Book of the week: Empire of Pain
Patrick Radden Keefe examines the dynasty behind the opioid crisis

“Some books make you so angry you want to chuck rocks at the bad guys they expose,” said John Arlidge in The Sunday Times. “This book is one of those.” It tells the story of the Sackler family, whose firm, Purdue Pharma, created the painkiller OxyContin, which “fuelled America’s opioid crisis”.
Although this isn’t the first book about the crisis, it goes further than any other: Patrick Radden Keefe, a writer for The New Yorker, draws on newly released court documents and more than 200 interviews to show how the Sacklers derived a multibillion-dollar fortune from a pill they “knew was highly addictive”.
The epidemic it spawned has destroyed communities, and killed half a million people – “more than died in all the wars the country has fought since 1945”. And yet for decades, the Sacklers “got away with it” – even becoming celebrated philanthropists, thanks to their lavish donations to museums and galleries.
The Week
Escape your echo chamber. Get the facts behind the news, plus analysis from multiple perspectives.

Sign up for The Week's Free Newsletters
From our morning news briefing to a weekly Good News Newsletter, get the best of The Week delivered directly to your inbox.
From our morning news briefing to a weekly Good News Newsletter, get the best of The Week delivered directly to your inbox.
The three Sackler brothers, Arthur, Mortimer and Raymond, were born to Jewish immigrants in Brooklyn, became doctors and bought Purdue in 1952, said Joanna Walters in Literary Review. Arthur became a “leading light in the nascent medical advertising industry” – a “toxic marriage of pills and ad men” – and deployed “all kinds of slippery tactics” to make Valium the most widely abused prescription drug of its day.
Where he led, his descendants followed, said Samanth Subramanian in The Guardian. When OxyContin was launched in 1996, the Sacklers relied on studies they themselves had funded to bolster the claim that it was less addictive than other opioids. The drug was approved by the Food and Drug Administration (FDA) – by an official who a year later was “working at Purdue, earning $400,000 a year”.
Equally amoral was Purdue’s marketing of OxyContin, said Melanie Reid in The Times. Sales reps “fanned out across the US”, targeting doctors in regions where many people lived with chronic pain. Patients were offered free 30-day taster courses, and doctors were incentivised to “titrate up” – gradually increase the dose. When it became clear that thousands were becoming addicted, Purdue shifted the blame to the drug users – as Arthur Sackler had done with Valium.
“It is a measure of great and fearless investigative writing that it achieves retribution where the law could not.” To this day, no Sackler has ever faced criminal prosecution – and the family has retained most of its billions in personal wealth. “But Radden Keefe has, word by forensic word, dismantled what mattered most to them: their reputation.”
A free daily email with the biggest news stories of the day – and the best features from TheWeek.com
Pan Macmillan 560pp £20; The Week Bookshop £15.99
The Week Bookshop
To order this title or any other book in print, visit theweekbookshop.co.uk, or speak to a bookseller on 020-3176 3835. Opening times: Monday to Saturday 9am-5.30pm and Sunday 10am-4pm.
-
Home Depots are the new epicenters of ICE raids
In the Spotlight The chain has not provided many comments on the ongoing raids
-
Why does Trump keep interfering in the NYC mayoral race?
Today's Big Question The president has seemingly taken an outsized interest in his hometown elections, but are his efforts to block Zohran Mamdani about political expediency or something deeper?
-
The pros and cons of banning cellphones in classrooms
Pros and cons The devices could be major distractions
-
Art review: Lorna Simpson: Source Notes
Feature Metropolitan Museum of Art, New York City, through Nov. 2
-
Jessica Francis Kane's 6 favorite books that prove less is more
Feature The author recommends works by Penelope Fitzgerald, Marie-Helene Bertino, and more
-
Book reviews: 'Baldwin: A Love Story' and 'The Fort Bragg Cartel: Drug Trafficking and Murder in the Special Forces'
Feature A loving James Baldwin biography and the drug crimes of two special ops veterans
-
Rigatoni with 'no-vodka sauce' recipe
The Week Recommends Comfort food meets a clever alcohol-free twist on a classic
-
6 blooming homes for gardeners
Feature Featuring a greenhouse in Illinois and 13 raised garden beds in New Mexico
-
The Roses: Olivia Colman and Benedict Cumberbatch star in black comedy reboot
The Week Recommends 'Acidly enjoyable' remake of the 1980s classic features a warring couple and toxic love
-
Film reviews: The Roses, Splitsville, and Twinless
Feature A happy union devolves into domestic warfare, a couple's open marriage reaps chaos, and an unlikely friendship takes surprising turns
-
Music reviews: Laufey, Deftones, and Earl Sweatshirt
Feature "A Matter of Time," "Private Music," and "Live Laugh Love"