'Empire of Pain' Author Patrick Radden Keefe Investigates The Sackler Family Empire of Pain author Patrick Radden Keefe says the Sackler family has "thrown a lot of energy" into trying to thwart his reporting about the family's involvement in the opioid crisis.

Journalist Investigates 'Crime Story' Of The Sackler Family And The Opioid Crisis

Journalist Investigates 'Crime Story' Of The Sackler Family And The Opioid Crisis

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Tufts University became the first major university to strip the Sackler name from its buildings in 2019. Boston Globe/Getty Images hide caption

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Boston Globe/Getty Images

Tufts University became the first major university to strip the Sackler name from its buildings in 2019.

Boston Globe/Getty Images

The Sackler family has spent decades making a name for itself in philanthropic circles, with sizable donations to the Metropolitan Museum of Art, the Louvre, the British Museum, Harvard University and Yale University, among other institutions.

But as the public began to scrutinize the source of the family's money, many museum wings and buildings that once displayed the Sackler name have removed it.

That's because members of the Sackler family own Purdue Pharma, which made billions of dollars selling OxyContin, an opioid painkiller stronger than morphine. Introduced in 1996, OxyContin has been largely blamed for the opioid addiction crisis that followed. The Sacklers and the company now face a combined total of more than 2,500 related lawsuits.

"As the opioid crisis has intensified, with roughly a half a million Americans having died in recent decades, you've started to see some of these institutions [that have received Sackler money] back away," New Yorker writer Patrick Radden Keefe says.

Keefe investigates the Sackler family and Purdue Pharma's role in the opioid crisis in his new book, Empire of Pain. He says that the widespread use of OxyContin created a community of people who developed a dependency on opioids — including many who later turned to heroin and fentanyl when OxyContin became harder to come by.

"You had a market that was cultivated by Purdue and grew and grew of people who were abusing prescription pharmaceuticals," Keefe says. "And then, at a certain point, a lot of them transition or graduate to illicit opioids, like heroin, and fentanyl, which, as we know, are incredibly deadly."

Though Keefe reached out to the family while researching the book, he says it declined to participate. Instead, he says, some members of the Sackler family have "thrown a lot of energy" into trying to thwart his reporting.

"They've told me that they may very well sue. They've told me I should preserve everything because it's going to be evidence in the eventual lawsuit," Keefe says. "One of the stories I tell in the book is about how Barry Meier, a New York Times reporter who was really one of the first to break the story about how OxyContin was not as great as the company had cracked it up to be, he dealt with these same types of threats 20 years ago. And so there's a continuity in their tactics, this tendency to throw their weight around and try and control the narrative."

Interview Highlights

On the belief within Purdue Pharma that there was "no ceiling" on OxyContin doses

Part of what was innovative about OxyContin was that you could have these huge doses, and there were some people at the company ... who believed that there was "no ceiling," was what they would call it, on the dose that somebody could take. And so you had not just 10 milligrams and 20 milligrams and 40 and 80.

Eventually the company introduced a 160-milligram OxyContin pill. They did end up taking that off the market after concern was expressed by some people in the government that if a kid took one 160-milligram OxyContin pill, the kid could die. And there's actually a moment that I discovered where a legal secretary at Purdue Pharma learns that they're going to be introducing this 160-milligram pill and says, and this was the quote, says to the general counsel at the time, "They're killing themselves with the 80s. Why would we come out with a 160?"

On when the Sacklers claim they realized OxyContin was addictive and lethal

Empire of Pain: The Secret History of the Sackler Dynasty, by Patrick Radden Keefe Doubleday hide caption

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Empire of Pain: The Secret History of the Sackler Dynasty, by Patrick Radden Keefe


There has long been a story told by Purdue Pharma and the Sacklers that they introduced this revolutionary painkiller in 1996 and that it helped lots and lots and lots of people — and I should say, that's true. It did actually bring relief to a lot of people who had been suffering from terrible pain. But the story that the family and the company always told is that it wasn't until the spring of the year 2000 — so really four years later — that they first started getting an indication that there might be a big problem with this drug, that lots of people might be abusing it and, indeed, overdosing and dying and becoming addicted to the drug.

There were two different very senior company officials who testified under oath before Congress that they didn't learn a thing until early 2000. Richard Sackler himself, one of the really key family members who was involved in the company and involved in the development of OxyContin, he said, in a sworn deposition, "We didn't really know there was a big problem until early 2000." And there was a claim that they learned about it from press reports. And that seemed just intuitively a little weird to me as a journalist. ... What's weird is the idea that the company would learn about it from the journalists, because one thing that any modern pharmaceutical company does is it tracks very carefully where the pills are being prescribed and sold. They keep very close track of which doctors are prescribing and in what way. And they do that for marketing reasons, because they want to know which doctors to target.

One of the oddities with OxyContin, we know now, is that there were, from pretty early on, some doctors who were prescribing way more than it would make sense for them to be prescribing — some regions where tons and tons of pills were going and Purdue would have known this.

On a Purdue Pharma legal secretary researching how people were abusing the drug

This is in 1999 — this is a year before the company claims that they learned about any of these problems. She went into these newsgroups and started doing research into ways in which people are abusing the drug. And it turned out there were lots and lots of people online talking about that Contin coating and that if you crush the Contin coating, if you crush the pill, then you can release the full dose of oxycodone all at once. And the people were doing that. In some cases, they're abusing the pills just by not swallowing them whole, but by just chewing them and swallowing them. Sometimes they would crush them up and snort them. Sometimes they would cook the powder in a spoon and inject them intravenously.

On Purdue Pharma changing the coating of OxyContin in 2010 to make it harder to smash and abuse

It did make it harder to abuse the drug. One of the former Purdue executives who I interviewed said that it was like when you tried to crush it, it would turn into a gummy bear. So it was hard to snort. You couldn't dissolve it. And interestingly ... one of the things I discovered is that the company learned right away that it was working — that this new formulation was harder to abuse — and the way they learned it is that their sales went down.

So sales of what, at the time, was the strongest version of the drug, the 80-milligram pill, actually dropped 25% nationwide after the introduction of this reformulation. One way of looking at that, you say: Isn't that great? Look at their commitment to doing the right thing and making this drug harder to abuse. The other way of looking at it is: Whoa, so 25% of sales of that strongest pill were going to the black market, effectively, before the reformulation.

On the 2,500-plus lawsuits against Purdue Pharma and the Sackler family and the Sackler legal strategy of having Purdue declare bankruptcy

OxyContin has been a fantastically profitable drug. It's generated some $35 billion in revenue since its introduction in the 1990s. And what's happened is just in the last few years, you've had this gathering storm of lawsuits seeking to hold, initially just the company, Purdue Pharma, but then eventually the family as well, responsible. Purdue and the Sacklers did this really interesting thing where the Sacklers at a certain point put the company into bankruptcy, because they had been taking so much money out of the company for so many years and it was now facing all these lawsuits. And so the company ends up with something like a billion dollars in cash and assets, and the Sacklers put it into bankruptcy. They don't declare bankruptcy themselves. And, in fact, we know from their own records they've taken more than $10 billion out of the company really over the course of just a decade or so. So it's this strange situation in which the company is bankrupt — the family financially is doing just fine.

On the company's rush for help in the final days of the Trump administration

You have to remember that this is a crime story. So Purdue Pharma, this company that they own and have profited from so handsomely, pled guilty to federal charges in 2007 that they had fraudulently marketed OxyContin. And the story was always that, after 2007, they cleaned up their act. They got on the straight and narrow, that they never did anything like that again. But the truth was that actually they expanded their sales force after 2007 and continued to do a lot of the same stuff that had gotten them in trouble in the first place. And in the last couple of years, there have been multiple different federal criminal investigations of the company.

What I learned in my reporting was that you had these different investigations and what the family and the company wanted to do was make a deal, and that at the Justice Department, you had some career prosecutors who thought that they really needed to crack down hard on Purdue and on the Sacklers because they had done this pretty bad conduct. It was quite recent. And they're kind of recidivist, if you think about it. They already got busted once and then continued to do some of the bad stuff that they had done in the past.

But what ended up happening is that there was a rush in the final days of the Trump administration to get this case sorted out. The way it was explained to me was somebody said, "They want to wind this thing up and with a soft touch." And so you ended up in a situation in which there was a deal where Purdue pled guilty to a new set of federal criminal charges and the Sacklers agreed to pay a fine of over $200 million to settle civil charges, but they wouldn't agree to admit any wrongdoing. And no executives from the company were charged or even named. So you end up in this weird situation where the company pleads guilty, but there's no human individual who could be said to have done anything wrong. ... It's like the company is a driverless car.