Empire of Pain: The Secret History of the Sackler Dynasty.

• Author: Kapp, Marshall B.

Empire of Pain: The Secret History of the Sackler Dynasty

By Patrick Radden Keefe Reviewed by Marshall B. Kapp

Over the past two decades, a plethora of lawsuits have been brought by federal, state, local, and tribal governments, as well as individual plaintiffs, against an array of manufacturers, wholesalers, retailers (pharmacies), and prescribers of opioid products. These legal actions have sought to impose criminal and/or civil liability for the tremendous human death and suffering caused by the opioid use disorders stemming from the defendants' alleged intentional and negligent misbehavior. This legal maelstrom continues today. For example, in a March 31 news release, Attorney General Moody indicated that, following more than $3 billion in settlements obtained from assorted pharmaceutical companies and distributors, the state of Florida would go to trial in April "to hold Walgreens accountable for its role in helping create and fuel the deadly opioid crisis devastating Florida families and draining taxpayer-funded resources." Two cases currently pending before the U.S. Supreme Court (Ruan v. United States and Kahn v. United States) question the extent of the federal government's power to convict a medical practitioner under the Controlled Substances Act for issuing a prescription outside "the usual course of professional practice."

Although a very wide net of culpability has been cast in the opioid epidemic drama, the main lightning rod for legal and ethical indignation has been Purdue Pharma, the developer, manufacturer, and marketer of OxyContin (among other products), the company that pioneered the modern era of opioid pain medications. Empire of Pain recounts the saga of OxyContin and its predecessor oxycodone. More centrally, this book tells in meticulous and dismaying detail the story of the Sackler family, the aggressive, financially voracious dynasty behind the OxyContin industry, who despite their early knowledge of the severe addiction potential oversaw...