In 1996, Purdue Pharma released OxyContin, the prescription painkiller largely blamed for the opioid addiction crisis that has killed about 500,000 Americans in recent decades. The company, now facing about 3,000 lawsuits, filed a bankruptcy plan this year to set up trusts that would distribute money to states, local governments, and tribal organizations for opioid abatement programs over the next nine years.
But the solution would leave the Sackler family, who own and made their fortune from the now-bankrupt OxyContin-producing company, alone—at least for the most part. Recent documents turned over to Rep. Carolyn Maloney (D-N.Y.), show that the family members who own the company are worth about $11 billion. The bankruptcy agreement would have them pay about $4.28 billion of their worth while also abating any personal liability in the lawsuits they and their company face. Meanwhile, the Sackler name still adorns a wing of New York City’s Metropolitan Museum of Art, and their sizable donations to institutions like the Louvre, the British Museum, Harvard University, and Yale University are still accepted without question.
A separation, however superficial, between company and family has, for the most part, protected the Sackler family from scrutiny. But in recent years the tides have been rising against the philanthropic family, who have long been names to know among the New York gala class.
In his latest book, Empire of Pain, New Yorker columnist Patrick Radden Keefe explores the Sacklers’ role in the current opioid crisis, dating back generations. The debut of OxyContin, he says, was actually over 50 years in the making. Arthur Sackler, who died in 1987, before OxyContin was introduced, was a marketing man and had a large role in the blending of commerce and medicine, revolutionizing the business by selling drugs like Valium directly to doctors instead of the consumer. Those marketing lessons, when turned to opioids, however, turned deadly.
Fortune spoke with Patrick Radden Keefe about his new book and the legacy (and future) of the Sackler family.
The conversation has been lightly edited for length and clarity.
Fortune: This is a story you’ve been reporting on for years, along with other journalists. What’s significant about this particular moment in time in relation to the Sackler family and OxyContin?
Patrick Radden Keefe: There are two reasons. The first is that it’s possible to tell the story now in a way that it really wasn’t for a long time because the family was very secretive and always has been, dating back to the 1950s. They never give interviews, and Purdue is a privately held company, so it’s very difficult to access documents or really have a sense of what’s going on inside. So I thought about trying to do a book in 2017, but I concluded that because Purdue was a black box, and nobody in the family ever talked, there would be no way to tell the story with the kind of granularity that I thought it needed. So the first big thing that changed is that all of this litigation produced huge reams of internal documents that show both a sustained and very high level of complicity inside the company, but then also show the family running the company in a very active, interventionist way. That kind of vivid detail that has been available just in the last couple of years makes it possible to write a big comprehensive book about the family’s role.
The other reason is that the end game is happening right now. It’s complicated, but there is a bankruptcy proceeding in White Plains, and that will be resolved by the end of the summer. Depending on how that works out, that’s really going to answer the question of what kind of accountability the Sacklers might face or not face.
This book is focused on the Sackler family, not on the victims of the opioid crisis. Why is the history of this family so important to tell?
You’re right. It was a very conscious choice on my part. One reason is that there are some very good books about the opioid crisis, and I didn’t want to write the sixth good book about that. But if you look at some of those earlier books, I was not the first person to report that this fascinating trio of philanthropists owned Purdue Pharma, but in each of those cases, those characters were one strand in a tapestry, where you had a whole series of other characters and areas of focus.
But when you look at the strategy of the Sacklers, and Purdue, their whole game plan was, How can we minimize the role of the family in these stories? It was almost as if at a certain point—and you see this in the internal emails—they could deal with a certain amount of bad press for Purdue. There’s an email where one of the PR executives at the company says, “The good news is there’s very little about the Sacklers.” And that was the approach for years, and it worked. There were no major institutions that had any issues with taking money from the family. People knew about Purdue, but people didn’t really draw the connection to all these Sackler wings and Sackler galleries.
I wanted to put the spotlight very directly on them. I wanted the family to be center stage. It’s also the case that it’s a great story. And this is part of what appealed to me; I’m very intrigued by family dynamics. One theme that I’ve always been really interested in is this denial and self-delusion, the stories that people tell themselves about the choices they’ve made in their lives. And all of that is on display in this vivid, dramatic fashion with the family.
I often fall into a trap when I’m writing about companies where I want to write about them as if they are their own living entities, you know “Microsoft did X today,” but companies aren’t sentient. It’s specific individuals making those decisions, and it’s easy to forget that.
It’s funny because there’s an associated thing which I’m sure you’ve encountered in other contexts: At the very end of the book I write about the fact that Purdue Pharma had a guilty plea in November, and they say the company is gonna pay $8 billion, which is a fake number because the company doesn’t have $8 billion; it’s in bankruptcy. But the Trump administration held a press conference about it, and there weren’t just no executives charged, but no executives even named. And so there’s just this weird thing where it’s like, the company is an automaton. Who did the bad thing?
So how do you hold individuals responsible?
I think individuals absolutely should be held responsible. There’s a great book by Jesse Eisinger called The Chickenshit Club all about the failure of the Department of Justice in general. He described this phenomenon during the Obama administration to just go very easy on corporate defenders and cut deals and not bring charges against individual executives. I don’t think you have to look much farther than the Purdue story to see how that works. After the 2007 guilty plea, where a lot of people felt like those executives should have been charged with felonies, [former Senator] Arlen Specter, who was a Republican on the Judiciary Committee, said his worry was that when you just get the company to pay a fine, it’s like a speeding ticket, and they’re just gonna keep moving. His prediction was they wouldn’t be reformed. Fast-forward to 2020, and Arlen Specter is dead, but he got his answer.
The Sackler name is still on a lot of buildings and wings, like at the Metropolitan Museum of Art in New York City. Do you see that ending for them, or will the association with Purdue eventually fade? Will they end up okay?
I think they’re going to walk away with most of their fortune. There’s been legislation introduced in the House recently called the Sackler Act that says that the bankruptcy judge in White Plains doesn’t have the right to free the Sacklers from all of these lawsuits that states want to bring. So if that passes it’s a different question. You could potentially see these lawsuits against the family continue. But otherwise, I think they’ll be released from their liabilities. They’ll pay an amount that’s, in absolute terms, a lot of money. But if you look at the amount of money they took out of the company, during a period of time when the company has now acknowledged it was committing fraud, it’s like 40 cents on the dollar.
In terms of the name, I don’t think they’re gonna get it back. I think that this legacy will follow them. I think these institutions, some of them will keep the name up. The Met has announced that they are reviewing whether or not the Sackler wing will continue to be called the Sackler wing. Harvard is now reviewing the status of certain names. I think it may be that the name has been permanently sullied.
Arthur Sackler, whose brothers co-ran Purdue Pharma, revolutionized the marketing of Valium and other drugs. How did that come to play in the marketing of OxyContin?
The single biggest choice I made in terms of how to write this book was to start with Arthur and devote a third of the book to him before you ever meet Richard Sackler and long before the introduction of OxyContin. And that was a very deliberate choice. You see the seeds for everything that follows starting in the 1950s with Arthur and his brothers. I think that you have a mingling of medicine and commerce and a comfort with conflicts of interest and a comfort with highly deceptive marketing associated with pharmaceuticals. You also see a willingness to co-opt the FDA. There’s a playbook that Purdue Pharma uses in 1996 to roll out OxyContin, and that is a playbook that Arthur Sackler pioneered with the drugs [like Valium] that he was helping market in the 1950s and 1960s. In both cases, the companies downplayed the risk of addiction when they marketed them. In the case of Valium, one of the things that Arthur promoted was to build a big sales force of what they call detail men and have them go out armed with medical literature to meet with doctors and try to persuade them about the medical benefits and many things that the drug can do.
There are so many parts of this story that led to where we are today and to the leniency that the Sacklers have enjoyed. Is there one particular piece, the court system or what have you, where reform would have the biggest and quickest impact on the current environment?
I think there’s two things. One is a systemic issue. Part of what I was trying to do in the book was capture that I think there’s a great deal of blame to be laid at the feet of the Sacklers, but also, this is a story about the corruption and erosion of a whole host of institutions. The FDA had major failures. Look at Curtis Wright, the FDA examiner who approved OxyContin and then left the FDA a year later to go work at Purdue for $400,000 a year. Richard Sackler, in a deposition, said that Curtis Wright had actually started calling Purdue about a job before he even left the FDA. I sued the FDA for documents, and I asked for all of the communications of Curtis Wright. The FDA came back and said, “Oh, it’s the weirdest thing, but we don’t have anything. It’s all either been lost or destroyed.” It’s a pretty clearly corrupt situation where this FDA examiner who approved OxyContin, and the way OxyContin would be marketed, then goes and works for the company.
Meanwhile, I’m trying to reconstruct what kind of influence was going on when he was at the agency, and the FDA says, “We can’t find anything.” But it’s not just the FDA, it’s Congress, it’s the Department of Justice, it’s big parts of the medical establishment. So there’s this systemic thing, which is that the sheer amount of money involved, I think, has meant that a lot of the checks that should be in place in society to not just achieve justice, but also to protect us as consumers, were not there because they had been co-opted.
The other thing is more of a human thing, which is just so dispiriting to me, but there are just a lot of very elite, very mercenary professionals. Mary Jo White and Rudy Giuliani who I think have been all too happy to enable a family like the Sacklers and a company like Purdue. There’s this strange thing where there’s the bad actor, but then around the bad actor is this ring of facilitators who work at fancy firms and have nice letterhead and get vetted and honored and treated like great exemplars of their professions. It’s one thing to represent Purdue in 2007. It’s another thing altogether in 2020 to say, “Oh, okay, so they didn’t actually get their act together after 2007 at all. They kept doing all the bad stuff. And now I’m going to represent them again.” And in the interim, hundreds of thousands of people got addicted to OxyContin.