Patrick Radden Keefe on the legacy of the Sackler Family in the opioid crisis

Patrick Radden Keefe, the author of ‘Empire of Pain: The Secret History of the Sackler Dynasty’ joins Yahoo Finance’s Alexis Christoforous and Sibile Marcellus to discuss his book, where he details his investigation into Purdue Pharma and the Sackler family, and the connections to the opioid crisis in the United States.

Video transcript

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KRISTIN MYERS: Welcome to "A Time for Change." I'm Kristin Myers here with Sibile Marcellus and Alexis Christoforous. Today, we will be turning our attention to the opioid crisis. Take a listen to some of these statistics.

Now, in this country, more than two million people are addicted to opioids. And every day, 136 Americans die of an opioid overdose according to the CDC. That is nearly 50,000 people a year.

SIBILE MARCELLUS: There is no name that is more synonymous with the opioid crisis as that of the Sackler family, who until recently were the owners of Purdue Pharma, the company that makes OxyContin, the powerful opioid painkiller. The family is worth billions.

ALEXIS CHRISTOFOROUS: And last year, that family cut ties with Purdue as the company declared bankruptcy and pled guilty to criminal charges related to its marketing of the drug. Our first guest has spent years investigating Purdue Pharma and the Sackler family. In fact, he turned his reporting into a book-- "Empire of Pain-- the Secret History of the Sackler Dynasty." Patrick Radden Keefe, thanks so much for joining us today. Based on your extensive research on your reporting, what is the difference between a drug-pusher and the Sackler family?

PATRICK RADDEN KEEFE: Well, one of them is selling a product that the FDA approved. I mean, I think if the Sacklers were with us today, they would say you know we didn't sell heroin on the street, we sold a painkiller that was approved by the FDA. And the FDA approved the way in which the drug could be marketed. Having said that, you know, how you feel about that as a justification depends on how you feel about the way in which the FDA has conducted itself, which I think when it comes to the opioid crisis leaves me wanting more.

SIBILE MARCELLUS: Patrick, before I ask you this question, I want to say that neither the Sackler family nor Purdue Pharma support your book, "Empire of Pain." Now, what surprised you most about the Sackler family in your reporting?

PATRICK RADDEN KEEFE: So, you know, what I wanted to do was actually look at three generations of this family-- not just tell an OxyContin story, but look at how the original fortune was made. And for that, you have to go back to the 1960s and actually the marketing of Valium. In terms of what I found most surprising, part of what I was looking at was this company, Purdue Pharma, a privately-held company, very much owned and controlled by the Sacklers-- and one of the things I wanted to know was, what did they know and when did they know it?

So they released OxyContin in 1996. This is a drug that has generated some $35 billion in revenue, but it has also led to a great tide of addiction and death. And what the company and the family have always said is, it wasn't until 2000 that we knew there was any kind of a problem going on. And I really was able to develop a lot of research-- you know, a lot of documentation that has come to me that I have in the book which demonstrates that that's really not true. In fact, there were signs almost immediately-- years before they say that there were-- that people knew at very high levels of Purdue that people were abusing the drug, were getting addicted, and were overdosing.

ALEXIS CHRISTOFOROUS: Patrick, I want to get back to the FDA for a moment. Because if the Sackler family and Purdue Pharma orchestrated the crime of the century, as some have said, how culpable is the FDA in aiding and abetting that crime?

PATRICK RADDEN KEEFE: I think it's highly culpable. I mean, the Sacklers keep pointing to the FDA and saying, they signed off on everything we did. But I'll tell you a story from the book-- when Purdue Pharma was originally submitting OxyContin for approval by the FDA, the top official at the FDA in charge of approving the drug for sale, but also of approving the way in which it could be marketed, was a guy named Curtis Wright.

So the drug ends up going through in record time, getting this approval, going on sale, becoming a blockbuster, and Curtis Wright decides he's ready to leave the government. And about a year later, he ends up taking a job at Purdue Pharma, the company that makes the drug that he's just approved, for roughly three times his government salary. I think his starting compensation was somewhere in the neighborhood of $400,000. So you tell me-- I mean, that's not a suitcase full of money getting slid under a table, but it does raise questions in my mind about corruption, and conflicts of interest, and how much we can trust the judgment of the FDA in having given such a green light to Purdue Pharma early on.

SIBILE MARCELLUS: Patrick, amid the pandemic, the nation's opioid epidemic has gotten much more complicated and much deadlier as it's turned into a drug overdose epidemic. Now, how would you say Purdue's illegal marketing of OxyContin and other opioid medication has been to blame?

PATRICK RADDEN KEEFE: So it's a fascinating story. I mean, basically, you had for a long time a lot of reluctance within the medical establishment in the United States to prescribe strong opioids, except in cases of very severe pain-- cancer pain, end of life care. Purdue Pharma and the Sacklers set out to change that with OxyContin.

And so there was a big push to market this drug not just for very severe pain, but also for moderate pain. You can understand from a business point of view why you would want to do that. It's a much bigger market, and a market that they estimated at potentially as many as 40 to 50 million people.

In order to do that, they had to downplay the risks of addiction. And so I've interviewed many former sales reps who worked for the company-- they went out and told doctors, it's not addictive. It's not addictive. It's addictive less than 1% of the time. That wasn't true.

That was wishful thinking at the time. We know that now. So what that did was it created a huge population of people who had become addicted to these drugs, to opioids. Eventually, you see a lot of these people start transitioning to heroin and to fentanyl. So on the one hand, I would say in the defense of the Sacklers, you know, they're not selling heroin, they're not selling fentanyl.

And those are really the leading killers now in the opioid crisis. On the other hand, this is kind of a Pandora's box situation in which you had the creation of a market, and it was really Purdue that was the tip of the spear there that created this market. And eventually, you get this market, and you find people-- I've interviewed many of them-- people who say, I never would have started off using heroin. I had an onramp here, which was prescription pills that came from a doctor. I developed a problem, and eventually I transitioned to heroin or, indeed, to fentanyl.

ALEXIS CHRISTOFOROUS: You know, when you look at the litigation brought against Purdue, we know the company has filed for bankruptcy. The family has settled for-- I think it's something like $4.5 billion with a number of different states. But no member of the Sackler family has been charged with any crime. Do you think that is still coming? Do you think they should be?

PATRICK RADDEN KEEFE: So a couple of things. I should say they haven't settled yet. The family has a proposal to settle with the states in which they would pay roughly $4.25 billion to help remediate the opioid crisis, but admit no wrongdoing. The company has declared bankruptcy, but there's an interesting little wrinkle here, which is that for about a decade, the Sacklers were quietly pulling money out of Purdue.

We know that they pulled at least $10 billion out of the company. And then at a certain point, you get all these lawsuits-- the coffers of the company are pretty empty, because the family's been taking money out, and they kicked the company into bankruptcy. So you have this kind of crazy situation now where Purdue Pharma is in bankruptcy, and the Sacklers are sitting on the sidelines with their $10 billion that they took out of the company.

And that money doesn't seem to be in danger. None of them have been charged with any criminal wrongdoing-- no members of the family-- even though the company has twice pled guilty to federal criminal charges. Will those charges come? I think it remains to be seen.

You have roughly 24 or 25 states that are suing individual members of the Sackler family. They want to continue with their cases. Those are civil cases. People have talked about bringing criminal charges. I think, frankly, those would be tough charges to bring. But I do think a lot of people looking at this situation in which the company goes bankrupt, the family walks away with billions and billions of dollars and admits no wrongdoing-- I think a lot of people find that pretty unsatisfying when you look at the magnitude of destruction that has come from this drug.

SIBILE MARCELLUS: And how much of Purdue Pharma's marketing tactics, which in the past they have admitted to being illegal, is prevalent today in prescription drugs that are marketed to Americans as they're watching their favorite TV shows?

PATRICK RADDEN KEEFE: Well, you know, I think there's a distinction there, which is that we watch TV and we see marketing aimed at us. A lot of what happened with Purdue Pharma was actually aimed at physicians, not necessarily at the consumer-- but at the doctor who people were trying to influence.

You talk to doctors-- I have doctor friends who say, I would never be influenced by a steak dinner. But there's a statistic in the book that some years, Purdue Pharma was spending $9 million a year just to buy food for doctors. And they were looking very closely at those numbers. They knew there was a very good return on investment for that kind of expenditure.

I think we've seen some of these really extreme cases. I mean, Insys is another company more recently that has gotten into a lot of trouble taking some of these types of practices, particularly when it comes to marketing to doctors and coopting doctors, to real extremes. Purdue ended up having to do away with its marketing force, basically. So they have cut it back to a point where they're not actively marketing those drugs at all at this point.

ALEXIS CHRISTOFOROUS: Patrick, over the past couple of years, we've seen a number of institutions, universities, and museums scrub the Sackler name off their buildings because we know that the Sacklers have given much, much money-- I guess it's billions over the years-- to different endeavors. Do you think we're going to see that trend continue? And then sort of, what do you think the legacy of the Sackler family will be after all this?

PATRICK RADDEN KEEFE: You know, it's interesting-- this is one of the stories I was trying to tell in the book is looking back quite a long way, and there's a moment at the height of the Great Depression, when Isaac Sackler, who's kind of the original patriarch of the family, takes his three sons and he says, listen, I've lost everything. I have nothing to give you.

The only thing I can give you is a good name. And he says, the most important thing a parent can give a child is a good name. And if you lose a fortune, you can always earn another one. But if you lose your good name, you'll never get it back.

And so you have this interesting story where for decades, the family put that name everywhere-- on art museums, on universities. And now you have this crazy situation in which they're kind of keeping the fortune. I mean, they're going to keep a great-- billions and billions of dollars. But I think they've lost the good name.

You've seen NYU recently took down the name, Tufts University, the Louvre in Paris. And I think we're probably going to see more institutions do that in the coming months and years.

ALEXIS CHRISTOFOROUS: Patrick, thank you so much for your in-depth reporting, and research, and for bringing this to the forefront. The name of the book, "Empire of Pain'-- Patrick Radden Keefe, thanks so much for your time today.