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. Amid all the venality and hypocrisy, one of the terrible ironies that emerges from Empire of Pain is how the Sacklers would privately rage about the poor impulse control of 'abusers' while remaining blind to their own.
... masterfully damning ... Empire of Pain, Keefe explains in his afterword, is a dynastic saga. Like Purdue, it is all about the Sackler family: how it transformed American medicine, the key role it played in the opioid crisis ... Empire of Pain amply demonstrates that Arthur [Sackler] created the playbook used to make OxyContin a blockbuster drug ... Keefe has a knack for crafting lucid, readable descriptions of the sort of arcane business arrangements the Sacklers favored. He is also indefatigable.
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. We see the Sacklers moving from marketing to entrepreneurship to art collecting to philanthropy to ignominy. It is an American story, and an American tragedy—and travesty ... thanks in large part to Keefe, the anonymity of the principals behind OxyContin not only is shattered, the fog that has shrouded the entire sad episode also has been stripped away.
In Empire of Pain, Keefe marshals a large pile of evidence and deploys it with prosecutorial precision ... How Purdue came to be...is one of many contorted tales of family conflict that can occasionally be difficult to follow. But Keefe is a gifted storyteller who excels at capturing personalities, which is no small thing given that the Sacklers didn’t provide access ... During the bankruptcy hearings, several family members of the deceased tried to speak, apparently hoping for closure. Among them was a woman who lost her brother ... She didn’t get to make her speech. The judge said it was inappropriate for the forum. But the story lives on in Keefe’s book—juxtaposed, as it should be, with that of the Sacklers.
In his impressive exposé the journalist Patrick Radden Keefe lays the blame [for the opioid crisis] directly at the feet of one elite family, the billionaire owners of Purdue Pharma. The decisions that birthed and perpetuated the epidemic were not made by employees or a management team, he reveals, but by members of this cultured clan of physicians, long acclaimed for their arts philanthropy ... As Keefe ably demonstrates, it was the Sacklers who dreamed up OxyContin as a solution to an anticipated revenue decline, and it was the Sacklers who insisted their powerful narcotic, the sort of drug previously reserved for terminal patients, be marketed aggressively and widely ... The book’s final part is less powerful, perhaps inevitably, as it covers the fits and starts of pending litigation against the company and its ongoing bankruptcy proceedings. Still, it is a compelling chronicle of the lengths to which the rich will go to avoid accountability and the sterling-resuméd lawyers and spin doctors eager to help ... I wish Keefe made space in this very long book — more than 500 pages with footnotes — to describe the effect of opioids on a family that wasn’t named Sackler ... That is a shame because Keefe is such a talented researcher and storyteller, and a sustained portrait of one of the multitude of families ruined by the Sacklers’ drug would have presented their callousness in even starker relief.
Put simply, this book will make your blood boil ... The broad contours of this story are well known...But what would normally be a weakness becomes a strength because Keefe is blessed with great timing. In the past few years, numerous lawsuits filed against Purdue by state attorneys general, cities and counties have finally cracked open the Sacklers’ dome of secrecy. Thousands of court documents have become public through discovery, including internal company emails and memos that give new insight into the family’s actions and thinking. Keefe combines this wealth of new material with his own extensive reporting to paint a devastating portrait of a family consumed by greed and unwilling to take the slightest responsibility or show the least sympathy for what it wrought ... While other accounts of the opioid crisis have tended to focus on the victims, Empire of Pain stays tightly focused on the perpetrators ... While Arthur’s life makes for fascinating reading, he played no role in the OxyContin saga, which made me question Keefe’s decision to devote fully one-third of the book to him. Arthur’s heirs, who after his death sold their stake in Purdue to his brothers, Raymond and Mortimer, will surely bemoan this choice...It’s hard not to agree with them. Arthur may have been the first to blur the lines between medicine and commerce, and he pioneered modern drug marketing, but his sins pale compared with those of the OxySacklers ... the trove of documents that has since come to light through the multidistrict litigation, which Keefe weaves into a highly readable and disturbing narrative, shatters any illusion that the Sacklers were in the dark about what was going on at the company.
Keefe has a way of making the inaccessible incredibly digestible, of morphing complex stories into page-turning thrillers, and he's done it again ... a scathing—but meticulously reported—takedown of the extended family behind OxyContin, widely believed to be at the root cause of our nation's opioid crisis. It's equal parts juicy society gossip (the Sackler name has been plastered across museums and foundations in New York and London, they attend society events with the likes of Michael Bloomberg) and historical record of how they built their dynasty and eventually pushed Oxy onto the market. It's not likely to flip-flop anyone's opinion over who is to blame for the addiction epidemic: If you've made it this far with your belief of the Sacklers' innocence intact, there's likely nothing that can be said to sway you. But for the rest of the reading public, it lives out every promise inherent in the word exposé ... there's a chance that fans of his may feel less closure than they hoped for after reading Empire. But what he has done is provide a record of this disaster and a terrific starting ground for other journalists and authors who'd like to pick up the torch (he also does break plenty of news, releasing WhatsApp conversations and emails between Sacklers that show the family members portraying themselves as victims of an anti-OxyContin news cycle, among other items).
... the fullest picture of Sackler family dynamics so far, including what the family knew about OxyContin’s dark side and when ... Moving alongside the history of how the Sacklers accumulated their wealth is Keefe’s lucid, unrelenting portrayal of how the Sacklers, especially Richard, were fully aware of alarming reports of overdose deaths related to their product but continued to press and press for more sales ... Keefe’s book is ultimately an important record of private greed facilitated by a corrupted government. The book’s conclusion is somewhat open-ended ... one thing that’s certain after reading Keefe’s book is that between an ever-growing death toll from overdose deaths and a generation of pain patients left to fend for themselves, much more than lawsuits and money is needed to get America out of this painful nightmare.
... among the revelations in Keefe’s tour-de-force account is the degree to which the Sacklers pioneered the aggressive advertising and direct selling to doctors of the US pharmaceutical industry ... Keefe whose previous book Say Nothing told the story of a hushed-up IRA killing in 1970s Belfast, brings to Empire of Pain the same coolly prosecutorial prose style, backed by voluminous research ... It is a long book and he walks a fine line between nailing down the facts and keeping the reader engaged ... But by talking to more than 200 people who knew generations of Sacklers, he brings to life the obsessive personalities and ferocious energy of some members.
Indefatigable investigative journalist Keefe crafts a page-turning corporate biography and jaw-dropping condemnation of the Sacklers’ amoral disregard for anything save the acquisition of power, privilege, and influence. In Keefe’s expert hands, the Sackler family saga becomes an enraging exposé of what happens when utter devotion to the accumulation of wealth is paired with an unscrupulous disregard for human health.
History repeats itself and disaster ensues in this sweeping saga of the rise and fall of the family behind OxyContin ... It's an altogether damning portrait...richly detailed and vividly written. Readers will be outraged and enthralled in equal measure.