Empire of Pain
How a dynasty fueled an epidemic
Description
In the years before OxyContin became a household word, the Sackler name meant something else entirely: a wing at the Metropolitan Museum of Art, a courtyard at the Louvre, galleries at the Smithsonian, a library at Oxford, whole institutes at Harvard and Columbia. For decades the family sat near the top of American philanthropy, its name chiseled into marble beside the great fortunes of the age. What almost nobody knew was where the money came from. In Empire of Pain, the journalist Patrick Radden Keefe spends more than five hundred pages answering that single question, and the answer implicates one of the deadliest public-health disasters in American history.
The company was Purdue Pharma, privately held, controlled by the descendants of three brothers named Arthur, Mortimer, and Raymond Sackler. In 1996 it launched a time-release painkiller it promised was different — less addictive, safer, a breakthrough for patients in genuine pain. Doctors believed it. Over the next two decades, prescription opioids and the street drugs that followed them were tied to the deaths of hundreds of thousands of Americans. Purdue made billions. The family kept its distance, its name on the buildings and off the bottles.
Keefe's book is not a courtroom drama or a policy paper. It is a family saga that spans three generations, from an ambitious son of immigrants in Depression-era Brooklyn to heirs defending a fortune in bankruptcy court. The story of how a dynasty built respectability on one product and reputation on another runs through all of it.
The question we’re asking : How did one family turn a painkiller into a fortune, a fortune into prestige, and prestige into a shield when the reckoning came?What we’ll see : A dynasty across three generations, the marketing machine behind a single pill, and the long fight over who would pay for the wreckage.
Table of contents
01Chapter 1 — The man who sold the doctors
The story does not start with a pill. It starts with an advertising man. Arthur Sackler, the eldest of three brothers born to Jewish immigrants in Brooklyn, trained as a psychiatrist but made his fortune in medical marketing. In the 1950s and 1960s he ran an agency that revolutionized how drugs were sold — not to patients, who could not buy them, but to the doctors who wrote the prescriptions. His signature triumph was Valium, which he helped turn into the most prescribed drug in the Western world.
Arthur's methods became the template for an industry. He understood that a physician trusted data, or the appearance of it, more than a sales pitch. So he wrapped promotion in the language of science — studies, journal ads, sponsored symposia, an entire medical newspaper he quietly controlled. He grasped that if you could shape what doctors read, you could shape what they prescribed. Keefe shows how the line between medical information and advertising, which Arthur spent his career erasing, would matter enormously decades later.
02Chapter 2 — A molecule and a script
By the 1990s Purdue was controlled by Raymond's and Mortimer's branches of the family, and it needed a blockbuster. Its earlier painkiller, MS Contin, was losing patent protection. The answer was oxycodone, a potent opioid, packed into a time-release coating that would dissolve slowly over twelve hours. The idea was elegant: steady relief, fewer pills, less of the peak-and-crash that made narcotics tempting to abuse. Purdue called it OxyContin and launched it in 1996.
The problem was the promise attached to it. Purdue told doctors the time-release formula made the drug less prone to abuse, and it seized on a line the Food and Drug Administration allowed onto the label — that delayed absorption 'is believed to reduce the abuse liability.' From that single clause the company built a marketing campaign of extraordinary reach. Sales representatives fanned out with the message that the risk of addiction was low, well under one percent, a figure drawn from evidence that could not bear the weight placed on it.
03Chapter 3 — The reckoning that money couldn't buy
For years the family stayed invisible. The name was everywhere in the art world and nowhere in the coverage of the epidemic; even reporters who wrote about OxyContin rarely connected Purdue to the philanthropists on the museum walls. That began to change in the mid-2010s, as journalists, activists, and a wave of lawsuits pulled the Sacklers into the light. Keefe's own reporting was part of that shift, and the book records how fiercely the family and its lawyers pushed back against it.
The pressure came from two directions at once. State attorneys general filed suit, and their complaints named individual Sacklers, quoting internal emails in which family members pressed for more aggressive sales. And the art world turned. The photographer Nan Goldin, who had survived her own OxyContin addiction, led protests inside the very institutions the family had funded, staging die-ins beneath the Sackler name. One by one, the Met, the Louvre, the Tate, the Guggenheim and others began stripping the name from their walls — the reversal of everything Arthur had bought.
04Chapter 4 — What a name on a wall protects
Step back from the Sacklers and Empire of Pain becomes a study of how a modern fortune insulates itself from its own consequences. The book's deepest subject is not a drug but a mechanism: the way concentrated private wealth can separate the source of money from the meaning of the name attached to it. The Sacklers did not hide the fortune. They displayed it, in the most public places culture offers, precisely so that the word 'Sackler' would summon galleries and endowments rather than overdose data.
Keefe shows this working at every level. Philanthropy did more than buy goodwill; it built an identity that had nothing to do with the business, so that for decades the two could not be spoken of in the same breath. The corporate structure did similar work. Because Purdue was private and the family sat on the board rather than in the executive suite, blame could always be routed to the company, to its salespeople, to the abusers of the drug — anywhere but to the people who owned it and drew the profits. When the 2007 plea came, executives took the fall; the owners were untouched.
05Conclusion
Empire of Pain ends where it cannot fully resolve, because the reckoning it describes was still unfolding as Keefe wrote. The family had lost its place on the museum walls and much of its public standing, but it had not lost the bulk of the fortune, and it had conceded no guilt. The gap between those two facts — reputation shattered, wealth largely intact, wrongdoing denied — is the book's final, unsettling image.
