Review: Empire of Pain: The Secret History of the Sackler Dynasty

Empire of Pain: The Secret History of the Sackler Dynasty by Patrick Radden Keefe
My rating: 5 of 5 stars

I have heard about the Opioid Crisis in USA, but have never known the actual roots and consequences.

This book, based on excellent investigative journalism, covers the story of Sacklers, the family which started their business in selling prescription drugs back in the 1930s. The first generation of Sacklers benefitted a lot thanks to smart selling tactics of anti-depressants. The second and the third generation of Sacklers benefitted even more by selling painkillers based on opioids via their main company Purdue Pharma (which was selling the best-selling drug OxyContin). The opioids are the medications prescribed by doctors to treat pain. They have essentially similar effects as morphine or heroine. They have proven to be highly addictive.

Investigations by Keefe revealed how ingeniously intertwined were Sacklers' efforts to both educate doctors and market to doctors. They have used aggressive sales tactics towards doctors, while at the same time sponsoring conferences, medical journals and retreats for medical community. They have managed to get officials from drug administration on their side too.

And, along the way, Sacklers were carefully developing their image as generous philanthropists of arts and education (preferring never to speak where the wealth has come from). They made many galleries and institutes were called after Sacklers.

It is a story of the worst of capitalism, unchecked, unlimited. You can essentially bribe doctors who get paid more when selling more medications to a population which spends more if they get addicted more. It is a visualisation of why healthcare as total in USA costs way more per capita than in any other developed country of the world.