I have written multiple times before about the opioid overdoses crisis and the major role in its growth played by the Sackler family and their family-owned company Purdue Pharma. I just finished reading the excellent book Empire of Pain: The Secret History of the Sackler Dynasty (2021) by Patrick Radden Keefe that carefully reveals the sordid history of the family in creating the crisis, something that the family went to great lengths to conceal from the public. He shows that while other companies also manufactured, distributed, and marketed the opioids that have caused so much suffering and deaths and continues to do so even today, the Sacklers played a special role in creating the crisis.

Drugs obtained from the poppy flower (opium and morphine) had long been known to be powerful in combating pain but were prescribed and used very sparingly because they were known to be highly addictive. They also carried with them social stigmas. Opium was associated with seedy underworld opium dens where people smoked pipes in dreamy semi-conscious states while morphine was a powerful drug that was injected and mainly used to treat incurable pain such as from cancer and was also used as a palliative at the end of life. Both those associations discouraged casual use.

What the Sacklers and Purdue Pharma did was develop and market a drug based on the opiod oxycodone under the brand name OxyContin. They claimed that they had eliminated the addictive aspects of the drug by encasing oxycodone in a coating that allowed the drug to be released slowly over a 12-hour period. They said that this eliminated the immediate highs and the subsequent lows of the drug that led to addiction. Furthermore, the drug could now be delivered in a tablet form, even though it required a prescription, and they made it seem like a mild over-the-counter painkiller like aspirin and acetaminophen. They marketed it with a vengeance to physicians and pharmacists, claiming that it should be the painkiller of choice for even everyday pain like that associated with sprains and arthritis and backache, and used their lobbying clout with the FDA and DEA to avoid close scrutiny of their claims by regulators in those agencies, even though they had little or no data to support those claims.

They also made the claim that the US was actually suffering an epidemic of untreated pain and that they had the solution for it. They placed advertisements in medical journals and distributed literature and recruited legions of sales reps to fan out over the country to persuade physicians to prescribe these drugs, telling them that it was very safe and non-addictive and that it should be the first painkiller of choice, to treat even mild and routine pain, rather than as a last resort. The pills came in doses of 10, 20, 40, 80, and even 160 milligrams and doctors were urged to use the higher dosages since that generated more profits for the company. They also marketed OxyContin to the public so that people would request it from their physicians. Furthermore, it is known that the effectiveness of opioids wane over time requiring users to use higher doses and more frequently to get the same results, which suited the growth model of the Sacklers perfectly.

They generously rewarded the sales reps who generated the most sales, urging them to sell more and larger doses. In addition, the doctors were showered with perks for prescribing the drug, such as dinners and trips and honoraria for attending and speaking at ‘seminars’ where the drug was pushed. The more that doctors prescribed the drugs and the higher the doses, the bigger were the rewards.

It should not be surprising that this resulted in so-called ‘pill mills’, small clinics in even small rural towns where lines of people lined up outside, while inside doctors busily wrote out massive numbers of prescriptions, sometimes not even examining the patients before doing so. Perdue had a data collection system that kept careful track of where and how much drugs were sold and the fact that some remote parts of the country were selling huge amounts of drugs was known to them but not only did not cause them to take steps to investigate what was obviously abuse, but were instead seen as success stories.

So while other opioid manufacturers (like Johnson & Johnson), distributors (like McKesson), and pharmacists all share in the blame for the opioid addiction crisis because they all knew that it was being wildly over-prescribed, the Sacklers were the ones who set the crisis going by removing the stigma associated with opioids and aggressively marketing it.

Furthermore the supposed 12-hour release time turned out to be not true. The effect of the drug wore off sooner leading to patients taking more than the recommended two pills per day. In addition, people found that if you crushed to drug into powder or chewed it or dissolved the powder in water and injected it, you could get the immediate highs of opium or morphine. Thus it became a street drug, much sought after and traded on the blackmarket. By the time authorities took action to address the epidemic by monitoring the sale of the drug and cracking down on pill mills, it was too late. There were now a huge number of addicts and to get their fix they moved on to other street drugs like heroin (an opioid derived from morphine) and fentanyl (a synthetic opioid that is even more powerful). A survey found that four out of five heroin users had started with OxyContin. Opioid overdoses overtook car accidents as the leading cause of preventable deaths in the US. It is estimated that one in two Americans know someone who has died from an opioid overdose and I am one of them, learning with shock that the daughter of a friend of mine had done so.

During all this, Perdue insisted that the drug addiction problem was not due to the drugs but was caused by people who were already addicts or who had addictive personalities abusing the drug and that anyone who used the drug properly under a doctor’s prescription would not get addicted. They persisted in this claim even as evidence mounted that people who had used the drug exactly as prescribed were becoming addicts. Their strategy was the same as that adopted by the tobacco companies earlier, claiming that the problem lay with users with addictive personalities and that their product was safe even as internal documents showed that they knew it was unsafe.

As for the Sackler family itself, family members were heavily involved in the day-to-day running of the company and made billions of dollars from it. But they went out of their way to prevent the Sackler name from being associated with Purdue. Their names could not be found on any publication or company website and since they were a private company, they were not required to produce federally required documents that would have revealed this fact.

While the Sacklers were careful to avoid having their name connected to Purdue or OxyContin in any way, they demanded that their names be prominently displayed as the donors of any contribution that they made to museums or universities or galleries so that one could not avoid seeing it everywhere in the worlds of academia, arts, and culture. This was so even for the smallest gift. In the Tate Modern gallery, for example, a silver plaque tells visitors they they are riding on the Sackler Escalator. As a result, while the Sackler name was everywhere, few people knew, even among their friends and acquaintance, where their money came from. As Keefe writes, “The source of of the Sacklers’ wealth continued to seem obscure and distant, as though the fortune had been acquired in the distant past.” They were seen as generous philanthropists, not as a ruthless and greedy family that profited greatly from the suffering of millions and who did not give a damn for anything other than lining their own pockets.

As I have written before, “I have reached such a level of cynicism that now when I hear someone described as a philanthropist, I immediately assume that they must be really awful people who have either got their money by practices that abuse and exploit people or that they are personally abusive to those immediately around them or most likely both, and they are now using their gifts to hide the ugly sources of their wealth or to buy silence.”

The public exposure of the Sacklers’ role in the drug epidemic began in 2019 when Maura Healey, the attorney general of Massachusetts, filed a legal complaint that not only charged Purdue as earlier lawsuits had done but also named eight members of the Sackler family as defendants, the first time the names had been so publicly linked to the crisis. That suit was joined by many other states also reeling from the human and economic costs of the opioid crisis. Those lawsuits resulted in the release of a trove of internal company documents and emails that opened the floodgates for investigative stories and negative publicity that the family tried to tamp down by attacking anyone who criticized them.

On his show Last Week Tonight, John Oliver devoted three episodes to excoriating Purdue and the Sacklers (I have linked to them in the past on this blog). The first one in 2017 only mentioned Purdue and not the Sacklers but after the lawsuit exposed their names and documents were released in the discovery process, the family got wind that a second one in 2019 was going to name and shame the Sacklers. One member of the family Jacqueline Sackler requested a meeting with Oliver to plead their case but he declined to meet them and went ahead with the show, which is well worth seeing.

Keefe writes that the Sacklers were furious.

Jacqueline sent off an irate email to others in the family. “This is my son’r favorite show,” she wrote. He watches it every week with all his friends. This situation is destroying our work, our friendships, our reputation and our ability to function in society. And worse, it dooms my children. How is my son supposed to apply to high school in September?”

Like her husband and others in the family, Jacqueline felt a vivid sense of persecution, an angry conviction that she and her relatives were being made to suffer. “I’m done having our family serving as a punching bag for problems that existed long before OxyContin and will exist long afterwards,” she wrote. “I have yet to see ANYTHING illegal or even immoral that this company has done.” This vilification was a “punishment” that was “being handed out to every man, woman and child, past present and future for an entire family, ” Jacqueline Sackler proclaimed. “Lives of children are being destroyed.” [p. 391]

When she says that the ‘lives of children are being destroyed’ she is referring to merely the embarrassment of the family’s children and not the millions of men, women, and children whose lives were utterly destroyed by the Sackler family. This lack of self-awareness is astounding but typical of such selfish people.

They are a truly despicable family.

Fearing that negative verdicts in the lawsuits would require them to pay massive penalties, the Sacklers tried to keep most of their wealth by siphoning billions of dollars out of the company making it a mere shadow of its former self, and then sought to make a deal where they declare bankruptcy and get a friendly judge to allow them to provide only a small amount of their own money to address the great suffering they caused. The deal also gave members of the family lifetime immunity from future lawsuits, a sweetheart deal if there ever was one.

The weird legal system in the US allows companies to effectively select which bankruptcy judge will hear their case. Purdue, although based in Connecticut, by paying a mere $50 fee was able to change its litigation address to the small town of White Plains, New York which they chose because it had just one bankruptcy judge Robert Drain who was well known to be very favorable to big companies. And he went along with this terrible deal in 2020.

Keefe’s book was published in 2021 and it ended on this somewhat down note with the Sacklers seemingly getting away scot-free. But the plaintiffs appealed and in 2024 the US Supreme Court rejected that deal, especially the immunity part. and sent it back to the lower courts for re-adjudication. But Drain had retired and in 2025 a different bankruptcy judge approved a new deal that was less friendly to the Sacklers.

The new agreement replaces one the U.S. Supreme Court rejected last year, finding it would have improperly protected members of the family against future lawsuits. Under the current agreement, entities that do not opt into the payments can still sue members of the family.
…

The plan calls for Purdue to be replaced with a new company, Knoa Pharma, to be controlled by a board appointed by states and with a mission of benefiting the public.

Sackler family members are also agreeing not to have their name put on institutions in exchange for contributions — something they’ve done often in the past, though many institutions have cut ties with them.

The company has also agreed to make public a trove of internal documents that could shed additional light into how the company promoted and monitored opioids.
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The latest plan allows lawsuits against Sackler family members by those who don’t opt into the deal. That change was a key to getting the new version approved in the aftermath of the high court’s ruling.

This time, few parties objected to the settlement, although some people who represented themselves and who were addicted to opioids — or had loved ones who were — raised concerns during the three-day confirmation hearing last week.

One of those self-represented people told Lane during the virtual hearing Tuesday that she planned to appeal.

There is a coda to this story that illustrates the curious ways of fate. Joss Sackler, the daughter-in-law of Richard Sackler (who is considered the father of OxyContin), used her share of the drug money to start a social club for rich young women that was pretentiously named Les Bouledogues Vigneronnes that held parties that cost $700 per guest and offered ‘curated wines’ (whatever that means) and also started a luxury fashion brand LBV. Keefe describes her in his book as having a Marie Antoinette level of entitlement and arrogance. But just three days ago, she was sentenced to nine months home confinement on an opioid-related charge, after admitting to addiction.

Joss Sackler, the wife of former Purdue Pharma board member David Sackler, was sentenced Friday to nine months of home confinement after pleading guilty to deleting WhatsApp messages that showed she was the intended recipient of an illegal shipment of prescription drugs from Colombia.

Sackler, who has a Ph.D. in linguistics and founded a fashion brand that ceased operations in 2023, admitted to becoming addicted to opioids – the very type of drug her family faced thousands of lawsuits for fueling addiction across the U.S.
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Under the plea agreement, the court can sentence Sackler to up to 20 years in prison if she fails to comply with its terms.

It seems strange that a Sackler of all people, a member of a family that had distributed vast quantities of opioid drugs all over the country, had to get the opioids to feed her addiction shipped to her from someone in Colombia. Perhaps she was trying to hide her addiction to opioids from her family.