the law suits, everything.
Hands down one of the best nonfiction books I have ever read.