What will I learn about: how Arthur Sackler revolutionized modern pharmaceutical advertising by marketing directly to physicians and using dubious tactics to push drugs like Valium?

Discover how Arthur Sackler revolutionized modern pharmaceutical advertising by marketing directly to physicians and using dubious tactics to push drugs like Valium.

What will I learn about: the origins of the Purdue Pharma dynasty, tracing its growth from selling unglamorous drugstore products to developing revolutionary time-release opiates?

Understand the origins of the Purdue Pharma dynasty, tracing its growth from selling unglamorous drugstore products to developing revolutionary time-release opiates.

What will I learn about: Learn why the Sackler family aggressively donated millions to brand prestigious global institutions with their name while intentionally obscuring their ties to the businesses funding their wealth?

Learn why the Sackler family aggressively donated millions to brand prestigious global institutions with their name while intentionally obscuring their ties to the businesses funding their wealth.

What will I learn about: how Purdue Pharma catalyzed the devastating opioid crisis by falsely marketing OxyContin as safe and pushing doctors to prescribe it for mild pain?

Find out how Purdue Pharma catalyzed the devastating opioid crisis by falsely marketing OxyContin as safe and pushing doctors to prescribe it for mild pain.

What will I learn about: Uncover the secretive, integrated network of medical advertising, research institutes, and sales data collection that the Sacklers built to silently manipulate physician prescribing habits?

Uncover the secretive, integrated network of medical advertising, research institutes, and sales data collection that the Sacklers built to silently manipulate physician prescribing habits.

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Empire of Pain

The Secret History of the Sackler Dynasty

Patrick Radden Keefe

★ 4.5 / 5(68 ratings)

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Society & Culture Biography & Memoir History

If You're Curious About These Questions...

You should listen to this audiobook

💡Did you know how one elusive family managed to convince the medical world that a highly addictive drug was actually safe for everyday use?
💡Have you ever wondered why some of the world’s most prestigious museums and universities were named after a family central to a global health catastrophe?
💡What’s the secret behind how a billionaire dynasty used a fortress of lawyers and political connections to shield themselves from accountability for decades?

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Key Takeaways from Empire of Pain

✓Discover how Arthur Sackler revolutionized modern pharmaceutical advertising by marketing directly to physicians and using dubious tactics to push drugs like Valium.
✓Understand the origins of the Purdue Pharma dynasty, tracing its growth from selling unglamorous drugstore products to developing revolutionary time-release opiates.
✓Learn why the Sackler family aggressively donated millions to brand prestigious global institutions with their name while intentionally obscuring their ties to the businesses funding their wealth.
✓Find out how Purdue Pharma catalyzed the devastating opioid crisis by falsely marketing OxyContin as safe and pushing doctors to prescribe it for mild pain.
✓Uncover the secretive, integrated network of medical advertising, research institutes, and sales data collection that the Sacklers built to silently manipulate physician prescribing habits.

Learning Tools

Reinforce what you learned from Empire of Pain

Mind Map

Empire of Pain

Foundation of the Empire+

The Sackler Paradox+

The OxyContin Strategy+

Denying the Crisis+

The Reckoning and Escape+

Quiz — Test Your Understanding

Question 1 of 8

How did Arthur Sackler revolutionize pharmaceutical advertising during his career?

A. By appealing directly to physicians through medical journals and enlisted doctors.
B. By creating the first television commercials for prescription drugs.
C. By lobbying Congress to allow direct-to-consumer advertising.
D. By offering money-back guarantees to patients who did not experience relief.

Question 2 of 8

What was the revolutionary aspect of MS Contin, the drug developed by Purdue Frederick prior to OxyContin?

A. It was the first non-addictive opioid approved by the FDA.
B. It used a time-release coating that allowed cancer patients to manage pain at home.
C. It was synthesized entirely from artificial chemicals rather than poppy plants.
D. It was the first painkiller that could be safely mixed with other medications.

Question 3 of 8

Which of the following best describes the Sackler family's approach to their public image and business ownership?

A. They used their pharmaceutical companies' names to sponsor art exhibits while remaining personally anonymous.
B. They actively became the public face of Purdue Pharma to build trust with physicians.
C. They generously donated to institutions for naming rights while intentionally obscuring their connection to their businesses.
D. They refused to donate to public institutions in order to keep their immense wealth entirely secret.

Question 4 of 8

What crucial strategy did Purdue Pharma use to ensure OxyContin would be far more lucrative than MS Contin?

A. They priced the drug significantly lower than generic alternatives to corner the market.
B. They marketed the drug for general, non-cancer pain to tap into a much wider patient demographic.
C. They sold the drug exclusively through their own mail-order pharmacy.
D. They designed the pill to be easily crushed so it would act faster for severe trauma patients.

Question 5 of 8

What was the basis for Purdue Pharma's claim that less than one percent of opioid patients became addicted to OxyContin?

A. A short letter to the editor buried in a medical journal based on one doctor's observations.
B. A comprehensive, ten-year clinical trial conducted by the FDA.
C. Peer-reviewed studies funded by the American Pain Foundation.
D. Internal research conducted secretly by Purdue Pharma executives.

Question 6 of 8

How did Purdue Pharma initially respond to reports that patients were experiencing withdrawal and that the drug was wearing off before 12 hours?

A. They immediately recalled the drug to adjust the time-release formula.
B. They blamed the issue on 'pseudo-addiction' and encouraged doctors to increase the patients' dosage.
C. They sued the FDA for providing incorrect labeling guidelines.
D. They admitted the drug's flaws and offered financial compensation to affected patients.

Question 7 of 8

What was the true impact and context of Purdue releasing a new, tamper-proof formula of OxyContin?

A. It was released early in the drug's lifecycle and successfully halted the opioid epidemic.
B. It was mandated by the FDA in 2007 as part of Purdue's guilty plea bargain.
C. It was released only after the original patent expired to block generics, and it ultimately drove many addicted users to heroin or fentanyl.
D. It was developed by the American Pain Foundation to provide a cheaper alternative to the original drug.

Question 8 of 8

What was the ultimate result of the massive 2019 litigation against Purdue Pharma and the Sackler family?

A. Several members of the Sackler family were sentenced to federal prison for fraud.
B. The Sacklers lost their company through bankruptcy but managed to protect billions of dollars in personal wealth without admitting wrongdoing.
C. Purdue Pharma was completely exonerated after proving the FDA was solely responsible for the crisis.
D. The Sacklers were forced to return all their profits, leaving the family completely bankrupt.

Empire of Pain — Full Chapter Overview

1Recommendation
21 — Chapter 1: Arthur and His Younger Brothers
32 — Chapter 2: The Sacklers Create a Dynasty
43 — Chapter 3: What Does a Name Mean?
54 — Chapter 4: The Next Generation Takes Up the Mantle
65 — Chapter 5: The Painkiller to Begin With and Keep Using
76 — Chapter 6: How a Crisis Was Made
87 — Chapter 7: The Billionaires’ Tarnished Reputation
98 — Final summary

Empire of Pain Summary & Overview

Empire of Pain (2021) follows the rise and fall of the elusive Sacklers, the billionaire family behind Purdue Pharma. Its blockbuster drug, OxyContin, was aggressively marketed as safe, but would go on to spur a devastating opioid crisis that claimed hundreds of thousands of lives. Yet the Sacklers’ fortress of lawyers, political connections and a philanthropic name would, time and again, protect them from responsibility.

Who Should Listen to Empire of Pain?

Current affairs enthusiasts
Lovers of family dynasty dramas
Anyone wanting to understand the opioid crisis

About the Author: Patrick Radden Keefe

Patrick Radden Keefe is an award winning journalist and staff writer at The New Yorker. In 2014 he received the National Magazine Award for Feature Writing. He has written several books, including the previous bestseller Say Nothing (2018).