On a cold New York afternoon a lady dressed in black entered New York’s Metropolitan Museum. A collective chorus echoed through its pristine halls. “Temple of Greed! Temple of Oxy!” Moments later protesters collapsed to the ground in a ‘die-in’, leaving behind a thousand orange pill bottles. On their labels a message - ‘Oxycontin - prescribed to you by the Sacklers’.  

With this one act, recovered addict and one of the most important photographers of her time, Nan Goldin turned back the clock on nearly half-a-century of corporate greed camouflaged by ‘quid pro quo’ philanthropy.The perpetrators? A prominent pharma family: the Sackler dynasty. 

In a searing indictment that uses journalistic rigour and masterful storytelling, author Patrick Raden Keefe’s  Empire of Pain: The Secret History of the Sackler Dynasty,  is a masterwork of fearless reportage. By unravelling a tragic phenomenon already in plain sight, it gives its central characters, the Sackler family, no room to step out of the light. As an expose, it is hardly the first book to cover the phenomenon. Its ancestry can be traced back to previous books on the subject: Barry Meier’s  Painkiller , Sam Quinone’s  Dreamland  and Beth Macy’s  Dopesick (now a series on Disney Hotstar).  Each a powerful voice against what is widely acknowledged as the source of mankind’s worst ever drug epidemic in history. With a death toll approaching half-a-million Americans, the only surprising aspect of the phenomenon’s literature is how long it has taken to enter the mainstream. 

Deliberate manipulation 

This oversight is not a coincidence, nor a symptom of media inattentiveness. What it is, detestably, is a willful ignorance and deliberate manipulation of regulatory supervision coupled with an insidious public relations campaign. Raden Keefe burrows deep, and in unearthing the damning details at the root of this national affliction also leaves behind a cautionary tale for leaders concerned with corporate reputation.  

Its point of origin is Arthur Sackler, an enterprising eldest of three brothers who rises from the hardscrabble immigrant life in New York to establish his entrepreneurial credentials. A doctor by training, he combines his training in psychiatry with an insatiable ambition and growing familiarity with the emerging field of medical advertising. Soon, his hidden web of enterprises focuses on what can only be described as a many tentacled vice-like grip on the market for pain treatment.   

What brands today aspire to in terms of salience and persuasion, Keene describes Arthur Sackler managing to architect over half-a-century ago. By introducing consumer marketing techniques through an advertising firm, owning trade publications, investing in pharmaceutical data collection, plying lazy journalists with stories, creating a ‘speakers bureau’ boasting a phalanx of cultivated experts, and pampering influencers (in this case doctors), Sackler is revealed as a marketing genius devoid of a moral compass. Unencumbered by ethical concerns emanating from such obvious conflicts of interest, his mesh of unseen influence combines with a cynical manipulation of underpaid and overworked regulators. The masterstroke though, is revealed later. With a fortune founded on the sale of addictive drugs like Librium and Valium to millions of Americans, Sackler constructed a series of philanthropic pursuits to lacquer an otherwise shadowy reputation by acquiring respectability through the patronage of prestigious institutions of art and education: Harvard, Columbia, Tufts, the Metropolitan Museum, the Guggenheim, even the Louvre and Oxford.  

Seeking immortality 

 

As Keefe makes clear, Arthur Sackler was not, however, an altruist. Each grant a cleverly crafted deal intended to indulge in tax incentives while grasping, like many billionaires do, for the one thing money was thought unable to buy - immortality. Meticulously crafted legal agreements would ensure ‘naming rights’ for the Sackler name to adorn the hallowed halls of these revered institutions. What seemed an act of enlightened largesse to the unknowing masses was, in fact, an act of grandiose publicity that it pretended not to be.  

 

Where  Empire of Pain  emerges triumphant is in its ability draw a throughline from this hidden history to subsequent generations of the Sackler dynasty. The second generation of Sacklers exhibited a feckless immorality that would precipitate an epidemic of unspeakable anguish. Following in his uncle’s footsteps, Richard Sackler would add an irrepressible expansionist urge to the repertoire of Purdue Pharma, the family enterprise. To decipher the Opiod crisis, Keefe traces the Richard Sackler era of Purdue’s rapacious rise by marketing potent tranquilisers that enslaved entire populations. In a series of steps undertaken to create a blackhole of demand for its lethal produce, the Sacklers manage to swallow communities and generations.  

What follows is the ceaseless massaging of a chemical poison into the medical fraternity and patient community. By vilifying ‘pain’, hoodwinking regulators, colluding with unethical practitioners, and quite simply, lying about the devastatingly addictive properties of opiates, the Sackler clan encircles large swathes of middle America. Like a poison ivy - seemingly helpful, but ultimately murderous, the Sacklers perpetrate the slow evisceration of whole towns for unfathomable wealth. What the book lacks in detailing the pain of common folk, it deliberately substitutes with an unforgiving look at the clan’s ruthless and Machiavellian tactics to increase the consumption of Opioids. 

 With each turning point in this saga the author autopsies the anatomy of staggering corporate malfeasance. When there are suffering patients, they are labeled as drug abusers. When there are zealous regulators, they are placed under duress and ultimately hired. When there are needy institutions, conditional endowments are dangled. When there are diligent journalists, they are intimidated and pilloried.  

A dire appraisal 

What ultimately emerges is a dire appraisal of a naive and impotent political and administrative establishment. One that favours the rich and influential over the average citizen, only to hollow out the soul of the communities it was created to serve. One that conspires together with supine sycophants who surround the Sackler family; the descendants of which squabble over supernormal profits, indulge in self-aggrandisement, and earn the disdain of employees who regard them as entitled and incompetent.  

In its quintessence,  Empire  is several things at once. A tribute to honest journalism, a cautionary tale for corporates, an x-ray of family-run businesses trapped in their self-centered echo-chambers. Reminiscent of  The Billionaire Raj,  an investigation into the gilded age of corporate wealth in India   by James Crabtree, it illustrates the perils of ‘regulatory capture’ - when vested interest, rather than the public good, guides policy making. It also shows us that there might be hope. 

The tale of the Sackler dynasty and its downfall, serves as a lesson to the powerful. No matter what their machinations, even the most powerful cannot control narratives in the afterlife, if they poison the communities on which their fortunes are founded. Nan Goldin’s protests eventually created a cascade of disavowal with various institutions of prestige jettisoning the Sackler name in the face of mounting protests. It is also a  masterclass for dynasties and their descendants alike. Teaching them that ultimately, it could be the very art they may try to co-opt that calls them to account, causing the shameful shrivelling of their manicured reputations.  

Empire of Pain: The Secret History of the Sackler Dynasty 

By: Patrick Raden Keefe 

Pages: 657 Published by Picador   

Price: Paperback: Rs 558

Check the book out on Amazon

The reviewer is Head, Customer Centricity, Tata group, and is always curious about what makes people think and act the way they do) 

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