This was a great book that is written like a novel. Empire of Pain is a highly readable history of the Sackler family and their rise and fall from grace. The book starts with the brothers Arthur, Mortimer, and Raymond, who made millions off of various medicines and advertisements for medicines. It continues, after Arthur's death, with the children of Mortimer and Raymond, who gradually take over the company. One in particular, Richard, son of Raymond, is especially important, as he invents and aggressively markets Oxycontin, the drug that would earn billions for the family and become a major cause of the opioid crisis in America.
The entire first part of the book is really about Arthur, who was the leader of the brothers. If you are totally interested in the opioid crisis and not the family, this part is probably not even necessary for you to read. However, it was really well-written and interesting. You get to see Arthur rise up from a working-class family in Brooklyn and become a multi-millionaire who is completely obsessed with work and collecting art and artifacts from around the world. His only other hobby is donating said art and artifacts (as well as millions of dollars) to museums so that he could have his name put on galleries and wings. His second wife said that, "Arthur found safety and comfort in objects; they could not hurt him, they could not make demands on him." Arthur had very little public life besides his philanthropy. Arthur's death is so abrupt and sudden I had to reread it. He felt chest pains and went to a hospital without informing his family and checked in under a fake name. He did not want to be dependent on anyone and feared that someone may take advantage of him while he was impaired. By the time his family found out that he was in the hospital, he was already dead. He left $600,000 to each of his four children and over $100 million to his third wife.
In general, this family sucks. It's not just Arthur. They're not just callous to all the human lives they ruined with Oxycontin, but they are also just terrible to each other. Constant fighting over money, disrespect for one another, and backstabbing. The environment they lived in seems really horrible.
Oxycontin even had a damaging effect on Purdue because it made higher returns than anything else. As a result, people didn't want to invest in products that couldn't return as much as Oxy, and there was simply nothing they could invent that was better. As a result, Purdue's profits depended more and more on Oxycontin, and the company never diversified. Purdue tried to claim that they were responsible for only 4% of the opioid epidemic, but that was only in pills sold. Purdue sold the highest-intensity pills, and when you account for that, they sold 27% of all oxycodone. In some areas, Purdue's market share was 30%.
The Sacklers, and their company, Purdue Pharma, knew early on that Oxycontin was addictive and that people were abusing it. They tried to argue that the special slow-release coating they put on it meant that the drug was not addictive, but all that happened was that addicted users would crush the pills or chew them to break that layer and get a huge hit of oxycodone. When Purdue finally got in trouble in 2007, three non-Sacklers took the fall and were each paid millions by the company. From 1997 to 2007, Purdue paid out $126 million to the Sacklers. But once they knew that the company was in trouble, they raided the treasury. After 2007, the company paid out billions to the Sacklers, who moved it overseas to avoid US authorities. The feds will be searching for that money for a long time.
Miscellaneous Facts:
- During the 1930's, many American medical schools established Jewish quotas, as by the mid-1930's more than 60% of applicants were Jewish. Yale marked Jewish applicants' forms with H for Hebrew.
- Curtis Wright (the former FDA Director, not the company Curtiss-Wright) left the FDA and worked for a small pharmaceutical firm for one year before accepting a position at Purdue Pharma (the Sackler company) that paid him a first-year compensation package of nearly $400,000 dollars. CORRUPT.
- African-Americans were hit less hard by the opioid epidemic. The author writes that doctors were less likely to prescribe black patients with opioids because they either did not trust them to take the drug responsibly or because they did not feel as much empathy or belief for/in their pain.
- Tasmania, Australia grows 85% of all the thebaine in the world. Thebaine is similar to opium and used in Oxycontin.
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