The Florida Bar

Florida Bar Journal

Empire of Pain: The Secret History of the Sackler Dynasty

By Patrick Radden Keefe Book Reviews

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 without hesitation or misgiving the widespread destruction of lives wrought by such addiction. The legal entanglements involving Purdue Pharma as a corporation in the regulatory and litigation arenas paralleled in some salient respects earlier legal offenses against tobacco and firearms companies and included a complicated bankruptcy strategy encompassing more than 100,000 individual claims in addition to those initiated by multiple state AGs. Eventually cases also were brought against individual members of the Sackler family on the pierced side of the corporate veil. All of these entanglements make up an important part of the factual and ethical retelling here.

Author Keefe, an investigative journalist and Yale Law graduate, devotes special attention to the pervasive legal advice and representation that enabled Purdue and the Sacklers to enrich themselves over the years at the expense of others’ addiction to opioids. He criticizes Purdue’s long-time in-house counsel and the formidable department he built for acting primarily as enabling consigliere and protector for an illicit enterprise. The chronicled efforts of in-house counsel and highly compensated outside firms raises a slew of compelling, difficult questions about the tipping point at which zealousness in client service, whether on behalf of a corporation or individual persons such as Sackler relatives, becomes objectionable complicity in moral and legal malfeasance.

This book makes for interesting and enlightening reading for anyone interested in the history of the contemporary American opioid misuse crisis. It will especially grab and hold the attention of a legal audience.

Marshall B. Kapp of Tallahassee is a member of The Florida Bar.