Empire of Pain

Empire of Pain is Patrick Radden Keefe's 2021 investigative non-fiction book, the New Yorker staff writer's follow-up to Say Nothing (2018) and the canonical contemporary investigative book on the OxyContin-era opioid crisis. The structure is the three-generation history of the Sackler family: Arthur, Mortimer, and Raymond Sackler, the three brothers who built the family fortune in the 1950s through medical-advertising and the original Valium marketing campaign, and their children (Richard Sackler in particular) who built the OxyContin marketing strategy that drove the contemporary American opioid epidemic. Keefe runs the full operational mechanics of the Purdue Pharma sales force, the Sackler family's art-philanthropy reputation laundering, the multi-decade pattern of legal-defensive corporate restructuring, and the eventual bankruptcy-and-litigation conclusion.

Keefe's structural method is the patient assembly of the documentary evidence (the depositions, the internal Purdue Pharma marketing memos, the FDA approval correspondence, the Sackler family financial records) into a sustained narrative non-fiction account of approximately eighty years of family-and-corporate decisions. The Arthur Sackler chapters in the front third are the most carefully researched contemporary American medical-marketing history. The Richard Sackler chapters in the middle third (the OxyContin product launch, the abuse-resistance marketing strategy, the deliberate suppression of internal evidence about addiction risk) are the structural moral center of the book. The art-museum chapters that thread across the entire book (the Sackler wing at the Met, the Sackler galleries at multiple institutions) provide the structural counterpoint to the legal-and-medical material.

Recommended as required contemporary American investigative non-fiction reading, as the right Keefe entry point, and as the canonical non-fiction companion to Demon Copperhead (Barbara Kingsolver). Read Say Nothing (2018) next. The Patrick Radden Keefe audiobook is the definitive audio production. Five stars without reservation.