The painful history of the Sacklers’ OxyContin empire.
Patrick Radden Keefe discusses his book about the Sackler family’s role in the US opioid crisis.
Photography by Fran Monks
Please remember that the value of an investment can fall and you may not get back the amount invested. This article originally featured in Baillie Gifford’s Spring 2022 issue of Trust magazine.
During his gap year, Patrick Radden Keefe sold tickets at a theatre on Harvard Square in Cambridge, Massachusetts, a stone’s throw from Harvard University’s Arthur M. Sackler Museum. Later, attending Columbia University in New York, he would visit the Sackler Wing at the Metropolitan Museum of Art (the name was dropped in December 2021). To him, the Sackler brand was in with the bricks of these elite institutions, and he gave it no further thought.
Then the New Yorker staff writer started reading about the US’s opioid crisis, blamed for more deaths than all American combat fatalities since the second world war. The penny dropped on learning about the role played by Purdue Pharma in developing the painkiller OxyContin. “I realised that the Sacklers own this company and said, ‘Wait a second, it’s those Sacklers?’”
When I meet him in a cafe near London’s Marylebone Station in early December 2021, Keefe, who won the Baillie Gifford Prize for Non-Fiction the previous month, is on his way to another book award ceremony at the National Gallery. “Three rooms down from the Sackler room,” he notes. The family’s extensive financial patronage of UK arts and academic institutions is now under scrutiny. Some beneficiaries, such as Serpentine Galleries and Tate Modern, have already chosen to remove the Sackler name.
Keefe’s investigation into the dynasty, whose vast fortune mushroomed through the development and aggressive marketing of OxyContin, has been widely acclaimed. The family, it’s safe to surmise, will not be happy about that.
Linda Geddes in conversation with Patrick Radden Keefe
Keefe modestly shrugs off the award ceremonies, speaking engagements and photoshoots the success of his book has brought him. When our hot drinks don’t turn up, he sips contentedly from a glass of tap water, enjoying the cafe’s complimentary fruit chews.
An investigative journalist with well-reviewed books on Northern Ireland’s troubles and New York’s Chinatown underworld behind him, Keefe likes to “go deep”. His interest in the Sacklers dates back to his investigation of Mexican drug cartels for The New York Times. “I noticed that the cartels were very sensitive to consumer demand, and you have this moment when they started suddenly sending more Mexican heroin into the United States in around 2010 or 2011.”
The reason was that over the previous decade, millions of Americans had become addicted to opioids through OxyContin and other prescription pharmaceuticals. Designed to slowly release a chemical cousin of morphine called oxycodone into the bloodstream, OxyContin was prescribed to people suffering from a vast range of conditions ranging from severe cancer pain to mild backache. But many patients found themselves addicted, and the crushed and snorted pills became a street drug with a thriving black market.
The Metropolitan Museum of Art has announced that seven exhibition spaces will be renamed, including the wing containing the Egyptian Temple of Dendur (pictured) © Seth Wenig/AP/Shutterstock
The introduction of a tamper-resistant formulation of OxyContin in 2010 saw many of these individuals turn to heroin to get their high.
In Empire of Pain, Keefe charts the rise of the Sackler dynasty, from its beginnings as Polish and Austrian immigrants in early 20th-century New York to its fall from grace, with multiple US states filing lawsuits against Purdue Pharma for deceptive marketing practices. The company filed for bankruptcy in 2019, agreeing to a $4.5bn settlement the following year.
It’s a fascinating story, not least because of the remarkable depth of characterisation Keefe achieves, despite no Sackler family member agreeing to be interviewed. Instead, Keefe spoke to those who had worked with them; who knew them socially; who had been college roommates or had worked as housekeepers, doormen, yoga instructors. Also helpful were the numerous court documents from previous litigation, including private emails and WhatsApp messages.
Their reputation lies in tatters, with arts and academic institutions cutting ties
The first third of the book focuses on Arthur, Mortimer and Raymond Sackler, three brothers who trained as doctors in New York. The eldest, Arthur, built the family’s first fortune. He left medicine to work in pharmaceuticals advertising, revolutionising the field and creating a world in which OxyContin and other drugs could later be aggressively promoted to doctors.
Arthur’s tactics included the placement of large advertisements in medical journals and newspapers to raise awareness of the benefits of certain drugs and their target patients. Others included the direct courting of medical opinion leaders and regulators, while armies of Purdue sales reps separately wined and dined family doctors, offering them branded freebies in the name of ‘medical education’.
I put it to Keefe that doctors bear some responsibility for the opioid epidemic. They were the ones writing the prescriptions and witnessing the consequences first-hand. “Doctors were absolutely complicit. In some instances, they were guilty of criminal misconduct: they would set up ‘pill mills’ and take money to issue prescriptions,” Keefe says.
However, he believes that naivety played its part. “A lot of doctors just didn’t know much about the treatment of pain, didn’t know much about opioids. Then you had this army of sales representatives who came along and said: ‘You have patients who are in pain, it’s terrible … and here we have this amazing wonder drug that’s not addictive, and it will deliver them from pain.’ Many were too quick to listen to that siren song.”
We discuss the disconnect between the ‘do no harm’ mantra that the Sacklers had learned at medical school and their apparent indifference to the suffering their products unleashed. Court documents make clear that Purdue Pharma was aware of the addiction problem from early on.
The book is scathing about the family culture permeating the business. “Somebody I interviewed said that a Purdue Pharma board meeting was like a particularly acrimonious Thanksgiving dinner.”
In part, this is what fascinated Keefe about the Sackler story. “It isn’t this impersonal kind of mega-corporation. It is actually this small and centrally controlled expression of the family that owns it.”
As for the Sacklers, although their reputation lies in tatters, with arts and academic institutions cutting ties, the family remains fantastically wealthy. Keefe tells me about a reader who said how much they were looking forward to reaching the climax of the book where the Sacklers get their comeuppance. That moment never comes. But as one lawyer quoted near the end of Keefe’s book reflects, despite all the Sacklers’ money, “they can’t buy their reputations back”.
This article first appeared in the Spring 2022 issue of Trust, Baillie Gifford’s bi-annual investment trust magazine. To register for a free copy, delivered to your door or to your inbox please visit bailliegifford.com/trust
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