Empire of Pain: The Secret History of the Sackler Dynasty

“But he had always possessed an entrepreneurial sensibility, a keen interest in business, and any vow he made to medicine could not change that. Besides, he had landed an interesting part-time job during medical school, yet another side gig, this time as a copywriter for a German pharmaceutical company called Schering. Arthur had discovered that of all his many talents one of the things he was particularly good at was selling things to people.”

This passage underlines Arthur Sackler’s complex character and varied interests. He made a “vow” to medicine—a vocational commitment—but he also considered divided loyalties in his nature. He has an “entrepreneurial sensibility,” a phrase that suggests that business and profit were part of his temperament and life philosophy, not mere interests. The proliferation of “side gigs” emphasizes his dedication to controlling as many aspects of the world as he could.

“This was the era of the ‘miracle drug’: the postwar years were a boom time for the pharmaceutical industry, and there was a widespread optimism about the potential of scientific innovation to devise unheard of chemical solutions that would cure death and disease and generate untold profits for drug makers. The same utopian promise that the Sacklers had been evangelizing for at Creedmoor—the idea that any human malady might one day be cured with a pill—was beginning to take hold in the culture at large.”

Arthur Sackler was, for all his singularity, a product of historical and social contexts. His entry into pharmaceuticals coincided with broader interest in medicine as an avenue for progress. Radden Keefe uses religious terminology to describe the Sacklers—they are “evangelists” for medicinal treatments of mental illness, as if they had a vocational calling.

“Arthur seems to have been aware that some might perceive a potential conflict between his roles as head of both a medical newspaper and a pharmaceutical advertising firm. He once explained that his tendency to remain obscure and anonymous as much as possible sprang from a sense that this would enable him to ‘do things the way I want to do them.’ Initially, his name could not be found anywhere on the masthead of the newspaper—nor could any acknowledgment to readers that the guiding editorial hand behind the publication happened to be heavily invested in the drug business. But Arthur was untroubled by these conflicts.”

Arthur Sackler emerges as a calculating figure, self-aware and sophisticated, though not concerned with the ethics of his behavior. He saw the “conflict” between his two overlapping business ventures, but chose secrecy over transparency because he was driven by his vision rather than ethical mores. The wording here emphasizes Arthur’s silent presence: A reader of his publications and his advertising had no way to find out the same person was responsible for both. Arthur was “untroubled” by this, suggesting that his overriding faith in himself prevented any stirrings of conscience or belief.

“In polishing his own public image, he relied heavily on an appearance of propriety and the idea that he was a righteous and judicious man of medicine. Yet his fortune could be traced directly to the rampant sales of two highly addictive tranquilizers. To be sure, Arthur had many business interests: he started companies left and right and invested widely in a range of industries. But the original House of Sackler was built on Valium, and it seems significant, and revealing, that for the rest of his life Arthur would downplay his association with the drug, emphasizing his achievements in other areas and deliberately obscuring (or leaving out altogether) the fact that his first fortune was made in medical advertising.”

Arthur’s preference for secrecy was a fundamental character trait. Rather than wrestle with his internal contradictions, Arthur concealed them, suggesting that his drive for growth and improvement was limited to business, not self-understanding. The phrasing “House of Sackler” is particularly evocative, alluding to the term for royal dynasties; however, Arthur’s dynasty would be built on profit, not divine right.

“When Kefauver was investigating the mob, he had noticed that racketeers insulated themselves with a cadre of putatively legitimate lawyers, politicians, and fixers. The steel industry did the same thing, paying top dollar to professional influence peddlers in pin-striped suits. As this new investigation got under way, Kefauver noticed that executives in the pharmaceutical industry had elevated this form of combat by well-paid proxy to an art.”

Senator Estes Kefauver was a foil for Arthur Sackler, a crusader for truth and transparency who had no use for secrets. Kefauver saw America as it was, not as it was advertised to be: a world of networks and patronage, where “influence peddlers” helped the rich to avoid accountability and legal consequences. His link between the Sacklers and organized crime would become a repeated refrain, suggesting an enduring line between Arthur and his progeny. Kefauver clearly saw Arthur Sackler as a part of American corruption, refusing to accept the idea that medicine and pharmaceuticals were too sacred an enterprise for conflicts of interest or use of political protection to occur.

“On several oversized pieces of paper, the staff tried to diagram the sprawling web of the Sacklers’ interests, with little boxes containing the names of corporations and individuals and a tangle of lines connecting them. ‘The Sackler empire is a completely integrated operation,’ Blair wrote. They could develop a drug, have it clinically tested, secure favorable reports from the doctors and hospitals with which they had connections, devise an advertising campaign in their agency, publish the clinical articles and the advertisements in their own medical journals, and use their public relations muscle to place articles in newspapers and magazines.”

Radden Keefe previously likened the Sacklers to a dynastic ruling family, but Kefauver and his staff see them as a network of power and influence. The use of “web” is particularly evocative, since it connotes intricacy and spiders trapping prey. The operation is “completely integrated”—no stage of pharmaceutical development, marketing, or sales is beyond the company’s reach. The family has “muscle” to influence the public, the key final stage in business success and marketing.

“Hoving unveiled the Sackler Wing with the launch of a new exhibit: The Treasures of King Tut. It was a masterstroke. The exhibit included fifty-five dazzling funerary objects discovered in the tomb of the boy emperor Tutankhamun. One evening, before the show was open to the public, the Met threw a black-tie gala in the new wing to celebrate. There was the temple, standing again, beautifully restored and dramatically lit, with the names of those two brothers who once drowned in the Nile still etched in the sandstone, along with the names of other visitors through the centuries, and now the names Arthur, Mortimer, and Raymond Tackler carved into the great edifice of the Met itself.

At the apotheosis of its power and influence, the Sackler dynasty commingles with the treasures of empires long gone. Their name is now associated with "dazzling” objects, and they can command an exclusive private celebration with fellow wealthy people. The Sackler brothers are compared to those who carved their names into the Temple of Dendur, suggesting that they too have achieved immortality, becoming part of a “great edifice” through the transformative power of wealth and philanthropy.

“Just as Isaac Sackler had repeated to his sons that sentiment about the importance of a ‘good name’ Arthur Sackler had a precept that he had often intoned to his own children. ‘When we leave,’ he told them ‘we have to leave the world a better place than when we arrived.’ There was a keen sense, in the Sackler Wing that afternoon in 1987, that though Arthur Sackler’s life had ended, it’s as too soon yet to take the full measure of his legacy.”

As Arthur’s section of the family saga comes to a close, Radden Keefe explicitly connects him to his father, Isaac. Both men, shaped by the immigration story that defined their lives, felt an obligation to be known in the world in a positive way. But, for all of his power and influence, Arthur did not get the last word: Richard Sackler would play a defining role in the family’s responsibility for the epidemic of opioid use disorder.

“As it happened, a new federal regulation was in the works that would forbid the grandfathering in of new twists on old drugs without the FDA’s standard New Drug Application. When Howard Udell learned that this regulation was coming, he decided that Purdue should try to beat it. ‘Before this goes into effect, let’s make MS Contin—and put it on the market,’ he said, according to a former executive who worked with him during this period. So without alerting the FDA, much less asking for permission, Purdue started manufacturing MS Contin at a plant in New Jersey and offered it for sale in October 1984.”

This episode underscores the importance of loyal retainers like Howard Udell to the Sackler family’s business practices. Udell sees regulation as something to “beat”—to be avoided, not honored. The emphasis on the company not waiting for “permission” underscores the sense that the corporate culture at Purdue was not invested in adherence to the law.

“So overwhelming were its powers that the user could become possessed by them, slipping into dependence or succumbing to permanent sleep. The plant could kill you. It could create a state of relaxation so profound that at a certain point you just stopped breathing. The opium poppy might have been used as a medicine, but it was also used as a poison and as an instrument of suicide. In the symbolic vocabulary of the Romans, the poppy stood for sleep, but also death.”

The history of humanity’s relationship to opioids is a dramatic cautionary tale. Earlier generations understood that the chemicals had “overwhelming powers”—no human will could resist their impact or thwart their lethal potential. Radden Keefe alludes to the Roman description of poppies as leading to either rest or death—a lack of reverence for this balancing act, he implies, has serious consequences. This history lesson foreshadows what the Sackler family failed to understand as they developed OxyContin.

“But the Sacklers assiduously distanced themselves not just from any sense of responsibility for the tragedy but from any connection to it whatsoever. The family issued no apologies or condolences. They appeared at no funerals. They made no public statements whatsoever. Howard Udell, the company lawyer, oversaw the legal response for the Sacklers, and as a rule he tended to counsel against issuing apologies or making any admissions of personal accountability.”

The explosion in New Jersey revealed fundamental truths about the Sacklers’ approach to accountability. They “distanced” themselves from the episode, as if avoiding imperfection and failure was more important than having contrition for loss of life. Radden Keefe catalogues a list of possible options to underline that the family chose none of them.

“The regions where the problem began often had large numbers of people who were out of work, or who worked hard, manual-labor jobs, people who were disabled or chronically ill, people who were suffering from pain. As it happened, these were also precisely the kinds of regions that Steven May and other Purdue sales reps had targeted—regions that the IMS data told them would be fertile terrain for OxyContin. In some cases, these communities also happened to have long-standing problems with prescription drug abuse. In some parts of Appalachia, people would pair an OxyContin with a Valium—one of Richard Sackler’s pills and one of his uncle Arthur’s. They called this ‘the Cadillac high.’”

The geographic distribution of the opioid use disorder crisis underscores that markets for drugs are not abstract, but are instead trace social problems and human needs. Purdue “targeted” populations high in people injured at work and people with disabilities—zeroing in with precision. The reference to Valium, and Richard and Arthur, underlines that the Sackler family legacy looks less benign when the whole country comes into view.

“In some ways, Richard’s argument about OxyContin mirrored the libertarian position of a firearms manufacturer who insists that he bears no responsibility for gun deaths. Guns don’t kill people; people kill people. 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. ‘Abusers aren’t victims,’ Richard said. ‘They are the victimizers.’”

Radden Keefe positions the pharmaceutical industry as part of a broader fabric of American life, comparing drug regulation opponents to the gun industry. Both have crafted narratives of culpability that absolve corporations while damning individuals. While the Sacklers are uncomfortable with taking responsibility themselves, Richard Sackler is unrestrained about blaming patients for opioid use disorder. He calls such individuals “victimizers,” positioning them as an entire social class devoted to harm, outside any moral universe he himself occupies.

“One rationale for this approach is that it is often easier to assemble evidence against this lower level, because these executives play a more hands-on operational role and leave behind a more extensive paper trail. But, in white-collar criminal cases, such defendants also make for notably soft targets. These are generally pampered men in middle age with soft hands and unblemished reputations. If you indict them on criminal charges, and they are suddenly looking at the prospect of actual jail time, the very thought of incarceration is enough to flood them with terror.”

Family drama turns into crime procedural, complete with investigations and legal maneuvering. Lower-level executives produce “paper trails” that leave evidence for investigators. The search for “soft targets” reveals the social and class identities of corporate America—elite men with “soft hands” provide a striking contrast to the manual laborers the company’s marketing aimed at. The goal is to create “terror” to play on the fear of status loss, to bring a corporation to justice.

“Haiti was just a couple of hundred miles across the water, and occasionally migrants who were desperate to flee that country would board flimsy vessels and navigate in the general direction of Turks. From time to time, a dead body would wash ashore, some poor soul who hadn’t survived the voyage, her dreams extinguished, her lungs full of seawater. But employees had been specifically instructed to be alert for this type of eventuality, and when a corpse washed in overnight, the whole staff would mobilize to make sure any trace of it had been removed from the beach before the guests arose the next morning.”

The imagery here brings out the moral costs of luxury. The Sacklers are so insulated from the rest of the world and its troubles that the “poor souls” who wash up on Turks are erased from their beach, to keep it pristine. Resort employees are “mobilized” to perform this task, as though they are a private army with a mission to shelter their customers from any reminders of less privileged humanity.

“He was not some south-of-the-border heroin baron. The fact that these junkies who had previously abused OxyContin were now moving on to heroin only solidified the family’s sense that they were beyond reproach. But Richard had always prided himself on his aptitude for data, and in this instance the data suggested that while the Sacklers certainly weren’t dealing heroin, it would be incorrect to suggest that they bore no connection whatsoever to the heroin crisis.”

Richard Sackler’s self-serving justifications about the heroin crisis reveal his desire to distance himself from any responsibility for opioid use disorder. He is American, not from “south of the border”—language that associates heroin with Mexico and people of color, rather than white men who grew up as scions of a privileged dynasty. Radden Keefe suggests that Richard’s reaction was emotional, not rational—data showed that tamper-proof OxyContin was in fact associated with a rise in heroin use.

“The danger, whether you are a billionaire executive or the president of the United States, is that you end up compounding the problem yourself by marginalizing any dissenting voices and creating a bubble in which loyalty is valued above all else. The Sacklers took pride in being loyal to those who showed great loyalty to them. If you stood by the family, they would take care of you. But it was an unwritten corollary in the company that anyone who quit to take another job would be blacklisted from returning, for life. Consequently, the Sacklers remained insulated by a retinue of stalwarts who both shared and reinforced the family’s view that the company was being unfairly maligned and had done nothing wrong.”

The organizational culture of Purdue was not unique—rulers often have trouble finding someone who will speak truth to power. The “bubble” metaphor underlines that the family was protected, but trapped, unable to recognize dissenting voices. “Loyalty” was the most important currency, with violations punished and never forgiven. The use of the phrase “retinue of stalwarts” evokes an image of monarchs surrounded by loyal courtiers determined to prevent them from experiencing doubt.

“Goldin’s most powerful weapon as an activist was her eye. Someone had alerted The New York Times, and a photographer showed up at the Guggenheim and took position on the ground floor, then pointed the camera up at the ceiling as the prescriptions floated down into the rotunda. It was an extraordinary image, with the white slips flickering through the museum’s white interior, past the bright red protest banners. Goldin and her fellow activists had wanted it to look like an actual snow flurry, so they printed eight thousand prescription slips, to ensure that there were enough to fill the space.”

Nan Goldin brings the narrative back to the life of Arthur Sackler: He loved and collected art, while Goldin produces it. Her creative vision and moral values lead her to oppose the family. Art is her “weapon”—a tool she uses to tell uncomfortable truths that might otherwise go ignored. Her juxtaposition of white prescription slips with a red banner makes viewers overwhelmed by the scope of the crisis. The word choice here also echoes the OxyContin launch in 1996 during a snowstorm—Goldin is interested not in a storm of profits, but a reckoning.

“Prometheus had warned the humans to be wary of any gifts from the gods. But they did not heed his warning, and Pandora opened her jar. In some versions of the story, Pandora can seem malevolent, deliberately unleashing a whirlwind of torment. In other tellings, she is naive, her greatest sin simply curiosity. As they sought to hide from a historic crisis of their own creation, the Sacklers could sometimes seem like Pandora, gazing, slack-jawed, at the momentous downstream consequences of their own decisions. They told the world, and themselves, that the jar was full of blessings, that it was a gift from the gods. Then they opened it, and they were wrong.”

Radden Keefe uses the Greek myth of Pandora to underline the power of unintended consequences. There are different versions of Pandora: a cunning schemer or an innocent girl. The Sacklers try to “hide” from the consequences of their choices like children hiding from their parents to avoid punishment. They are “slack-jawed”—a gesture that makes speech, and thus acceptance of wrongdoing, literally impossible. They are captives to their own false narrative that they have made a “gift from the gods”; they refuse other interpretations of OxyContin.

But now, when they broke into the proceedings asking to be heard, and he was confronted with the actual human beings whose suffering he had so frequently and casually invoked, he seemed unsettled, and eager to retreat back into the comforting obfuscations of the law. ‘I hold hearings on what is scheduled before me,’ Drain said. ‘There are literally hundreds of thousands of people who have lost dear family members because of opioids.’ Another pause. ‘I… um… I don’t think that this is the proper forum to do this.’ Krawczyk tried to interject, but Drain kept going. The hurt and suffering of families like hers was ‘front and center in my mind,’ he assured her—and in the minds of the ‘lawyers and financial people,’ too. But ‘we simply can’t turn these hearings into something that the law really doesn’t contemplate,’ he concluded. ‘So I’m not going to let you speak further on this.’”

Judge Drain cuts an unsympathetic figure, unprepared to confront “actual human beings” in his courtroom. He is “unsettled” and prefers “obfuscations”—like the Sacklers, he wants a comforting narrative rather than pain and tragedy. He rules that the scope of the crisis is too large for his hearings without offering any real remedy. The law in his courtroom is silent about questions of broader justice or emotional pain: The judge insists that he feels for Kimberly Krawczyk while refusing to let her speak.

“They resented being cast as the villains in a drama, but it was their own stunted, stubborn blindness that made them so well suited to the role. They couldn’t change. There was something undeniably ritualistic about the hearing that morning. If the community could not hold the family accountable, it would subject them to a ceremonial shaming. It likely seemed, to Kathe and David, that the whole exercise was theater: that the lawmakers were performing outrage, just as they had performed compassion. But the proceeding was also, in some fundamental way, an expression of democracy: OxyContin had visited destruction on so many communities, and now, the representatives of those communities had gathered to give voice, like some awful Greek chorus, to all of their collective indignation.”

During the 2021 congressional hearings, the Sacklers found themselves in a “drama” like actors in a morality play. Because they were too “stubborn” to recast themselves into a more compassionate role, they undergo “ceremonial shaming”—a public acknowledgement of their lost status and what they have done to earn it. Radden Keefe evokes the dramatic device of the “Greek chorus”—a group of actors in classical theater that explains the morality and philosophical import of each scene.

“Nearly a century earlier, during the height of the Depression, Isaac Sackler told his three sons that if you lose a fortune, you can always earn another, but if you lose your good name, you can never recover it. Sounding very much like Isaac Sackler, Maura Healey concluded, ‘They can’t buy their reputations back.’”

Evoking Isaac Sackler shows that the family has come far from its origins, not only materially, but morally. Isaac believed that material prosperity was less important than a moral reputation, and insisted on this throughout his life. But the person who voices this belief in 2020 and 2021 is not a Sackler but Maura Healey. The family chooses denial and silence over a public reckoning, betraying the values their dynasty was founded on.

“I would spend hours talking with intelligent people who had worked at the company, and they could acknowledge all sorts of infirmities in the corporate culture and make astute observations about the personalities involved, but when it came to OxyContin’s role in the opioid crisis, they would do their best to explain it away. Even in the face of voluminous evidence, of guilty pleas to felony charges, of thousands of lawsuits, of study after study, of so many dead, they retreated to the old truths, about abuse versus addiction, about heroin and fentanyl. 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.”

Former employees of the Sacklers were so entwined in the company’s decades of ethically dubious behavior that to acknowledge responsibility became impossible. The company culture relied on this cognitive dissonance, rewarding blind loyalty and stressing the need for silence at all times.