Book Review: Empire of Pain by Patrick Radden Keefe

“The chief task in life is simply this: to identify and separate matters so that I can say clearly to myself which are externals not under my control, and which have to do with the choices I actually control. Where then do I look for good and evil? Not to uncontrollable externals, but within myself to the choices that are my own . . . .” ~ Epictetus

By Catherine Austin Fitts

Empire of Pain: The Secret History of the Sackler Dynasty by Patrick Radden Keefe tells the story of the Sackler family and their rise to billionaire status based on one generation developing a fraudulent marketing model for American pharmaceuticals and the next generation upending the pain management model of American medicine and launching the opioid epidemic, all with the help and support of captured regulators.

Much has been written about the opioid epidemic and the role of OxyContin, the product made by the Sackler’s pharmaceutical company, Purdue Pharma. What Keefe adds with Empire of Pain is a wealth of detail regarding the actual hands-on role of the Sackler family in creating and building the entire OxyContin and opioid epidemic affair.

Empire of Pain is both well written and documented. Unlike earlier efforts by investigative reporters, Keefe had the benefit of volumes of legal discovery in multiple lawsuits and state attorney general actions against Purdue and the Sacklers.

It is fair to say that the Sacklers knew they were engineering a holocaust. With Richard Sackler in the lead, they did it with both foresight and intention. Their only concern along the way was how to manage the risk to their family name and fortune and assure plausible deniability to all sides of the family, including financial beneficiaries not directly involved in operations.

I first became interested in the story of the Sacklers and the opioid epidemic after watching the series The Pharmacist about Louisiana pharmacist Dan Snyder, who spent years trying to stop the opioid epidemic after his son was murdered by an addict.

What struck me most was that the FDA approved OxyContin immediately after the disastrous budget confrontation of October 1995. This was the moment when the U.S. establishment, in frustration, gave up on trying to achieve financial responsibility in the U.S. “You don’t understand, they have given up on the country, they are moving all the money out starting in the fall” was the description given to me in the spring of 1997 by the President of the largest U.S. pension fund. Indeed, that fall was the beginning of the financial coup d’état, during which $21 trillion was reported unaccounted for by DOD and HUD—two agencies of the U.S. government.

What happened after the budget deal fell apart in 1995 was the beginning of what I call “the great poisoning”—multiple government policies designed to increase physical and financial toxicity and depress physical and financial immune systems—that has resulted in a steady deterioration of the health and wealth of the U.S. middle and lower classes. This looked to me like one of the variables in the retirement algorithm embedded in the U.S. budget wars. If you cannot get the body politic to save the necessary funds for retirement, then another option is to lower life expectancy below the retirement age. So I found it remarkable that the effort to put predatory mortgage lending and fraud on steroids began at the same time the FDA approved OxyContin. That was also the same period when the Clinton Administration threw its full weight behind dramatic increases in prison populations and the creation of a private for-profit prison industry.

Keefe does an excellent job at unveiling the next round of answerability for the opioid epidemic by documenting the Sacklers’ intimate responsibility. However, he does not take his investigation very far beyond the Sacklers. A billion-dollar pharmaceutical company is a complex operation. It needs approvals and good-standing certificates to operate in every state. It needs doctors and pharmacists to recommend and distribute its products. It needs banks that are willing to implement its transactions. It needs employees and sales reps who are willing to implement what the company is doing and keep its products selling, including to clearly illegal pill mills. It needs expensive lawyers to represent and defend it. Indeed, some of the highest-priced legal talent representing Purdue Pharma was also deeply involved in making HUD mortgage fraud go. Finally, it needs approvals from multiple regulators.

To my mind, there are two possible explanations for the Sacklers’ success in marketing OxyContin. One is that the U.S. financial leadership took the position that they had given up on the country, and they were no longer going to expend political capital stopping people like the Sacklers from feeding on the carcass. The other is that the Sacklers were green-lighted to implement a part of the “great poisoning” and were simply ground troops in a much larger effort. After all, their marketing of OxyContin began in the same year that Gary Webb broke the Dark Alliance story about trafficking of crack cocaine by U.S. intelligence agencies.

In either scenario, the Sacklers would have been required to channel all of their profits to the appropriate asset managers for reinvestment in the companies leading globalization. In other words, this may have been “Sackler money” in name only. A portion would likely have been designated for philanthropy to fund Harvard University, Rockefeller University, and Ivy League schools as well as leading art museums in world capitals. The rest would have been reinvested in the stocks and bonds of the big banks and Silicon Valley companies, and in U.S. bets in Asia and the emerging markets. Financial centralization was underway. Harvard and the university and foundation endowments were likely aligned. That is, the National Security State would likely have dictated where “its” capital would go.

With a few exceptions, Keefe is silent on where the real billions were invested – who managed the money and what investments were purchased. If we could find that out, it would tell us a lot about who really engineered the opioid crisis.

In this respect, the Sacklers were no different from the Arab sheikhs during the 1973 “oil crisis.” As long as Chase (now JPMorgan Chase) controlled the reinvestment of the profits, better to hide the true control behind distant bedouins rather than let angry consumers appreciate who was really pulling the strings that doubled their gas prices. After all, the U.S. Army and Air Force were available to remind the distant bedouins not to reinvest too much of their profits locally. And the U.S. Navy was available to protect or stop any oil freighter sailing on the global sea lanes if the bedouins misbehaved.

The OxyContin epidemic was first and foremost engineered by New York psychiatrist and billionaire Richard Sackler when he ran Purdue Pharma. One of the final scenes from The Pharmacist is from one of Sackler's depositions—the family was, at that point, the well-deserved target of more than 1,600 lawsuits. You have not sufficiently contemplated the psychopathy and hubris of the Sacklers until you have read The Empire of Pain, seen The Pharmacist, and watched this video.





But the problem is far wider and deeper that the Sackler family. I have a dear friend who once lived in New York. She used to say about a perfectly horrible New York family that was deeply invested in dirty tricks as a HUD landlord, “Those are dreadful people.“ Healthy societies do not let dreadful people accumulate this much power or harm this many people. Those dreadful people had a lot of help. If an enterprising attorney general were to follow where the real money was reinvested and by whom, we could perhaps learn a great deal about the opioid crisis and the “great poisoning.” After all, economic warfare is about generating enormous profits from killing your enemy. In this, fraudulent pharmaceutical business models appear to be enormously successful for Mr. Global.

Let’s hope the very talented Patrick Radden Keefe and other enterprising journalists keep digging. In the meantime, make sure you find doctors and nurses who have not signed up for Mr. Global’s pharma model and the “great poisoning.”

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Related reading:

Patrick Radden Keefe on Wikipedia