"They were careless people . . . they smashed up things and creatures and then retreated back into their money or their vast carelessness or whatever it was that kept them together, and let other people clean up the mess." —[a:F. Scott Fitzgerald|3190|F. Scott Fitzgerald|https://images.gr-assets.com/authors/1517864008p2/3190.jpg], [b:The Great Gatsby|4671|The Great Gatsby|F. Scott Fitzgerald|https://i.gr-assets.com/images/S/compressed.photo.goodreads.com/books/1490528560l/4671._SY75_.jpg|245494], received by Radden Keefe on a slip of paper from an anonymous source along with a document-filled thumb drive.

Radden Keefe has compiled and assembled an incredibly riveting account of the Sackler family — the family history, their companies, their wealth, and their denial of their part in the collective culpability in the American opioid crisis.

"It is a peculiar hallmark of the American economy that you can produce a dangerous product and effectively off-load any legal liability for whatever destruction that product may cause by pointing to the individual responsibility of the consumer." (I.e., Guns don't kill people; people kill people.)

The foundational understanding of where they began by showcasing the original three brothers who started it all (Arthur, Mortimer, and Raymond) and how they got to where they are now is told in such a clear and engaging way that this hefty nonfiction account read very much like a novel at times. Adding to that feeling was partially due to having to wade through the extravagance and unbelievable performative blindness as exhibited by the Sacklers.

One of the incredible parts of this account for me was the way this not only showed that the Sacklers need to shoulder a good bit of the blame for the opioid crisis (which I believed before going into this book) but that they also, in any future reference of such, need to be part of the conversation of the marriage of marketing and medicine, something that has been prevented from happening in many other countries. Direct-to-consumer advertising of prescription drugs is only legal in the United States and New Zealand.

"'Is the public likely to benefit, if practicing physicians and medical educators must perform their duties amidst the clamor and striving of merchants seeking to increase the sales of drugs?' Charles May, a prominent professor at the Columbia Medical School, wondered. He worried about what he described as "an unwholesome entanglement" between the people who prescribe our medicines and the people who make and market them."

An undeniably well-written and thoroughly researched book, Empire of Pain delivers.

Audiobook, as narrated by the author: Radden Keefe delivered a wonderfully nuanced performance for what could easily be a dry and bland account of a singular American family saga. His voice was impassioned and confident and that is saying a lot for a reporter reading their own work on such a difficult but thoroughly detailed topic.