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Littler Books cover of Empire of Pain: The Secret History of the Sackler Dynasty Summary

Empire of Pain: The Secret History of the Sackler Dynasty Summary

Patrick Radden Keefe

3.6 minutes to read • Updated April 6, 2025

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Book Description

An exploration of the Sackler family's rise and their pivotal role in the opioid crisis.

If You Just Remember One Thing

The Sackler family's aggressive and deceptive marketing of OxyContin, despite knowing its addictive potential, played a ce... More

Bullet Point Summary and Quotes

  1. The Sackler brothers (Arthur, Mortimer, and Raymond) were First-Generation Americans born to Galician and Polish immigrants, Issac and Sophie. Isaac initially ran a grocery store and later invested in real estate. The family struggled financially as their businesses faltered and the Great Depression hit. Issac and Sophie wanted their children to continue their education but could not pay for it.
    1. "It must have been painful for Isaac to say this. But he insisted that he had not given his children nothing. On the contrary, he had bestowed upon them something more valuable than money. 'What I have given you is the most important thing a father can give,' Isaac told Arthur, Mortimer, and Raymond. What he had given them, he said, was 'a good name.'"
  2. The Sackler brothers built immense wealth and philanthropic renown through their company, Purdue Pharma. Their fortune largely came from the painkiller OxyContin, launched in 1996 and marketed as safe, which generated billions for the family. The Sacklers aggressively pushed OxyContin despite knowing its addictive potential, fueling a devastating opioid crisis that caused widespread addiction and death.
  3. Arthur was a driven entrepreneur from a young age. He juggled multiple jobs in high school and college, eventually becoming a doctor and a successful medical advertising executive who revolutionized pharmaceutical marketing.
  4. Arthur's innovative and morally questionable advertising strategies, especially for tranquilizer Valium, targeted physicians and helped make it the most prescribed drug in America.
  5. Arthur remained closely connected to his younger brothers, Mortimer and Raymond, helping them establish medical careers and eventually buying a small pharmaceutical company with them in 1952 -- Purdue Frederick.
  6. Mortimer and Raymond managed the company day-to-day while Arthur focused on his advertising agency and other integrated ventures.
  7. Arthur strategically integrated his ventures -- advertising, medical publications, and pharmaceutical data collection -- to boost Purdue's influence and profits.
  8. Mortimer led a lavish lifestyle in Europe, spearheading expansion there. Raymond remained low-profile and family-oriented in Connecticut.
  9. Purdue's acquisition of a British morphine pill (MS Contin) marked a major breakthrough in pain management.
    1. “MS Contin really was an incredible medicine because it allowed cancer patients, particularly, not to have to be hospitalized to have their pain treated.”
  10. The Sackler family used philanthropy and naming rights at prestigious institutions like the Met and the Guggenheim to elevate their social status and legacy. However, they distanced themselves from their businesses.
  11. Purdue sold MS Contin without approval from the Food and Drug Administration. The company argued that the only active ingredient (morphine) had long been approved.
  12. Arthur's death in 1987 led to power struggles within the family and the eventual creation of Purdue Pharma by the second generation Sacklers, including Mortimer's and Raymond's children.
  13. MS Contin faced a looming patent expiration, prompting the development of a much stronger opioid (OxyContin) with Richard Sackler (Raymond's son) playing a leading and obsessive role.
  14. In 1994, Michael Friedman, the head of marketing at Purdue, sent a secret memo outlining the idea of reshaping attitudes toward opioid prescriptions to expand OxyContin's use beyond cancer treatment.
  15. Purdue cultivated a close relationship with FDA official Curtis Wright, who fast-tracked OxyContin's approval.
    1. "After the approval for OxyContin went through, he resigned from the FDA... Barely a year later, he moved on, to a new position at Purdue Pharma, in Norwalk, with a first-year compensation package of nearly $400,000."
    2. The unsubstantiated label "Delayed absorption, as provided by OxyContin tablets, is believed to reduce the abuse liability of the drug." was added to the package under Wright.
  16. Purdue's aggressive marketing employed a large sales force that used misleading talking points to downplay OxyContin's addictive potential.
  17. Purdue's claim that patients rarely get addicted to opioids came from an unsubstantiated letter to the editor of New England Journal of Medicine.
    1. "Much later, one of the authors of the letter, Hershel Jick, would say that he was 'amazed' by the degree to which Purdue and other companies used this minor academic offering to justify the mass marketing of strong opioids."
  18. Purdue funded deceptive astroturf advocacy groups to push for looser pain management standards.
  19. “Since its release nearly two decades earlier, OxyContin had generated some $35 billion.”
  20. Despite internal reports and sales reps noting abuse of OxyContin as early as 1997, Purdue dismissed concerns. Purdue shifted blame to users and law enforcement, portraying addiction as a problem of individual behavior rather than a flaw in the drug or its marketing.
  21. "Lurking in the discussion groups, West [Purdue's legal secretary] found people talking about crushing OxyContin tablets, sucking the time-release coating off, snorting the drug, cooking it, shooting it with a hypodermic needle... the memo was then circulated to numerous senior Purdue officials and to 'all the Sacklers' who were then actively involved in the company."
  22. A 2007 criminal investigation resulted in a guilty plea and a $600 million fine for Purdue, but key evidence was sealed, and no Sackler family members faced charges (though three executives took pleas without felonies).
  23. As the opioid crisis worsened, public outrage erupted against the Sackler family, leading to demands for their name's removal from institutions.
  24. As the patent OxyContin was expiring, Purdue developed a new tamperproof version called OxyContin OP. It had no effect on the opioid crisis.
    1. “Inside the company, there was an acknowledgment that Purdue's claims about abuse deterrence were, at best, theoretical. The Sacklers knew, because their staff informed them, that the leading method for abusing OxyContin was not snorting or shooting the pills at all but swallowing them whole, which the reformulation would not prevent.”
    2. “The reality was that a lot of these people were already addicted. Many had been for years. They had passed a point of no return. And as it happened, there was an inexpensive substitute for OxyContin that was cheaper and stronger and widely available: heroin.”
    3. “In subsequent years, scholars would sift through statistics related to the sudden rise in heroin overdoses beginning in 2010 and conclude that many of the Americans who were taking heroin had started out taking OxyContin and other prescription drugs. According to the American Society of Addiction Medicine, four out of five people who started using heroin during this period did so after initially abusing prescription painkillers.”
  25. Purdue faced further massive litigation over its role in the crisis. The company declared bankruptcy and was restructured. While the Sacklers contributed billions to the settlement (largely from selling another firm after withdrawing funds from Purdue), they admitted no wrongdoing, faced no criminal charges, and retained their personal wealth, though their family name became permanently tarnished.

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