Amazon.com: Customer reviews: Empire of Pain: The Secret History of the Sackler Dynasty

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Up till 3 a.m.

Reviewed in the United States on April 19, 2021

I knew the general outlines of the story, but the book still kept me up till three a.m. reading it! Opioids, and their marketing, were the slipperiest of slopes and the nation skidded down the hill.

As a doc, I knew of the overprescribing in the late 1990's and wondered how a "controlled substance" could make it from the factory to the streets with such ease. Now I know. At least I never wrote a script for it and never took a single dose of this poison.

Evil. Pure, homegrown, evil. Aided and abetted by lawyers, and even McKinsey. NO ONE bothered to say what everyone knew: there was no excuse for the flood of opioids. No excuse except the addiction to money.

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Meesha

Wasn't the hard hitting piece I was hoping for

Reviewed in the United States on May 23, 2021

The 1st half of this book was a page turner. I loved the history of the 3 brothers. The struggles, the effort, the clever manipulation. What clearly laid the groundwork for the next generations to create an opioid crisis in the US. This was well done. The back half of the book lost all of the sizzle. I was bored. I also couldn't quite connect the comparison of gun manufacturers being just like the Sacklers, since drug addiction and the pending death that often accompany it are A) Not a constitutional right and B) Guns are not addictive nor do they guarantee death. The two instances where the book tied to draw this correlation created a total lack of journalistic credibility for me. Perhaps that's why I lost interest. I'd recommend this book regardless, for decent education purposes. But I wouldn't recommend wasting a weekend cover to cover on this.

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From the United States

Thomas Tansey

Too long and too biased

Reviewed in the United States on July 26, 2021

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Way too long. Too many extraneous sections and passages. Needs to be culled of at least 150 pages. The Sackler family, starting with the generation of Arthur, Mortimer and Raymond, made its initial fortune with Valium. The brothers were great philathropists, endowing mainly art museums in several countries. They insisted that their Sackler name be prominently displayed on their donated buildings and wings. Then they got into selling opioid drugs, the most famous, and notorious, being Oxycontin. They marketed it, through Parma, aggressively, offering large bonuses to sales reps who got doctors to prescribe lots of this medication/drug, to relieve pain. Doctors then, for the most part, were unaware of its addictive danger, Parma wasn't about to enlighten them. Tons of money flowed into Parma coffers. Three generations of Sacklers were profiled. Many of them were doctors, with genuine medical credentials. With all the money pouring in, Pharma was able to hire top lobbyists, lawyers, and other people of influence to thwart off negative publicity and investigations. It worked, for years anyway. Then the walls started caving in. Sacklers sucked hundreds of millions of dollars out of Pharma. There were numerous shell companies and offshore tax havens where assets were sequestered. The bottom fell out for the Sacklers when numerous state attorneys general and some private attorneys filed lawsuits against Pharma for addicting thousands upon thousands of Oxycontin users inundated with a tsunami of lawsuits, Pharma filed for bankruptcy, which stopped cold all pending lawsuits . The matter is still in bankruptcy. The Sacklers made an offer. They would throw in some $4 billion, would dissolve Pharma, a separate trust would be set up, in which the Sacklers would have no interest, so the money could be paid out for rehab. As part of the offer, the Sacklers wanted a third-party release, whereby all claims against them would be barred, even claims that have not yet been filed. The bankruptcy judge is considering it. As of the writing of this review, that's where the matter is. A hearing is scheduled before the judge on August 8th, of this year, 2021.

And now for the bias by the author. He states that the drug, Oxycontin, can be prescribed by doctors for pain and will last for twelve hours. So two pills a day should do the trick. Then the author says effect of the pain pill only last for eight hours, leaving the patients with inadequate medication apparently. This is ridiculous on it face. The duration of the beneficial effects of the drug varies from patient to patient. Pain is subjective. Some people have a low threshold for pain; others have a high threshold. And the intensity of the pain varies with physical activity. So the eight-hour limit is nonsense, and, to me, a sign of author bias.

How many hundred of thousands, or even millions, of patients benefitted from acute or chronic pain thank to this drug? How many of them were able to do their work or engage in non-work and recreational activities, thanks to this drug? We don't know because the author didn't delve into that.

Something else the author didn't get into. How many patients were getting the drug from a physician, let's say 40 mg.to be taken twice a day. The patient tells the doctor he needs the pill more than twice a day. Maybe four times a day. Or he tells the doctor he needs a larger dose, do the doctor changes the 40mg to 80mg. But the patient gives the extra doses to friends who use it recreationally. Worse, the patient sells the drug illegally on the street. Don't tell me this doesn't happen. The author doesn't explore this either.

10 people found this helpful

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M. Dearing

BIASED

Reviewed in the United States on June 3, 2021

Verified Purchase

Excellent book, yet it has too much bias. Frankly, mostcof the illegal drugs are not from pharmacy. They are from the streets of Mexico & China, where they are cut and made dangerous. There are tens of thousands who are guilty, not just the one company

12 people found this helpful

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ginger forbes

interesting

Reviewed in the United States on August 20, 2021

Verified Purchase

I was very interested in the Sackler family and their story of OxyContin. Way too much detail to keep my interest.

One person found this helpful

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S. Christensen

Where was the editor?

Reviewed in the United States on May 7, 2021

The tale of the Sacklers and the opioid crisis is amazing, but this book is a mess. Where was the editor? The entire first part of the book is entirely unnecessary to the story of Oxycontin and the genesis of the opioid crisis. The author probably wanted to include it because he spent so much time researching the Sackler family, but any good editor would have cut most of it out. And the rest of the book is filled with minor characters that serve only to show the author’s bias. Like why are we told all about an artist who is a recovered heroin addict, who unwisely takes a prescription opioid, gets re-addicted, and then spends years protesting the Sacklers at museums and art galleries? The author also naively criticizes the techniques that Purdue Pharma used to extend the life of their patent, not realizing that such “evergreening” is standard practice in the industry. The Sacklers were a part of this crisis, but they didn’t cause it alone, and much more time should have been spent on the FDA, AMA, physicians, and pharmacists who also participated. Worst of all is that the book was published before the story was finished, without any resolution to the Purdue Pharma bankruptcy or lawsuits.

19 people found this helpful

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A. Watson

Audio Version belies a Hatchet Job

Reviewed in the United States on May 13, 2021

The Sacklers have been condemned aplenty and certainly bear a great amount of responsibility for the Opiod Crisis. Having read-and liked "Say Nothing", I thought this would be an even-handed investigative journalist's telling of the story. But the audio version quickly reveals-through the author's narration of the whole book in a arrogant and smart-alecky tone-that the objective was to mock literally everything any Sackler did and anyone involved in the pharmaceutical industry. About 2/3rds of the way through, O’Keefe writes about the young documentary film maker, Madeleine Sackler, who married into the family. She has been justly celebrated for her productions about charter schools (“The Lottery”) and prisons (“OG”). Though married into the family, she has had her own career. Nonetheless, the cancel culture-and O’Keefe-want to discredit her work solely because she doesn’t disclose her relationship. The book was not interesting because from the get-go it was a hatchet job. THIS IS NOT TO DEFEND any of the above. I just wanted a professional, investigative read. O’Keefe is a bonafide member of the “Cancel Culture,” celebrating any attempt to ruin any Sackler of any generation. He cites Yale University’s renaming of Calhoun Hall (due to his association with slavery) and infers that the university should not simply cease taking any new Sackler money, but expunge that name as well because the Yale community is harmed by use of the name. Of course, you don’t see any Yalie calling for removal of Eli Yale’s name (slave owner) because they all benefit grandly from the use of the name on degrees, t-shirts, and resumes. Hypocrisy of the highest order.

9 people found this helpful

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Nancy

Keefe misses one big point, THE FDA should be held accountable for their actions.

Reviewed in the United States on September 15, 2021

While the book is interesting and I agree the Sacker family should be held accountable; it seems as if a lot of others should be held accountable. Why the Sackler family did not stand trial in 2002, and "Udell, Feiedman and Goldenheim" were the ones to take the fall seems like the prosecutions fault. Purdue Pharma was a privately held company, so share holders would not be financially affected if the company went under. In addition, there are other "pharmaceutical" companies that produce "opioids", I realize the issue was the strength and dosing of this particular opioid. The Sackler's should be held accountable for their negligence in marketing of the drug. The FDA should be held accountable for allowing the drug to be approved quicker than any other drug had ever been approved and without reliable proven testing. In addition, then the FDA allowed the manufacturer (Purdue) to basically write up parts of the literature that is presented to doctors and consumers as if it was from the "FDA". The FDA also allowed Purdue to make the claim that OxyContin was less prone to abuse than other pain killers, without any proof. pg 268. The FDA should be held accountable.
I know other companies have been sued over opioids at this point, to include Johnson and Johnson.
This book seemed like a witch hunt that rambled and introduced some people (that played little if any role to the overall story). Timelines jumped around a little too much for me personally. I know there were pages and pages of notes and source material, almost to the point of ridiculous. ( who is really going to go through all that to verify)
Some conversations or "peoples thoughts" were enhanced or made up as there were no witnesses to the conversations or thoughts of people. This makes me think the book should have been published as "almost non-fiction'. In addition, Keefe says the Sackler family donated over 50% of it's political contributions to the Republican party. So that might be true, but I believe it is 52 Republican and 48 to the democrats. Keefe also says almost everyone that worked at Purdue was a Republican, how did he get that information? Some states keep that confidential. Michael Bloomberg a "democrat" helped out the Sackler family, see Hannah Dreier for ProPublica Feb. 27, 2020. Since the book somehow manages to blame the Trump administration for wrapping up the investigation too quickly in 2020 pg 420; I don't think anyone else did any better at holding the Sackler's accountable.
The book was somewhat informative and interesting but I certainly don't believe every word I read, especially when it takes a political turn. The country has an opioid problem; but another problem is the current "fix", it has created yet another problem; people who actually need opioids for pain after surgery or cancer or end of life (palliative care) can not always get the medication they need. I know this to be true, a friend had esophageal cancer and was being prescribed one 500 mg vicodin per day! Yes, in the end opioids are dangerous in the wrong hands, but sometimes useful to treat pain.

3 people found this helpful

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Milia Glafira

Reviewed in the United States on May 24, 2022

This is just ridiculous. With a well written book I expected >t to be subjective which it's highly not at all!!
Very interesting to follow the actual history of the brothers, the family. However painting them as sole villains, how d--b is thaat!?! 🤷‍♂️ Like saying Volvo or Chrysler is responsible for all carcrashes and deaths. Ridiculous, right!? We all have a choice, and as other reviews mentioned already there's no account to the background of these people who had Oxycontin in their system when dying. How many ended themselves? , how many were in fact pain patients, or cancer patients or such?.? How many were psychiatric patients who were severely damaged? And there goes the questions... But sure anything sells with the right marketing.

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C. Cheston

Simply a hit job.

Reviewed in the United States on September 23, 2021

Was everything done by the Sacklers evil? This author would have you believe so.
A more evenhanded treatment would be of value. This book is simply sensationalism.

4 people found this helpful

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