Narrator: In the spring of 2019, inside a sterile New York conference room, a lawyer named Paul Hanly posed a question to Kathe Sackler, a member of one of America’s wealthiest dynasties. He asked if she recognized that hundreds of thousands of Americans had become addicted to a drug her family’s company, Purdue Pharma, had created. Kathe, a physician herself, did not hesitate. She not only defended the drug, OxyContin, as a "very good medicine," but she also claimed credit for the idea of its creation. This moment, a stark juxtaposition of immense pride and catastrophic public harm, lies at the heart of the opioid epidemic. It raises a chilling question: how did a single family, celebrated for its philanthropy and whose name adorned the walls of the world’s most prestigious museums, become the architects of a crisis that has claimed nearly half a million American lives?

The answer is meticulously detailed in Patrick Radden Keefe’s investigative masterpiece, Empire of Pain: The Secret History of the Sackler Dynasty. The book reveals that the opioid crisis was not a tragic accident, but the calculated result of a multi-generational pursuit of profit, shrouded in a carefully constructed veneer of respectability.

Narrator: The story of Purdue Pharma’s success begins not with OxyContin, but with the patriarch of the family business, Arthur Sackler. A brilliant and relentlessly ambitious man, Arthur revolutionized pharmaceutical advertising in the post-war era. Before him, drug marketing was a staid affair. Arthur, however, saw that doctors, the gatekeepers of prescriptions, could be marketed to just like any other consumer.

His work on drugs like Librium and Valium for the company Roche provides a perfect case study. Arthur’s advertising agency, McAdams, created campaigns that medicalized everyday anxiety, particularly targeting women with ads depicting them as frazzled housewives or neurotic career women who needed a "little yellow pill." He understood that to sell a drug, you had to sell the disease. His campaigns created a sense of urgency and need, circumventing FDA regulations by planting favorable stories in popular magazines and funding "educational" materials for doctors that were, in reality, sophisticated marketing. He pioneered the use of "key opinion leaders"—respected physicians paid to endorse a drug—and built a system where brand loyalty was paramount. This was the playbook: identify a market, create a narrative of need, influence doctors, and sell, sell, sell. This very strategy would later be weaponized by his family to launch OxyContin.

Narrator: By the 1980s, Arthur’s brothers, Mortimer and Raymond, were running Purdue Frederick. Their first major success came from a British subsidiary, Napp, which developed a revolutionary controlled-release morphine pill called MS Contin. It was a godsend for cancer patients, offering steady relief from severe pain. The drug was a blockbuster, but it had a fatal flaw for a pharmaceutical company: a patent with an expiration date.

As the 1990s dawned, the Sacklers faced a "patent cliff." Once MS Contin’s patent expired, generic competition would decimate their profits. The family, now with Raymond’s son Richard Sackler taking a more aggressive role, needed a successor. They found it in oxycodone, an old, powerful opioid. By applying their signature controlled-release technology, they created OxyContin. The plan, however, was not just to replace MS Contin. Richard Sackler saw a much larger, untapped market: non-cancer pain. He believed the medical establishment was too fearful of opioids, or "opiophobic," and that millions of Americans with conditions like back pain or arthritis were suffering needlessly. The mission became to change the culture of prescribing itself, convincing doctors that the risk of addiction was a myth and that OxyContin was the safe, long-lasting solution.

Narrator: Purdue Pharma launched OxyContin in 1996 with a marketing blitz of unprecedented scale and aggression. At a launch event, Richard Sackler told his new, massive sales force to expect a "blizzard of prescriptions that will bury the competition." The sales reps were trained with a carefully crafted message. They were told to emphasize that due to its 12-hour, controlled-release formula, the risk of addiction was "less than one percent." This statistic was based on a flimsy, out-of-context letter to an editor and was not supported by any clinical study of OxyContin itself.

Sales reps, incentivized by a lucrative bonus system that rewarded higher-dose prescriptions, targeted general practitioners who had little training in pain management. They were given promotional materials, including fishing hats and stuffed animals, and were taken to lavish all-expenses-paid "pain management" seminars in sunny locales. The company’s own internal documents and sales training videos show a clear strategy to mislead doctors. For example, when some doctors noted the 12-hour relief was not lasting, causing patients to suffer withdrawal and crave their next dose, sales reps were instructed to tell them to prescribe a stronger dose, not a more frequent one. This cycle of escalating dosage was a direct pathway to addiction for countless patients.

Narrator: As reports of OxyContin abuse, addiction, and death began to surface in the late 1990s, Purdue Pharma and the Sackler family responded not with alarm, but with denial and deflection. Their strategy was to blame the victims. In internal emails, Richard Sackler referred to people struggling with addiction as "abusers" and "scum of the earth," arguing they were the "victimizers," not the victims.

This disregard for human life had a precedent. In 1995, a chemical plant in New Jersey owned by the Sacklers exploded due to egregious safety violations, killing five workers. The family never issued a public apology or condolences. Similarly, with OxyContin, the company consistently downplayed the crisis. They knew from their own sales data about "pill mill" doctors prescribing enormous quantities of the drug, yet they rarely reported them to authorities, as doing so would cut off a lucrative revenue stream. When a federal prosecutor in Maine, Jay McCloskey, raised the alarm in 2000, Purdue executives dismissed him as "overly zealous" before eventually hiring him as a consultant, effectively silencing a key critic.

Narrator: By the mid-2000s, the federal government could no longer ignore the crisis. Federal prosecutors in Virginia, led by John Brownlee, built an ironclad criminal case against Purdue and three of its top executives. They had evidence of fraudulent marketing, false testimony to Congress, and a clear pattern of deception. They intended to bring felony charges that could result in prison time.

However, the Sacklers deployed their immense wealth and influence. They hired a team of high-powered lawyers, including former New York City Mayor Rudy Giuliani, to lobby the Department of Justice in Washington. In a controversial decision, the DOJ overruled the prosecutors and allowed the executives to plead guilty to lesser misdemeanor charges, avoiding jail time. Purdue Pharma, the company, pleaded guilty to a felony, but the $600 million fine was a fraction of the more than $30 billion in revenue the drug had generated. Crucially, no member of the Sackler family was charged. They had successfully used their employees as scapegoats, allowing them to "take the fall to protect the family."

Narrator: In the years following the 2007 plea deal, the Sackler family’s reputation began to crumble. Activists, led by the photographer Nan Goldin who had survived her own OxyContin addiction, began protesting at the museums that bore the Sackler name. Her group, PAIN, staged "die-ins" at the Guggenheim and the Met's Sackler Wing, throwing empty pill bottles into reflecting pools and demanding these institutions sever ties with the family. One by one, major cultural institutions like the Louvre, the Tate, and the National Portrait Gallery announced they would no longer accept Sackler money, and some began the process of "un-naming" their galleries.

Yet, even as their name became synonymous with the opioid crisis in the West, the Sacklers were exporting their playbook abroad. Through their international network of companies, Mundipharma, they began aggressively marketing OxyContin in emerging markets like China, Brazil, and Mexico. They used the same tactics: funding pain societies, downplaying addiction risks, and pushing for wider use of opioids, seeding a new crisis on a global scale.

Narrator: The single most important takeaway from Empire of Pain is that the American opioid crisis was not an inevitable public health tragedy; it was a crisis of accountability, manufactured by a family that prioritized profits over people with ruthless, single-minded dedication. The Sacklers did not just sell a pill; they sold a false narrative of safety, and in doing so, they unleashed a "blizzard" of addiction and death that continues to devastate communities.

The book leaves us with a deeply unsettling question about justice in the modern age. While the Sackler name has been stripped from museum walls, the family has largely been shielded from meaningful legal consequences, retaining the vast majority of their fortune. It challenges us to consider what true accountability looks like when wealth and influence can so effectively insulate the powerful from the consequences of their actions, leaving a legacy of both celebrated philanthropy and immeasurable pain.