People in every demographic group and every part of the country became hooked on powerful drugs. Many lost their jobs, savings, homes, and families and they became ensnared in the criminal justice system. Hundreds of thousands died from drug overdoses. Communities were decimated.
The drug pushers were protected by high-powered lawyers like Mary Jo White, Eric Holder, and Rudolph Giuliani, as well as battalions of lawyers from some of the most prestigious law firms in the country.
Who are these drug dealers? Brown-skinned drug lords from Latin America?
Of course not.
The legal clients are a network of privately-owned drug companies connected to Purdue Pharma, which has been run by three generations of the Sackler family. They are privileged graduates of elite institutions who learned to “play” the system to enrich and protect themselves by using virtually every corrupt practice imaginable.
The outrageous story of how this happened is described in Empire of Pain: The Secret History of the Sackler Dynasty, written by investigative journalist Patrick Radden Keefe, who is a staff writer for the New Yorker. This post is based on this amazing book.
The first generation of Sacklers in the Purdue network were three brothers, all doctors, who were concerned about problems of patients’ untreated pain. However, they were much more concerned about making as much money as fast as possible by hook or by crook. Here’s an excerpt from the publisher’s summary:
Arthur devised the marketing for Valium, and built the first great Sackler fortune. He purchased a drug manufacturer, Purdue Frederick, which would be run by Raymond and Mortimer. The brothers began collecting art, and wives, and grand residences in exotic locales. Their children and grandchildren grew up in luxury.
Forty years later, Raymond’s son Richard ran the family-owned Purdue. The template Arthur Sackler created to sell Valium – co-opting doctors, influencing the FDA, downplaying the drug’s addictiveness – was employed to launch a far more potent product: OxyContin. The drug went on to generate some thirty-five billion dollars in revenue, and to launch a public health crisis in which hundreds of thousands would die.
This is the saga of three generations of a single family and the mark they would leave on the world, a tale that moves from the bustling streets of early twentieth-century Brooklyn to the seaside palaces of Greenwich, Connecticut, and Cap d’Antibes to the corridors of power in Washington, D.C. Empire of Pain chronicles the multiple investigations of the Sacklers and their company, and the scorched-earth legal tactics that the family has used to evade accountability. The history of the Sackler dynasty is rife with drama – baroque personal lives; bitter disputes over estates; fistfights in boardrooms; glittering art collections; Machiavellian courtroom maneuvers; and the calculated use of money to burnish reputations and crush the less powerful.
Empire of Pain is a masterpiece of narrative reporting and writing, exhaustively documented and ferociously compelling. It is a portrait of the excesses of America’s second Gilded Age, a study of impunity among the super elite and a relentless investigation of the naked greed and indifference to human suffering that built one of the world’s great fortunes.
Pain, Opioids, Addiction, and the Sacklers
Intense pain from injuries and illnesses is a serious problem. In carefully limited doses that are closely monitored by doctors who are concerned about their patients’ well-being, opioids like OxyContin are valuable treatments.
However, when people take opioids for an extended time, the drugs change people’s brain chemistry so that they become addicted to the drugs. If they stop taking the drugs, they experience excruciating withdrawal. Symptoms often include pain in various parts of the body, stomach cramps, vomiting, fever, sweats, chills, increased heart rate, anxiety, and irritability. It’s not surprising that people crave drugs that produce euphoric highs even at the risk of agonizing withdrawal. When people can’t get or afford opioids, they sometimes get heroin on the street, which is cheaper and may be easier to obtain.
Recovering from addiction is very hard, which may involve gradually reducing the dosage, substituting other medications, and other treatments. Recovery can take years, and people often suffer relapses.
Evidence from litigation against the Sackler empire shows that they were well aware of the dangers of addiction to OxyContin but they didn’t care that it hurt others. According to Empire of Pain, the drug dealers mostly cared about making as much money as fast as possible.
The Sacklers generally argued that they were separate from their companies – except when it benefitted them in bankruptcy proceedings. The companies were closely managed by members of the Sackler family, so I refer to them collectively as the Sacklers.
They perfected numerous schemes to corrupt the systems that were supposed to protect the public. For example, they convinced Curtis Wright, the FDA official responsible for approving the drug labeling, to approve a highly deceptive label that the drug dealers used in marketing. After Wright left the FDA, he got a lucrative job at Purdue.
Using various false claims, the Sacklers misled patients, sales people, pharmacists, doctors, and medical experts. For example, the Sacklers deceptively touted a short letter to the New England Journal of Medicine stating that less than one percent of patients getting OxyContin became addicted. The letter did not report a scientific study. It referred only to patients confined to a hospital where prescriptions were carefully controlled.
The Sacklers used many schemes incentivizing professionals to promote the drug. Some doctors ran “pill mills” generating huge sums by giving an obscene number of prescriptions to addicted people. The Sacklers kept data on how much each doctor prescribed and they knew about the pill mills. The Sacklers not only failed to report the doctors to law enforcement, but wanted them to keep prescribing the drug and thus increase the Sacklers’ profits.
To get a visceral feel of the Sacklers’ corruption and how it affected people hooked on their drug, watch the powerful Hulu series, Dopesick. It has four interweaving storylines, following the Sackler family, Purdue sales representatives, people in an Virginia mining community devastated by the drug, and prosecutors investigating the Sacklers. Most of the portrayals are scrupulously accurate. The users and doctors in Virginia are composite characters that provide very vivid illustrations of withdrawal experiences and why users are so desperate to get the drug.
The series tracks the uphill battle of federal prosecutors in Virginia to hold the Sacklers accountable for their actions. It shows their investigation and negotiations within the Justice Department and with Purdue. The Sacklers thwarted regulation through high-powered influence on administrative agencies and DOJ. The final negotiation with Purdue was fascinating and, alas, not surprising considering that Purdue had incredible power.
Dopesick has a narrower focus than Empire of Pain, as it begins with the second generation of Sacklers, deals only with the situation in the Appalachian community, and ends with a settlement in 2007. Empire of Pain covers three generations of Sacklers and Purdue operations much more broadly, and it continues through the bankruptcy proceedings this year.
I highly recommend both. Dopesick, being a TV dramatization, is much more emotionally compelling. Empire of Pain is much more thorough.
High-Powered Lawyers Protecting a Ruthless Drug-Dealing Mob
The Sacklers are extremely evil. With no remorse, they “earned” billions of dollars by knowingly causing immense pain throughout the US and around the world. After Purdue and several executives (but no Sacklers) pleaded guilty to misdemeanors in 2007, they didn’t stop their illegal activities and actually increased their deadly marketing efforts. Richard Sackler testified that he and his family bore no responsibility for the opioid crisis. Indeed, the Sacklers see themselves as victims of “criminals” who abused their drugs and harmed their interests and reputations. They belong in the chutzpah hall of shame.
Experts estimate the damages caused by the Sacklers in the trillions of dollars. In the bankruptcy settlement of claims by more than 600,000 individuals, municipalities, hospitals, tribes and states, the Sacklers are required to pay $4.5 billion over nine years. Individuals and families of those who suffered from addiction or died from an overdose can get no more than $48,000. The Sacklers are protected from liability even though they did not file for bankruptcy protection. In the years leading up to the bankruptcy, they anticipated numerous claims and moved more than $10 billion dollars from Purdue into an opaque web of hard-to-reach offshore accounts. Experts believe that the Sacklers will not face any criminal or personal civil liability and will retain billions of dollars.
While the Sacklers get off with relatively little liability, tens of thousands of low-level drug users and dealers fill our prisons and jails, effectively destroying their lives and hollowing out families and communities.
Since the Sacklers introduced OxyContin in 1996, their lawyers used super-hardball tactics to threaten a growing cadre of claimants, employees, regulators, prosecutors, journalists, and activists who challenged their drug-dealing activities. In both the 2007 and 2021 settlements, the Sacklers escaped their just deserts by threatening to prolong litigation for years and deprive injured parties of remedies that they desperately needed.
Defendants are entitled to legal representation, and everyone knows that powerful, rich defendants get the best representation that money can buy. One observer quoted in Empire of Pain noted that many prosecutors spend the first part of their careers putting criminals in prison and the second part of their careers defending them.
Under Rule 1.16 of the ABA Model Rules of Professional Conduct, lawyers may withdraw from representing clients who take actions that the lawyers consider “repugnant.” Obviously, the Sacklers didn’t do anything repugnant enough for their lawyers to stop taking lots of their money.