Empire of Pain: The Secret History of the Sackler Dynasty (2021) traces the rise of the wealthy and influential Sackler family and their central role in the American opioid crisis through their company, Purdue Pharma.
The making of a dynasty
The book begins with brothers Arthur Sackler, Mortimer Sackler, and Raymond Sackler, who built enormous wealth through pharmaceuticals and innovative drug marketing.
Arthur in particular transformed pharmaceutical advertising, helping create modern drug marketing techniques.
The rise of OxyContin
In the 1990s, Purdue introduced OxyContin, a powerful opioid painkiller.
The company aggressively marketed it to doctors, often minimizing addiction risks and encouraging broad prescribing. The book argues that these practices contributed significantly to widespread opioid addiction in the United States.
Secrecy and reputation management
Keefe portrays the Sacklers as intensely private while simultaneously seeking public prestige through donations to museums, universities, and cultural institutions.
As the opioid crisis worsened, the family worked to protect both its wealth and reputation.
Accountability and power
A major theme is how wealth, political influence, and complex corporate structures can shield powerful people from legal and public accountability.
Deep investigative reporting based on court records, documents, interviews, and internal company materials.
Reads with the pace of a novel while remaining heavily documented.
Illuminates the connections among business, medicine, philanthropy, and public health.
Some critics argue that the book places overwhelming emphasis on the Sacklers and less on broader causes of the opioid epidemic, such as physician prescribing culture, regulatory failures, and socioeconomic factors.
Because it focuses on one family, some readers may find the broader context underdeveloped.
The book is valuable for understanding how the American opioid epidemic developed and for exploring larger questions about corporate responsibility, philanthropy, and the influence of wealth in society. It is widely regarded as one of the most important works of investigative journalism on the opioid crisis.