Usually it is 20 years. Two decades during which the pharmaceutical company that has patented a drug has a monopoly to market it. But when the patent expires, another company can make a generic version of the same drug and the price drops or plummets. If good entrepreneurs are those who know how to anticipate the moment when they may lose their main source of income, in the case of the pharmaceutical sector, those who succeed in patenting a new drug that allow them to continue making profits are right. At that point was Purdue Frederick in the early 1990s. Traditionally, it was a company that had specialized in non-prescription essentials (from a laxative to a disinfectant), but in 1980 it began distributing a pain medicine that was multiplying its benefits. It was the MS Contin.
Until the new pill was marketed, morphine had basically been administered intravenously. But from then on it could be consumed at home and with a prescription thanks to an innovative system: a pill liner that made it possible to regulate the diffusion of the drug in the bloodstream for a long and precise period of time. In 1990, the company began to think of an alternative for when this patent expired: another new opioid that was also released into the blood in a controlled manner. This is stated in an investigator’s memorandum to Purdue’s board of directors. It consisted of two branches of one of the leading philanthropic families in the West: the Sacklers.
The new drug would not release morphine, but instead another derivative of opium: oxycodone. Unlike the first, which depresses the nervous system, this stimulates it. In 1996 American doctors began to prescribe OxyContin. The introduction and marketing of this legal drug would be the main cause of the opioid crisis in the United States, considered an epidemic since 2015. That year, more Americans died from overdoses than from guns or car accidents. For it to take effect, it had to be taken more frequently than advertised, it created addiction and soon there were those who were chopping the pill to inhale or inject oxycodone. In the company the danger was realized very early. I do not care. The goal was to identify the top prescribers and sell, sell, and sell. Addiction equaled profit.
In October 2017, the weekly The New Yorker published a photo report illustrating the devastation of the opioid crisis. Black and white photos taken in an Ohio county. Junkie stamps, syringes, policemen, a morgue, and shattered families. In that same number the report was published Empire of Pain. Its author was Patrick Radden Keefe and its protagonists were the three brothers who founded the Sackler saga – the first-born, Arthur, was considered a medici– and their offspring. By this time Radden should have already delivered to his publisher Do not say anything, a non-fiction masterpiece that chronicles the political violence in Ireland with mind-boggling tension. It seems to the reader that he is with the terrorists in their homes, in the barracks of the security forces or in prison cells. That feeling of being inside the hidden was repeating itself.
With that long article, after a year of research, Radden took a risk. For half a century, the strategy of the Sacklers had been to present themselves in public life as philanthropists – giving names to rooms in large museums (from the Metropolitan to the Louvre), to research centers in leading universities … -. Thus, at the same time, they had made invisible the origin and multiplication of their fortune, gaining the money and influence necessary to block any investigation that could reach them. But in his article Radden illuminated that opacity, reconstructed the family history and, in the end, held the family responsible for the tragedy. And three years later he was to display that same obsession with truth in The empire of pain.
Like his previous book, this one is also addictive. Through its many faces, we contemplate the evolution of New York City throughout the 20th century, the uses of advertising by pharmaceutical companies, the social impact of Valium – the first drug to achieve revenues of more than 100 millions of dollars—, the prestige of philanthropy or the lobbying forging that is inserted in civil society, attracts lawyers who had been prosecutors or scientists who had been regulators.
In 2019, an attorney’s lawsuit gave the public access to the Sacklers’ private correspondence. Thus we enter into that decadent empire and we also end up reading, already in our pandemic, a piece of court journalism that would have excited Janet Malcolm, even if power brings justice again. But literature saves. Thanks to Radden’s great journalism, it has been revealed to us how money engulfed the mechanics of a merciless emporium that grew rich despite its conscious deadly greed. Thanks to reporters like him and dozens of activists, the Sackler name is disappearing from the temples of knowledge that it colonized.
THE EMPIRE OF PAIN / THE EMPIRE OF PAIN
Patrick Radden Keefe
Translation by Luis Jesús Negro, Francesc Pedrosa and Albino Santos / Ricard Gil (in Catalan)
Reservoir Books / Periscopi (cat.), 2021
688/600 pages. 23.90 euros
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