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In the years leading up to the Great Depression, when a recent immigrant could hustle to make a living, if not gather untold riches, Isaac Sackler had but one lesson to impart to his sons Arthur, Mortimer, and Raymond: “If you lose a fortune, you can always earn another. But if you lose your good name, you can never get it back.” Isaac’s sons and their children would, indeed, go on to amass several fortunes, soaring to the multiple billions of dollars. The family’s good name would adorn the world’s most venerated museums and universities, from New York to Tel Aviv, London to Los Angeles. But how it would have pained Isaac to see, a century after imparting his worldly wisdom, that, while the money was still there, the family’s name was no longer revered, and that the carefully curated reputation based on the Sackler family’s philanthropy would be permanently and irrevocably tarnished by their development of a drug that became a scourge. From the earliest forays into medical marketing to its final days dodging bankruptcies, the Sackler empire was founded on battling pain, first with the breakthrough drugs Librium and Valium and ending with the engine of the opioid crisis, the highly addictive OxyContin. Indefatigable investigative journalist Keefe crafts a page-turning corporate biography and jaw-dropping condemnation of the Sacklers’ amoral disregard for anything save the acquisition of power, privilege, and influence. In Keefe’s expert hands, the Sackler family saga becomes an enraging exposé of what happens when utter devotion to the accumulation of wealth is paired with an unscrupulous disregard for human health.

Kirkus
Copyright © Kirkus Reviews, used with permission.

Richly researched account of the Sackler pharmaceutical dynasty, agents of the opioid-addiction epidemic that plagues us today. In his latest excellent book, Keefe opens in a conference room packed with lawyers, all there to depose “a woman in her early seventies, a medical doctor, though she had never actually practiced medicine.” Kathe Sackler, thanks to the invention of a drug called OxyContin, was a member of one of the wealthiest families in the world, holding some $14 billion. The founder of that dynasty had established numerous patterns that held for generations. Though he had insisted that family philanthropy be prominently credited “through elaborate ‘naming rights’ contracts,” the family name would not extend to their pharmaceutical company, Purdue Pharma. The family would also not accept responsibility for any untoward effects that its products might have. Thus, when asked whether she acknowledged that hundreds of thousands of Americans had become addicted to OxyContin, Kathe answered, “I don’t know the answer to that.” Keefe turns up plenty of answers, including the details of how the Sacklers—the first generation of three brothers, followed by their children and grandchildren—marketed their goods, beginning with “ethical drugs” (as distinct from illegal ones) to treat mental illness, Librium and then Valium, which were effectively the same thing but were advertised as treating different maladies: “If Librium was the cure for ‘anxiety,’ Valium should be prescribed for ‘psychic tension.’ ” By Keefe’s reckoning, by the mid-1970s, Valium was being prescribed 60 million times per year, resulting in fantastic profits for Purdue. OxyContin followed in 1996—and then the opioid crisis, responsibility for which has been heavily litigated and for which the Sacklers finally filed bankruptcy even though they “remained one of the wealthiest families in the United States.” Of particular interest is the book-closing account of the Sacklers’ legal efforts to intimidate the author as he tried to make his way through the “fog of collective denial” that shrouded them. A definitive, damning, urgent tale of overweening avarice at tremendous cost to society. Copyright © Kirkus Reviews, used with permission.