Marketing can outrun science.
Purdue trained reps to call OxyContin addiction risk 'less than one percent' without data.
Book summary
Award-Winner / Critically AcclaimedGoodreads FavoritePerennial Seller
Empire of Pain
by Patrick Radden Keefe
Philanthropy, marketing genius, and public health catastrophe collide in one American family
The Sackler dynasty's fortune and downfall amid the opioid crisis
4.8(9.8k)Published 2021
Topics
Public HealthCorporate EthicsLitigationMarketing
Reading companion
How to read Empire of Pain with Readever
Read chronologically but keep a parallel note stream: one for family history, one for marketing innovation, one for legal fallout. In Readever, link quotes about OxyContin's "abuse-deterrent" claims to the lawsuits they later triggered.
Things to know before reading
- The book references overdose statistics and grieving families; brace for emotional testimony
- Complex legal proceedings (bankruptcy court, civil settlements) feature heavily—lean on Readever's context cards
- Keefe critiques cultural institutions complicit in Sackler philanthropy; expect art-world references
- The narrative questions capitalism, philanthropy, and regulatory capture simultaneously
Brief summary
Empire of Pain in a nutshell
Investigative journalist Patrick Radden Keefe traces three generations of Sacklers—from the immigrant brothers who marketed Valium to the next wave that unleashed OxyContin. Drawing on depositions, leaked emails, and internal marketing decks, he shows how Purdue Pharma outmaneuvered regulators, rewrote pain-management norms, and hid addiction data even as overdoses soared. The book doubles as a study in reputational laundering through art museums and universities.
Key ideas overview
Empire of Pain summary of 3 key ideas
Empire building is easier than accountability when regulators, marketers, and nonprofits align.
Philanthropy is reputational armor.
Museum wings and university chairs kept the Sackler name prestigious while lawsuits mounted.
Accountability requires collective pressure.
Activists, state AGs, and journalists coordinated to pierce corporate veils.
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Deep dive
Key ideas in Empire of Pain
Key idea 1
Marketing can outrun science.
Purdue trained reps to call OxyContin addiction risk 'less than one percent' without data.
Keefe shows how pseudo-academic pamphlets, pain-management conferences, and targeted bonuses spread misinformation faster than peer review. Readers learn to interrogate medical messaging, especially when sales incentives loom large.
Key idea 2
Philanthropy is reputational armor.
Museum wings and university chairs kept the Sackler name prestigious while lawsuits mounted.
By funding art and research, the family embedded itself in elite culture, making critics seem ungrateful. The lesson: follow the money but also the naming rights—they may hide harmful revenue streams.
Key idea 3
Accountability requires collective pressure.
Activists, state AGs, and journalists coordinated to pierce corporate veils.
Only when multiple states sued, bankruptcy judges demanded disclosure, and museums refused donations did the Sackler brand crack. It's a blueprint for tackling other industries whose products cause widespread harm.
Context
What is Empire of Pain about?
Keefe traces three generations of the Sackler family, from Arthur Sackler's advertising innovations for Valium to Richard Sackler's aggressive launch of OxyContin and the philanthropic empire that followed. The book shows how marketing, regulatory capture, and philanthropy intertwined to build—and protect—a fortune tied to addiction.
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Review
Empire of Pain review
Reviewers celebrate Keefe's ability to turn sprawling legal and medical history into propulsive narrative. The New York Times called it "a masterpiece of narrative reporting," while The Atlantic praised the way he "balances outrage with restraint." The book won the Baillie Gifford Prize and became a staple in discussions about corporate accountability.
Critical reception: Longlisted for the National Book Award, named one of the best books of 2021 by The Washington Post, Time, and NPR.
- Winner of the Baillie Gifford Prize for Nonfiction (2021)
- National Book Critics Circle Award finalist
- Cited by lawmakers during opioid hearings
- Optioned for television adaptation by Netflix
- Endorsed by medical journals for its investigative rigor
Who should read Empire of Pain?
Healthcare leaders navigating marketing claims and compliance
Philanthropy and museum boards evaluating donor reputations
Journalists and policy students studying corporate accountability
Readers of *Bad Blood* or *The Radium Girls* seeking modern parallels
About the author
Patrick Radden Keefe is a staff writer at The New Yorker known for meticulous investigative features. His previous book Say Nothing won the Orwell Prize. Keefe studied at Columbia, Cambridge, and the London School of Economics and has received fellowships from the Guggenheim Foundation and the Cullman Center at the New York Public Library.
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Final summary
Empire of Pain demonstrates that reputational polish cannot mask systemic harm forever. By tracing the Sacklers' ascent and unraveling their philanthropic shields, Keefe arms readers with a blueprint for interrogating any company that profits from addictive products.
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