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

Radden Keefe

“And all who heard should see them there,
And all should cry, Beware! Beware!
His flashing eyes, his floating hair!
Weave a circle round him thrice,
And close your eyes with holy dread
For he on honey-dew hath fed,
And drunk the milk of Paradise.”

-Samuel Taylor Coleridge, Kubla Khan, 1797¹

“For not to think of what I needs must feel,
But to be still and patient, all I can;
And haply by abstruse research to steal
From my own nature all the natural man—
This was my sole resource, my only plan:
Till that which suits a part infects the whole,
And now is almost grown the habit of my soul.”

-Samuel Taylor Coleridge, Dejection: An Ode, 1802²

Vicki was no longer young when she died, but she wasn’t old either. I’d known her since childhood; she was a good friend of one of my aunts and the mother of more than one of my friends. In my earliest memories, she was a frequent presence in my life. Nearly two decades ago, she fell in a parking lot, hurt – but did not break – her hip, and was prescribed oxycodone by a doctor to manage her pain. Within a few years, she passed away after a fatal overdose of methadone. She was not much older than I am now.

Her son Eric soldiered on. Like too many other of the boys I grew up with, he had enlisted in the military to assist the U.S. government in the prosecution of the “War on Terror.” When he came back to civilian life, he bore the physical and psychological wounds of battle. In due course, he too became addicted to opioid. A little less than two years ago he was found dead in the back of his pickup truck.

For all the pain and sorrow that I felt in writing the previous paragraphs, there’s nothing particularly remarkable about this story. Many of you have endured similar and perhaps practically identical tragedies; many more of you know friends or acquaintances who have. The seemingly intractable problem of opioid abuse and the increasing number of overdose deaths it generates, year after year, are two of the ongoing catastrophes symptomatic of the broader decline of the United States.

The causes of this epidemic are manifold and interlocking. The victims of the opioid epidemic aren’t entirely innocent, of course, but libertarian insistence on atomistic “personal responsibility” conveniently excuses the parties responsible for creating and sustaining the conditions in which opioid abuse could take root and flourish. Of these parties, the pharmaceutical industry is uniquely and extraordinarily guilty, and of the players in the pharmaceutical industry, none are more guilty than the Sacklers. (I have often bitterly remarked that there are no better examples of the necessity, utility, and moral laudability of the bygone governmental practice of public executions.)

“Eukodol is a chemical variation of codeine – dihydro-oxy-codeine. … Eukodol is like a combination of junk [heroin] and C[ocaine]. Trust the Germans to concoct some really evil shit.”

– William S. Burroughs, Naked Lunch, 19593

“…[T]ake the next step in pain relief.”

– Oxycontin advertisement, 1996

Patrick Radden Keefe’s 2021 book Empire of Pain: The Secret History of the Sackler Dynasty is a masterful, meticulous work that lays out the history of the Sackler family, Purdue Pharma, and Oxycontin in exhaustive – but never exhausting – detail. (The title of my review is drawn from the revelation on page 327 that the Serpentine Gallery in Kensington Gardens was renamed “the Serpentine Sackler” in 2013 in honor of the family’s philanthropy.) Excluding the acknowledgements, references, and index the text in the hardcover edition runs to 452 pages; nevertheless, as I finished reading, I found myself wishing that it wouldn’t end. To the author’s credit, he achieved something resembling journalistic detachment and objectivity in his treatment of his subject matter.

In short: really, read this book. It is impossible to adequately understand the origins of the incestuous relationships between the pharmaceutical industry, the medical profession, advertisers, and various regulatory agencies without reference to the events the author capably narrates. The creation, marketing, and distribution of Oxycontin loom largest, but other once miraculous drugs also appear throughout; antibiotics, anxiolytics, and analgesics abound. Purdue Pharma is there, of course, but then too so is Pfizer. Suffice it to say that Oxycontin would never have been possible without the success of Valium, Valium would never have been possible without the success of Librium, and the success of Librium would never have been possible without Arthur Sackler.

The special genius of Arthur Sackler, his brothers, and their offspring was not in drug discovery; the drugs that made them rich were discovered by others. The Sacklers excelled in the creation of narratives and the management of perception. When Librium (chlordiazepoxide) came to market, Arthur Sackler saw to it that the public image of Librium was that it was a new, safe, nonaddictive replacement for the older and admittedly more dangerous barbiturates. Early concerns about the dangers of Librium and Valium (diazepam) were waived away; the problem was with the individuals using them, the drugs themselves were perfectly safe. Eventually, the conclusion that the dependence syndromes induced by Librium and its many descendants (including the thankfully no longer ubiquitous Xanax) were largely indistinguishable from those produced by barbiturates and the classical sedative-hypnotic, alcohol, proved inescapable, but only after the damage had been done.

When Purdue Pharma developed and released Oxycontin, Richard Sackler followed his uncle’s marketing strategy to a T. When one stops to think about it, after thousands of years of human experience with opium and its derivatives, the fact that anyone at all fell for the claim that Oxycontin had no significant abuse or dependence liability is remarkable enough, but that this narrative beguiled large swathes of the medical profession is nothing short of astounding. In just the past two centuries, morphine was promoted as a nonaddictive substitute for opium and heroin was promoted as a nonaddictive substitute for morphine. Nonetheless, extended-release oxycodone was successfully promoted as a nonaddictive substitute for the whole panoply of opioid analgesics. Based on past performance, it seems that the real question is not if this cycle will repeat, but when.

“[…] [H]ave the balls as a man to call out the individuals, don’t call them Jews, call them by their name and start a war against those individuals, they’re not Jewish.”

-Lex Fridman to Ye, October 24, 2022⁴

“I find it unacceptable that a person will be considered a member of the Jewish people when he does great things, but not considered part of our people when he does amazingly despicable things.”

-Sever Plocker, December 21, 2006⁵

Arthur Sackler and his brothers were the descendants of Jewish immigrants from the Ukraine and….

[…] This is just an excerpt from the April 2023 Issue of Culture Wars magazine. To read the full article, please purchase a digital download of the magazine, or become a subscriber!