Empire of Pain

Patrick Radden Keefe traces three generations of the Sackler family, the owners of Purdue Pharma, from patriarch Arthur Sackler's pioneering and ethically dubious pharmaceutical marketing innovations through to Purdue's aggressive promotion of OxyContin in the 1990s and 2000s, and the family's decades-long campaign to deny, deflect, and litigate away responsibility as the opioid crisis killed hundreds of thousands of Americans. Keefe builds a meticulous, court-document-backed case that Purdue Pharma knew, far earlier than it publicly admitted, that OxyContin was being widely misused and diverted, and marketed the drug aggressively to primary care doctors anyway, while family members simultaneously cultivated a philanthropic reputation through major donations to museums and universities worldwide.

This matters as a case study in how legal, respectable institutions — a pharmaceutical company, elite philanthropy, the civil justice system — can be used to generate immense harm while insulating the people responsible from meaningful accountability; Purdue's eventual guilty pleas and bankruptcy settlement left most Sacklers personally shielded from the kind of consequences the scale of the crisis might suggest they deserved, a resolution Keefe presents as a genuine institutional failure worth scrutinizing rather than a natural endpoint.

Who should read it

Anyone who wants to understand the corporate and legal machinery behind America's opioid crisis, and readers interested in how wealthy families use philanthropy, litigation, and reputation management to control public narratives about their own conduct. It's essential reading for anyone who assumed the opioid epidemic was primarily a story about street drugs rather than a legally marketed pharmaceutical product.

About the author

Patrick Radden Keefe is an American investigative journalist and staff writer at The New Yorker, known for deeply reported narrative nonfiction including Say Nothing, about the Troubles in Northern Ireland.