Opioids: The rise and fall of the Sackler family

"No one has impacted the very nature of medical marketing more than the multi-talented Dr. Arthur Sackler," says the Medical Advertising Hall of Fame about the man whose family name is now synonymous with the opioid epidemic.

The Pneumology Blog
By Dr. Sophie Christoph

"No one has impacted the very nature of medical marketing more than the multi-talented Dr. Arthur Sackler," says the Medical Advertising Hall of Fame about the man whose family name is now synonymous with the opioid epidemic.

Article translated from the original German version 

Key aspects:

Obama described the opioid epidemic as “costing lives… devastating communities.” A recent article in The Lancet described medical advertising as the “glossy front” of this epidemic.1 Three generations of the Sackler family, whose fortune was built by Valium and whose reputation was destroyed by Oxycodone, were behind the beginnings of the crisis.

Recognising the misery of addiction to Oxycodone manufactured by the Sackler companies after some 50 years

Prior to becoming known as a fancy drug clan, the Sacklers had access to the highest ranks of society thanks to their philanthropic activities. The family donated tens of millions to the world's most famous museums and universities. But these donations were not given out without expecting something in return. The reward was to have their name displayed in an influential and prominent way: at the Metropolitan Museum in New York, the wing with the ancient Egyptian temple of Dendur was named after the family. The Guggenheim Museum, the Smithsonian, the Louvre, and universities such as Harvard and Oxford all dedicated rooms to the family’s name.2

Arthur M. Sackler (1913-87) was a psychiatrist, researcher, and owner of an exclusive marketing agency. In 1952, he and his brothers Mortimer and Raymond bought a small pharmaceutical company called Purdue Frederick. Arthur conceptualized the marketing for Valium and accumulated the first major Sackler fortune. In the 1990s, they eventually came up with the new painkiller Oxycontin, which was launched in 1995. 

The fact that Arthur Sackler was admitted to the Medical Advertising Hall of Fame (MAHF) in 1997 is largely due to his role in bringing marketing to the medical world.

Purdue's marketing experts made sure that pain was no longer considered a symptom, but that pain itself was to be treated. As Arthur Sackler sought funding to conduct research on pharmaceutical therapies for mental illness, he also published The Medical Tribune; a magazine that was itself funded by drug advertising and distributed to physicians free of charge.1

Oxycontin marked a breakthrough for the company. The drug generated revenue of around $35 billion.3 Boasting a fortune of $14 billion, the family was ranked in the top 20 “Forbes” list of wealthiest American families in 2015 – well ahead of the Rockefellers. The cost is a public health crisis of unprecedented proportions. The number of drug-related deaths increased sixfold between 1995 and 2019. In 2019, more than 70% of those who died did so from opioids like Oxycodone.

End of the Sackler era marked by a captivating book

Patrick Radden Keefe portrayed the story of the Sackler dynasty in a revealing book that has since been shortlisted multiple times, won several awards, and has become a New York Times bestseller in no time: The Empire of Pain. He begins by describing the personalities of the Sackler brothers in the early days of their social advancement, their characters, their worldviews, and their peculiarities. As one reader puts it in a review, “I was […] under the impression that I knew everyone pretty well and I was surprised that there was no sign of any criminal energy.”4

But Keefe is known for his exhaustive research and has already won prizes for his previous work “Say Nothing”. His book then unfolds into something that many readers describe as a Grisham thriller, a real page-turner where the reader always wants to know what will happen next. At the end of each chapter, Keefe drops another bombshell.

Many reviewers would state something along the lines of: “Great book, well written and hard to fathom that the Sackler family could get away with their actions for so long. And even now, nothing seems to have changed or impacted their wealth. Unbelievable and disturbing.”4

In terms of events, the book virtually covers the period up to its own publication date. After being bombarded by thousands of lawsuits from its victims and bereaved families, Purdue Pharma pleaded guilty to criminal charges surrounding the marketing of the drug, including bribes paid to physicians, and reached a multibillion-dollar settlement. The Sacklers were able to buy their way out by reaching a bankruptcy agreement and paying fines. All currently remain at large.1


  1. McCartney, M. The fall of a poisoned empire. The Lancet 399, 135 (2022).
  2. Pharmabranche: Opioid-Epidemie: Oxycontin-Hersteller-Familie Sackler muss Milliarden zahlen. https://www.handelsblatt.com/unternehmen/industrie/pharmabranche-opioid-epidemie-oxycontin-hersteller-familie-sackler-muss-milliarden-zahlen-/27574964.html.
  3. Empire of Pain by Patrick Radden Keefe: 9780385545686 | PenguinRandomHouse.com: Books. PenguinRandomhouse.com https://www.penguinrandomhouse.com/books/612861/empire-of-pain-by-patrick-radden-keefe/.
  4. Keefe, P. R. Empire of Pain: The Secret History of the Sackler Dynasty. https://www.amazon.de/Empire-Pain-History-Sackler-Dynasty/dp/0385547749/ref=asc_df_0385547749/?tag=googshopde-21&linkCode=df0&hvadid=500802940980&hvpos=&hvnetw=g&hvrand=6910843186563812535&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9068539&hvtargid=pla-1190362786695&psc=1&th=1&psc=1 (2021).