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The Sackler family has been a prominent philanthropic dynasty, with close to 14 billion dollars, in the class of Mellons and Rockefellers. The group has been involved with the Metropolitan Museum, Rockefeller University, Harvard, Tufts, NYU, Oxford, and the Guggenheim Museum—among others. One might say, as a museum director opined, a modern Medici. They have also been involved with several thousand lawsuits.
The drug manufacturer known as Purdue Pharma (on whose board were many Sacklers) introduced OxyContin, which was involved with 450,000 overdose deaths. The three Sacklers involved who had M.D.s were all psychiatrists. This empire should be known to all M.D.s, but to neurologists and psychiatrists, in particular.
The saga that Keefe describes in this book in exquisite detail is truly monumental—on the scale of the tobacco story. Corporate efforts to repeatedly underestimate the hazards of opioids were facilitated “unwittingly” (?) by the FDA! The Sackler family was brilliantly defended by lawyers of impeccable credentials and political savoir
faire. The notion that the FDA actually protects the U.S. consumer was nothing but a “comforting myth” according to Barbara Moulton—as far back as Estes Kefauver's senatorial committee in the late 1950s. How effectively the current FDA functions remains “uncertain” in the public domain.
The Sacklers were extraordinarily skillful marketers with newspapers, journals, and multiple local physicians. The notion about the safety of opioids was certainly aided by the American Pain Society and academics such as Russell Portenoy and Katherine Foley. Several judges were chosen to more favorably consider the outcome of the situation. At one point the international scope of the opioid crisis was formidable.
The text of Empire of Pain is separated into three books: Patriarch, Dynasty, and Legacy. These comprise 29 chapters.
An early chapter, “The Dendur Derby,” (Chapter 7) in Patriarch (10 chapters long) describes the Metropolitan Museum's