I had not heard about this book by Patrick Radden Keefe until my book club elected to read about and discuss it for our July book. I knew absolutely nothing about the Sackler family. I don’t think I had ever heard of them before this book.
If you’re as clueless about this book as I was when I first picked it up (I listened to the audiobook, which Keefe reads himself, and he’s better at it than most nonfiction writers), it focuses on the Sackler family, who have made billions of dollars off the sale of oxycontin, which has contributed to, if not outright created our current opioid crisis.
The book starts with Isaac Sackler, whose sons, Arthur, Raymond, and Mortimer, all co-founded and co-ran Purdue Pharma, the company that ended up getting the patent for oxycontin.
I’m not sure why Keefe decided to go so far back into the family history. Maybe because he wanted to give an idea of why Arthur always felt like he had to strive for more, no matter how much he had. Isaac made some good real estate investments and was doing pretty well for himself, but then the Great Depression hit and he lost everything. He managed his affairs pretty well, so that he did not die in debt, but he had nothing left to pass on to his sons when he died. He told them that a fortune lost can be won back again, but once you’ve lost your good name, there’s no coming back from that.
Once Arthur had become an established millionaire, he became an art collector and made huge donations to colleges, universities, and museums in order to have his name on all the different buildings. At the same time, he was very particular about how his name was used, so that each donation came with a lot of red tape.
Arthur and his brothers all went to medical school, but Arthur always had a knack for advertising and making money, even before he went to medical school. After medical school, he used his talents to advertise prescription drugs, while using his medical degree to make it look like he was a trustworthy source of medical information. His entire advertising campaign relied on deliberately providing the appearance of educating his readers, while maintaining enough plausible deniability to ease his conscience and maybe hold up in court? He did get called before the Senate at one point for his advertising practices and basically filibustered his way through it, which manages to be both impressive and despicable at the same time.
After Purdue Pharma was sued by every state (or almost every state) in the country for their deceptive advertising practices and their unethical practices of continuing to sell oxycontin to doctors they knew were running drug mills, Arthur’s ex-wife claimed Arthur never would have let the company do any of that. And yet Purdue Pharma used Arthur’s playbook when it came to advertising the drug.
Keefe’s research into how Arthur convinced both doctors and the public to buy the drugs he was advertising had me so paranoid about the pharmaceutical industry. Not that I was ever a fan of Big Pharma, but this book just gave me more reasons not to trust anything they say or do.
I should probably reveal that I was on oxycontin for a few months when I was 16. I had back surgery to correct my scoliosis, which is a pretty painful operation, so I was prescribed both oxycontin and valium (which also makes a brief appearance in this book). So when Keefe was rattling off dates, I was trying to line up my experience with what he was discussing. He briefly mentions when it was famously revealed that Rush Limbaugh was addicted to oxycontin. That news broke right around the time I was weaning myself off oxycontin and Keefe writes as though that was the beginning of people realizing how addictive oxycontin was.
But I don’t ever remember my GP being casual about my oxycontin use. In fact, he came up with a plan for me to wean myself off of it because we both knew how addictive it was (for the record, getting off of it sucked, but as far as I was concerned, being on it was worse because the claims about oxycontin not having any side effects are just more lies).
One of the most mind boggling parts of the book is towards the end when Keefe describes a WhatsApp conversation between the current generation of Sacklers who own and run (and deny they run) Purdue Pharma. According to Keefe, the conversation is full of strategies and theories about getting out of their legal mess without any indication they feel any remorse or acknowledgement that they did anything wrong. Instead, they see themselves as the victims because they’re getting sued. As much as I might occasionally indulge in fantasies of getting rich, I hope I never become that out of touch.