Empire of Pain

Empire of Pain details the Sackler family's pharmaceutical businesses. The Sacklers have given us librium, valium, oxycontin as well as the antiseptic betadine and the laxative senotkot.  From the language that the author has used, it is obvious that this book was intended not just to ruin the family name (which they did a good job of themselves) but to show that the opioid epidemic in the U. S. was directly caused by the use of oxycontin. However, "gaps" in the meticulously researched expose speak loudly.  

The Sackler brothers Arthur, Raymond and Mortimer were the children of American immigrants Isaac and Sophie Sackler. As first generation kids, their parents instilled in them the desire to make a name for the family. Sophie wanted all of her sons to be doctors and they all became one. Arthur, being the oldest, led his brothers to inherit all of his jobs and businesses when he went to college, whether that be a paper route or a vice president in one of his many corporations that he started while still in high school. When it came time to start a new corporation for the Sackler family, Purdue Pharma, Arthur's push to succeed caused him to shelter the family under 30 shadow companies. This business structure remained over the decades. These umbrella corporations handled things that would be a conflict of interest for Purdue Pharma, such as medical advertising and medical trials. The main company did the research and development, the drug trials and the advertising of the drug. Arthur made a ton of money for the family and succeeding generations merely followed his business plan.

Another one of Arthur's ideas was to take a product and advertise it as not just being for the main purpose it was created for but also to broaden its functions so that more people would want to buy the product. Arthur was a master advertiser. He was taking over the advertising for companies when he was still in high school. With the Sacklers being involved in pharmaceuticals, they were steering people toward drugs that were created for patients with severe pain even though their pain might be considered slight or moderate. These company strategies were later determined to be criminal and resulted in the company's downfall.

The author performed meticulous research. He read every document in every lawsuit of which the family was a part. The author's premise that oxycontin was the sole cause of the opioid epidemic does not hold water. He shows how those people prone to addiction and those who were already addicted to other drugs became addicted to oxycontin. However, he does not cite any data that shows that all people with chronic pain became addicted.  This was the family's defense. Many patients with chronic pain from identifiable conditions shown on x-rays and MRIs could not be shown to be addicted. Given that the author researched every single document on Purdue Pharma it is suspicious to me that there was no study showing this to be true. The author always refers to specific documents to prove his point. However, he sidetracked on this point and I can only surmise that is because there is no evidence to the contrary. 

A big part why family members behaved the way they did was due to their overwhelming wealth. The second and third generations grew up with no boundaries and no real concern for how well they performed in school or how well they performed their jobs in the company. If a problem arose concerning reports of addiction from oxycontin use, they simply ignored it because it was not in their interest.

Empire of Pain is a great resource for readers who want to learn the details about the oxycontin problem.  I highly recommend it.  5 out of 5 stars.