BOOK REVIEW: Patrick Radden Keefe’s ‘Empire of Pain’

Sheela Clary is a teacher and writer born and raised in South Berkshire county.

Four out of five heroin addicts started out misusing prescription opioids, and while Oxycontin is not the only prescription opioid, without the marketing deceptions its founders created, we’d likely have no opioid crisis.

The opioid crisis that’s played out like a slow-moving horror movie over the past two decades has killed close to half a million Americans and thousands of Massachusetts citizens. It kills about 100 residents in Berkshire County annually. Off the top of my head, I can think of five South County victims. A single mother with a warm smile. Her sister. A budding chef. The brother of one of my former students. A young woman with long blond hair. This is to say nothing of the millions more whose early deaths by suicide or accident were indirectly caused by opioid addictions, or the millions of survivors whose lives have been derailed by them.

For a four-part series I wrote in 2018, I interviewed a recovering heroin addict whose life started to unravel the moment someone offered her an OxyContin pill at a party a decade earlier. “People were selling them [OxyContins] for $80 an 80-milligram pill, and I could do that in one shot! I probably jumped to heroin within that same year. When you have someone saying this will do the same thing for you, but it’s a tenth of the price? Sounds good to me. Oxy and heroin, there’s no difference. They are the same. They are the same. If you can’t find any heroin, an oxy pill’s gonna do the same thing for you.”

The name OxyContin is a combination of the powerful narcotic derivation oxycodone, and contin, as in “continuous.” The Sackler family’s company Purdue Pharma first developed this technology in the blockbuster pill’s precursor, MS Contin, a morphine drug with a coating that was meant to assure that each pill’s punch would be released slowly, over a 12-hour period. But, as my interview subject discovered, all you had to do was remove the coating, crush the pill, and snort or inject it for a quick high.

Four out of five heroin addicts started out misusing prescription opioids, and while OxyContin is not the only prescription opioid, without the medical marketing deceptions its founders developed and road-tested in the 1950s, we’d likely have no opioid crisis. Since the drug’s launch, in 1996, Purdue Pharma has made 30 billion dollars off of OxyContin, which is why nearly every state, as well as hundreds of municipalities and Native American tribes, has sued them. In June 2018, Massachusetts’ own Attorney General Maura Healey was the first to name individual Sackler family members on the suits.

Nearly three years later, the legal journey seems to be nearly over, with the Sacklers having successfully siphoned off most of the company’s assets into myriad shell companies and off-shore accounts, and threatening to declare bankruptcy. Their latest settlement offer includes the idea of turning the company into a public trust, and to let creditors reap the proceeds from future OxyContin sales. Maura Healey and New York’s Letitia James are leading the charge to hold out for more money and a better deal that gets at the family’s personal wealth.

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