What is *Empire of Pain* by Patrick Radden Keefe about?

*Empire of Pain* investigates the Sackler dynasty, the wealthy family behind Purdue Pharma, and their role in fueling the opioid crisis through aggressive marketing of OxyContin. Patrick Radden Keefe traces three generations of Sacklers, exposing their manipulation of medical regulations, exploitation of vulnerable communities, and use of philanthropy to whitewash their reputation. The book blends corporate history with a moral reckoning of greed and accountability.

Who should read *Empire of Pain*?

This book is essential for readers interested in investigative journalism, corporate ethics, or public health crises. It appeals to fans of narrative nonfiction, true crime, and those seeking to understand systemic failures that enabled the opioid epidemic. Policymakers, healthcare professionals, and ethics scholars will find its insights into pharmaceutical marketing practices particularly relevant.

Is *Empire of Pain* worth reading?

Yes. Hailed as a "masterpiece of narrative reporting" (*The Washington Post*), *Empire of Pain* won the 2021 Baillie Gifford Prize and was shortlisted for the National Book Critics Circle Award. Keefe’s rigorous research and gripping prose make it a definitive account of corporate impunity, though some critique its dense detail in early chapters.

How did the Sackler family market OxyContin?

Purdue Pharma, led by Sackler family members, falsely claimed OxyContin provided 12-hour pain relief despite internal studies showing efficacy waned at 8 hours. They incentivized doctors to prescribe higher doses, targeted regions with manual labor industries (e.g., West Virginia coal miners), and downplayed addiction risks. Sales reps used deceptive tactics, including funding research to exaggerate the drug’s safety.

What ethical criticisms does *Empire of Pain* highlight?

The book condemns the Sacklers’ prioritization of profit over public health, their legal evasion tactics, and use of philanthropy to obscure their role in the opioid crisis. Keefe emphasizes how Purdue Pharma’s practices exploited regulatory loopholes and marginalized communities, leading to over 500,000 overdose deaths in the U.S. since 1999.

How does *Empire of Pain* critique corporate accountability?

Keefe illustrates systemic failures: Purdue Pharma paid billions in settlements but avoided admitting wrongdoing, while the Sacklers shielded personal wealth via offshore accounts. The U.S. legal system, he argues, often protects wealthy corporations over individuals, enabling cycles of harm without meaningful consequences.

What role did philanthropy play in the Sackler family’s image?

The Sacklers donated to museums, universities, and cultural institutions (e.g., the Met’s Sackler Wing), using philanthropy to launder their reputation. These contributions, funded by OxyContin profits, shifted public perception from “drug profiteers” to “benevolent patrons” until advocacy groups exposed the hypocrisy.

What are the main criticisms of *Empire of Pain*?

Some reviewers note excessive detail in early chapters about the Sacklers’ pre-OxyContin history, which slows pacing. Keefe also repeats key points (e.g., the 12-hour efficacy myth) for emphasis, which a few readers find redundant. Despite this, the book is widely praised for its depth and narrative force.

Empire of Pain

Patrick Radden Keefe

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Overview of Empire of Pain

"Empire of Pain" exposes the Sackler dynasty behind America's devastating opioid crisis. Obama's favorite book of 2021 reveals how one family's greed killed thousands. "So many 'they did what?' moments" - this expose inspired Netflix's "Painkiller" and changed pharmaceutical accountability forever.

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Chapter 1

The Opioid Dynasty: How One Family's Greed Fueled America's Crisis

In 2007, the pharmaceutical company Purdue Pharma pleaded guilty to federal charges of misbranding OxyContin, paying a $600 million fine that seemed astronomical at the time. Yet behind closed doors, the company's owners-the secretive Sackler family-celebrated. The settlement represented less than half of what they paid themselves that year alone. "It's nothing to us," remarked one executive. This moment encapsulates the stunning disconnect that defines Patrick Radden Keefe's "Empire of Pain"-a book that has become required reading for understanding America's opioid epidemic. Named one of Time magazine's 100 most influential books of the decade and endorsed by figures ranging from Oprah Winfrey to Barack Obama, this investigative masterpiece traces how three brothers built a pharmaceutical dynasty that profited immensely from addiction while maintaining a pristine public image through philanthropy. The story's cultural impact extends beyond literature-inspiring lawsuits, museum protests, and even HBO's Emmy-winning drama "Succession," which draws clear parallels to the Sackler family dynamics. As one former Purdue employee put it: "They had blood money, and they knew it."

Chapter 2

From Brooklyn to Billions: The Sackler Brothers' Rise

The Sackler dynasty began with three ambitious brothers from a modest Jewish immigrant family in Brooklyn. Arthur, the eldest, was the undisputed leader-brilliant, driven, and uncompromising. After their father Isaac's grocery business failed during the Depression, he instilled in his sons a mantra that would ironically foreshadow their legacy: "If you lose a fortune, you can always earn another, but if you lose your good name, you can never get it back." Arthur financed his brothers' medical education and secured positions for them at Creedmoor Psychiatric Center, where they witnessed the brutal realities of mental illness treatment in the 1940s. Patients were subjected to electroshock therapy that left them disoriented and traumatized, or lobotomies that transformed them into compliant zombies. Sylvia Plath, who underwent electroshock, described it as "a great jolt drubbed me till I thought my bones would break," while musician Lou Reed emerged "stupor-like" after treatment at Creedmoor. The brothers conducted groundbreaking research suggesting mental illness had biochemical causes rather than being purely hereditary or psychological. They injected schizophrenic patients with histamine, and nearly a third improved enough to be discharged. Their work attracted enthusiastic press coverage, with local newspapers celebrating them as local boys made good. But Arthur's true genius emerged in pharmaceutical advertising. Joining William Douglas McAdams' agency in 1942, he revolutionized how drugs were marketed to doctors. He infused traditionally staid medical advertising with consumer marketing techniques-catchy copy, splashy graphics, and celebrity endorsements from prominent physicians. When Pfizer developed the antibiotic Terramycin, Arthur promised company president John McKeen: "You give me the money, and I'm going to make Terramycin and the name of your company household words." Arthur's approach targeted physicians directly through medical journals, creating ads with "a very serious, clinical look-a physician talking to a physician," as colleague John Kallir observed. When critics like Professor Charles May warned about the "unwholesome entanglement" between prescribers and marketers, Arthur dismissed such concerns, arguing he wasn't advertising but educating. He maintained that doctors were unimpeachable professionals who couldn't be manipulated like "housewives reading magazines." The strategy worked brilliantly. By the 1950s, Arthur had become the marketing mastermind behind blockbuster tranquilizers like Librium and Valium, which generated unprecedented profits for pharmaceutical companies. His influence was so profound that when inducted into the Medical Advertising Hall of Fame, he would be credited as the person who brought "the full power of advertising and promotion to pharmaceutical marketing."

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Chapter 3

The Medicine Men: Creating a Marketing Revolution

Arthur Sackler's marketing genius reached its apex with the tranquilizer Valium, transforming it into the pharmaceutical industry's first billion-dollar drug. Through sophisticated campaigns targeting women with taglines like "35, single and psychoneurotic," Arthur helped Valium become America's most prescribed medication, with sixty million prescriptions written annually. Despite emerging evidence of addiction and withdrawal, the marketing continued unabated, dismissing concerns by blaming patients who "just get addicted" rather than acknowledging the drug's inherent risks. The Sackler brothers operated with extraordinary secrecy, creating what investigators would later call an "octopus" of interconnected businesses. When Senator Estes Kefauver launched investigations into pharmaceutical marketing practices in the early 1960s, his staff discovered the brothers' headquarters on East Sixty-Second Street housed at least twenty separate corporate entities in "a bee-hive of activity." They diagrammed the sprawling empire on oversized papers, concluding "The Sackler empire is a completely integrated operation" that could develop drugs, secure favorable clinical reports, create advertising campaigns, publish in their own journals, and place articles in mainstream media. Particularly troubling was Arthur's relationship with Henry Welch, the FDA's chief of antibiotics. Welch received substantial payments from medical journals connected to the Sacklers while overseeing drug approvals. When this conflict of interest was exposed, Welch resigned from the FDA and retired to Florida. Arthur, however, escaped unscathed. When called to testify before Kefauver's committee, he hired legendary Washington fixer Clark Clifford and dominated the hearing with what one observer described as a patrician accent that he "wielded like a switchblade." He lectured the committee about how medical advertising saves lives, telling Senator Kefauver, "If you personally had taken the training that a physician requires to get a degree, you would never have made this mistake." As their wealth grew, the brothers began cultivating a philanthropic image. Arthur became an obsessive collector of Asian art, amassing one of the world's greatest private collections. He negotiated a remarkable arrangement with the Metropolitan Museum of Art, establishing a private "enclave" within the museum where he stored thousands of personal art objects and installed his own curator-all with a special lock preventing Met staff access. When Egypt offered the ancient Temple of Dendur to the United States, Arthur and his brothers donated $3.5 million to house it at the Met, stipulating that each brother would be named individually with their middle initials and "M.D." following their names. This philanthropy served a dual purpose-tax advantages and social legitimacy. Arthur purchased Asian masterpieces the Met had acquired in the 1920s at their original prices, then donated them back with each piece described as a "gift of Arthur Sackler." For tax purposes, he declared each donation at current market value rather than purchase price-a classic maneuver that was charitable yet profitable.

Chapter 4

Family Fractures and the Birth of OxyContin

As the Sackler empire expanded, family tensions emerged. Mortimer embraced a jet-setting European lifestyle, dividing time between luxurious homes in London, Paris, and Cap d'Antibes. He divorced his first wife Muriel and married Gertraud "Geri" Wimmer, an Austrian art gallery manager barely twenty years old-the same age as his daughter. Raymond maintained a quieter life in suburban Long Island with his wife Beverly, raising two sons, Richard and Jonathan. Arthur's personal life grew increasingly complicated. While married to his second wife Marietta, he began seeing Jillian Tully, whom he met in London when she was twenty-eight and he was in his mid-fifties. Arthur told Jillian he was estranged from Marietta and wanted to marry her, maintaining three separate households with women who all considered themselves "Mrs. Arthur Sackler." The definitive fracture between the brothers stemmed from a business betrayal involving IMS Health, a pharmaceutical data company. Though officially founded by their associate Bill Frohlich, Arthur had secretly conceived the idea but used Frohlich as his front man to avoid another conflict of interest. After Frohlich died in 1971, Raymond and Mortimer made nearly $37 million when IMS went public, while refusing to share the windfall with Arthur despite their longstanding agreement. Arthur was "pissed off" because he "didn't get any participation," and his daughter Elizabeth recalled this betrayal as "the beginning of the whole rift." Meanwhile, a darker family tragedy unfolded. Mortimer's son Bobby struggled with mental illness and drug addiction, eventually jumping to his death from his mother's ninth-floor apartment in 1975 after an argument. The family kept Bobby's suicide out of the press, publishing only a small death notice stating Robert Mortimer Sackler had died "suddenly in the 24th year of his life." Though the Sacklers had put their name everywhere, when a family member died young and tragically, they erased him from their public narrative. After Arthur's death in 1987, his heirs sold their one-third interest in Purdue Frederick to Mortimer and Raymond for $22 million-"a spectacularly foolish transaction" given the company's imminent success with MS Contin, a time-released morphine pill. Under Richard Sackler's leadership, Purdue began developing OxyContin, a controlled-release oxycodone pill that would transform the company's fortunes. Richard pursued OxyContin's development with obsessive dedication, telling a friend, "You won't believe how committed I am to make OxyContin a huge success. It is almost that I dedicated my life to it." The timing aligned perfectly with an emerging movement to reconsider pain treatment. Russell Portenoy, who called himself "the King of Pain," developed an early relationship with Purdue and argued that opioids were a "gift from nature" that could be used long-term without serious addiction risks.

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Chapter 5

Selling Addiction: The OxyContin Marketing Machine

In January 1996, as a massive blizzard paralyzed the East Coast, Purdue Pharma's sales force gathered at the luxurious Wigwam resort outside Phoenix for the official launch of OxyContin. Richard Sackler delivered an enthusiastic speech, declaring the snowstorm back east an "omen of change" that would herald "a blizzard of prescriptions that will bury the competition." This was Richard's moment to transform the family company into something more aggressive and profitable than his father and uncles had built. "OxyContin tablets is the most important product launch in the company's history," he proclaimed, concluding with an uncharacteristically emotional "I love this business!" Purdue's marketing strategy was brilliantly deceptive. The company discovered that while morphine carried the stigma of death and addiction, many physicians incorrectly believed oxycodone was weaker than morphine, when it was actually twice as potent. Rather than correct this dangerous misunderstanding, Purdue decided to capitalize on it. Their internal documents revealed they considered it "extremely dangerous" to make physicians think OxyContin was as strong as morphine, even though it was stronger. Sales representatives were drilled to convince physicians that OxyContin should be "the painkiller to start with and to stay with" for moderate to severe pain. When doctors expressed concerns about addiction, reps were trained to "overcome objections" by claiming that "fewer than 1 percent" of patients became addicted. They cited a five-sentence letter to the editor in the New England Journal of Medicine (misleadingly presented as a comprehensive study) claiming "addiction rare in patients treated with narcotics." The marketing blitz included all-expenses-paid trips to "pain management seminars" in luxury destinations, a speakers bureau paying thousands of doctors, and distribution of branded merchandise. Purdue spent millions funding ostensibly independent pain advocacy organizations that promoted opioid use. Pain specialist Russell Portenoy, who had financial ties to Purdue while leading major pain organizations, later acknowledged that "no other company had previously promoted an opioid drug as aggressively." Purdue flooded doctors with OxyContin-branded merchandise-fishing hats, plush toys, luggage tags-ensuring physicians encountered reminders everywhere. Sales reps employed crafty tactics like bringing complimentary lunches to secure time with busy doctors. Though Arthur Sackler had long maintained that physicians were above influence, Richard knew better-internal data showed doctors who attended Purdue-sponsored dinners wrote more than twice as many OxyContin prescriptions as the control group, with "weekend meetings" proving most effective. The company strategically targeted "opioid naive" family physicians rather than pain specialists, becoming their primary source of information about opioid prescribing. Using IMS data (ironically, from the company Arthur had founded), reps identified high-prescribing "whales" and regions with workers' compensation cases. When territories hit certain sales volumes, Purdue would split them, adding more reps to accelerate growth. The strategy worked brilliantly-sales doubled year after year, reaching $601 million by September 1999.

Chapter 6

The Human Cost: Addiction, Death, and Denial

As OxyContin sales soared, the first signs of widespread abuse emerged. Steven May, an ex-cop who joined Purdue in 1999, recalled a sobering moment in 2000 when visiting a top-prescribing doctor in West Virginia. The physician was distraught because a relative had just died from an OxyContin overdose-a stark reality check against the company's success narrative. OxyContin abuse spread like an airborne virus through rural communities-starting in Maine, Pennsylvania, Ohio, and Appalachia. These regions, deliberately targeted by Purdue's sales force based on IMS data, often had high rates of manual labor, disability, chronic pain, and existing prescription drug abuse. Users combined OxyContin with Valium for what they called "the Cadillac high." Communities transformed as the drug claimed victim after victim, with black market pills selling for a dollar per milligram. Despite Richard Sackler's sworn testimony that he first heard of OxyContin abuse in early 2000, Purdue had received warnings from its sales force since 1997. Investigators later found hundreds of sales rep reports mentioning "street value," "snort," and "crush." By 1999, reps were reporting "credibility issues" as physicians recognized OxyContin as "the street drug all the drug addicts are seeking." Richard had even received emails describing how users were snorting the pills. As evidence mounted, Richard Sackler adopted his uncle Arthur's strategy: blame the users, not the drug. "Hammer on the abusers in every way possible," Richard declared, calling them "reckless criminals" and "the culprits." This became Purdue's official position, with executives claiming they were "losing sales because physicians have become scared"-even as profits soared. "Abusers aren't victims," Richard insisted. "They are the victimizers." Many OxyContin victims weren't recreational users but legitimate patients who took the drug as prescribed. The company's insistence on twelve-hour dosing created problems Purdue knew about before FDA approval. In their own study with ninety women in Puerto Rico, roughly half needed more medication before twelve hours elapsed. Despite this, Purdue built an entire marketing campaign around twice-daily dosing, creating a cycle of withdrawal between doses-precisely the "peaks and troughs" they claimed OxyContin avoided. By 2001, the company knew 20% of prescriptions were being written on more frequent schedules, with one internal document noting these numbers were "very scary." Howard Udell, Purdue's longtime lawyer considered "the heart and soul of the organization," tasked his secretary with researching OxyContin abuse online in 1999. Using the pseudonym "Ann Hedonia," she discovered users discussing how to defeat the time-release mechanism by crushing, snorting, or injecting the drug. Her findings were circulated to senior officials and "all the Sacklers" involved with the company. As media coverage of abuse increased, Udell became increasingly secretive, apparently concerned about potential litigation.

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Chapter 7

Legal Battles and Corporate Shield

When faced with mounting criticism, Purdue assembled a formidable legal battalion under Howard Udell's direction. Udell, the company's wartime consigliere, adopted an unapologetic posture of giving no quarter, spending $45 million fighting lawsuits by 2002 with "no budget" constraints. When asked about dedicating profits to rehabilitation, Udell deflected responsibility, insisting addicts "need help" but claiming "the system has failed them earlier on." To counter criticism, Purdue cultivated "grassroots" patient advocacy organizations that were actually corporate fronts. Richard Sackler boasted, "We can get virtually every senator and congressman we want to talk to on the phone in the next 72 hours." Following advice from Kathleen Foley that "it would be better if the advocacy came from outside the drug company," Purdue heavily funded groups like the American Pain Foundation and the Pain Care Forum (run by Purdue's own lobbyist Burt Rosen). Purdue aggressively targeted journalists who criticized OxyContin. When the Orlando Sentinel published a nine-month investigation suggesting patients could become accidentally addicted while following prescriptions, Purdue's crisis manager Eric Dezenhall scrutinized the reporting for flaws. Finding that some subjects had prior drug histories and that many overdose victims had multiple substances in their systems, Purdue threatened legal action and forced a major retraction. In 2003, as a federal investigation intensified, Richard Sackler stepped down as president of Purdue, though this was merely a change in title rather than role. He remained deeply involved in operations, obsessively monitoring OxyContin's performance. Other family members including Jonathan, Kathe, and Mortimer Sackler also stepped down as vice presidents, though prosecutors later noted "those moves were for show." Despite mounting evidence against them, the Sacklers maintained a formidable legal defense team including Howard Udell, Howard Shapiro, Mary Jo White, and Rudy Giuliani. Federal prosecutor John Brownlee built a strong case, with potential penalties of $1.6 billion on the table. His team prepared a 100-page prosecution memo detailing years of corporate malfeasance, showing executives had testified "falsely and fraudulently" to Congress. However, in a shocking reversal after a meeting between Purdue's defense team and Assistant Attorney General Alice Fisher, prosecutors were informed they could not pursue felony charges against the executives-only misdemeanors. This decision became "an orphan directive" with Fisher, Deputy AG Paul McNulty, and others refusing to take responsibility. One former Justice official called it "a political outcome that Purdue bought." The sentencing in Abingdon became a public spectacle with victims from across the country attending. Parents who had lost children to OxyContin addiction delivered heartrending testimonies directly addressing Friedman, Goldenheim, and Udell. Lynn Locascio called them responsible for "a modern-day plague," while Ed Bisch implored the judge to reject the plea bargain.

Chapter 8

The Empire's Collapse and the Reckoning

Despite the guilty plea and $600 million fine, Purdue quickly returned to its aggressive marketing tactics. The company publicly claimed to have improved compliance, but internally continued promoting OxyContin as non-addictive. By 2008, with America facing a full-blown opioid crisis highlighted by Heath Ledger's overdose death, OxyContin sales reached a new high of $3 billion annually. In 2010, Purdue quietly replaced its original OxyContin with a reformulated version marked "OP" instead of "OC." The new pills contained the same oxycodone payload but featured an abuse-resistant coating that turned gummy when crushed. The timing of the reformulation revealed Purdue's true motivation: patent protection. With the original OxyContin patent set to expire in 2013, the company employed an "evergreening" strategy to extend its monopoly. While the reformulation made the drug harder to abuse, it had devastating unintended consequences. Four out of five people who started using heroin during this period had initially abused prescription painkillers. A study of 244 people who entered treatment for OxyContin abuse after the 2010 reformulation found that a third switched to other drugs, with 70% turning to heroin. As OxyContin sales plateaued in the United States amid growing awareness of opioid risks, the Sacklers turned to international markets through their Mundipharma network. They deployed the same playbook that had worked domestically: manufacturing statistics about untreated pain crises and dispatching "pain ambassadors"-paid physicians who promoted opioids globally while warning about "opiophobia." The family's carefully constructed philanthropic image began to crumble when photographer Nan Goldin, who had overcome her own OxyContin addiction, founded P.A.I.N. (Prescription Addiction Intervention Now). In March 2018, Goldin led a dramatic protest at the Metropolitan Museum of Art's Sackler Wing. With approximately a hundred activists, they shouted "Temple of greed! Temple of Oxy!" and staged a "die-in" around the reflecting pool. Protesters threw nearly a thousand orange pill bottles into the pool, each bearing a specially designed label reading "OxyContin - Prescribed to you by the Sacklers." Former Mississippi Attorney General Mike Moore, who had successfully taken on Big Tobacco in the 1990s, began building a coalition to pursue opioid manufacturers. Having witnessed his own nephew's addiction to opioids, Moore rejected the Sacklers' libertarian defense that they bore no responsibility for how people used their products. Moore and fellow lawyers initiated a wave of lawsuits from states, cities, counties and Native American tribes. In 2019, Massachusetts Attorney General Maura Healey released a 274-page complaint presenting a damning catalog of evidence against the Sacklers. The document was filled with meeting minutes, board presentations, and internal emails revealing the family's direct involvement in Purdue's operations. It exposed Richard Sackler's demonization of addicted patients, his disappointment at "only" $20 million in weekly OxyContin sales, and the family's continued push for higher doses despite CDC warnings.

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Chapter 9

Legacy of Destruction: The Sacklers' Fall from Grace

On September 15, 2019, Purdue Pharma officially filed for bankruptcy. The company had strategically prepared for this moment, changing its address months earlier to ensure their case would be heard by bankruptcy judge Robert Drain in New York's Southern District. This calculated move halted all lawsuits against Purdue, preventing imminent trials in Ohio and elsewhere. The Sacklers proposed a "global resolution" in which they would relinquish control of Purdue, converting it into a public trust, and contribute money to address the opioid crisis in exchange for immunity from "all potential federal liability." Headlines announced "Purdue Pharma Offers $10-12 Billion to Settle Opioid Claims," but the details revealed a less impressive offer. The actual Sackler contribution would be just $3 billion-not paid out of pocket but financed by selling Mundipharma, their international opioid business. As the bankruptcy proceeded, prestigious institutions began distancing themselves from the family. The Louvre in Paris removed all Sackler signage from its galleries. Tufts University announced it would strip the Sackler name from five facilities and programs, with Dean Harris Berman explaining students found it "incongruous with the mission of the school." Workers literally chiseled the name off buildings, leaving only "ghost marks" where it had been. When called to testify before Congress in December 2020, David and Kathe Sackler expressed "deep sadness about the opioid crisis" but continued to deny personal responsibility. When Representative Welch compared the family to El Chapo, Kathe bristled, insisting "The Sackler family doesn't have a felony conviction." Tennessee's Jim Cooper delivered the most devastating assessment: "Watching you testify makes my blood boil. I'm not sure that I'm aware of any family in America that's more evil than yours." The 2020 pandemic only intensified the opioid crisis as isolation and economic stress drove people to relapse, with overdose rates spiking nationwide. Meanwhile, Mortimer and Jacqueline quietly sold their East Seventy-Fifth Street townhouse for $38 million, reportedly moving to London-a city known for welcoming oligarchs with questionable fortunes. The DOJ resolution's proposal to turn Purdue into a public-benefit corporation that would distribute opioid profits to states fighting the crisis carried a bitter irony. Decades earlier, Arthur, Mortimer, and Raymond had made a pact with Bill Frohlich that their shared business would become a charitable trust after the last man died. Richard Leather, the attorney who formalized that agreement, found it infuriating to see the family now using such an arrangement to fend off litigation. "This agreement was not designed to make Richard Sackler rich," Leather said. "It was designed to achieve a gift to humanity." In 1947, when Richard was still a toddler, his father and uncles had created their first family foundation "in memory of Isaac Sackler" with the stated aim "to help alleviate man's suffering"-a mission that stood in stark contrast to their legacy. As Isaac had warned his sons decades earlier: while fortunes can be rebuilt, a lost good name can never be recovered.

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Key Themes in Empire of Pain

opioid epidemic origins
pharmaceutical marketing ethics
corporate accountability
philanthropic reputation laundering
dynastic wealth

Quotes from Empire of Pain

"They had blood money, and they knew it."
"It's nothing to us," remarked one executive.
"The Sackler empire is a completely integrated operation"
"If you lose your good name, you can never get it back."
"35, single and psychoneurotic"

Characters in Empire of Pain

Arthur SacklerThe eldest brother and marketing mastermind
Patrick Radden KeefeAuthor and investigative journalist
Estes KefauverSenator who investigated pharmaceutical marketing
Henry WelchFDA chief of antibiotics with Sackler ties
John McKeenPresident of Pfizer during Terramycin's launch

About the Author

Patrick Radden Keefe, the New York Times bestselling author of Empire of Pain: The Secret History of the Sackler Dynasty, is an award-winning investigative journalist renowned for his deep dives into systemic corruption and power dynamics. A staff writer at The New Yorker since 2006, Keefe specializes in narrative nonfiction that exposes hidden truths, from corporate malfeasance to historical conflicts.

His work on Empire of Pain—a searing exploration of the Sackler family’s role in the opioid crisis—draws on his expertise in unearthing documents and conducting penetrating interviews, honed through earlier books like Say Nothing (a National Book Critics Circle Award winner) and The Snakehead.

Keefe’s reporting has earned accolades including the Orwell Prize and a Guggenheim Fellowship. His podcast Wind of Change, investigating Cold War espionage, topped 2020 year-end lists. Empire of Pain, a finalist for the FT Business Book of the Year, has been translated into 20 languages and cemented Keefe’s reputation as a master chronicler of institutional accountability. The book’s adaptation into a limited series is currently in development.

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108

"Reading used to feel like a chore. Now it’s just part of my lifestyle."

@Erin, Investment Banking Associate , NYC

254

"Feels effortless compared to reading. I’ve finished 6 books this month already."

@djmikemoore

"BeFreed turned my guilty doomscrolling into something that feels productive and inspiring."

@Pitiful

4.5K

"BeFreed turned my commute into learning time. 20-min podcasts are perfect for finishing books I never had time for."

@SofiaP

"BeFreed replaced my podcast queue. Imagine Spotify for books — that’s it. 🙌"

@Jaded_Falcon

201

"It is great for me to learn something from the book without reading it."

@OojasSalunke

"The themed book list podcasts help me connect ideas across authors—like a guided audio journey."

@Leo, Law Student, UPenn

483

"Makes me feel smarter every time before going to work"

@Cashflowbubu

"Instead of endless scrolling, I just hit play on BeFreed. It saves me so much time."

@Moemenn

"I never knew where to start with nonfiction—BeFreed’s book lists turned into podcasts gave me a clear path."

@Chloe, Solo founder, LA

117

"Perfect balance between learning and entertainment. Finished ‘Thinking, Fast and Slow’ on my commute this week."

@Raaaaaachelw

"Crazy how much I learned while walking the dog. BeFreed = small habits → big gains."

@Matt, YC alum

108

"Reading used to feel like a chore. Now it’s just part of my lifestyle."

@Erin, Investment Banking Associate , NYC

254

"Feels effortless compared to reading. I’ve finished 6 books this month already."

@djmikemoore

"BeFreed turned my guilty doomscrolling into something that feels productive and inspiring."

@Pitiful

4.5K

"BeFreed turned my commute into learning time. 20-min podcasts are perfect for finishing books I never had time for."

@SofiaP

"BeFreed replaced my podcast queue. Imagine Spotify for books — that’s it. 🙌"

@Jaded_Falcon

201

"It is great for me to learn something from the book without reading it."

@OojasSalunke

"The themed book list podcasts help me connect ideas across authors—like a guided audio journey."

@Leo, Law Student, UPenn

483

"Makes me feel smarter every time before going to work"

@Cashflowbubu

"Instead of endless scrolling, I just hit play on BeFreed. It saves me so much time."

@Moemenn

"I never knew where to start with nonfiction—BeFreed’s book lists turned into podcasts gave me a clear path."

@Chloe, Solo founder, LA

117

"Perfect balance between learning and entertainment. Finished ‘Thinking, Fast and Slow’ on my commute this week."

@Raaaaaachelw

"Crazy how much I learned while walking the dog. BeFreed = small habits → big gains."

@Matt, YC alum

108

"Reading used to feel like a chore. Now it’s just part of my lifestyle."

@Erin, Investment Banking Associate , NYC

254

"Feels effortless compared to reading. I’ve finished 6 books this month already."

@djmikemoore

"BeFreed turned my guilty doomscrolling into something that feels productive and inspiring."

@Pitiful

4.5K

"BeFreed turned my commute into learning time. 20-min podcasts are perfect for finishing books I never had time for."

@SofiaP

"BeFreed replaced my podcast queue. Imagine Spotify for books — that’s it. 🙌"

@Jaded_Falcon

201

"It is great for me to learn something from the book without reading it."

@OojasSalunke

"The themed book list podcasts help me connect ideas across authors—like a guided audio journey."

@Leo, Law Student, UPenn

483

"Makes me feel smarter every time before going to work"

@Cashflowbubu

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Chapter 5

Empire of Pain

OverviewOverview of Empire of Pain

One book. Many ways to hear it.

The Opioid Dynasty: How One Family's Greed Fueled America's Crisis

From Brooklyn to Billions: The Sackler Brothers' Rise

See every word as you hear it

The Medicine Men: Creating a Marketing Revolution

Family Fractures and the Birth of OxyContin

Get more out of Empire of Pain

Selling Addiction: The OxyContin Marketing Machine

The Human Cost: Addiction, Death, and Denial

See every word as you hear it

Legal Battles and Corporate Shield

The Empire's Collapse and the Reckoning

Get more out of Empire of Pain

Legacy of Destruction: The Sacklers' Fall from Grace

You made it to the end of Empire of Pain

Key Themes in Empire of Pain

Quotes from Empire of Pain

Characters in Empire of Pain

About the Author

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1,000,000+ curious minds.

1,000,000+ curious minds.

One book. Many ways to hear it.

The Opioid Dynasty: How One Family's Greed Fueled America's Crisis

From Brooklyn to Billions: The Sackler Brothers' Rise

See every word as you hear it

The Medicine Men: Creating a Marketing Revolution

Family Fractures and the Birth of OxyContin

Get more out of Empire of Pain

Selling Addiction: The OxyContin Marketing Machine

The Human Cost: Addiction, Death, and Denial

See every word as you hear it

Legal Battles and Corporate Shield

The Empire's Collapse and the Reckoning

Get more out of Empire of Pain

Legacy of Destruction: The Sacklers' Fall from Grace

You made it to the end of Empire of Pain

Users also liked

Discover more

Overview of Empire of Pain