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Publisher's Summary

National Book Critics Circle Nominee

A New York Times Notable Book of the Year

New York Times best seller

A grand, devastating portrait of three generations of the Sackler family, famed for their philanthropy, whose fortune was built by Valium and whose reputation was destroyed by OxyContin. From the prize-winning and best-selling author of Say Nothing

The history of the Sackler dynasty is rife with drama - baroque personal lives; bitter disputes over estates; fistfights in boardrooms; glittering art collections; Machiavellian courtroom maneuvers; and the calculated use of money to burnish reputations and crush the less powerful. The Sackler name has adorned 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 the sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing a blockbuster painkiller that was the catalyst for the opioid crisis. 

Empire of Pain begins with the story of three doctor brothers, Raymond, Mortimer, and the incalculably energetic Arthur, who weathered the poverty of the Great Depression and appalling anti-Semitism. Working at a barbaric mental institution, Arthur saw a better way and conducted groundbreaking research into drug treatments. He also had a genius for marketing, especially for pharmaceuticals, and bought a small ad firm.

Arthur devised the marketing for Valium, and built the first great Sackler fortune. He purchased a drug manufacturer, Purdue Frederick, which would be run by Raymond and Mortimer. The brothers began collecting art, and wives, and grand residences in exotic locales. Their children and grandchildren grew up in luxury.

Forty years later, Raymond’s son Richard ran the family-owned Purdue. The template Arthur Sackler created to sell Valium - co-opting doctors, influencing the FDA, downplaying the drug’s addictiveness - was employed to launch a far more potent product: OxyContin. The drug went on to generate some 35 billion dollars in revenue, and to launch a public health crisis in which hundreds of thousands would die. 

This is the saga of three generations of a single family and the mark they would leave on the world, a tale that moves from the bustling streets of early 20th-century Brooklyn to the seaside palaces of Greenwich, Connecticut, and Cap d’Antibes to the corridors of power in Washington, DC.  Empire of Pain chronicles the multiple investigations of the Sacklers and their company, and the scorched-earth legal tactics that the family has used to evade accountability. 

Empire of Pain is a masterpiece of narrative reporting and writing, exhaustively documented and ferociously compelling. It is a portrait of the excesses of America’s second Gilded Age, a study of impunity among the super elite and a relentless investigation of the naked greed and indifference to human suffering that built one of the world’s great fortunes.

©2021 Patrick Radden Keefe (P)2021 Random House Audio

What the critics say

2021 Financial Times and McKinsey Business Book of the Year Award"

2022 J. Anthony Lukas Book Prize

2021 National Book Critics Circle Awards

2022 PEN/John Kenneth Galbraith Award for Nonfiction

2021 The Baillie Gifford Prize

New York Times Book Review 100 Notable Books of the Year • One of The Washington Post's 10 Best Books of 2021 • TIME Magazine 100 Must Read Books of 2021 • One the Best Books of the Year: NPR, Slate, EW, Boston Globe, Goodreads, The Guardian, Town & Country, BuzzFeed, LitHub, Vulture, and more • Winner of the Baillie Gifford Prize for Non-Fiction • One of President Obama's Favorite Books of the Year

“I read everything he writes. Every time he writes a book, I read it. Every time he writes an article, I read it … he’s a national treasure.” - Rachel Maddow, host of MSNBC’s “The Rachel Maddow Show” and author of the #1 New York Times bestselling Blowout 

“An engrossing (and frequently enraging) tale of striving, secrecy and self-delusion….Keefe nimbly guides us through the thicket of family intrigues and betrayals… Even when detailing the most sordid episodes, Keefe’s narrative voice is calm and admirably restrained, allowing his prodigious reporting to speak for itself. His portrait of the family is all the more damning for its stark lucidity.” - Jennifer Szalai, The New York Times 

“A true tragedy in multiple acts. It is the story of a family that lost its moorings and its morals… Written with novelistic family-dynasty and family-dynamic sweep, EMPIRE OF PAIN is a pharmaceutical FORSYTHE SAGA, a book that in its way is addictive, with a page-turning forward momentum.”  - David M. Shribman, The Boston Globe

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What listeners say about Empire of Pain

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It hurts to read this book.

Before you overdose, opioids kill you one day at a time. In 2013, at age 83, my mother had a hip replacement. It hurt. She saw a locum in the small Canadian town where she lived. “Don’t worry,” he said, “you can take as much as you want, you won’t get addicted.” Anyone who is reading this book knows what happens next.

You can’t recover, or the supply dries up. So you manage to keep getting sicker. One cane became two. Two canes became a walker. The walker became a wheelchair. Terrible, terrible pain, can’t get out of bed anymore. The path to the nursing home strewn with lies, cruelty, recklessness, despair. While her overdoses were not fatal, opioids ruined her, and they tore our family apart. My mom died in 2017, still trying to figure out how to get “something stronger.”

The book resonated with me because it located our experience on the continuum of pain and death created by the Sackler Empire. So much suffering and loss is still happening two decades after the you-can’t-get-addicted lie was exposed. I read the book, and I wept.

Today is Mother’s Day.

15 people found this helpful

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One of the best Expose stories I ever read

This is a story of a Pharma scandal (OxyContin) that I knew a little from the recent press coverage of the family’s settlement in court.

Patrick Keefe brings this scandal to life by tracing the Sackler’s family history and the progression of their pursuits as drug manufacturers.

The wealth of data presented in this book, its insightful analysis and beautifully written prose is what makes the book such a delight to read, despite the tragedy associated with the OxyContin scandal.

Most importantly this is a book that is probably best enjoyed in its audio, rather than written version. That is because Patrick does a superb interpretative job of reading it.

Don’t get discouraged by the book’s length. You will be satisfied from beginning to the very end.

5 people found this helpful

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Great, objective overview of the path of Purdue

Well written, extremely well researched and thorough. Provides a comprehensive insight into how the Sackler family came into their wealth, and more broadly highlights some of the issues around pharmaceutical marketing and general corruption of the government agencies responsible.

2 people found this helpful

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Fascinating, frightening and essential listening!

Ever since reading an article in the Guardian a number of years ago on the Sackler family, I have been both fascinated and disgusted and the complete disregard that this family had for life. Their horrific arrogance to use the blood money they received from all the victims of OxyContin for their philanthropy and an addiction of their own to slap their name on any building they saw fit is beyond comprehension.
There are countless books/articles/videos on the devastation of OxyContin…but no book has ever dived as deep into the lengths that this family has gone to give a false narrative of exactly what their intentions were from the very beginning.
The narrator manages to keep you hooked and interested throughout, not an easy feat for such a long book!

2 people found this helpful

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  • JMS
  • 2021-06-09

I predict major awards for this one! Unforgettable

Every once in a while, I listen to work of narrative non-fiction so extraordinary, so outrageous, and so heartbreaking that I’m reminded that truth is stranger than fiction. Empire of Pain is all those things. If you listen to this audiobook, prepare to feel angry. Even outraged. Listen to my complete review on the Audiobook Reviews in Five Minutes podcast

2 people found this helpful

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Living it

Being one of perhaps thousands of parents with a child in the grips of opioid addiction this book did not provide me relief that perhaps I had hoped for. Rather I am left disgusted and angered and steadfast that we as a society have in no way dealt with what led to this crisis in a way that we could say ‘it’ll never happen again’.

The depth and expanse of the history of repeated failures, criminality and decades of uninterrupted damage the author has revealed provides some understanding of what led us here. There is no mystery. There are however significant unanswered calls for accountability. That the FDA and Canada’s HPFB failed completely to protect the average citizen requires addressing.

A must read for the unveiling of the on-going crisis.

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Amazing book

This book read like a mystery novel, there were so many twists and turns. It was so well documented and researched. I had listened to a podcast called “the Wind of Change” by Patrick Radden Keene and so enjoyed how he narrated and researched this podcast that when I saw he had written Empire of Pain I immediately bought it on Audible.

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Wow!

An incredible feat of investigative journalism detailing the rise and fall of the Sackler family, who developed, marketed and sold OxyContin with a full understanding of its addictive nature and its contribution to the opioid crisis. Whatever you think you know, there's more. The author is a great narrator, too. Excellent.

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Remarkable

This seems to be one of the great, revealing works of our time. I am deeply impressed by Keefe’s research and writing style that kept me enthralled throughout.
Greed, by the wealthy, has been a topic I’ve been curious about for many years. This book brings the opportunity to see how the blind greediness of the Sackler family originated in the disturbing brilliance of Arthur Sackler to the blatant horror of the latter generations.
The legal and governing system’s corrupt associations with the wealthy is on full display.
May mercy be extended to the USA because you live in a warped and cruel form of capitalism.
Bravo to Keefe! You did incredible work.

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Beyond shocking, and powerfully disturbing.

As a physician practising interventional pain management for the past 17 years, I have a deep and personal connection to the opioid crisis, and of course to Purdue, and the company’s past unsavoury and unbridled efforts to aggressively market their product in the very ways detailed in Mr. Keefe’s daunting account.

Like a number of other physicians, I was aggressively approached and indeed courted by the beautifully coifed Purdue salesforce in 2012, when they were to release their “tamper resistant” version of OxyContin here in Canada (branded as OxyNEO) and was asked to host a number of educational seminars on chronic pain management, essentially to promote the ‘safety’ of this new and improved formulation.

As a hired KOL (key opinion leader) in the medical field, when presenting what is deemed an ‘accredited’ educational deck to colleagues, it is accepted that a speaker may change about 5% of the contents to incorporate their own opinions, reflecting an individual physician’s personal “off label” recommendations, without losing the accredited status. To be clear, the word “accredited” in this context means that the educational deck has been approved by relevant medical societies in the jurisdiction at hand, as well as legislation pertaining to the prevailing laws governing pharmaceutical advertising and promotion for VALIDATED educational credits that all practicing doctors must regularly undertake.

When I was hired to give half a dozen of these presentations on behalf of Purdue, the one glaring thing that I noticed in the deck, is that there was absolutely ZERO reference to any dangers of the obvious and significant addictive potential from their strong opioid medication, and the possibility of death from such addiction and acute overdose. I was stunned to review this ‘accredited’ deck and see absolutely no mention of this. Anywhere. Looking back in retrospect, and with the advantage of now having read Mr. Keefe’s book, this just speaks to the shocking lack of proper regulatory oversight, if not actual complicit participation in this sad chapter of history.

At the time, I naively thought this omission was merely an odd and unfortunate oversight on the part of Purdue (and the regulators with oversight!) and proceeded to insert an extra slide (only ONE) right near the beginning of the deck, which simply spoke to the obvious: notwithstanding any abuse-deterrent coating, this medication clearly still had significant addictive potential, and should be prescribed judiciously, and with utmost caution. This was the only insert I added to the entire presentation.

Following my first such presentation to a group of physicians (and by all accounts it was well received by the attendees), the very next day my Purdue sales rep showed up in my office with lunch for everyone, and proceeded in a very deferential and smiling way to suggest that “I might want to remove that slide for the remainder of my presentations”.

I was absolutely stunned, and irate. I flew off the handle, indicated that I was so obviously and clearly only speaking an ethical truth, instructed the rep to not ever make clinical and medical suggestions to me again, and to leave my office, take the lunch with him that he had brought, and to not return.

The following day I received a very courteous and polite email from one of the senior people at Purdue Canada, explaining to me that “we have decided to go in a different direction” and indicated they had found another speaker, and would be sending me a cheque for the full balance of all the talks that I had yet to give.

At a subsequent global meeting of the IASP (International Association for the Study of Pain) in Milan that later fall, I was on another speaker panel, that unbeknownst to me it had a dinner event associated with it that was sponsored by Purdue, I was barred from entering. This was the first time I realized the power and corruption of this company.

Needless to say, all this led me to a complete disassociation with Purdue, and frankly, a distrust for the entire opiate-peddling pharmaceutical industry.

My correspondence with Purdue at the time surrounding this event left me so shocked and incredulous, that although it is now more than a decade since it happened, I kept everything on my computer in a file, time-stamped and locked, for posterity. As well, a copy of my presentation deck, in which I merely changed the one slide with an appropriate warning, is also locked, and time-stamped. I only wish that I had known of Mr. Keefe’s writing of this exposé, as surely my little anecdote might have added to this unbelievably orchestrated and pervasive cloak of corruption and misinformation that the Sackler family knowingly oversaw and perpetrated for so long. And of course, it was not until much, much later that I even learned of the association of this family to Purdue.

This book is an absolutely incredibly well written and completely shocking account of how all of this came to be. Personally, what absolutely flabbergasted me, was the extent to which all of this was so well known, literally more than a decade prior to my own brief involvement with the company, now already a decade ago.

Thank you Mr. Keefe for writing such a much-needed accounting of this deeply sad chapter in medical history. One can only hope that we all will learn something from this, but sadly, I am deeply skeptical, given what history has shown us time and again.

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  • Edward Bisch
  • 2021-04-13

Full Account of the Sackler Conspiracy

Since losing my son in 2001 and living much of the book , I can attest that this book covers it all and I believe anyone who listens to this will come to one conclusion that this is a CRIME story.
Only the SacklerACT can prevent a horrible ending to this chapter in history that Patrick masterfully chronicled.

91 people found this helpful

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  • Elizabeth Lund
  • 2021-04-18

MUST READ... you need to know who the Sackler family is

Mr Keefe gives a very informative story with a clear insight to a family that most of us had never heard of. The Sackler family hid behind their pharmaceutical company Purdue Pharma, making billions of dollars, knowing that people were becoming addicted to their OxyContin that they sold. The Sacklers’ did not have a care in the world that people were dying everyday because of their drug that caused the opioid crisis. The Sacklers’ just continued on living the high life at the expense of other families. Mr Keefe opens your eyes to the corruption that goes on with the pharmaceutical industry and how people with money are offered a different justice then the rest of us. A true tragedy that could have and should have been stopped years before.

52 people found this helpful

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  • Candy
  • 2021-04-21

Definitely a Must Read!

One of the best non fiction books I've read. The story of the 3 arrogant generations associated with the opioid crisis is eye opening.

32 people found this helpful

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  • Cris McBride
  • 2021-04-20

Wow! Now I understand the opioid epidemic!

Having come of age as Valium, then MS Contin, and Oxicontin became major approaches to dealing with anxiety and pain, and having heard physicians repeat the sales pitch they received from a drug sales rep, the information presented in this book was not only very interesting, but more important, very educational.
The author has been meticulous in researching the information that he presents. The book is well written, presenting the information in a historical context to explain how the Sackler family businesses managed to create and market the drugs that would destroy so many lives. I highly recommend this book.

26 people found this helpful

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  • Amazon Customer
  • 2021-04-20

Thank you to Patrick Radden Keefe

I am very grateful for this book that exposes the truth about OxyContin and the Sackler family. My nephew started on OxyContin problem and quickly graduated to heroin use. He has been in and out of drug rehabilitation his whole adult life and struggled now with felonies and other stigma.

22 people found this helpful

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  • Nina Jacobson
  • 2021-04-20

Unputdownable

You won't find a better reporter or storyteller than Patrick Radden Keefe. I was spellbound from the first page.

21 people found this helpful

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  • L. Gronet
  • 2021-04-21

Excellent!

Great writing and investigating. This family is beyond evil, and now I know the FDA is too!

16 people found this helpful

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  • Tim
  • 2021-04-19

Devil’s Family

How many families will cry over this book, remembering their loved ones passing away from their addiction from Oxycodone? “Empire of Pain” has been highly publicized in the upcoming weeks before it’s debut. We all know the opiate pandemic and the millions of lives that were lost, but how much do we know the Devil’s Family? If you want to know more about the Sackler’s, then this book is all about their family’s history.

16 people found this helpful

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  • Neil Solanky
  • 2021-04-21

Excellent

Have recommended it to everyone I have talked to since I started the book. I would expect nothing less from Keefe, a magnificent writer, researcher, and journalist. Thorough, but not dull for a single second.

12 people found this helpful

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  • Xavier
  • 2021-04-20

Excellent

This and his book on the troubles, Say Nothing, are excellently reported and well written.

12 people found this helpful