EMPIRE OF PAIN

By Patrick Radden Keefe

Have you heard of the Sackler family? Perhaps the name rings a bell.

In the UK alone, there is (or was) the Sackler Building at the Royal College of Art, the Sackler Education Centre at the V&A, the Sackler Room at the National Gallery, Sackler Hall at the Museum of London, the Sackler Pavilion at the National Theatre, Sackler Studios at the Globe Theatre, the Sackler Library at the University of Oxford, and even a stained-glass window in Westminster Abbey dedicated to the Sacklers.

For decades, the Sackler family has been a striking example of how we commonly understand the difference between philanthropy and charity. Instead of giving purely for the sake of giving (charity), the Sacklers attached stringent contractual provisions to their gifts, stipulating that their name must appear on everything and prescribing that most of their gifts be paid in instalments (so that the tax advantages often meant the Sacklers were better off for having given the gift).

They donated millions of dollars a year, racking up a long list of prizes, scholarships, buildings, and even an escalator bearing their name. This giving started only one generation ago. So where did all this money come from?

Pharmaceuticals and drug advertising. Primarily, in the case of the second Sackler generation to give away billions of dollars, OxyContin. Does that ring a bell too?

For decades, the Sacklers quietly made obscene amounts of money from aggressively pushing the opiod OxyContin. It wasn't until fairly recently that reporters matched the hallowed Sackler name, bestowed on our most loved institutions, with the source of their wealth: the drug credited with fuelling the opioid crisis.

Empire of Pain is a paradigm of outstanding investigative journalism. Maintaining an almost unwavering commitment to going no further than describing the facts as he has had demonstrated to him, Keefe tells the story of a family dynasty built on greed, corruption, and total disregard for people affected by their actions.

The book is a devastating portrait of many things: the Sackler family, but also the corruption and failings of federal and state institutions, politicians, doctors, pharmacists, courts, judges, and the way that we have separated the legal construct of a company from the individuals running it to such a degree that people can get away with wreaking unbelievable harm upon society for their personal profit.

One reason the book is so engaging is Keefe's detached, almost deadpan telling of the facts. It will make your blood boil, but Keefe doesn't whip the story up into a scandal: the facts are a scandal.

The immoral and illegal behaviour of the Sacklers is so incredibly enraging that the fire doesn't need fanning. Expertly heading off any criticism of the work for unduly focusing on one family or neglecting the wider context, Keefe relays the very real considerations of pain patients and explains that the Sacklers weren't solely responsible for the crisis. That the facts, even told in a balanced, mostly unemotional way, are still shockingly reprehensible is what makes this book so important.

An endnote: parts of the book detail the deplorable strategies suggested and validated by external consultants hired by the Sacklers including, predictably, McKinsey & Co. Empire of Pain is a portrayal of a family obsessed with putting their name to things, despite their disgraceful behaviour in generating the wealth they used to do so. You'll join me, then, in being astounded that the book was shortlisted for Business Book of the Year 2021, a prize which is sponsored by (and bears the name of) McKinsey & Co. McKinsey's name is on the cover of a book that relays, at times with excruciating detail, the company's dreadful role in driving the opioid crisis. You cannot make this stuff up.