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Demon’s Pain Makes Him Bleed - Part 2 - Empire of Pain

Schuyler Pagenstecher

Updated: Oct 2, 2023

Welcome to Hot Write Now’s second post, where I recommend a book that you should read. To continue this series of book recommendations, Demon’s Pain Makes Him Bleed, I suggest that you read Empire of Pain: The Secret History of the Sackler Dynasty by Patrick Radden Keefe.


Why you should read Empire of Pain

The company  distributed a pamphlet to doctors that suggested addiction “is not caused by drugs.” Rather, “it is triggered in a susceptible individual by exposure to drugs, most commonly through abuse.” (Page 336)

In Demon’s Pain Makes Him Bleed Part 1 I recommended that you read Demon Copperhead, a coming of age novel set during the opioid epidemic in the narrator’s home of Lee County, Virginia, that excels in portraying how OxyContin, a semi-synthetic opioid, came to ravage much of rural America. Many of the factual details author Barbara Kingsolver deftly employs in Demon can be validated in this post’s book: Empire of Pain.


Patrick Radden Keefe’s Empire of Pain, a work of narrative non-fiction, examines several generations of the Sackler family, who amassed a fortune by marketing Valium in the 1960s, and subsequently developing OxyContin with their privately held company Purdue Pharma. Progenitor Arthur Sackler and his nephew-heir-apparent Richard Sackler serve as the primary figures in Empire of Pain, and Radden Keefe’s decades spanning account keeps the reader engaged all the way.


Radden Keefe’s captivating, detailed writing is best demonstrated with direct quotes, so let’s start with an anecdote on Arthur Sackler’s high school experience at Erasmus Hall High School in Brooklyn during the Great Depression:

In addition to his studies, he  joined the student newspaper as an editor and found an opening in the school’s publishing office, selling advertising for school publications. Rather than accept a standard pay arrangement, Arthur proposed that he receive a small commission on any ad sale he made. The administration agreed, and soon Arthur was making money. Nor was he content with the one job. He set up a business to handle photography for the school yearbook. After selling advertising space to Drake Business Schools, a chain specializing in postsecondary clerical education, he proposed to the company that they make him—a high school student—their advertising manager. And they did. (Page 16)

Where many high school kids struggle to convince their neighbors to pay them to do a mediocre job shoveling their driveway, A. Sackler was operating as a capitalist version of the protagonist in Wes Anderson’s Rushmore (1998). This early fondness for advertising continued throughout Arthur’s life, but his adult career in the pharmaceutical advertising space of the ‘50s and ‘60s is not as cute as the high school student/advertising manager:

One of the ads, a brochure that had been sent to doctors in the mail, said, More and More Physicians Find Sigmamycin the Antibiotic Therapy of Choice It featured an array of business cards with the names, addresses, and office hours of eight doctors, who appeared to be endorsing the product. There was a doctor in Miami, another in Tucson, a third in Lowell, Massachusetts. Sigmamycin was not just “highly effective,” the ad suggested, but “clinically proved.” Intrigued, Lear  wrote to the doctors himself. His letters came back unopened. He sent telegrams, only to be informed that no such addresses existed. Finally, he tried calling the telephone numbers on the business cards in the ad, but without success: the numbers were made up, too. Pfizer had blasted this advertisement, with its fake endorsements, to physicians across the country. And it looked so plausible, so real, with the special patina of authority conferred by eight MDs. The ad was polished, impressive, and fundamentally deceptive. It had been produced by Arthur Sackler’s agency. (Page 95)

Arthur Sackler’s agency was unsurprisingly successful with these tactics (which he applied to Valium in addition to the antibiotic mentioned above), and he used some of his earnings to amass a collection of Chinese art. If the name Sackler sounds familiar to you, much of his collection can be seen at the Smithsonian's Arthur M. Sackler Gallery.

Whereas the Sacklers tended to insist, through elaborate “naming rights” contracts, that any gallery or research center that received their generosity must prominently feature the family name, the family business was not named after the Sacklers. In fact, you could scour Purdue Pharma’s website and find no mention of the Sacklers whatsoever. (Page 4)

The Sackler family’s next generation continued to employ Arthur Sackler’s dark arts of deception to great financial success. With Richard Sackler, Arthur’s nephew, at the helm, Purdue Pharma used similar tactics to launch OxyContin:

The  sales team had what the company described as “non-branded” literature: material generated by ostensibly independent groups, which had actually been produced or funded by Purdue. The company established a speakers bureau, through which it paid several thousand doctors to attend medical conferences and deliver presentations about the merits of strong opioids. Doctors were offered all-expenses-paid trips to “pain management seminars” in places like Scottsdale, Arizona, and Boca Raton, Florida. In the initial five years after OxyContin’s release, the company sponsored seven thousand of these seminars. (Page 240)

Seven thousand seminars! That’s almost four a day for those five years! And where was Richard Sackler during all of this? At times he was operating out of a B movie bad guy’s corporate lair with his animal sidekick UNCH:

He  had a bulldog, which he often brought with him . The dog was named UNCH, after the stock market abbreviation for “Unchanged,” which indicates that a company’s share price ended the trading day at the same level where it started. Sometimes, an employee would get dressed up in his best suit for a meeting with Richard, only to arrive in the boss’s book-lined office and notice, under the glass-topped desk, that UNCH was slobbering all over the freshly pressed leg of his trousers. UNCH had a tendency to shit in the hallways, and Richard had a tendency to not pick it up. So visitors to the ninth floor learned to weave around the occasional deposit left by the dog on the royal purple carpet. (Page 350)

While this image of Richard + UNCH is absurd and funny, the profit and human cost behind OxyContin is absurd and tragic. Some estimates put the Sackler’s OxyContin fortune at $14 billion, and the CDC estimates prescription and illicit opioid overdose killed 500,000 people in America from 1999 - 2020.


Empire of Pain is one of my new favorite books of narrative non-fiction, and reading Patrick Radden Keefe’s work is an engaging, haunting journey. You should also read this book to better understand the forces behind the opioid epidemic, and the harmful deception that corporations are capable of.


Miscellaneous

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Sources

Empire of Pain was my primary source for putting this together, and I also used these:

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