Impersonal Responsibility

Empire of Pain:
The Secret History of the Sackler Dynasty
by patrick radden keefe
doubleday, 560 pages, $32.50

How are we to assign responsibility for the opioid epidemic? Patrick Radden Keefe—the New Yorker staff writer who in 2017 wrote a lengthy profile of the Sackler family, owners of Purdue Pharma—offers an easy answer in his new book Empire of Pain: The Secret History of the Sackler Dynasty. Engagingly written and thoroughly researched, it describes how brothers Arthur, Mortimer, and Raymond Sackler came to own Purdue, and how Purdue came to be America’s leading purveyor of opioids, helping spark the overdose crisis that killed some 93,000 people last year alone. Empire tracks the family fortune back through the generations to Arthur’s successes in the early days of pharmaceutical advertising, which won the family entry into the ranks of New York high society. 

The most remarkable thing about Arthur Sackler was his assiduous avoidance of personal responsibility. The Sackler “patriarch” consistently presented himself as a passive victim, subject to forces beyond his control. His first adulterous affair and subsequent divorce was, according to an authorized biographical account, “inevitable.” His wife “simply could not keep up with him.” It was nobody’s fault (certainly not Arthur’s) that a man of such genius ran off with another woman.

Similarly, in 1962 when Congress discovered that Arthur simul­taneously ran a drug manufacturer, a pharmaceutical advertising firm, that firm’s sole competitor, and several medical journals that ran ads, he threw up his hands. He was a mere educator, he said, being targeted by congressmen who weren’t experts in medicine. All Arthur did, by his own account, was report facts via ads to those who were experts, and they were prescribing his company’s drugs—one of which was the infamous tranquilizer Valium. He just acted as a conduit for the science. 

Arthur’s success ­depended on his ability to obscure his personal responsibility, and to play victim. He shared this trait with his brothers Raymond and Mortimer—with whom he co-owned Purdue—and many of their progeny. After Purdue released the opioid painkiller OxyContin in 1996, it funded official-sounding groups and public speakers who positioned themselves as experts on pain relief and advocated the widespread prescription of opioids. Purdue and the Sacklers, of course, insisted they were only following the science and responding to a pre-existing demand.

When confronted with the fact that people were abusing Oxy­Contin, Purdue responded by ramping up sales efforts, and its leaders claimed they were being maligned by trial lawyers out for a quick buck and attorneys general seeking headlines. Purdue chairman Richard Sackler placed blame elsewhere. In private emails, he declared that “­abusers aren’t victims; they are the victimizers,” and he called opioid addicts “reckless criminals” and “culprits.” Of course, he recognized how this looked. “Calling drug addicts ‘scum of the earth’ will guarantee that I become the poster child for liberals [who want to] distribute the blame to someone else.” The company couldn’t help it if people with “addictive personalities” were misusing its product and giving it a bad name—or so Richard believed.

The legal system has, by and large, taken the Sacklers’ side. Lawsuits against Purdue and the ­Sackler family have failed, ending out of court with the family paying token amounts to keep things quiet. The suits came to an end in August of this year, when the Sacklers reached a bankruptcy settlement, ­dissolving the company and paying $4.5 billion to be absolved from legal liability for the opioid crisis. According to Nonprofit Quarterly, the Sacklers have fallen from being the country’s sixteenth to being its thirty-­first most wealthy family.

Keefe has to settle for a more symbolic version of justice: the multitude of artists, activists, and elected officials who swoop in at the end of empire to protest the Sackler family. Among these are Nan Goldin, an art photographer and onetime opioid addict who in 2018 staged a protest/performance art piece in the Sackler Wing of the Metropolitan Museum of Art. The House of Representatives held an equally symbolic hearing about the Sacklers’ role in the opioid ­crisis last year. These events treated the ­Sacklers like bad apples, ­ill-­intentioned impostors among an otherwise honest and ­responsible elite.

Keefe is eager to place blame on the Sacklers, and rightly so. But he downplays the role others played in the affair. “The opioid crisis,” he writes, “is, among other things, a parable about the awesome capacity of private industry to subvert public institutions.” The Sacklers got FDA approval for OxyContin and avoided legislative regulation because, in Keefe’s telling, “the FDA was compromised and Congress was neutralized or outright co-opted.”

This portrayal assumes the rapaciousness of private actors and the high-mindedness of government, an inversion of the idea, popular on the right, that business is basically good and government basically bad. It overlooks the fact that corporations and government agencies naturally work hand in hand in modern America, in a system that Howard Wiarda described as “creeping corporatism.” Government agencies and government agents deserve a share of the blame.

Goldin, for instance, made her name in the art world with photographs that critics described as “heroin chic”—romanticized portraits of drug use in New York’s gay underground. If she has ever wondered whether her work may have helped normalize substance abuse, and thereby contributed in its own small way to the addiction crisis, Keefe doesn’t let on.

The businesspeople, the civil servants, and the high-profile protesters all hold the same basic convictions: that they themselves are victims here, that other guys are bad apples, and that the system is only flawed insofar as it lets those apples bob up to the top. They all—and Keefe with them—hold out hope that good elites will save us from bad elites, that public-minded civil servants or bohemian rebels speaking their truth will take down the ­Sacklers, or at least bring some catharsis. None of these hopes have come to pass.

In theory, ours is a free country where the hardest-working and most enterprising people rise to the top. The system is supposed to root out the lazy, passive, buck-shifting self-victimizers. In practice, everyone at the top experiences his own position as constrained by incentives and competitors. If our elites believe in personal responsibility at all, they believe in it primarily for other people. Neither the Sacklers, nor the government officials who enabled them, nor the artists who promoted and profited from a permissive culture are eager to accept blame for the opioid crisis. This is only human nature. But their avoiding accountability is easier today than it once would have been. Administrative agencies operate independently of political control. Complex corporate structures shield actors and obscure responsibility. A vast network of NGOs provides support to activists who lack popular support and artists who offend public taste.

Arthur Sackler’s genius was to see this reality. He didn’t invent a new drug, and he likely didn’t work much harder than any other Brooklyn-born child of blue-collar immigrants. He took advantage of the emerging corporate structures of the early twentieth century, especially in the brand-new advertising industry. From day one, he and his brothers surrounded themselves with shell corporations, complicated backroom agreements, and plenty of lawyers. Arthur went from a middle-class professional to a billionaire by building barriers around himself—so many and with such obscurity that he was able to hide numerous conflicts of interest from outside scrutiny.

No single actor is to blame for the opioid crisis. It arose from ­mutually reinforcing institutions whose governing concern is the marginal increase of a share price or the GDP, which they tout as reliable proxies for the common good. All of them had incentives to do what they did, and no one felt he was in a position to say no to the extra dollar. There is a lesson here. Populist discontent has to call for institutional change as well as changes of personnel—remove the swamp creatures, cancel the Sacklers, but the same institutions and incentives will persist.

Philip Jeffery is a deputy opinion editor of Newsweek.

Image by Hybrid Art House via Creative Commons. Image cropped.