The Sackler Dynasty: From Immigrant Dreams to the Opioid Crisis
Empire of Pain by Patrick Radden Keefe is a meticulously researched exposé that chronicles the rise of the Sackler family, from their humble immigrant roots to their role in one of the most devastating public health crises in modern history. This blog post delves into the key moments of their journey, their contributions to medicine and philanthropy, and the dark legacy of OxyContin.
The Immigrant Dream: Building the Sackler Legacy
At the turn of the 20th century, the United States was a land of opportunity for immigrants like Isaac Sackler and Sophie Greenberg. Hailing from the Austrian Empire and Poland, respectively, they arrived with dreams of a better life. Their union laid the foundation for a family that would become one of America’s most influential dynasties.
Isaac, a visionary patriarch, instilled ambition and values in his three sons—Arthur, Mortimer, and Raymond—urging them to pursue careers in medicine. Arthur, the eldest, emerged as the family’s trailblazer, balancing medical expertise with entrepreneurial flair. By age 15, he was already supporting his family financially, showcasing a knack for innovation that would define his career.
Key Takeaway: The Sacklers’ story begins with the classic American Dream, highlighting how determination and vision can create generational success.
Pioneering Psychiatry: The Sacklers’ Medical Breakthroughs
The Sackler brothers faced significant hurdles in their pursuit of medical careers. While Arthur graduated from NYU’s medical school, Mortimer and Raymond were forced to study abroad in Scotland due to restrictive Jewish quotas in U.S. institutions. World War II further disrupted their education, leading them to complete their studies at a non-accredited school in Massachusetts.
At Creedmoor Psychiatric Center, the brothers united to challenge the era’s brutal psychiatric treatments, such as electroshock therapy. Their groundbreaking research into brain chemistry revealed that histamine injections could mimic the effects of electroshock, offering a less invasive alternative. This discovery led to the establishment of the Greedmoor Institute for Psychobiologic Studies in 1950, a milestone that propelled their careers and contributed to the deinstitutionalization of American asylums.
Did You Know? In 1955, U.S. mental institution admissions dropped for the first time in 25 years, thanks in part to the Sacklers’ innovations.
Revolutionizing Pharmaceutical Marketing
Arthur Sackler’s genius extended beyond medicine into marketing. With 15 years of advertising experience by his 30th birthday, he joined William Douglas McAdams, a pharmaceutical ad agency, where he quickly rose to prominence. His campaign for Pfizer’s Terramycin antibiotic redefined industry standards by targeting medical professionals directly through ads in medical journals and covert “studies” funded by pharmaceutical companies.
This strategy not only made Terramycin a household name but also earned Arthur a spot in the Medical Advertising Hall of Fame. By acquiring McAdams and secretly controlling a rival agency, L.W. Frohlich, Arthur and his associates dominated pharmaceutical marketing, raising ethical questions about the influence of advertising on medical care.
The Musketeers Agreement and Purdue Pharma
Arthur’s business acumen extended to strategic partnerships, including the secretive “Musketeers Agreement” with his brothers and Bill Frohlich. This pact ensured that their business interests would pass to surviving partners, with the final survivor’s assets donated to charity. In 1952, Arthur acquired Purdue Frederick (later Purdue Pharma) for his brothers, though he remained a silent partner.
This move marked the Sacklers’ entry into drug manufacturing, setting the stage for their later ventures into pain management. However, it also laid the groundwork for conflicts of interest that would haunt the family.
Philanthropy and Immortality
Arthur’s passion for art and philanthropy became a family hallmark. His extensive collection of Asian art led to significant donations to institutions like the Metropolitan Museum of Art, the Smithsonian, Harvard, and the Louvre. The Sackler name adorned galleries, libraries, and museums worldwide, securing their legacy among the global elite.
Philanthropy offered more than prestige—it promised immortality. As Keefe notes, having the Sackler name etched on cultural institutions ensured their legacy would endure. However, this legacy would later be tainted by controversy.
Notable Institutions:
- Sackler Wing at the Metropolitan Museum of Art (housing the Temple of Dendur)
- Arthur M. Sackler Gallery at the Smithsonian
- Sackler Library at the University of Oxford
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The Rise of OxyContin and the Opioid Crisis
The Sackler dynasty’s darkest chapter began with Purdue Pharma’s shift to pain management under the leadership of Raymond’s son, Richard. Their first major drug, MS Contin (a morphine-based painkiller), was marketed discreetly to avoid stigma. However, the introduction of OxyContin in 1996, driven by Mortimer’s daughter Katie, marked a turning point.
OxyContin, containing the powerful opioid oxycodone, was aggressively marketed as a safe, long-acting painkiller despite its high addiction potential. Purdue’s sales reps, armed with misleading claims, targeted physicians nationwide, fueling a surge in prescriptions. By the early 2000s, warning signs of widespread addiction emerged, leading to a federal investigation.
In 2007, Purdue pleaded guilty to felony misbranding, paying a $600 million fine. Yet, no Sackler family members faced prosecution, and the company continued its practices unabated.
The Fall of an Empire
The opioid epidemic’s toll became undeniable, with thousands of Americans succumbing to addiction and overdose. A 2017 Los Angeles Times article exposed OxyContin’s exaggerated 12-hour pain relief claims, revealing severe withdrawal symptoms that drove addiction. By 2020, 49 states had filed lawsuits against Purdue, and for the first time, Sackler family members were named in legal proceedings.
Despite their political connections and legal defenses, the Sacklers could not escape public scrutiny. Purdue filed for bankruptcy in 2022, with the family agreeing to pay significant damages but avoiding prison. Their once-revered name was removed from institutions worldwide, symbolizing their fall from grace.
Key Statistic: The opioid crisis has claimed over 500,000 lives in the U.S. since 1999, with OxyContin playing a significant role.
Lessons from Empire of Pain
Keefe’s Empire of Pain is a cautionary tale of ambition, greed, and the consequences of unchecked power. The Sacklers’ contributions to medicine and philanthropy are undeniable, but their role in the opioid crisis overshadows their achievements. The book challenges us to question the ethics of pharmaceutical marketing and the accountability of those who profit from public harm.
Key Takeaways:
- Ambition and innovation can lead to groundbreaking advancements but also catastrophic consequences.
- Philanthropy cannot erase ethical failures or buy lasting goodwill.
- Transparency and accountability are critical in industries that impact public health.
Why You Should Read Empire of Pain
Patrick Radden Keefe’s Empire of Pain is a riveting exploration of a family’s rise to power and their catastrophic fall. Through meticulous research and compelling storytelling, Keefe uncovers the complex interplay of ambition, ethics, and responsibility. Whether you’re interested in medical history, corporate ethics, or the opioid crisis, this book offers profound insights into the forces that shape our world.
