The book Empire of Pain: The Secret History of the Sackler Dynasty (Doubleday, 2021), by American journalist Patrick Radden Keefe.

WHY IS IT WORTH READING?

Since its publication in 2021, the book Empire of Pain has become increasingly prominent on the shelves of bookstores and libraries around the world, receiving an avalanche of positive reviews.

Written by the acclaimed author Patrick Radden Keefe, this meticulously researched and engaging book is a must-read for those seeking to uncover the secret history of the Sackler family—often referred to as “the most evil family in America”—and to understand how they may be responsible for triggering one of the worst public health crises ever faced in the United States.

The Sackler family, known for their love of the arts and their philanthropy in the 1930s and 1940s, have a dark side that few knew about, but which is very well addressed in the book. During their years in medical school, the Sackler brothers became adept at shock therapy and began using it to treat their psychiatric patients and even patients without symptoms.

Unfortunately, these treatments often resulted in patients being subjected to inhumane conditions, which led to many of them dying. At a crucial time in the history of medicine, in the 1960s, the Sackler brothers bought a small pharmaceutical company that would later become Purdue Pharma.

At the time, they were already amassing fortunes selling highly addictive anxiolytics. When the patent for these drugs expired, the Sackler brothers needed a replacement.

Keefe delves into the central theme of his book, which deals with how the pharmaceutical company Purdue Pharma produced the highly addictive painkiller called Oxycontin. Every detail is thoroughly explored by the author, including the unlawful filing of documents to the Food and Drug Administration (FDA), the regulatory agency for drugs in the United States, to regulate drug sales.

After its approval, Oxycontin became the best-selling drug in the United States, overtaking Viagra. The business practices adopted by Purdue Pharma are highly controversial and include excessive and inappropriate prescriptions for the drug, as well as the manipulation of documents and protocols that mitigated the impact of Oxycontin on patients’ health.

Additionally, the company used aggressive marketing tactics to boost drug sales, such as advertisements posted in doctors’ offices that include images of people with the phrase “I got my life back,” and even financial incentives for doctors who prescribed Oxycontin frequently.

The pharmaceutical company even paid other doctors to convince colleagues of the supposed benefits of Oxycontin, even though the drug is more potent than morphine and highly addictive.

Unfortunately, Oxycontin has played a major role in the opioid epidemic that has hit several countries, particularly the United States, leading to an alarming number of overdose deaths—around 500,000 people in the last 20 years.

Although the crisis was officially recognized in the 1990s, we can clearly see how the Sackler family’s questionable business practices were responsible for this calamity.

In 2007, Purdue Pharma and some of its executives pleaded guilty to criminal charges related to promoting Oxycontin. They were fined US$634 million and sentenced to provide community service.

However, the Sackler family did not face any serious criminal charges for their actions and retained ownership of the company. In 2019, the company filed for bankruptcy after facing thousands of lawsuits filed by local and state governments in the United States and victims of the opioid crisis.

The Sackler family agreed to pay US$225 million in a settlement with the courts to resolve civil charges related to Oxycontin.

With its engaging and unbiased approach, the book is a valuable resource for anyone interested in understanding the causes and consequences of the opioid epidemic that affects so many people and communities throughout the United States. In fact, the book has become a reference point for scholars, health professionals, researchers, and the general public seeking to better understand this complex issue.

Overall, Empire of Pain is an extremely important and provocative book, which sheds light on the opioid epidemic, the pharmaceutical industry, and the way that wealth and power can be used to shield individuals and companies from their responsibilities.

Opinion articles do not necessarily reflect the views of Science Arena or Hospital Israelita Albert Einstein.

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