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Patrick Radden Keefe on opioids and the Sackler family

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Patrick Radden Keefe is the journalist and author behind Empire of Pain: The Secret History of the Sackler Dynasty. His book takes a hard look at the family behind Perdue Pharmaceuticals - the family many blame for the opioid crisis. Hannah McCarthy, host of NHPR’s Civics 101, sat down with Patrick backstage at the Music Hall Lounge to talk about opioid settlements and the Sackler family.

Patrick Radden Keefe - Full Interview


Hannah McCarthy: Let's dig in. I don't want to keep you too long, and I'm just I'm going to start with attempting to clarify what's going on currently. So I know it was October I believe that the DOJ said we have finished our investigations. Right? And I know that Connecticut's AG and a handful of other states have non consent complaints against the bankruptcy procedures because the Sacklers are not actually bankrupt. Right. I guess I should just ask you, what do you know about the current state of the money?

Patrick Radden Keefe: Purdue Pharma declared bankruptcy in 2019, right? The oddity of that was that the company had made so much money. So you might wonder how they could be declaring bankruptcy. And part of the reason is that the Sacklers had been quietly taking money out of the company for years. I think because they knew this day would come when there'd be all these lawsuits. So you end up with this weird bankruptcy case where the company is bankrupt and there's all these people who've been affected by OxyContin and the opioid crisis kind of fighting over the scraps of the company, and then the family sitting on the sidelines having taken $10 billion out. They committed to paying an amount of money which kept going up, I think, you know, for a while it was 3 billion and then it went up to 4.5. And at 4.5, you had a bunch of states that said, okay, we can live with that. That's that's a number we can live with. We'll consent to this deal. What the Sacklers were getting in exchange is this grant of immunity from any future civil lawsuits. But some states, like Connecticut, continued to object and actually the number then went up to 6 billion. And I don't know exactly where they are in terms of all the internal wrangling on this. And I do know that the trustee, the Justice Department trustee's office has objected. But I have a feeling in the fullness of time this deal will be approved. I think this is probably the way it's going to end.

Hannah McCarthy: Okay do you think that there's any chance that this bankruptcy procedure that was used essentially to both win the Sacklers freedom from future liability as well as they they sort of cheated the system in order to get all this money out or I suppose they did not cheat the system but they used it to great advantage.

Patrick Radden Keefe: Yes.

Hannah McCarthy: And I know that that that subsection of the DOJ is interested in that not happening again in the future. Is there any chance that this particular case will alter the way that bankruptcy works in the US?

Patrick Radden Keefe: It might. I mean, I think it already has, at least in New York State, where part of the reason that this case played out the way it did is that absurdly, from my perspective, a company and depending on which state you're in, a company can can choose who their bankruptcy judge is, where they want to declare bankruptcy. And so Purdue picked this judge in White Plains, New York, who I think they had good reason to believe would be amenable to the sort of arrangement that the Sacklers were hoping for. And it turned out he was. And now that's determined by lottery. Like you can no longer do that in New York. So there are small changes like that. But but no, I mean, I actually think the trend lines are kind of heading in the opposite direction where there are other companies and other controversies lately where you get parties trying essentially to get out of enormous liability by declaring bankruptcy, often in ways that don't make a lot of sense. So you have some party, whether it's a you know, in this case a family that owns the company. But sometimes it's it's a company and then they carve out one particular little corporate entity, and that's the entity that declares bankruptcy and kind of takes the hit. But, you know, in this sort of corporate shell game, the mother ship keeps its money and doesn't declare bankruptcy and is able to avoid all of that liability, that sort of thing, I'm afraid, doesn't seem like it's going to be curtailed. I actually think it may be in a scary way, the future.

Hannah McCarthy: So let's talk about what the Sacklers are actually losing here, right? I mean, you hear $6 Billion. That sounds like a lot of money. There are every state in the nation has suffered from the opioid crisis for which the Sacklers are quite culpable. To what degree is that actually going to hurt them?

Patrick Radden Keefe: This is such a great question, because one thing that I think it's worth exploring is billionaire math. And the way in which math for billionaires is different than it is for you and me. So I think a lot of people hear that the Sacklers are going to pay $6 Billion to help remediate the opioid crisis, and that seems like a lot of money. But first of all, in terms of the magnitude of the damage done. It's nothing. It's a drop in the bucket. The estimates are that the opioid crisis is costing more than $2 trillion. So $6 billion is really not much at all. And then also in terms of the outlay for the family, when you look at the fine print of the deal, they're going to pay out $6 billion over 19 years. And they have a fortune that's estimated to be $11 billion today. So when you look at just the returns that you get on $11 billion fortune every year, if you're paying it out over 19 years, it's most likely the case that they'll never have to touch their principal. They can just pay it with their investment returns so they'll be richer when they're done paying the $6 billion 19 years from now than they are today. And so I think some people see the headline 6 billion dollars and it looks like justice. But when you when you kind of get under the hood and you look at the way that works in practice, it's really not.

Hannah McCarthy: Yeah. And when it comes to what states are receiving, you know, New Hampshire sent out a press release saying, hey, success, we're going to get millions of dollars because of this and here are our plans. Does it seem as though this money is going to make a meaningful difference to states across the country? Have you been hearing plans that sound like, Yeah, I mean, we're really going to be pushing back against the opioid crisis, providing services for people and providing remuneration for people who were hurt throughout the years that the Sacklers were producing this product.

Patrick Radden Keefe: I think it's too soon to say, but I will say that there is a there's a kind of specter from the past that everybody is aware of, which is the big tobacco settlements that generated billions of dollars for the states. But what happened is it was very often the case that that money, instead of going into cancer treatment or prevention campaigns or various other ways of of addressing the kind of specifics of smoking related social and medical problems, a lot of that money just went into general funds for the states and was used for. I don't know what, you know, highways or or whatever else they might have spent that money on. And so I think there's a fear that that could happen. This question of how much money is actually going to go to each state, and then how do we audit that to make sure that the money goes to the most deserving recipients? And it's a hard thing. I mean, I think even in the context of the bankruptcy, you had parties who were ostensibly on the same side. So in some cases, this would be like state attorneys general really trying to hold the Sacklers to account. But then also victims groups, you know, people who had battled addiction themselves, people who'd lost loved ones, people whose lives have been totally upended by OxyContin, who I think in many cases felt as though they had been kind of sidelined in the process, that these payments going to families who had suffered tend to get smaller and smaller. And I think in most cases, it's it's just like a few thousand bucks. It's not a whole lot at all.

Hannah McCarthy: Yeah. And speaking of those individuals who were hurt, I feel like one of the few moments in the book where it seems as though someone with relative power might be feeling shame or sympathy or something is Judge Drain. When you have people calling in to the proceedings and expressing utterly horrific losses. Right. But you never including the Sacklers most recent statement of regret, which was really more of a I'm sorry your feelings were hurt, right, by what I did. Did you ever encounter in all of your archival research and every email that you read and any recording that you listened to a member of the Sackler family expressing what sounded like genuine regret and a sense of their own culpability for what had happened?

Patrick Radden Keefe: Never. And this is really striking because part of what was so fascinating to me about this story and I get into this in the book at great length, is this is not a family that gets along. This family fights. They don't agree about anything. There's different wings of the family. There's all these rivalries and animosities. You know, I had I interviewed somebody who used to work at Purdue Pharma who said that because all these Sackler members, family members are on the board, that when you went to present before the board, it was like, you know, having to make a work presentation at like the most unpleasant, hostile Thanksgiving dinner you can imagine. The one thing they seem to agree on is that none of them have done anything wrong. Nobody's apologizing for anything. You get this kind of crazy idea that they're willing to pay $6 Billion to make this go away. But one of their stipulations is we will admit no wrongdoing and we're not going to make apologies to anyone. So it's quite striking. And with Judge Drain, I mean, to me, that part of the reason that I, I listened in real time when people called in to. The bankruptcy proceedings. And what had struck me over the course of the bankruptcy was in part because its bankruptcy law, which is just the most boring, complicated, specialized thing possible. It's the opposite of a courtroom drama. It kind of tries to to seal out all the human drama that you would expect. And in part because it happened during COVID. So it didn't even happen in a physical courtroom that people could go to. All of this was just over Zoom. I felt as though the humans were totally written out of the process. And there was this kind of amazing moment where these real human beings would call in, in tears and confront the judge. And I don't know if he felt regret or shame, but it did seem to me that he he he didn't really know how to operate in that realm where suddenly you have a flesh and blood human being saying, let me tell you about my loved one who died.

Hannah McCarthy: It might have been wishful reading on my part.

Patrick Radden Keefe: Yeah, maybe. Yeah, exactly. Giving them giving him more credit than he's due.

Hannah McCarthy: Yeah. It seems to me like generational denial of of culpability, of having played any role in the pain that those individuals have felt. I wonder your take on where that started in the family, because you've got Arthur Sackler, right? You've got this patriarch of the pharmaceutical company who himself establishes the most effective, if not the most moral or safe way to market a drug. How did he set the bar for the way the Sackler family would continue to behave? What was he like?

Patrick Radden Keefe: It's funny, you know, I didn't think of this as an opioid crisis book. I thought of it as a family saga. And part of what's so interesting is that when you look at all of the different aspects of the OxyContin story, the story about what this one drug company did in the 1990s, the seeds for all of that are actually planted decades earlier by Arthur, by one of these three brothers. And Arthur Sackler was just this charismatic, kind of creative, brilliant guy with a slightly wobbly moral moral compass, but enormous ambition. And he really invented medical advertising as we know it today. He was sort of the Don Draper of the pharmaceutical advertising business in the 1950s, and he made his first great fortune marketing Valium, another addictive drug that was the blockbuster of its day. And so much of what the rest of the Sackler family used to push OxyContin in the 1990s was really invented by Arthur decades earlier. That to me, this was a story in which you get these kind of patterns where there are these these things that repeat themselves. And so it's as if Arthur invents this toolbox and he uses it to become fabulously rich, and then he dies in 1987. And it's only after his death that his brothers and their children take these tools that Arthur devised and create a product that is more successful than anything, more successful and more destructive than anything Arthur ever could have envisioned.

Hannah McCarthy: Yeah. And about that destruction. I mean, I know from reading your book, right, that the Sacklers were well aware of how addictive and deadly OxyContin was, regardless of whether or not it was under the supervision of a physician. But can you just describe the process of their finding out and what they did about it?

Patrick Radden Keefe: Yeah, I mean, I should say, you know, sometimes there are people who say, look at the greed of this family. They deliberately they knew that they were putting this addictive drug out there. And I don't know that I believe that. I haven't seen evidence of that. I think that they were reckless. I think they actually believed that it wouldn't be addictive. And there was no basis for believing that other than just wishful thinking. But I think they had this hypothesis, which is that for thousands of years, humans have known that products that derive from the opium poppy, whether it's oxycodone or heroin or morphine, have these two qualities. They can alleviate pain and make you feel amazing, which is great. And then also they can be dangerously addictive and you could never get the one without the other. And that was sort of the paradox. And this family came along and they said, until now, you know, we've figured out a way to give you all the therapeutic upsides and none of the downsides. No side effects can't be abused, not addictive. And we found out pretty quickly that they were wrong. I mean, the drug is released in early '96, and within a year or two, there's reports coming in that actually people are abusing it and they're overdosing and they're dying. Kids are dying. This, to me is the most interesting part of the story. Not so much what they did when they launched the drug, but what do you do when you find out that this drug that is so successful and bringing billions of dollars is killing people and rather than slow things down, they said full speed ahead. The problem isn't the drug, it's the abusers, that these are people with addictive personalities. There are people with poor moral character. It's really about them. It's not about our product.

Hannah McCarthy: To me, that feels like a piece of family myth making, which I think any family narrative research would churn up. But I feel like the Sacklers make it a competitive sport. Can you talk a little bit about the stories they tell themselves to maintain what they believe the Sacklers are?

Patrick Radden Keefe: Yeah, this was the aspect of it that I was most interested in is I'm always interested in what are the stories that people tell themselves about the bad things that they're doing. And for any of us, it's an interesting question. What do you tell yourself when you look in the mirror in the morning, you know about who you are and how you're living your life? But it's it's more interesting with a family when there's a group of people. I think it's important to remember that this is a family that's starting in the 1950s and early sixties was putting the Sackler name up on museums and university lecture halls and all these elite institutions. And so in the end, this is a story about two kinds of branding. It's about branding and marketing of a drug claiming that a dangerous drug was safe. But it's also about branding and marketing of a family. And this notion that the name Sackler was synonymous with generosity and philanthropy and prestige and art. And I think that that was this very conscientious, multi-decade project for this family. And so you can see how when people start to question that now, there's a there's an email that Richard Sackler got that I quote in the book where a friend of his says, God, you know, everybody's overdosing on OxyContin, this drug that's making you so rich, you're looking you're going to be the Pablo Escobar of the new millennium. And it's interesting to think that if a friend of mine sent me that email, I think it would knock the wind out of me. I mean, I think I would have to really think very hard about what I was doing with my life. But with Richard, he just kept on moving, you know, he just kind of assimilates it. And I think that that's a function of how good the Sacklers were at kind of selling, but also buying the romance of their own family narrative.

Hannah McCarthy: One thing that I found so kind of gallingly striking was the way that this family separated themselves from Purdue Pharmaceuticals. It was the Sackler family. Yes, they're wealthy and it's Purdue. Can you describe the ways in which despite that public separation, this was very much a family company?

Patrick Radden Keefe: Yeah, You know, it's funny, when I first started work on this project, this is back in 2016, in a way, there was a lot that was out there that was known. It was just that people hadn't really connected the dots. And so it was known that OxyContin was the drug that really helped launch the opioid crisis. It was known that it was made by Purdue Pharma. It was known that Purdue Pharma was owned by the Sackler family, and it was known that the Sacklers were this elite family in the art world. But what was incredible to me was I went to Purdue Pharma's website and I knew that the family still dominated the board of directors of the company and I couldn't find the Sackler name anywhere on the website. And that just struck me as so weird. I thought, So your name is on all these museums, but it's nowhere to be found on the company that I know you own, and I know that you're all on the board. That just struck me as kind of fishy on its face. And as a reporter, that's, you know, that's always it always makes you think that you might be on to something. But there had been this very concerted effort to distance the family in a kind of cosmetic way from the business. And that functioned in a number of ways. I mean, there were a number of family members who were intimately involved. They were on the board. Some of them served as executives at the company who when they were out in the world, you know, socially, like I've interviewed people who knew them socially, and they would say, oh, yeah, they're always a little vague about it.

Patrick Radden Keefe: They said it was this family company. Like nobody had any idea that these people had offices at the company that they were going in all the time that they were helping, call the shots. And then there's another level to it, which is interesting to me, which is that there's the younger generations. So these second and third generation Sacklers who are, you know, millennials and Gen Z Sacklers, who in their lives, their social and professional lives, they say, Oh, it has nothing to do with me. It's my grandfather's company. I don't have anything. I have no relationship, I've never worked at the company, was never on the board. I don't know why people would would suggest that I have anything to do with this. So we know that in the case of at least one of these kids who's whose taxes were eventually leaked to ProPublica, that by the time he was 21 years old, he was worth $200 million. And that money came from the sale of OxyContin. And so to me, it's this kind of interesting dissonance, right? The idea that that the story they could tell was, oh, it has nothing to do with me because I wasn't the one, you know, driving the car that was my father or that was my uncle. In my mind, if if you're worth hundreds of millions of dollars from the sale of OxyContin, you should have to answer to people whose lives have been destroyed by the drug.

Hannah McCarthy: I mean, there's that one. I'm. Her name is escaping me, but she's a filmmaker.

Patrick Radden Keefe: Madeline.

Hannah McCarthy: Madeline, and she makes films about people convicted of crimes and put into prison, many of whom may have been convicted of selling and distributing OxyContin on the black market. And totally denies any kind of connection between herself.

Patrick Radden Keefe: Denies it entirely to the point where I interviewed the great actor Jeffrey Wright, who was actually the star of her film. And when he had questions for her, he just said, you know, look, we've made this film about mass incarceration, and yet some of the people that you're making the film about are people whose lives have really been upended by by opioids, by the war on drugs. You know, don't you feel as though we should talk about this? And she never wrote back, which, you know, I don't think that's the approach you take when when you have a good answer to that question, I'll put it that way.

Hannah McCarthy: Now, when it comes to the Sackler name on so many things, and if you've lived in New York or Boston, both of which I have ever since I was young, it was just everywhere. Yeah, the name was just there and I never really thought about what or why, aside from it must be a wealthy family who loves the arts. That name is being stripped of many institutions, and I believe that it's actually part of the bankruptcy settlement deal that they have to take their name off of some things. Maybe that's just in Connecticut. I can check.

Patrick Radden Keefe: I don't think it's that they have to. I think that there may be provisions about them not resisting if others do, I could I could be wrong. But I don't think there's anything that says it's obligatory.

Hannah McCarthy: Okay, got it. But still, you've got these they're so prolific, right. And the name is coming down. Do you have any sense of whether the living Sacklers really care about that? Is it going to affect them even if it's just their ego to have that name stripped of all of these institutions?

Patrick Radden Keefe: Well, to me, that's that's the the that's one of the redeeming features of this story is that in some ways, this is a very tragic story because the opioid crisis is itself a tragedy and an ongoing tragedy and because it's a story in which the bad guys get away with it in the end. I mean, it's a story in which a billionaire family is not going to face criminal charges. They're not going to face meaningful civil litigation, and they're going to get to keep their billions. The one saving grace is that their name is coming down from all these institutions. And I wouldn't pretend that that's justice or accountability. You know, it's not going to bring anybody back to life. But I do think that for this family in particular, that has a certain sting because this is a family that for seven decades invested so much time and energy and money in to emblazon that emblazoning that name, you know, in marble on these elite palaces of art and education. And so to see it come down, to see the idea that, you know, the name is toxic, frankly, take hold. And and I think in some ways, you know, a lot of people know who the Sacklers are today. Whereas wasn't necessarily true. And I was like you, I sort of ambiently was aware of the Sackler name and I thought I thought it was probably some rich family from the 19th century that made their money in railroads, you know. And I do think people know now, and that has caught up with them. So, you know, is it enough? No. But, you know, is it something that I think is going to hit them in a special way because of how devoted they've been to to venerating their own family name? Yeah, I do.

Hannah McCarthy: And when it comes to the future for the Sacklers, what I do know for sure is that part of this deal is that many more documents are going to have to be released pertaining to the Sacklers. Right? And I know in your truly wonderful I believe it's a note on sources at the very end of the book where I mean, as a journalist and a writer, I'm reading someone saying, just to clarify, I'm a professional and this is all sourced information. I don't just say things, but, you know, the Sackler is accused you of just saying things right and making things up.

Patrick Radden Keefe: So, yeah, it does. You tend to want to show your work when you have a billionaire family threatening to sue you.

Hannah McCarthy: But, you know, you say that you hope that your book can be a roadmap for future scholars, future journalists. Do you have any words of advice or caution for whoever might look into the ever deepening pile of documents and do archival research about the Sacklers? What would you say to them before they dive in?

Patrick Radden Keefe: Oh, I mean, I would encourage them to, I would say go to it. I think the there's you know, you'll deal with some friction. I mean, part of the story that I wanted to tell in my book is that this is a family and a company that when people tried to tell the truth about what they were doing, would harass them, essentially, you know, as a form of legal harassment. Right. And I got dozens of letters from from their lawyers. But I do think that in our system, if you're telling the truth, that's a great defense. And the wonderful thing about documents is they're undeniable. And so in my interactions with their lawyers, there were these kind of funny moments where they would say the lawyers would assert something very confidently that I knew wasn't true. And then I would come back and say, Well, how do you explain this email from Mortimer Sackler in which he said, X, Y, and Z, and then they just wouldn't respond to that. And so I think documents have a real power. And I think that in the negotiations over the bankruptcy, it was something that particularly the state of Massachusetts, Maura Healey, the new governor elect of Massachusetts, but at the time the attorney general really pushed for was a huge document repository. Was that all of the documents from Purdue were going to have to get turned over and eventually be searchable and accessible to anyone. So that was a really hard fought thing. And I think the least that the rest of us can do is dive into those documents.

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