In the annals of America’s worst families, there are horrors to behold. Everyone knows the Trumps, and maybe the Mercers, who funded Breitbart News and Parler, the app where planning for the Capitol riot took place. Stephen Miller seems determined to compete with them. They must all make space for the Sacklers, whose role in America’s opioid crisis ranks them among history’s most notable entries. For all the attention the Sacklers have garnered, however, their history as a family remains under-scrutinized. From afar they resemble a collective entity, not a grouping of individuals responsible for individual misdeeds. That will soon change.
Empire of Pain, Patrick Radden Keefe’s new history of the Sackler clan, does not locate a moral conscience anywhere in the family at all. Certainly not in Richard Sackler, who once suggested that the family’s company, Purdue Pharma, “hammer” on OxyContin addicts in “any way possible.” Not in Arthur Sackler, who died before OxyContin hit the market, and whose descendants have tried to claim a form of innocence. Arthur, the mind behind the aggressive marketing of Valium, devised the very techniques Purdue would use to sell OxyContin directly to doctors, as Keefe, a writer for The New Yorker, shows.
Some ground may be familiar to those who have followed news of the Sacklers and Purdue over time. As Keefe notes, other reporters have covered the opioid crisis at length. Western Virginia’s legal war on Purdue features in journalist Beth Macy’s 2018 book, Dopesick, for example. Empire of Pain differs from other books in the genre because it is principally a family history — one the Sacklers took care to avoid. In Keefe’s account, they resurface as individual characters, with biographies and motivations and feuds. The result will undo decades of philanthropic effort to link the Sackler name with public good.
The truth can be an ugly, violent thing. No Sackler emerges fully unblemished from Keefe’s able dissection of the family fortune. Keefe is a precise chronicler. From the brilliant first generation to the what, me worry? attitude of the youngest Sacklers, he depicts a family responsible for suffering on an incredible scale. They remain purposefully oblivious and then, whenever confronted with the fruits of their genius, react with defensive fury. The original three Sackler brothers combined a sincere belief in the power of medicine to relieve agony with an equal dedication to the free market, a libertarian hell brew that eventually destroyed thousands of lives. All the while, they pursued a different kind of investment: philanthropy, mostly in the biomedical sciences and the arts.
What Arthur Sackler truly craved, one of his ex-wives mused to Keefe, went beyond mere financial gain. His obsession with art, especially with the collection thereof, rested with its ability to outlive him. To Sackler, art represented “the possibility of immortality,” she said.
Mortality is harder for others to escape. While the Sacklers amassed an almost unimaginable fortune, people began to die. The CDC says overdose deaths from prescription opioids have been increasing since at least 1999, three years after OxyContin’s introduction to the market. Though the drug isn’t solely responsible for the increase, there’s significant evidence that Purdue, and the Sacklers, knew OxyContin was more potent than other drugs on offer. And the failsafes didn’t work. Each OxyContin pill was coated in a controlled-release material meant to reduce the potential for addiction. Purdue believed they’d “hacked” opium’s natural properties, Keefe wrote, and told the FDA and prescribing physicians the same. It was fairly easy, however, to hack the hack — to crush the pill, and snort it. That fancy coating didn’t guarantee 12-hour pain relief either. Purdue knew from its own research that many patients needed another dose well before 12 hours expired, which increased the amount of OxyContin they had to consume for relief.
Purdue knew, also, that people were dying. So did the Sacklers, who not only owned the company but intervened regularly in its affairs. It was Richard Sackler who urged, repeatedly, the aggressive marketing of OxyContin; all Sacklers involved would insist on the innocence of the drug. But the sales reps had told them the score. Their reports began flooding in from West Virginia, and Maine, and western Virginia. In rural areas already depleted by decades of extractive capitalism and industry decline, OxyContin was kerosene. People were overdosing, at rates that increased exponentially over time. I grew up in rural southwestern Virginia, and when I left for cities far afield, pills seemed to be all anyone knew about the place I was from, a fun-house mirror image of home. I could not escape the Sacklers, or their legacy. I despise them.
In 2001, western Virginia tried to defend itself. John Brownlee, the U.S. Attorney for the region, told his deputies Rick Mountcastle and Randy Ramseyer to investigate Purdue. They subpoenaed documents on the marketing of OxyContin, preparing themselves for a battle they knew they were unlikely to win. (My childhood home isn’t far from the courthouse where Purdue executives would eventually plead, and my family attended church with Mountcastle for a few years.) They uncovered a now-familiar fact. “What the investigators discovered, as they pored over this material, was that nearly every major element of the story that Purdue had been telling about its own conduct was untrue,” Keefe writes.
Then, despite the evidence, the Bush Justice Department declined to support felony charges against three Purdue executives. Instead, they pleaded guilty to misdemeanor charges in 2007 while the Sacklers survived unscathed. Three years later, Purdue introduced a reformulated version of OxyContin, designed to be safer and impossible to crush. Purdue had not discovered altruistic qualities in itself — the patent on original OxyContin was about to expire. Reformulation allowed Purdue to extend the patent and make more money. In doing so, Purdue helped launch another wave of overdose deaths, as people with prescription drug-use disorder turned to heroin for relief.
Nothing seemed to damage The Family, as Mountcastle called them. The Sacklers maintained their innocence, and opened their pocketbooks, and the world looked away.
By the time I moved to New York City in 2016, the Sackler family had practically painted my new home with its name. The Brooklyn Museum is home to the Elizabeth A. Sackler Center for Feminist Art. (Elizabeth, a descendant of Arthur, routinely insists that she has not directly profited from the sale of OxyContin. Others argue persuasively that all Sacklers are complicit in the opioid crisis.) There is a Sackler wing of the Metropolitan Museum of Art, whose origins Keefe examines at length. Arthur Sackler’s relationship with Met began with an unusual arrangement: a family enclave in a public space. This arrangement subverted the original mission of the Met — in Keefe’s words, that it would “be free and open to the public, but subsidized by gifts from the rich” — and the museum’s staff originally had no access to the enclave. Sackler even installed a lock to keep them out.
As atypical as his early agreement with the Met might have been, Sackler understood something profound about the nature of philanthropy. It is distinct both from charity and from welfare. Arthur’s own attorney, Michael Sonnenreich, is quoted bluntly articulating its real qualities: “If you put your name on something it is not charity, it’s philanthropy. You get something for it. If you want your name on it, it’s a business deal.” A person does not have to be a committed political observer to hear something of Trump in the statement, even though Trump himself is no philanthropic giant. Under capitalism, everything can be business. Philanthropy embraces this fact, promising wealthy men like Arthur Sackler the immortality they crave.
Philanthropy’s proponents argue that the public receives a good deal in return for massaging a few wealthy egos. It’s thanks to Arthur Sackler that the Temple of Dendur sits on the Upper East Side, not Egypt. And if the rich don’t step in, who will? The U.S. government invests very little in either the creation or preservation of art. Trump and Ronald Reagan both tried to kill funding for the National Endowment for the Arts; the Heritage Foundation even calls the NEA “an unwarranted extension of the federal government into the voluntary sector.” The arts are properly the realm of philanthropists, this logic argues, and the government should stay out. For cultural workers like my parents, who eke out a living teaching classical music to children in the same place the Sacklers scavenged for profit, philanthropy offers hope in an underfunded world. They would also say that this is only true of philanthropy because the government abandoned its responsibilities to the public. They would say that art is good for everyone, and must be available to everyone, and that the future of art cannot depend on the whims of wealthy men.
There is a price to giving families like the Sacklers the public-relations boost they desire. With time, the universities and museums that once gladly took Sackler money learned exactly how high that price would be. Nan Goldin taught them. The artist, who says she became addicted to OxyContin after a doctor prescribed it to her for wrist surgery, forced the art world to reckon with the Sackler legacy. With PAIN, her collective, she took the fight directly to the museums and galleries that still took Sackler money and put the Sackler name on the walls. “Temple of greed! Temple of Oxy!,” PAIN once activists shouted inside the Met. Arthur Sackler may have won his bid for immortality. The Sackler wing even still bears his name. His legacy, though, will be quite different from what he’d dreamed.
Spare a brief thought for the Sacklers: No fortune is innocent. There could be a hundred books like Empire of Pain, each scrutinizing the coffers of a different super-wealthy family, and the revelations would be sordid. The opioid crisis makes unique monsters of the Sacklers, but they aren’t the only ghouls around. Labor exploitation and unsavory connections to the business right are profitable, and they frequently lay the foundation for great familial wealth. This country concluded long ago that it would trade the public good for whatever largesse its tycoons would shed. Through philanthropy, the Sacklers took advantage of all that capitalism could offer.
To focus exclusively on the Sacklers, or hold them up as unprecedented American monsters, would be an error. People made a similar mistake with the Trumps. Both families are easy to hate; I maintain thriving hobbies in this area. But the Trumps and the Sacklers are only what America allowed them to become. An entire rotten structure lurks behind the Sackler name. They are not the first family to escape serious prosecution for wrongdoing. They aren’t the first to route a fortune offshore. They are certainly not the first to use philanthropy as misdirection. Philanthropy merely reinforces the greatest sins of capitalism. It asks no questions of a fortune and offers much by way of reward. Only over the last few years have universities begun removing the Sackler name; only recently have museums stopped taking Sackler money. It took Goldin and PAIN, and years of dogged reporting from Keefe and many others, to finally turn the screw. Even now, the Sacklers could get away with it — most of it.
Weeks before the presidential election, the Trump Justice Department announced a global settlement with Purdue Pharma, ending its criminal and civil investigations into the company and the Sacklers. The Sacklers would pay a small fine relative to their fortune, which is worth billions; they would also admit no wrongdoing. Purdue has filed for bankruptcy, and hopes to restructure itself independent of the Sacklers. Keefe observes that in an effort to shield their fortune, the Sacklers have reversed themselves. While they once insisted that they and Purdue were separate entities, they are now arguing the opposite: that lawsuits against Purdue are, in effect, lawsuits against the family.
The slow gears of the law still grind, but public opinion moves at a different pace. Nobody really doubts now that Purdue and the Sacklers were one and the same, and Empire of Pain reinforces that perception with reported facts. In this way, Keefe has accomplished something similar to what Nan Goldin and PAIN have done, what attorneys have been trying to do for over a decade. He forces The Family into the light.