Empire of Pain: The Secret History of the Sackler Dynasty

In 2019, a team of economists studying the origins of the opioid crisis and Purdue’s possible role in it turned to the marketing documents uncovered by litigation, and discovered that some states had more barriers to opioid prescription than others, requiring more documentation with the state. Purdue’s records prove that the company saw this as a barrier to profits, deciding that selling elsewhere would be preferable. The research team then studied the disparate impacts between states that had this prescription limit, and those that did not. They found that “even in 2019 […] overdose deaths in the triplicate states, from all opioids, were some of the lowest in the nation” (407). The study also determined that increased demand for heroin coincided with the release of tamperproof OxyContin.

Nan Goldin’s protest movement against Purdue gathered outside company headquarters; Sculptor Frank Huntley made an art instillation featuring a “sculpture of a skeleton […] fashioned out of three hundred pill bottles and a plastic skull” (410) to memorialize his own addiction struggle. Soon after, Goldin stormed the Louvre, and the museum removed Mortimer Sackler’s dedicated spaces there. Her friends recalled that she pushed the family out of the artistic community, a protection of her own space. Jillian Sackler was outraged and dismayed by the Smithsonian’s similar distancing. However, as late as 2019, Harvard and Yale resisted pressure to remove the Sackler name from buildings. Tufts University, in a thorough reckoning, removed the name from “five facilities and buildings” (414).

Bankruptcy judge Robert Drain was generally uninterested in the Sackler family’s misdeeds. Although the Department of Justice sued Purdue over fraudulent prescriptions and the company’s incentives to doctors to prescribe excessively, the Trump administration announced in fall 2020 only a few charges against Purdue and only a small fine against the Sacklers. Trump’s deputy attorney general, Jeffrey Rosen, insisted the settlement was fair and that criminal charges were unnecessary. Judge Drain sought a “permanent” ban on future litigation against the family by any state (422).

NYU stripped the Sackler name from its medical school in fall 2020. At the end of that same year, most of the Sacklers declined to testify in congressional hearings about Purdue, preventing a replay of what the tobacco industry had faced in 1994. Only David Sackler spoke briefly, after hearing testimony from Nan Goldin and other survivors. In the hearings, a representative told David: “you and your family are addicted to money” (430).

In fall 2021, the Purdue bankruptcy was formalized. The Sacklers escaped civil liability, but they did not escape Attorney General Maura Healey’s zeal for the truth: Purdue’s documented role in the crisis would be available to the public. Healey called her archive a “reckoning,” declaring “they can’t buy their reputations back” (433)—a fall from grace Radden Keefe compares to family patriarch Isaac Sackler’s belief in the power of the family name. Purdue became a charitable trust to “fend off litigation” with no higher goals (433).

At home during the pandemic isolation, Radden Keefe realizes that he and his family are under surveillance. His 2017 New Yorker article helped “make a difference” to public conversation about opioids and introduced him to Nan Goldin. Maura Healey’s findings for her investigation became an important source for further work on the family. Radden Keefe stresses that he has no wish to delegitimize pain patients, only to underscore the Sacklers’ use of their pain as a shield from liability. The family strongly opposed Radden Keefe’s book, declining to be interviewed. Raymond’s children hired an attorney to stop its publication. Radden Keefe reflects that his interviews showcased the power of “collective denial”—few Purdue employees could truly contemplate the depth of the crisis, as to do otherwise was “too demoralizing” (440).

Radden Keefe’s source notes are partly a record of his interactions with the Sackler family and their attorney. He reiterates that the company and family routinely fall back on FDA approval of OxyContin and its instructions as proof of their innocence.

Court records are a key source for much of his analysis of Purdue’s strategy around OxyContin sales. He deliberately anonymized some interview subjects, like Martha West. One such anonymous source sent him a trove of documents on a flash drive, quoting The Great Gatsby to explain sharing secret depositions and other records. Radden Keefe ends by noting that the bankruptcy proceedings will be a key source for future research, hoping that his book will be a “road map” for others (451).