Then the brothers bought a small, humdrum drug company named Purdue Frederick, a manufacturer of earwax remover, antiseptic and constipation pills.

Sackler hid his connection to his journals, so when his partners in the publications were accused of bribing a government official – of even writing a speech for him, to improve the prospects of a new Pfizer antibiotic – Sackler stayed off camera. He hawked Valium and other tranquilisers so effectively, Keefe writes, that “patients had started going to their doctors and requesting each new wonder drug by name”. With his two brothers he took over an advertising agency that marketed drugs to physicians, mostly through a free medical newspaper that he published himself. Empire of Pain is an attentive history of the family, and gathers up evidence of how the Sacklers were aware of the ways in which Ox圜ontin drove the opioid-abuse epidemic – how, in fact, they even marketed the drug to capitalise on it.Īrthur Sackler, the restless eldest son of European Jewish immigrants, was a qualified psychiatrist, but his fortune rose from his marketing skills. Keefe brings to the Sacklers the same unflagging energy for research that lit up his previous book, Say Nothing, about a murder in Northern Ireland. Its name adorned the sites of cultural cachet that it had purchased: the Sackler Wings at the Louvre in Paris and New York’s Metropolitan Museum of Art the Serpentine Sackler Gallery in London buildings at Harvard, Oxford and other universities. Patrick Radden Keefe first wrote about the Sacklers four years ago in the New Yorker, just as Americans were getting angry about how the family that sold Ox圜ontin was also celebrated for its philanthropy. At least half a million people have died from overdosing on opioids such as Ox圜ontin the tablet became a way into heroin use. The Sacklers ran Purdue Pharma, which sold Ox圜ontin, the pain medication that ignited a blaze of drug abuse across the US. One of the people to have recognised this most clearly was Arthur Sackler, the patriarch of a pharmaceutical dynasty that is the subject of Empire of Pain.

In the US, in particular, the gap between saviour and salesman is a chance to make money off the most captive of markets: the sick hoping to get well again. The industry relies on the doctor’s unimpeachable image, on the patient’s worried willingness to accept anything that is prescribed. Yet these doctors are also the frontline vendors in an industrial complex, which includes hospitals, equipment-makers, insurance companies and drug firms, their eyes all fastened on their profit margins. The art of medicine is so manifestly a higher purpose – the safeguarding of human life itself – that its practitioners enjoy a kind of immaculate moral authority. W hat a strange, uniquely illusive figure the doctor is.

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