Empire of Pain: The Secret History of the Sackler Dynasty

by Patrick Radden Keefe

In fact, more Americans had lost their lives from opioid overdoses than had died in all of the wars the country had fought since World War II.

A 2016 study found that purchasing even a single meal with a value of $20 for a physician can be enough to change the way that he prescribes. And for all their lip service to the contrary, the Sacklers didn’t need studies to tell them this. Some years, Purdue would allocate as much as $9 million just to buy food for doctors.

When Bayer marketed heroin at the turn of the twentieth century, it offered free samples of the drug to potential customers. When Roche was seeking a foothold for Valium in Canada during the 1970s, the company gave away eighty-two million Valium pills as free samples in a single year. If you are selling a product that makes people feel good (and may also be highly addictive), that first free hit will generally pay for itself many times over.

In some ways, Richard’s argument about OxyContin mirrored the libertarian position of a firearms manufacturer who insists that he bears no responsibility for gun deaths. Guns don’t kill people; people kill people. It is a peculiar hallmark of the American economy that you can produce a dangerous product and effectively off-load any legal liability for whatever destruction that product may cause by pointing to the individual responsibility of the consumer.

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

Ohio was an apt forum for this showdown. By 2016, 2.3 million people in the state—approximately 20 percent of the total population—received a prescription for opioids. Half of the children who were in foster care across the state had opioid-addicted parents. People were dying from overdoses at such a rate that local coroners had run out of room in which to store all the bodies and were forced to seek makeshift alternatives.