Empire of Pain

This is the third such book that I have read in the last couple of years, the other two being “The Billion Dollar Loser” on WeWork and on Adam Neumann and “Bad Blood” on Theranos and on Elizabeth Holmes. While the first is about a business built on hubris and the second about a complete fraud, “The Empire of Pain” was the most shocking of the three. It is about a legitimate business that was extremely successful but one that was built using several unethical means and one that ultimately caused the death of thousands of Americans. The book traces the history of the Sackler family and of Purdue Pharma, starting with the early years of Arthur , Mortimer and Raymond Sackler, children of an immigrant family in New York. Their parents desired their sons to become doctors, given the perceived nobleness of the profession, which turns out ironic given the later history of the family. The first section traces the lives and the initial wealth creation of the three brothers, especially that of Arthur. It gives an insight into their ambiguous views on integrity around medical products and conflicts of interest and their desire to be recognised as a leading family in the country. The second section is about the rise of OxyContin as a majorly profitable drug for Purdue, the issue of widespread addiction caused by it and Purdue’s attempts to fight the hundreds of legal cases. The final session is about the third generation and the eventual fall of the company. The book is extremely well-researched and written in a way that makes it interesting reading despite the subject matter and the length of the book. The Sackler empire was built on Roche’s Librium and Valium, especially the latter. By the time Valium was controlled, it was used by 20 million Americans and became the most widely consumed — and abused — prescription drug. The second generation of Sacklers multiplied that wealth with OxyContin.It could be argued that OxyContin was a legal drug, approved by the FDA, but the fact was that America did not have an opioid crisis before the drug’s introduction. It is also clear that the company was aware of the problem for a long time but chose to ignore it for selfish reasons. And its usage of its legal teams, influential government representatives, threats and otherwise Machiavellian methods to thwart any attempts to stop it is simply shocking. The lack of oversight by government institutions is particularly galling — as Keefe puts it, “the opioid industry is, among other things, a parable about the awesome capability of private industry to subvert public institutions”. As I write this review, the Sackler family appears to have got away with it. They have had to pay billions of dollars as penalties, have had to give up their stake in Purdue Pharma and have to bear the ignominy of seeing their family name stripped away from many of their philanthropic attempts. However, they still have several billions of dollars of wealth created by the opioid crisis, have had no criminal charges against them and seem to have procured immunity against future legal liabilities. And that’s indeed a pity! Pros: Extremely well researched, the narrative style makes it an interesting read despite its length Cons: The length of the book to some extent

This *outstanding* book by Patrick Keefe is special for me 'coz it amplifies: - the moral challenge entrepreneurs have to 'do right' at the cost of losing millions and alternatively succumbing to self-satisfying excuses that eventually harm people. (In my case, the resolve is NOT to build "real money mobile games" that addict people). This book is a masterpiece! Why: - Apart from "Red Notice" (reviewed by me), it's the only other book I've read that mentions real-life threats to the author's life (implying the deep impact). - An critical story to learn - as a business grows, the hard choice becomes choosing between morals or profits. In this case, the sheer immorality of the entrepreneurs is staggering. - Deep entrepreneurial insights. How a 'right and left brain' combination (knowledge of medicine and marketing acumen) help companies scale. An ability we must all inculcate. - A deep, important lesson - what is 'legally' right does not mean it's good to go. What is 'morally' right is more important. - How money can buy anything (fame, status, prestige). Indicating that the most glorified institutions of the world are always up for sale. - Life can turn at any moment. "during the Depression, there were doctors in Brooklyn who were reduced to selling apples on the street." - Case study of the birth of 'native' advertising - The dark world of vested interests - 'Philanthropy wasn’t charity, as his lawyer Michael Sonnenreich insisted. It was a business deal." - Chronicles of obsessive behaviour to control outcomes “They were putting pressure on the White House,” the executive said." - The business of professional bribery - "A 2016 study found that purchasing even a single meal with a value of $20 for a physician can be enough to change the way that he prescribes." A MUST Buy and read.

Very good book. Gripping. Revealing how some exploit and make money. That ill-gotten money makes more illegal money. Realized even FDA in USA is not fully trustworthy. Amazing writeup. Recommend to all.

Hats off to the author for pulling this off! The book is marvelous in all respects, fantastic research, great narration and most importantly, for having the spine to call out the extent to which greed can take over. It's a pity that the Sackler family got away without losing anything (more or less). And in general, history will make us shamefully look back at how we allow(ed) large scale white collar crimes and criminals to go scot free..

After reading this book, I feel, anyone and any organisation can be bought in America, you just have to offer the right price.

Empire of Pain is absolutely fascinating but also thoroughly sickening. It clearly illustrates how wealth confers power to corrupt institutions that were created to protect the public. The book is extremely well written and informative. I agree with Illinois congressman Raja Krishnamoorthi's conclusion that the Sacklers were addicted to money. Their addiction completely destroyed their humanity. I also agree with Tennessee congressman Jim Cooper's feeling that he's not aware of any family in America that's more evil than the Sacklers. At Rs. 453, it's a fantastic bargain.

Good book

"Empire of Pain" is a deeply human story of unimaginable greed and corruption. As a firm believer in the free-market economy, I found this book unsettling. It exposes how powerful corporations, armed with immense wealth and influence, can manipulate the system and escape serious consequences. This was the first investigative nonfiction book I’ve ever read, and it has drawn me toward the genre—thanks to Patrick Radden Keefe’s brilliant storytelling. His meticulous research and compelling narrative make this a gripping and eye-opening read.

- ‘Empire of pain’ by Patrick Radden Keefe is incredible, well researched but also a gripping read. It tells the story of three generations of the Sackler family, starting with three brothers and led by Arthur Sackler, whose family started off impoverished but made a lot of money out of marketing drugs though became better known through their philanthropy - there are museums and institutions all over the world that have their names on them. They were certainly known more for this than the valium and librium that they initially sold. And what has been fascinating is when I’ve discussed this story with friends and colleagues in UK, I’ve been amazed that hardly anyone has heard of the opioid crisis in USA and the wide range of deaths it has caused. - The next generation, who were born into the family wealth, had more interest in making lots of money whilst selling their humanity. Chief culprit was Richard Sackler but the rest of the family are pretty much liars and unpleasant - and so wilfully blind to the harm that they deny they have caused or aware that this is so - but they knew. The drug that made them even richer was OxyContin, an opioid that managed pain but turned many who took it into an addiction so strong that many died and thousands of others had lives ruined. They became a legalised version of a drug cartel - though this was approved by the legal American government body (FDA - Food and Drug Administration) that regulates a drugs safety and efficacy. The drug is still causing deaths every day along with other replacements such as fentanyl and has killed more people than all wars that America has fought in since the second world war. - At the same time as reading this book I also stumbled across the television programme ‘dopesick’ with Micheal Keaton that also tells some of this story as well as focusing on the effects that the drug had on innocent citizens (Empire of Pain focuses more on the family). It is really worth watching this program alongside reading the book ‘Empire of pain’. - Empire of Pain seems to have won an awful lot of business books of the year in the end of year best books of the year, although this is definitely a reflection on how not to run a business - unless your aim is to run a business while selling your soul. However the book is more of a horror story and reads like a thriller wrapped up in a corporation of family members who are pretty much legal drug barons, peddling pain, misery, and opioids and addiction in a legal manner and creating an empire of pain that this book so beautifully depicts. - This book is a five star essential read and one of the best books I read in 2021. It has many lessons to teach and the story is riveting. I am off to find more books by this author.

Sakura (cherry blossom) is a Japanese slang term that refers to adorning banal products by conspicuous hired people. Arthur Sackler's Sakura-marketing promotion brought exorbitant money to the Sackler family. Each country has a policy on drugs, and when it comes to painkillers, doctors are strictly prohibited from prescribing opioids in Japan, even though patients yearn to remove chronic pain. The book reveals the dark side of the pharmaceutical industry and the inappropriate drug authorization systems in the US—a very horrible non-fiction story. Pain is annoying but an essential vital sign we should accept to some extent. Would I take the COVID-19 vaccines if I had read this book before?

This was the first non fiction book i have read in a long long time and it was a great experience. It’s an astonishing story, written down in a very clear and captivating style. (And interesting to keep following it in the press).

“I started reading Patrick Radden Keefe due to the book ‘Say Nothing’ about IRA activities in Northern Ireland. Subsequently, I read ‘Empire of Pain,’ detailing how the Sackler family, posing as philanthropists, contributed to the opioid epidemic in the USA. They aggressively promoted OxyContin through Purdue Pharma reps, encouraging doctors to prescribe this highly addictive painkiller, containing oxycodone, a semi-synthetic derivative of opium. The book reveals the deceptive promotion, leading to widespread addiction and the destruction of lives and families over the past 30 years in the USA and beyond. Engaging read, a truly deserving 5-star book!”

Everything Patrick Radden Keefe writes is immaculately researched and brilliantly written. Empire of Pain is one of his best and encouraged me to read everything else he has written. This is an absolute must-read for anyone interested in investigative journalism at its best and to understand where the opioid crisis in America began. It's a riveting read with all the facts beautifully presented. A real tour de force.