Dope sick America

Empire of Pain by Patrick Radden Keefe

The early 21^st century is an age characterised by some spectacular acts of wishful thinking on the part of America’s elite. The cleverest people in the world, in the richest country on earth, have together come up with such harebrained schemes as a subprime mortgage crisis brought about by lending huge amounts of money to people who obviously couldn’t pay it back; they had a cunning plan to introduce democracy to a highly clannish and divided country which was obviously destined to descend into hideous civil war; and, with the most tragic consequences at home, they swallowed the idea that pain could be treated by drugs without the risk of addiction.  

Empire of Pain is Patrick Radden Keefe’s account of the opioid epidemic and how the Sacklers rose to power and wealth before suffering a spectacular fall from grace. It covers in depth much of the story told in the television series Dopesick, which also came out in 2021, but goes further into the history of the drug company and the family who grew rich from pain treatment.

The primary narrative is that classic Greek tale of hubris, of a family so obsessed with its name that it gave countless amounts to philanthropic ventures and artworks in order to carve its name into posterity, and yet ended up becoming so notorious as to suffer the fate of damnatio memoriae.

Yet the background story is also about wishful thinking in the medical profession, and the OxyContin epidemic for which they became notorious was not even the first case. Arthur Sackler, the founding patriarch of the dynasty alongside his two younger brothers, had made his fortune in the post-war period when a mix of heady optimism about the power of science and a new naivety about human nature led to many disastrous decisions being made.