“Why should they be entitled to our sympathies?” “These are criminals,” Richard Sackler, a physician and then president of the company, emailed a friend in 2001 after news reports of patients becoming addicted in West Virginia.

The Sacklers’ motivation, Keefe suggests, was simple greed, and they were aided in this project by a pair of noxious family traits: the refusal to admit error and a shocking inability to empathize. Ox圜ontin rushed in first, but competitors followed eventually they were joined by Mexican cartels dealing heroin and Chinese traffickers of fentanyl. That decision to push the drug as a treatment for common aches and pains kicked open a door. The death toll, grievous as it is, attests only to a fraction of the suffering inflicted on tens of millions of citizens.Ī factory job exported to China is a crushing loss, but it cannot compare to the ravages of an addicted relative: the years of stealing and lying, the arrests, the destroyed marriages, the homes mortgaged and remortgaged and then lost to pay for rehab, the children born addicted and then thrown into foster care or the arms of stunned grandparents.Īs Keefe ably demonstrates, it was the Sacklers who dreamed up Ox圜ontin as a solution to an anticipated revenue decline, and it was the Sacklers who insisted their powerful narcotic, the sort of drug previously reserved for terminal patients, be marketed aggressively and widely. Since the late 1990s, nearly 500,000 Americans have died, with white working people in places like Appalachia, the Rust Belt and Florida particularly hard hit. There are any number of credible explanations, mostly based in economics and race, but one often overlooked factor is the opioid epidemic. Why have they cast off civic values and embraced conspiracy theories? Why do they flock to candidates who offer little beyond a middle finger raised at elites? What is behind their seething rage? Liberals have spent a lot of time recently puzzling over the behavior and attitudes of working-class Americans. If you buy books linked on our site, The Times may earn a commission from, whose fees support independent bookstores. Empire of Pain: The Secret History of the Sackler Dynasty

Empires of pain