A Great Read: Empire of Pain

On the boring banality of immorality. WSIR #31

OK, people, I had a whole other topic in mind for this week, but I just finished the non-fiction book Empire of Pain and very much would like to talk all about it, so damn the torpedoes!

(Sorry. I jumped right in there. Hi. How are you? How was your week? Did you eat enough veggies and take care of yourself? I missed you.)

OK SO ANYWAY this book. Written by the author who wrote Say Nothing (which really is excellent, and you should read that also, possibly even first), this is a deeply researched and reported look at three generations of the Sackler family, who created Purdue Pharma and OxyContin, the drug arguably responsible for the scale of the opioid epidemic.

Now, there’s unfortunately no shortage of powerful writing about America’s heartbreaking and devastating opioid addiction (don’t miss Dopesick, for one), but this book keeps its lens solely trained on the Sackler family itself. Who they are, how they came to run this empire, what they did and did not do, and - most importantly - what responsibility they bear and how they personally and legally have found ways to elude accountability.

Here are a few reasons this book spoke to me:

This guy really knows how to tell a non-fiction story.

Keefe is an investigative journalist by trade and per his own account, he reviewed tens of thousands of documents, transcripts, emails, etc. in reporting this book. With such a broad topic, so much material, and so many players, this book could have been all over the place, or tediously footnoted, but instead it reads like a crime novel, or the very best profile piece that just happens to be 450 pages. It’s focused, easy to follow, and beautifully illustrated with anecdotes, dialogues, and the most perfectly timed stories. There are more than a few chapter-ending, blood-boiling, writerly mic drops.

Pro tip: Do not read his Wikipedia if you don’t want to feel bad about what YOU have accomplished by age 45.

It’s a study in the dangers of concentrated power.

The Sacklers ran Purdue as a family business, making all the decisions and siphoning most of the astronomical profits out of the business and into their personal accounts. It’s no new insight, but this book is a fascinating view of what happens when very wealthy, powerful people (often wealthy and powerful due to previous generations) think they are the smartest people in the room, and surround themselves with enablers to that effect. Even when faced with dozens of state lawsuits, even when confronted internally by employees, nothing could dissuade the Sacklers from their direction and rightness, which ultimately led to the bankruptcy of the business (though very little personal impact to the family and fortune.)

It’s a frank reflection on personal accountability, where we place blame, and how we absolve ourselves.

My sweetheart and I talk a lot about how everyone thinks they’re the good guy - we all find ways to justify to ourselves that what we’re doing, and how we’re benefitting from it, is okay. Throughout this book we see the Sacklers employ that time-honored American defense used by gun manufacturers, the tobacco industry, and social media platforms - that they simply make a product. If someone chooses to harm themselves and others with said product, so the argument goes, the company can bear no responsibility. And if a Sackler granddaughter with no role in Purdue Pharma chooses to live her life while benefitting from the wealth of her grandfather, she wonders why she must face social stigma. “We’re the good guys” comes up again and again in ways both galling but also pretty complicated.

Beyond the billionaire Sacklers, though, of employees, when faced with an avalanche of evidence about how Purdue contributed to hundreds of thousands of deaths, of suffering, of legal maneuvering and intimidation of reporters, Keefe writes this:

“They retreated to the old truths, about abuse versus addiction, about heroin and fentanyl. I wondered if, for some of these people, it was just too demoralizing to take a sober measure of their own complicity, if it was simply too much for the human conscience to bear.”

I mean … whew. Beyond this skillful writing, the book asks the question about this human instinct to self-justify, to great effect.

The way systems are set up to protect power and influence.

Keefe makes the point that over and over, the Sacklers and Purdue not only eluded accountability but benefitted from the kind of influence and protection that money and influence can buy, not to mention the ways unfettered corporate growth can be allowed and justified. Whether through extreme chumminess with the FDA, or donations to politicians and institutions, or bottomless coffers for advertising and lawyers, or even the laws around pharmaceutical patents and oversight, the book details how the company was able to operate essentially without accountability for decades. Again, Keefe says it better:

“The opioid crisis is, among other things, a parable about the awesome capability of private industry to subvert public institutions.”

I mean, do not read this book if you are not ready to just get all HET UP about the fact that, other than social stigma around the Sackler name, there’s been virtually no consequence for the company and family despite the hundreds of thousands of opioid deaths, not to mention the millions of Americans who have been incarcerated for drug possession NO DO NOT GET ME STARTED.

There’s repeated use of the phrase “attorneys general”

I mean, the man is a New Yorker journalist with a book editor, so naturally he would have the correct usage but it charms me every time I read it! More use of this phrase please!

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SO, obviously, I recommend it. I’ve read fair critiques of Empire of Pain that its focus on the family to the general exclusion of the stories of addiction underplays the human tragedy of the opioid crisis. So you may have that same reading. To me, this is almost less about opioids themselves than it is about all the systems - political, institutional, and psychological - that lead to these kinds of crises. And for that, it’s an interesting, thought-provoking non-fiction read.

Have you read it? Will you read it? Please let me know what you thought!

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If this book isn’t your jam, you can check out some past suggestions from the archive (perhaps some escapist reading?) or see all kinds of suggestions on my Bookshop.org page. Any book purchased through Bookshop.org supports indie bookstores in the US, UK and Spain. Which is pretty cool.

Also, the image above in the “Current Reading Queue” is from a piece of artwork in my dad’s den. He’s one of the most prolific readers I know and has many built-in bookshelves and reading nooks, which is basically my life goal. Also, he’s pretty great, so if you’re reading this, Dad, Happy Father’s Day!