Book Review: Empire of Pain by Patrick Radden Keefe


The highly anticipated portrait of three generations of the Sackler family, by the prize-winning, bestselling author of Say Nothing.

The Sackler name adorns the walls of many storied institutions: Harvard, the Metropolitan Museum of Art, Oxford, the Louvre. They are one of the richest families in the world, known for their lavish donations to the arts and sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing OxyContin, a blockbuster painkiller that was a catalyst for the opioid crisis.

Empire of Pain is a masterpiece of narrative reporting and writing, exhaustively documented and ferociously compelling.


This is actually my second time reading this book, it’s just that I didn’t finish it on my first try. Not that I had any complaints about the writing, it’s just that it was a very difficult and sometimes unbearable account of greed and destruction and I couldn’t handle it. But I did wanna get to know the whole narrative, so here I am continuing it. And it was as compelling as I was hoping it would be.

The author and journalist is great at creating a narrative and keeping the readers engaged. He starts off this story with the arrival of Isaac Sackler in the US at the turn of the 20th century, who wanted his sons to become doctors and was proud to have given them a “good name”. I guess it’s ironic that it’s this good name that is currently being removed from all the museums and institutions the family patronized because no one rightfully wants to be associated with them.

Capitalism might be lauded as the only option which will give people power over their own lives and help them earn money but this book shows what a confluence of capitalism, greed, indifference and a broken healthcare system can lead to. The Sacklers might have perfected the formula of relentlessly advertising their drugs in a way that made it impossible for people not to want to try them, while knowing that Oxy had addictive properties and lying about it, and making billions out of it – and they definitely have the largest culpability in this matter – but it would be amiss if we don’t also blame the politicians who live in Big Pharma’s pockets and would rather the corporations made money than people have affordable healthcare; we can’t forget the regulators or other government officials who probably took bribes and looked the other way or even approved the drug without due diligence; the doctors who were enticed by the free gifts and other incentives and forgot their oath while over prescribing Oxy; even the medical journals who promoted it as a wonder drug; and the sales people who were technically only doing their jobs but helped push the drug into the hands of the vulnerable people. Everyone has their own culpability in the death and destruction and trauma that ensued but I’m sure not many will ever face any consequences for what they’ve done.


The Sackler family is definitely getting away with their billions while Purdue Pharma is the one that’s bankrupt. Even the $6 billion settlement that was announced this year can’t make up for the more than 500,000 deaths and the families across the country who have been wrecked. And the Sackler family I’m sure has much more money to live a rich life for generations. But in a country where the rich can away with pretty much anything with the veneer of a corporation covering them and when we have politicians who are most concerned about the rights of the billionaires to exploit more people, I guess we should be satisfied with just the fact that the Sackler name will be forever tainted due to being the main progenitors of the opioid crisis and that they have ruined the “good name” their patriarch thought he was giving them.

5 star

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