The following version of this book was used to create the guide: Keefe, Patrick Radden. Empire of Pain: The Secret History of the Sackler Dynasty. Doubleday, 2021.

Empire of Pain is the story of the Sackler family's fortunes in America. Sophie and Isaac Sackler come to New York City at the turn of the century and raise a family of three boys--Arthur, Mortimer, and Raymond. Isaac is not successful in business, but Arthur, the eldest son, is determined to make a name for himself and for his family. Arthur excels in his studies at Erasmus High School while holding down a remarkable number of part-time jobs. When Arthur's brothers grow old enough to attend Erasmus, Arthur passes down his part-time jobs to them. Arthur attends medical school and becomes a psychiatrist who also works in medical marketing, and Mortimer and Raymond take this path as well. Soon, all three brothers focus on medical marketing. Arthur is the first brother to make millions from marketing Librium and Valium. He spends much of this money on his growing families (with several wives) and his insatiable desire for the finest Chinese art and furniture.

In time, all three brothers become rich and hand off most of the day-to-day business of Purdue Pharma, their successful pharmaceutical company, to their sons and daughters. Richard Sackler, son of Raymond, the youngest brother, takes over Purdue Pharma and rolls out a new and very powerful pain reliever called OxyContin. Richard trains his sales representatives to market directly to doctors, even to those not well-versed in pain management. The sales reps suggest that doctors start and stay with OxyContin and raise the dose whenever needed because the highest doses of OxyContin are most profitable. Flush with money, the Sacklers begin their many philanthropic projects such as endowing new wings of museums or building new lecture halls--all with strict stipulations that the Sackler name will be clearly visible.

Slowly but steadily, sales representatives carry reports of OxyContin addiction back to Sackler headquarters. The Sacklers boldly refute these claims and cite an article in the New England Journal of Medicine which concludes that addiction to pain medicine is rare. The only problem with this article is the fact that it is not an article at all. It is a five sentence letter to the editor. Sales representatives continue to pitch high levels of OxyContin, and "pill mills" spring up in economically challenged neighborhoods. These pill mills are doctors' offices that offer bogus physical exams and endless OxyContin prescriptions. Soon, state prosecutors see the devastation wrought by OxyContin, and they band together to sue Purdue Pharma for damages. Eventually, after much delay, Purdue pays out damages while Sackler family members achieve lifetime immunity from further lawsuits.

Finally, Americans learn the truth about the drug that has been killing its neighbors. OxyContin is highly addictive and may easily lead to overdoses, and Purdue Pharma executives knew this truth all along. Now the Great Unnaming commences--a tremendous effort to scrub the Sackler name from museums and institutes of higher education. In the end, Sackler family members could not give their money away.