House of Pain You’re aware America is under siege, fighting anopioid epidemic that has exploded into a public-health emergency. You’ve heard of OxyContin, the pain medication to which countless patients have become addicted. ¶ But do you know that the company that makes Oxy and reaps the billions of dollars in profits it generates is owned by one secretive family? ¶ Meet the Sacklers. By Christopher Glazek

NDC 590111-430-10 30mg One Hundred Tablets O x y C o n t i n ® Take ONLY as prescribed L.P. In case of emergency, dial 911 immediately Stamford, Connecticut Only Usual Dosage: Read accompanying prescribing literature. Swallow tablets whole. Do not cut, break, chew, crush, or dissolve. Dispense in a tight, light-resistant container. Store at 25°C (77°F); excursions permitted between 15–30°C (59°–86°F). / 101 the Sackler institutes at Cornell, Colum- doses of OxyContin and other prescrip- a single product that approaches the Sack- tious provider, setting the tone—and America’s most widely prescribed medica- bia, McGill, Edinburgh, , Sussex, tion painkillers. Thousands more have died lers’ haul from OxyContin. often choosing the path—for his younger tion—the first to reach more than $100 mil- and King’s College London tackle psycho- after starting on a prescription opioid and Even so, hardly anyone associates the brothers. After attending medical school lion in sales. Arthur, whose compensation biology, with an emphasis on early child- then switching to a drug with a cheaper Sackler name with their company’s lone on Arthur’s dime, Mortimer and Raymond depended on the volume of pills sold, was hood development. street price, such as heroin. Not all of these blockbuster drug. “The Fords, Hewletts, followed him to jobs at the Creedmoor psy- richly rewarded, and he later became one of The Sacklers’ philanthropy differs from deaths are related to OxyContin—dozens Packards, Johnsons—all those families put chiatric hospital in Queens. There, they the first inductees into the Medical Adver- that of civic populists like Andrew Car- of other painkillers, including generics, their name on their product because they coauthored more than one hundred stud- tising Hall of Fame. negie, who built hundreds of libraries in have flooded the market in the past thirty were proud,” said Keith Humphreys, a ies on the biochemical roots of mental As Arthur’s fortune grew, he turned T small towns, and Bill Gates, whose foun- years. Nevertheless, Purdue Pharma was professor of psychiatry at Stanford Univer- illness. The brothers’ research was promis- his acquisitive instincts to the art market, dation ministers to global masses. Instead, the first to achieve a dominant share of the sity School of Medicine who has written ing—they were among the first to identify quickly amassing the world’s largest pri- the family has donated its fortune to blue- market for long-acting opioids, accounting extensively about the opioid crisis. “The a link between psychosis and the hormone vate collection of ancient Chinese artifacts. chip brands, braiding the family name into for more than half of prescriptions by 2001. Sacklers have hidden their connection to cortisone—but their findings were mostly According to a memoir by Marietta Lutze, the patronage network of the world’s most According to the Centers for Disease their product. They don’t call it ‘Sackler ignored by their professional peers, who, his second wife, collecting, exhibiting, own- The newly installed Sackler Courtyard at prestigious, well-endowed institutions. The Control, fifty-three thousand Americans Pharma.’ They don’t call their pills ‘Sackler in keeping with the era, favored a Freudian ing, and donating art fed Arthur’s “driv- London’s Victoria and Albert Museum Sackler name is everywhere, evoking auto- died from opioid overdoses in 2016, more pills.’ And when they’re questioned, they model of mental illness. ing necessity for prestige and recognition.” is one of the most glittering places in the matic reverence; the Sacklers themselves, than the thirty-six thousand who died in say, ‘Well, it’s a privately developed world. Eleven thousand white however, are rarely seen. car crashes in 2015 or the thirty-five thou- held firm, we’re a family, porcelain tiles, inlaid like a shattered back- The descendants of Mortimer and sand who died from gun violence that year. we like to keep our pri- gammon board, cover a surface the size of , a pair of psychiatrist This past July, Donald Trump’s Commis- vacy, you understand.’ ” six tennis courts. According to the V&A’s brothers from , are members of sion on Combating Drug Addiction and the To the extent that The Sacklers have been millionaires for director, the regal setting is intended to a billionaire clan with homes scattered Opioid Crisis, led by New Jersey governor the Sacklers have culti- serve as a “living room for London,” by across Connecticut, London, Utah, Gstaad, Chris Christie, declared that opioids were vated a reputation, it’s decades, but their real money—the money from which he presumably means a living room the Hamptons, and, especially, New York killing roughly 142 Americans each day, a for being earnest heal- for Kensington, the museum’s neighbor- City. It was not until 2015 that they were tally vividly described as “September 11th ers, judicious stewards of painkillers—is of a relatively recent vintage. hood, which is among the country’s wealth- noticed by Forbes, which added them to every three weeks.” The epidemic has also scientific progress, and iest. In late June, Kate Middleton, the the list of America’s richest families. The exacted a crushing financial toll: Accord- connoisseurs of old and Duchess of Cambridge, was summoned magazine pegged their wealth, shared ing to a study published by the Ameri- beautiful things. Few are to consecrate the courtyard, said to be the among twenty heirs, at a conservative $14 can Public Health Association, using data aware that during the world’s first outdoor space made of porce- billion. (Descendants of Arthur Sackler, from 2013—before the epidemic entered crucial period of OxyContin’s development Concurrent with his psychiatric work, Rewarding at first, collecting soon became lain; stepping onto the ceramic expanse, Mortimer and Raymond’s older brother, its current, more virulent phase—the total and promotion, members Arthur Sackler made his name in pharma- a mania that took over his life. “Boxes of she silently mouthed, “Wow.” split off decades ago and are mere multi- economic burden from opioid use stood at actively led Purdue’s day-to-day affairs, fill- ceutical advertising, which at the time con- artifacts of tremendous value piled up in The Sackler Courtyard is the latest addi- millionaires.) To a remarkable degree, about $80 billion, adding together health ing the majority of its board slots and sup- sisted almost exclusively of pitches from numerous storage locations,” she wrote, tion to an impressive portfolio. There’s the those who share in the billions appear to costs, criminal-justice costs, and GDP loss plying top executives. By any assessment, so-called “detail men” who sold drugs to “there was too much to open, too much to Sackler Wing at New York’s Metropolitan have abided by an oath of omertà: Never from drug-dependent Americans leaving the family’s leaders have pulled off three of doctors door-to-door. Arthur intuited appreciate; some objects known only by a Museum of Art, which houses the majes- comment publicly on the source of the the workforce. Tobacco remains, by a sig- the great marketing triumphs of the mod- that print ads in medical journals could packing list.” Under an avalanche of “ritual tic Temple of Dendur, a sandstone shrine family’s wealth. nificant multiple, the country’s most lethal ern era: The first is selling OxyContin; the have a revolutionary effect on pharma- bronzes and weapons, mirrors and ceram- from ancient Egypt; additional Sackler That may be because the greatest part of product, responsible for some 480,000 second is promoting the Sackler name; and ceutical sales, especially given the excite- ics, inscribed bones and archaic jades,” wings at the Louvre and the Royal Acad- that $14 billion fortune tallied by Forbes deaths per year. But although billions have the third is ensuring that, as far as the pub- ment surrounding the “miracle drugs” of their lives were “often in chaos.” “Addic- emy; stand-alone Sackler museums at Har- came from OxyContin, the narcotic pain- been made from tobacco, cars, and fire- lic is aware, the first and the second have the 1950s—steroids, antibiotics, antihis- tion is a curse,” Lutze noted, “be it drugs, vard and Peking Universities; and named killer regarded by many public-health arms, it’s not clear that any of those enter- nothing to do with one another. tamines, and psychotropics. In 1952, the women, or collecting.” Sackler galleries at the Smithsonian, the experts as among the most dangerous prod- prises has generated a family fortune from same year that he and his brothers acquired When Arthur donated his art and money Serpentine, and Oxford’s Ashmolean. ucts ever sold on a mass scale. Since 1996, Purdue, Arthur became the first adman to museums, he often imposed onerous The Guggenheim in New York has a Sack- when the drug was brought to market by If you head north on I-95 through to convince The Journal of the American terms. According to a memoir written by ler Center, and the American Museum of Purdue Pharma, the American branch Stamford, Connecticut, you will spot, Medical Association, one of the profession’s Thomas Hoving, the Met director from Natural History has a Sackler Educational of the Sacklers’ pharmaceutical empire, on the left, a giant misshapen glass cube. most august publications, to include a color 1967 to 1977, when Arthur established Lab. Members of the family, legendary in more than two hundred thousand people Along the building’s top edge, white letter- advertorial brochure. the Sackler Gallery at the Metropolitan museum circles for their pursuit of nam- in the United States have died from over- ing spells out one stamford forum. No In the 1960s, Arthur was contracted by Museum of Art to house Chinese antiqui- ing rights, have also underwritten projects markings visible from the highway indicate Roche to develop an advertising strategy for ties, in 1963, he required the museum to of a more modest caliber—a Sackler Stair- the presence of the building’s owner and a new antianxiety medication called Valium. collaborate on a byzantine tax-avoidance case at Berlin’s Jewish Museum; a Sack- chief occupant, Purdue Pharma. This posed a challenge, because the effects maneuver. In accordance with the scheme, ler Escalator at the Modern; a Sackler Originally known as Purdue Freder- of the medication were nearly indistinguish- the museum first sold Arthur a large quan- Crossing in . A popular spe- ick, the first iteration of the company was able from those of Librium, another Roche tity of ancient artifacts at the deflated cies of pink rose is named after a Sackler. founded in 1892 on New York’s Lower tranquilizer that was already on the market. 1920s prices for which they had origi- So is an asteroid. East Side as a peddler of patent medicines. Arthur differentiated Valium by audaciously nally been acquired. Arthur then donated The Sackler name is no less prominent For decades, it sustained itself with sales inflating its range of indications. Whereas back the artifacts at 1960s prices, in the among the emerald quads of higher educa- of Gray’s Glycerine Tonic, a sherry-based Librium was sold as a treatment for garden- process taking a tax deduction so hefty tion, where it’s possible to receive degrees liquid of “broad application” marketed as variety anxiety, Valium was positioned as that it likely exceeded the value of his ini- Arthur Sackler from Sackler schools, participate in Sack- a remedy for everything from anemia to an elixir for a problem Arthur christened tial donation. Three years later, in con- ler colloquiums, take courses from pro- tuberculosis. The company was purchased “psychic tension.” According to his ads, nection with another donation, Arthur fessors with endowed Sackler chairs, and in 1952 by Arthur Sackler, thirty-nine, and psychic tension, the forebear of today’s negotiated an even more unusual arrange- attend annual Sackler lectures on topics was run by his brothers, Mortimer, thirty- “stress,” was the secret culprit behind a host ment. This time, the Met opened a secret such as theoretical astrophysics and human six, and Raymond, thirty-two. of somatic conditions, including heartburn, chamber above the museum’s auditorium to rights. The Sackler Institute for Nutrition The Sackler brothers came from a family gastrointestinal issues, insomnia, and rest- provide Arthur with free storage for some Science supports research on obesity and of Jewish immigrants in Flatbush, Brook- less-leg syndrome. The campaign was such five thousand objects from his private micronutrient deficiencies. Meanwhile, lyn. Arthur was a headstrong and ambi- a success that for a time Valium became collection, relieving him of the substan-

102 November 2017_Esquire illustration: Ryan Melgar November 2017_Esquire 103 dinner for the designer Valentino, which Arthur called “disgusting.” According to THE SUN NEVER SETS ON THE SACKLER EMPIRE Met chronicler Michael Gross, he was Raymond and also denied that coveted ticket of arrival, Beverly Sackler, 2004. a board seat. (Jillian Sackler said it was Over the last half century, the Sacklers have donated hundreds of millions of dollars. Their Arthur who rejected the board seat, after name is on everything from a rose* to an asteroid.** Here, a partial list of their beneficiaries. repeated offers by the museum.) In 1982, in a bad breakup with the Met, Arthur benzo; in Raymond and Mortimer’s case, ↓ ARTS ↓ ↓ SCIENCES ↓ donated the best parts of his collection, an opioid—and market it as a salve for a plus $4 million, to the Smithsonian in vast range of indications. ⬤ The Metropolitan Museum of Art ⬤ The British Museum ⬤ The New York Academy of Sciences Washington, D. C. In the years before it swooped into the ⬤ The Guggenheim ⬤ Westminster Abbey ⬤ pain-management business, Purdue had ⬤ The American Museum of ⬤ Cambridge University ⬤ Dana-Farber Cancer Institute, been a small industry player, specializing younger in over-the-counter remedies like ear-wax Natural History, New York ⬤ The National Gallery Arthur’s brothers, Mortimer and Raymond, looked Raymond led Purdue Frederick as its top remover and laxatives. Its most successful ⬤ Harvard University of Scotland ⬤ Memorial Sloan Kettering Cancer so much alike that when they worked executive for several decades, while Mor- product, acquired in 1966, was Betadine, ⬤ The Smithsonian Institution ⬤ The Jewish Museum, Berlin Center, New York The Serpentine Sackler Gallery together at Creedmoor, they fooled the timer led Napp Pharmaceuticals, the fam- a powerful antiseptic purchased in indus- ⬤ Stamford Center for the Arts ⬤ Oxford University ⬤ The American Museum of Natural ⬤ The Royal Scottish Academy staff by pretending to be one another. Their ily’s drug company in the UK. In practice, trial quantities by the U. S. government to ⬤ The Royal Academy of Arts, London ⬤ The Royal Botanic Gardens, London History, New York ⬤ University of Salzburg physical similarities did not extend to their a family spokesperson said, “the brothers prevent infection among wounded soldiers personalities, however. Tage Honore, Pur- worked closely together leading both com- in Vietnam. ⬤ The Louvre ⬤ Victoria and Albert Museum ⬤ Rutgers University ⬤ Leiden University, the Netherlands due’s vice-president of discovery of research panies.” Arthur, the adman, had no official The turning point, according to company ⬤ The , London ⬤ Peking University ⬤ Princeton University ⬤ University of Copenhagen from 2000 to 2005, described them as “like role in the family’s pharmaceutical opera- lore, came in 1972, when a London doctor ⬤ The National Gallery, London ⬤ Institute for Advanced Study, ⬤ University of Oslo day and night.” Mortimer, said Honore, was tions. According to Barry Meier’s Pain Killer, working for Cicely Saunders, the Florence ⬤ The Natural History The Sackler Courtyard, Princeton ⬤ University of Edinburgh “extroverted—a ‘world man,’ I would call a prescient account of the rise of OxyContin Nightingale of the modern hospice move- Victoria and Albert Museum Museum, London ⬤ Yale University ⬤  it.” He acquired a reputation as a big-spend- published in 2003, Raymond and Mor- ment, approached Napp with the idea of ing, transatlantic playboy, living most of the timer bought Arthur’s share in Purdue creating a timed-release morphine pill. A ⬤ The , London ⬤ Boston University ⬤  year in opulent homes in , Switzer- from his estate for ⬤ The Museum of London ⬤ ⬤ King’s College London land, and France. (In 1974, he renounced $22.4 million after ⬤ The Old Vic ⬤ Harvard University ⬤ University College London his U. S. citizenship to become a citizen of he died in 1987. In ⬤ Shakespeare’s Globe Trust ⬤ Clark University, Worcester, ⬤ The Royal Society, London Austria, which infuriated his patriotic older an email exchange, ⬤ The Royal Ballet School, London ⬤ Reading University, brother.) Like Arthur, Mortimer became Arthur’s daughter As OxyContin dwindles ⬤ The Royal Opera House, London ⬤ University of Toledo Reading, England a major museum donor and married three Elizabeth Sackler, a wives over the course of his life. historian of feminist in the U. S., its ⬤ Dulwich Picture Gallery, London ⬤ Duke University ⬤ Cambridge University markets Mortimer had his own feuds with the Met. art who sits on the ⬤ Tate ⬤ University of Nebraska ⬤ The Academy of Medical On his seventieth birthday, in 1986, the board of the Brooklyn abroad are expanding. The Sacklers restored a bear ⬤ Tate Modern diorama at the American ⬤ The Mayo Clinic Sciences museum agreed to make the Temple of Den- Museum and supports Museum of Natural History ⬤ University of Texas ⬤ Cardiff University dur available to him for a party but refused to a variety of progres- Temple of Dendur ⬤ Stanford University ⬤ Institut des Hautes Études allow him to redecorate the ancient shrine: sive causes, emphat- Together with other improvements, Mor- ically distanced her ⬤  Institute of Technology Scientifiques, France timer and his interior designer, flown in from branch of the family from her cousins’ busi- long-acting morphine pill, the doctor rea- ⬤ Rockefeller University, New York ⬤ Tel Aviv University Europe, had hoped to spiff up the temple by nesses. “Neither I, nor my siblings, nor my soned, would allow dying cancer patients to ⬤ Weill Cornell Medical College, ⬤ McGill University, adding extra pillars. Also galling to Mor- children have ever had ownership in or any sleep through the night without an IV. At the New York Montreal timer was the sale of naming rights for one of benefit whatsoever from Purdue Pharma or time, treatment with opioids was stigma- ⬤ The National Academy of Sciences, ⬤ University of Toronto the Sackler Wing’s balconies to a donor from OxyContin,” she wrote, while also praising tized in the United States, owing in part to Washington, D. C. Japan. “They sold it twice,” Mortimer fumed “the breadth of my father’s brilliance and a heroin epidemic fueled by returning Viet- to a reporter from New York magazine. important works.” Jillian, Arthur’s widow, nam veterans. “Opiophobia,” as it came to ⬤ Massachusetts Institute Raymond, the youngest brother, cut a said her husband had died too soon: “His be called, prevented skittish doctors from of Technology different figure—“a family man,” said Hon- enemies have gotten the last word.” treating most patients, including nearly all ⬤ University of Washington ore. Kind and mild-mannered, he stayed infants, with strong pain medication of any ⬤ University of Connecticut with the same woman his entire life. Lutze kind. In hospice care, though, addiction was ⬤ Columbia University The Sackler Rose concluded that Raymond owed his com- The Sacklers have been mil- not a concern: It didn’t matter whether ter- ⬤ University of California, Berkeley paratively serene nature to having missed lionaires for decades, but their real minal patients became hooked in their final KEY the worst years of the Depression. “He had money—the money from painkillers—is days. Over the course of the seventies, build- ** Named 7690 Sackler, in honor of summer vacations in camp, which Arthur of comparatively recent vintage. The vehi- ing on a slow-release technology the com- *NAMING RIGHTS PURCHASED AT A CHARITY AUCTION IN 2002 ⬤U.S.A. | ⬤Europe | ⬤Other Raymond and Beverly’s contributions never had,” she wrote. “The feeling of the cle of that fortune was OxyContin, but its pany had already developed for an asthma BY THERESA SACKLER IN HONOR OF HER HUSBAND, MORTIMER. to astronomical research. two older brothers about the youngest was, engine, the driving power that made them medication, Napp created what came to be ‘Let the kid enjoy himself.’ ” so many billions, was not so much the drug known as the “Contin” system. In 1981, tial burden of fire protection and other In 1974, when Arthur and his brothers official quipped, “All that was missing was itself as it was Arthur’s original marketing Napp introduced a timed-release mor- insurance costs. (In an email exchange, Jil- made a large gift to the Met—$3.5 mil- a note of their office hours.”) insight, rehabbed for the era of chronic- phine pill in the UK; six years later, Purdue lian Sackler, Arthur’s third wife, called lion, to erect the Temple of Dendur— Hoving said that the Met hoped that pain management. That simple but prof- brought the same drug to market in the U. S. Hoving’s tax-deduction story “fake news.” they stipulated that all museum signage, Arthur would eventually donate his collec- itable idea was to take a substance with as MS Contin. She also noted that New York’s attorney catalog entries, and bulletins referring to tion to the museum, but over time Arthur addictive properties—in Arthur’s case, a MS Contin quickly became the gold general conducted an investigation into objects in the newly opened Sackler Wing grew disgruntled over a series of rankling standard for pain relief in cancer care. Arthur’s dealings with the Met and cleared had to include the names of all three broth- slights. For one, the Temple of Dendur was At the same time, a number of clinicians him of wrongdoing.) ers, each followed by “M.D.” (One museum being rented out for parties, including a and his third associated with the (continued on page 124) wife, Theresa, 2004. 104 November 2017_Esquire November 2017_Esquire 105 tric with ardent, relentless ambitions. Born in man, a Purdue sales rep from 1974 to 1998. reduce the abuse liability of a drug.” ican Academy of Pain Medicine. (Purdue fifteen-minute talk, and they’d get $500.” HOUSE OF PAIN 1945, he holds degrees from Columbia Uni- “And right in the middle, he put in, ‘If you’re The theory was that addicts would shy also launched its own group, called Partners Between 1996 and 2001, the number of (continued from page 105) versity and NYU Medical School. According reading this, then you must call my secretary away from timed-released drugs, preferring Against Pain.) As the decade wore on, these OxyContin prescriptions surged from about to a bio on the website of the Koch Institute at this number and give her this secret pass- an immediate rush. In practice, OxyContin, organizations, which critics have character- three hundred thousand to nearly six mil- for Integrative Cancer Research at MIT, where word.’ He wanted to check and see if the reps which crammed a huge amount of pure nar- ized as front groups for the pharmaceutical lion, and reports of abuse started to bub- Richard serves on the advisory board, he were reading this shit. We called it ‘Playin’ cotic into a single pill, became a lusted-after industry, began pressuring health regulators ble up in places like West Virginia, Florida, started working at Purdue as his father’s assis- Passwords.’ ” According to Sherman, Richard target for addicts, who quickly discovered to make pain “the fifth vital sign”—a number, and Maine. (Research would later show a tant at age twenty-six before eventually lead- started taking a more prominent role in the that the timed-release mechanism in Oxy- measured on a subjective ten-point scale, to direct correlation between prescription vol- ing the firm’s R&D division and, separately, company during the early 1980s. “The shift Contin was easy to circumvent—you could be asked and recorded at every doctor’s visit. ume in an area and rates of abuse and over- its sales and marketing division. In 1999, while was abrupt,” he said. “Raymond was just so simply crush a pill and snort it to get most As an internal strategy document put it, Pur- dose.) Hundreds of doctors were eventually Mortimer and Raymond remained Purdue’s nice and down-to-earth and calm and gentle.” of the narcotic payload in a single inhala- due’s ambition was to “attach an emotional arrested for running pill mills. According to co-CEOs, Richard joined them at the top of When Richard came, “things got a lot harder. tion. This wasn’t exactly news to the manu- aspect to noncancer pain” so that doctors an investigation in the Los Angeles Times, the company as president, a position he relin- Richard really wanted Purdue to be big—I facturer: OxyContin’s own packaging warned would feel pressure to “treat it more seriously even though Purdue kept an internal list of quished in 2003 to become cochairman of the mean really big.” that consuming broken pills would thwart the and aggressively.” The company rebranded doctors it suspected of criminal diversion, burgeoning chronic-pain movement started board. The few publicly available pictures of To effectively capitalize on the chronic-pain timed-release system and subject patients to pain relief as a sacred right: a universal nar- it didn’t volunteer this information to law advocating the use of powerful opioids for him are generic and sphinxlike—a white guy movement, Purdue knew it needed to move a potentially fatal overdose. MS Contin had cotic entitlement available not only to the ter- enforcement until years later. noncancer conditions like back pain and neu- with a receding hairline. He is one of the few beyond MS Contin. “Morphine had a stigma,” contended with similar vulnerabilities, and as minally ill but to every American. As criticism of OxyContin mounted ropathic pain, afflictions that at their worst Sacklers to consistently smile for the camera. said Riddle. “People hear the word and say, a result commanded a hefty premium on the OxyContin’s sales started out small in through the aughts, Purdue responded with could be debilitating. In 1986, two doc- In a photo on what appears to be his Facebook ‘Wait a minute, I’m not dying or anything.’ ” street. But the “reduced abuse liability” claim 1996, in part because Purdue first focused on symbolic concessions while retaining its vol- tors from Memorial Sloan Kettering hospi- profile, Richard is wearing a tan suit and a pink Aside from its terminal aura, MS Contin that added wings to the sales of OxyContin the cancer market to gain formulary accep- ume-driven business model. To prevent tal in New York published a fateful article in tie, his right hand casually scrunched into his had a further handicap: Its patent was set to had not been approved for MS Contin. It was tance from HMOs and state Medicaid pro- addicts from forging prescriptions, the com- a medical journal that purported to show, pocket, projecting a jaunty charm. Divorced expire in the late nineties. In a 1990 memo removed from OxyContin in 2001 and would grams. Over the next several years, though, pany gave doctors tamper-resistant prescrip- based on a cohort of thirty-eight patients, in 2013, he lists his relationship status on the addressed to Richard and other executives, never be approved again for any other opioid. the company doubled its sales force to six tion pads; to mollify pharmacists worried that long-term opioid treatment was safe profile as “It’s complicated.” Purdue’s VP of clinical research, Robert The year after OxyContin’s release, Cur- hundred—equal to the total number of DEA about robberies, Purdue offered to replace, and effective so long as patients had no his- Richard’s political contributions have gone Kaiko, suggested that the company work on tis Wright, the FDA examiner who approved diversion agents employed to combat the sale free of charge, any stolen drugs; to gather tory of drug abuse. Soon enough, opi- mostly to Republicans—including Strom a pill containing , a chemical simi- the pharmaceutical’s original application, of prescription drugs on the black market— data on drug abuse and diversion, the com- oid advocates dredged up a letter to the Thurmond and Herman Cain—though at lar to morphine that was also derived from the quit. After a stint at another pharmaceutical and began targeting general practitioners, pany launched a national monitoring program editor published in The New England Journal times he has also given to Democrats. (His opium poppy. When it came to branding, oxy- company, he began working for Purdue. In dentists, OB/GYNs, physician assistants, called RADARS. of Medicine in 1980 that suggested, based on a ex-wife, Beth Sackler, has given almost exclu- codone had a key advantage: Although it was an interview with Esquire, Wright defended nurses, and residents. By 2001, annual Oxy- Critics were not impressed. In a letter to highly unrepresentative cohort, that the risk of sively to Democrats.) In 2008, he wrote a 50 percent stronger than morphine, many his work at the FDA and at Purdue. “At the Contin sales had surged past $1 billion. Sales in July 2001, Richard Blu- addiction from long-term opioid use was less letter to the editor of The Wall Street Jour- doctors believed—wrongly—that it was sub- time, it was believed that extended-release reps were encouraged to downplay addiction menthal, then Connecticut’s attorney gen- than 1 percent. Though ultimately disavowed nal denouncing Muslim support for suicide stantially less powerful. They were deceived formulations were intrinsically less abusable,” risks. “It was sell, sell, sell,” recalled Sher- eral and now a U. S. senator, called the by its author, the letter ended up getting cited in bombing, a concern that seems to persist: Since about its potency in part because oxycodone he insisted. “It came as a rather big shock to man. “We were directed to lie. Why mince company’s efforts “cosmetic.” As Blumen- medical journals more than six hundred times. 2014, his charitable organization, the Richard was widely known as one of the active ingre- everybody—the government and Purdue— words about it? Greed took hold and over- thal had deduced, the root problem of the As the country was reexamining pain, and Beth Sackler Foundation, has donated to dients in Percocet, a relatively weak opioid- that people found ways to grind up, chew up, ruled everything. They saw that potential for prescription-opioid epidemic was the high Raymond’s eldest son, Richard Sackler, was several anti-Muslim groups, including three acetaminophen combination that doctors snort, dissolve, and inject the pills.” Prevent- billions of dollars and just went after it.” volume of prescriptions written for power- searching for new applications for Purdue’s organizations classified as hate groups by often prescribed for painful injuries. “It really ing abuse, he said, had to be balanced against Flush with cash, Purdue pioneered a high- ful opioids. “It is time for Purdue Pharma to timed-release Contin system. “At all the the Southern Poverty Law Center. (The fam- didn’t have the same connotation that mor- providing relief to chronic-pain sufferers. “In cost promotion strategy, effectively providing change its practices,” Blumenthal warned meetings, that was a constant source of dis- ily spokesperson said, “It was never Richard phine did in people’s minds,” said Riddle. the mid-nineties,” he recalled, “the very best kickbacks—which were legal under Amer- Richard, “not just its public-relations cussion—‘What else can we use the Contin Sackler’s intention to donate to an anti-Mus- A common malapropism led to fur- pain specialists told the medical community ican law—to each part of the distribution strategy.” system for?’ ” said Peter Lacouture, a senior lim or hate group.”) The foundation has also ther advantage for Purdue. “Some people they were not prescribing opioids enough. chain. Wholesalers got rebates in exchange It wasn’t just that doctors were writing director of clinical research at Purdue from donated to True the Vote, the “voter-fraud would call it oxy-codeine” instead of oxyco- That was not something generated by Pur- for keeping OxyContin off prior authoriza- huge numbers of prescriptions; it was also 1991 to 2001. “And that’s where Richard watchdog” that was the original source done, recalled Lacouture. “Codeine is very due—that was not a secret plan, that was not tion lists. Pharmacists got refunds on their that the prescriptions were often for extraor- would fire some ideas—maybe antibiotics, for Donald Trump’s inaccurate claim that weak.” When Purdue eventually pleaded a plot, that was not a clever marketing ploy. initial orders. Patients got coupons for thirty- dinarily high doses. A single dose of Per- maybe chemotherapy—he was always out three million illegal immigrants voted in the guilty to felony charges in 2007 for crimi- Chronic pain is horrible. In the right circum- day starter supplies. Academics got grants. cocet contains between 2.5 and 10mg of there digging.” Richard’s spitballing wasn’t 2016 election. nally “misbranding” OxyContin, it acknowl- stances, opioid therapy is nothing short of Medical journals got millions in advertising. oxycodone. OxyContin came in 10-, 20-, 30-, idle blather. A trained physician, he treasured Former employees describe Richard as a edged exploiting doctors’ misconceptions miraculous; you give people their lives back.” Senators and members of Congress on key 40-, and 80mg formulations and, for a time, his role as a research scientist and appeared man with an unnerving intelligence, alter- about oxycodone’s strength. In court docu- In Wright’s account, the Sacklers were not committees got donations from Purdue and even 160mg. Purdue’s greatest competitive as an inventor on dozens of the company’s nately detached and pouncing. In meetings, ments, the company said it was “well aware just great employers, they were great people. from members of the Sackler family. advantage in dominating the pain market, patents (though not on the patents for Oxy- his face was often glued to his laptop. “This of the incorrect view held by many physi- “No company in the history of pharmaceu- It was doctors, though, who received the it had determined early on, was that Oxy- Contin). In the tradition of his uncle Arthur, was pre-smartphone days,” said Riddle. “He’d cians that oxycodone was weaker than mor- ticals,” he said, “has worked harder to try to most attention. “We used to fly doctors Contin lasted twelve hours, enough to sleep Richard was also fascinated by sales mes- be typing away and you think he wasn’t even phine” and “did not want to do anything ‘to prevent abuse of their product than Purdue.” to these ‘seminars,’ ” said Sherman, which through the night. But for many patients, the saging. “He was very interested in the com- listening, and then all of the sudden his head make physicians think that oxycodone was were, in practice, “just golf trips to Pebble drug lasted only six or eight hours, creating mercial side and also very interested in would pop up and he’d be asking a very pointed stronger or equal to morphine’ or to ‘take any PURDUE DID NOT invent the chronic-pain Beach. It was graft.” Though offering perks a cycle of crash and euphoria that one aca- marketing approaches,” said Sally Allen Riddle, question.” He was notorious for peppering sub- steps . . . that would affect the unique position movement, but it used that movement to and freebies to doctors was hardly uncom- demic called “a perfect recipe for addiction.” Purdue’s former executive director for ordinates with unexpected, rapid-fire queries, that OxyContin’ ” held among physicians. engineer a crucial shift. Wright is correct that mon in the industry, it was unprecedented When confronted with complaints about product management. “He didn’t always wait sometimes in the middle of the night. “Richard Purdue did not merely neglect to clear up in the nineties patients suffering from chronic in the marketing of a Schedule II narcotic. “breakthrough pain”—meaning that the pills for the research results.” (A Purdue spokes- had the mind of someone who’s going two hun- confusion about the strength of OxyContin. pain often received inadequate treatment. For some physicians, the junkets to sunny weren’t working as long as advertised—Pur- person said that Richard “always consid- dred miles an hour,” said Lacouture. “He could As the company later admitted, it mislead- But the call for clinical reforms also became a locales weren’t enough to persuade them to due’s sales reps were given strict instructions ered relevant scientific information when be a little bit disconnected in the way he would ingly promoted OxyContin as less addic- flexible alibi for overly aggressive prescribing prescribe. To entice the holdouts—a group to tell doctors to strengthen the dose rather making decisions.”) communicate. Whether it was on the weekend tive than older opioids on the market. In this practices. By the end of the decade, clinical the company referred to internally as “prob- than increase dosing frequency. Perhaps the most private member of a gener- or a holiday or a Christmas party, you could deception, Purdue had a big assist from the proponents of opioid treatment, supported lem doctors”—the reps would dangle the Over the next several years, dozens of ally secretive family, Richard appears nowhere always expect the unexpected.” FDA, which allowed the company to include by millions in funding from Purdue and other lure of Purdue’s lucrative speakers’ bureau. class-action lawsuits were brought against on Purdue’s website. From public records and Richard also had an appetite for microman- an astonishing labeling claim in OxyContin’s pharmaceutical companies, had organized “Everybody was automatically approved,” Purdue. Many were dismissed, but in some conversations with former employees, though, agement. “I remember one time he mailed out package insert: “Delayed absorption, as pro- themselves into advocacy groups with names said Sherman. “We would set up these cases Purdue wrote big checks to avoid going a rough portrait emerges of a testy eccen- a rambling sales bulletin,” said Shelby Sher- vided by OxyContin tablets, is believed to like the American Pain Society and the Amer- little dinners, and they’d make their little to trial. Several plaintiffs’ lawyers found that

124 November 2017_Esquire November 2017_Esquire 125 the company was willing to go to great lengths change of heart coincided with two develop- Holding fast to family tradition, Raymond’s The American market for OxyContin is Statement of Ownership, to prevent Richard Sackler from having to ments: First, an increasing number of addicts, and Mortimer’s heirs declined to be inter- dwindling. According to Purdue, prescriptions Management, and Circulation testify under oath. “They didn’t want him unable to afford OxyContin’s high street price, viewed for this article. Instead, through a fell 33 percent between 2012 and 2016. But 1. Publication title: Esquire. 2. Publication number: 0561-9100. deposed, I can tell you that much,” recalled were turning to cheaper alternatives like her- spokesperson, they put forward two deco- while the company’s primary product may be 3. Filing date: October 1, 2017. HELP 4. Issue frequency: Monthly, except combined issues in Marvin Masters, a lawyer who brought a oin; second, OxyContin was nearing the end of rated academics who have been on the receiv- in eclipse in the United States, international December/January and June/July. class-action suit against Purdue in the early its patents. Purdue suddenly argued that the ing end of the family’s largesse: Phillip Sharp, markets for pain medications are expanding. 5. Number of issues published annually: 10. CARRY OUR 6. Annual subscription price: $7.97. 7. Complete mailing address of known office of publica- 2000s in West Virginia. “They were willing to drug it had been selling for nearly fifteen years the Nobel-prize-winning MIT geneticist, and According to an investigation last year in the tion: 300 West 57th Street, New York, NY 10019. sit down and settle the case to keep from doing was so prone to abuse that generic manufac- Herbert Pardes, formerly the dean of faculty Contact person: Ellie Festger. Los Angeles Times, Mundipharma, the Sack- WOUNDED Telephone: 212-649-2816. that.” Purdue tried to get Richard removed turers should not be allowed to copy it. at Columbia University’s medical school and ler-owned company charged with developing 8. Complete mailing address of headquarters or general business office of publisher: 300 West 57th Street, from the suit, but when that didn’t work, Pur- On April 16, 2013, the day some of the CEO of New York-Presbyterian Hospital. Both new markets, is employing a suite of famil- WARRIORS New York, NY 10019. 9. Full names and complete mailing addresses of due settled with the plaintiffs for more than key patents for OxyContin were scheduled men effusively praised the Sacklers’ donations iar tactics in countries like Mexico, Brazil, publisher, editor, and managing editor. Publisher: Jack Essig, 300 West 57th Street, New York, NY 10019. $20 million. Paul Hanly, a New York class-ac- to expire, the FDA followed Purdue’s lead, to the arts and sciences, marveling at their loy- and China to stoke concern for as-yet-unher- HOME. Editor: Jay Fielden, 300 West 57th Street, New York, NY 10019. Managing editor: John Kenney, 300 West 57th tion lawyer who won a large settlement from declaring that no generic versions of the origi- alty to academic excellence. “Once you were alded “silent epidemics” of untreated pain. In Street, New York, NY 10019. 10. Owner: Hearst Communications, Inc., registered office: Purdue in 2007, had a similar recollection. nal OxyContin formulation could be sold. The on that exalted list of philanthropic projects,” Colombia, according to the L. A. Times, the 300 West 57th Street, New York, NY 10019. Stockholders of Hearst Communications, Inc., are: “We were attempting to take Richard Sack- company had effectively won several additional Pardes told Esquire, “you were there, and company went so far as to circulate a press Hearst Holdings, Inc., registered office: 300 West 57th Street, New York, NY 10019, and CDS Global, ler’s deposition,” he said, “around the time years of patent protection for its golden goose. you were in a position to secure additional release suggesting that 47 percent of the pop- Inc., registered office: 1901 Bell Avenue, Des Moines, Iowa 50315. that they agreed to a settlement.” (A spokes- philanthropy. It was like a family acquisition.” ulation suffered from chronic pain. 11. None. OPIOID WITHDRAWAL, 12. Not applicable. person for the company said, “Purdue did not which causes aches, Pardes called the Sacklers “the nicest, most In May, a dozen lawmakers in Congress, 13. Publication title: Esquire. 14. Issue date for circulation data below: September 2017. settle any cases to avoid the deposition of Dr. vomiting, and restless anxiety, is a gruesome gentle people you could imagine.” As for the inspired by the L. A. Times investigation, sent 15. Extent and nature of circulation: Richard Sackler, or any other individual.”) process to experience as an adult. It’s consid- family’s connection to OxyContin, he said a bipartisan letter to the World Health Orga- Average no. copies each issue during preceding 12 months When the federal government finally erably worse for the twenty thousand or so that it had simply never come up as an issue in A. Total number of copies: 804,558 nization warning that Sackler-owned compa- B. Paid circulation (by mail and outside the mail) stepped in, in 2007, it extracted historic American babies who emerge each year from the faculty lounge or the hospital break room. nies were preparing to flood foreign countries 1. Mailed outside-county paid subscriptions stated on PS Form 3541: 616,042 terms of surrender from the company. Purdue opioid-soaked wombs. These infants, sud- “I have never heard one inch about that,” with legal narcotics. “Purdue began the opioid 2. Mailed in-county paid subscriptions stated on PS Form 3541: not applicable pleaded guilty to felony charges, admitting denly cut off from their supply, cry uncon- he said. crisis that has devastated American communi- 3. Paid distribution outside the mails including sales through dealers and carriers, that it had lied to doctors about OxyContin’s trollably. Their skin is mottled. They cannot Pardes’s ostrichlike avoidance is not ties,” the letter reads. “Today, Mundipharma street vendors, counter sales, and other paid distribution outside USPS: 29,250 abuse potential. (The technical charge was fall asleep. Their bodies are shaken by trem- unusual. In 2008, Raymond and his wife is using many of the same deceptive and reck- 4. Paid distribution by other classes of mail through the USPS: not applicable “misbranding a drug with intent to defraud ors and, in the worst cases, seizures. Bottles donated an undisclosed amount to Yale to less practices to sell OxyContin abroad.” Sig- C. Total paid distribution: 645,292 D. Free or nominal rate distribution (by mail or mislead.”) Under the agreement, the com- of milk leave them distraught, because they start the Raymond and Beverly Sackler Insti- nificantly, the letter calls out the Sackler and outside the mail) 1. Free or nominal rate outside-county pany paid $600 million in fines and its three cannot maneuver their lips with enough pre- tute for Biological, Physical and Engineering family by name, leaving no room for the pub- copies included on PS Form 3541: 69,925 2. Free or nominal rate in-county copies top executives at the time—its medical direc- cision to create suction. Treatment comes in Sciences. Lynne Regan, its current director, lic to wonder about the identities of the people included on PS Form 3541: not applicable 3. Free or nominal rate copies mailed tor, general counsel, and Richard’s successor the form of drops of morphine pushed from told me that neither students nor faculty have who stood behind Mundipharma. at other classes through the USPS: not applicable 4. Free or nominal rate distribution as president—pleaded guilty to misdemeanor a syringe into the babies’ mouths. Weaning ever brought up the OxyContin connection. The final assessment of the Sacklers’ global outside the mail: 9,201 charges. The executives paid $34.5 million sometimes takes a week but can last as long “Most people don’t know about that,” she E. Total free or nominal rate distribution: 79,127 impact will take years to work out. In some F. Total distribution: 724,419 out of their own pockets and performed four as twelve. It’s a heartrending, expensive pro- said. “I think people are mainly oblivious.” A places, though, they have already left their G. Copies not distributed: 80,139 H. Total: 804,557 hundred hours of community service. It was cess, typically carried out in the neonatal spokesperson for the university added, “Yale mark. In July, Raymond, the last remain- I. Percent paid: 89.08% one of the harshest penalties ever imposed on ICU, where newborns have limited access to does not vet donors for controversies that ing of the original Sackler brothers, died at 16. A. Requested and paid electronic copies: 44,400 B. Total requested and paid print copies a pharmaceutical company. (In a statement their mothers. may or may not arise.” ninety-seven. Over the years, he had won and requested/paid electronic copies: 689,692 C. Total requested copy distribution and to Esquire, Purdue said that it “abides by the But the children of OxyContin, its heirs The controversy surrounding OxyCon- a British knighthood, been made an Offi- requested/paid electronic copies: 768,819 D. Percent paid and/or requested circulation highest ethical standards and legal require- and legatees, are many and various. The sec- tin shows little sign of receding. In 2016, the cer of France’s Légion d’Honneur, and (both print and electronic copies): 89.71% ments.” The statement went on: “We want ond- and third-generation descendants of CDC issued a startling warning: There was no received one of the highest possible hon- No. copies of single issue published nearest to filing date A. Total number of copies: 787,100 physicians to use their professional judgment, Raymond and Mortimer Sackler spend their good evidence that opioids were an effective ors from the royal house of the Netherlands. B. Paid circulation (by mail and outside the mail) 1. Mailed outside-county paid and we were not trying to pressure them.”) money in the ways we have come to expect treatment for chronic pain beyond six weeks. One of his final accolades came in June 2013, Wounded Warrior Project’s purpose subscriptions stated on PS Form 3541: 614,549 2. Mailed in-county paid subscriptions stated No Sacklers were named in the 2007 suit. from the not-so-idle rich. Notably, several have There was, on the other hand, an abundance when Anthony Monaco, the president of is to raise awareness and enlist the on PS Form 3541: not applicable 3. Paid distribution outside the mails Indeed, the Sackler name appeared nowhere made children a special focus of their business of evidence that long-term treatment with Tufts University, traveled to Purdue Phar- including sales through dealers and carriers, public’s aid for the needs of injured street vendors, counter sales, and other in the plea agreement, even though Richard and philanthropic endeavors. One Sackler heir opioids had harmful effects. (A recent paper ma’s headquarters in Stamford to bestow paid distribution outside USPS: 28,300 service members; to help injured 4. Paid distribution by other classes had been one of the company’s top executives helped start an iPhone app called RedRover, by Princeton economist Alan Krueger sug- upon Raymond an honorary doctorate. The of mail through the USPS: not applicable servicemen and women aid and C. Total paid distribution: 642,849 during most of the period covered by the set- which generates ideas for child-friendly activ- gests that chronic opioid use may account for Sacklers had made a number of transforma- D. Free or nominal rate distribution tlement. He did eventually have to give a depo- ities for urban parents; another runs a child- more than 20 percent of the decline in Amer- 1. Free or nominal rate outside-county tional donations to the university over the assist each other; and to provide copies included on PS Form 3541: 69,757 sition in 2015, in a case brought by Kentucky’s development center near Central Park; another ican labor-force participation from 1999 to years—endowing, among other things, the 2. Free or nominal rate in-county copies unique, direct programs and services included on PS Form 3541: not applicable attorney general. Richard’s testimony—the is a donor to charter-school causes, as well as 2015.) Millions of opioid prescriptions for Sackler School of Graduate Biomedical Sci- 3. Free or nominal rate copies mailed to meet their needs. Learn more at other classes through the USPS: not applicable only known record of a Sackler speaking about an investor in an education start-up called Alt- chronic pain had been written in the preced- ences. At Tufts, as at most schools, honorary 4. Free or nominal rate distribution outside the mail: 5,900 the crisis the family’s company helped cre- School. Yet another is the founder of Beespace, ing two decades, and the CDC was calling into degrees are traditionally awarded on cam- or find out how you can help at E. Total free or nominal rate distribution: 75,657 F. Total distribution: 718,506 ate—was promptly sealed. (In 2016, The Bos- an “incubator for emerging nonprofits,” which question whether many of them should have pus during commencement, but in consider- woundedwarriorproject.org. G. Copies not distributed: 68,594 H. Total: 787,100 ton Globe asked a court in Kentucky to unseal provides resources and mentoring for initia- been written at all. At least twenty-five gov- ation of Raymond’s advanced age, Monaco I. Percent paid: 89.47% the deposition, which is said to have lasted sev- tives like the Malala Fund, which invests in ernment entities, ranging from states to small trekked to Purdue for a special ceremony. 16. A. Requested and paid electronic copies: 44,000 B. Total requested and paid print copies and eral hours. The Globe won a lower-court ruling education programs for women in the develop- cities, have recently filed lawsuits against Pur- The audience that day was limited to fam- requested/paid electronic copies: 686,849 C. Total requested copy distribution and in May 2016. As of press time, the matter was ing world, and Yoga Foster, whose objective is due to recover damages associated with the ily members, select university officials, and requested/paid electronic copies: 762,506 D. Percent paid and/or requested circulation before an appeals court.) to bring “accessible, sustainable yoga programs opioid epidemic. a scrum of employees. Addressing the crowd (both print and electronic copies): 90.08% In 2010, Purdue executed a breathtaking into schools across the country.” Other Sackler The Sacklers, though, will likely emerge of intimates, Monaco praised his benefac- 17. Publication of statement of ownership: If the publica- heirs get to do the fun stuff: One helps finance tion is a general publication, publication of this state- pivot: Embracing the arguments critics had untouched: Because of a sweeping non-pros- tor. “It would be impossible to calculate how ment is required. Will be printed in the November 2017 been making for years about OxyContin’s small, interesting films like The Witch; a sec- ecution agreement negotiated during the many lives you have saved, how many scien- issue of this publication. 18. Signature and title of editor, publisher, business susceptibility to abuse, the company released ond married a famous cricket player; a third 2007 settlement, most new criminal litigation tific fields you have redefined, and how many manager, or owner: Jack Essig, Publisher a new formulation of the medication that is a sound artist; a fourth started a production against Purdue can only address activity that new physicians, scientists, mathematicians, I certify that all information furnished on this form is true and complete. I understand that anyone who furnishes was harder to snort or inject. Purdue seized company with Boyd Holbrook, star of the Net- occurred after that date. Neither Richard nor and engineers are doing important work as false or misleading information on this form or who omits material or information requested on the form may be sub- the occasion to rebrand itself as an industry flix series Narcos; a fifth founded a small chain any other family members have occupied an a result of your entrepreneurial spirit.” He ject to criminal sanctions (including fines and imprison- ment) and/or civil sanctions (including civil penalties). leader in abuse-deterrent technology. The of gastropubs in New York called the Smith. executive position at the company since 2003. concluded, “You are a world changer.” ,,,,,,,,,,,,,,,,,,, 126 November 2017_Esquire © 2017 Wounded Warrior Project® All Rights Reserved