It’s no secret that OxyContin was a primary cause of the opioid crisis that has cost countless lives and an estimated $2 trillion in the United States.

This deeply researched book tells a more complete story, digging into the family whose reckless pursuit of wealth from the laboratory through doctors’ offices to users who needed to alleviate pain and ended up in the grip of a far more powerful force.

As author Patrick Radden Keefe sums it up in “Empire of Pain,” three generations of the Sackler family tried to whitewash their involvement in the crisis and keep it separate from the philanthropy that plastered their name on museums, educational institutions and other high-profile sites worldwide.

Despite their mixture of ostentatious philanthropy and secretive family finance, Keefe says, they ended up losing both credibility and the cachet they sought among the superrich:

“… unlike a lot of human beings, they didn’t seem to learn from what they saw transpiring in the world around them. They could produce a rehearsed simulacrum of human empathy, but they seemed incapable of comprehending their own role in the story, and impervious to any genuine moral epiphany. They resented being cast as the villains in a drama, but it was their own stunted, stubborn blindness that made them so well suited to the role.”

The story begins with brothers Arthur, Mortimer and Raymond Sackler, who all earned medical degrees. As they moved from treating patients to purveying pills, their concentration on business far surpassed any attention to their offspring. When a young daughter pleaded with Arthur, “Play with me, Daddy,” his response was telling.

“I’m going to wait until you’re an adult. Then I’ll have a conversation with you.”

That single-minded devotion to business led to huge success, first with tranquilizers like Valium, then with the realization that doctors were looking for a non-narcotic way to ease people’s pain. The result was megadrug OxyContin — a version of the pain reliever oxycodone designed to release its relief over time.

Along the way, the Sacklers devised new strategies for getting drugs into the bodies of patients, with their company Purdue Pharma, deploying armies of aggressive sales reps to doctors’ offices nationwide. Their mantra was that OxyContin was the drug “to start with and to stay with.”

But as with many tales of scientific overreach, a sad reckoning occurred. OxyContin was far from the safe drug that Purdue claimed, and users soon discovered how the pills could provide not just gradual, time-released relief as advertised. Instead, OxyContin could lead to instant highs, and the more that patients used, the higher doses of the drug they needed. Soon, many needed to turn to heroin and other narcotics to get their fix.

When the epidemic ensued, Purdue tried unsuccessfully to deflect blame, saying the problem was not with the drug but with those who abused it. And as the negative consequences of OxyContin grew, the hospitals, universities, museums and other institutions that had benefitted from the family’s generosity grew wary of the family connection, and the Sackler name began to disappear from many of the institutions that once sought their support.

The controversy even reached that modern measure of public scorn, late-night television, where Stephen Colbert said the family had a revised version of the Hippocratic Oath: “First, do no harm. Unless harming is incredibly profitable.”

The Sacklers’ story is a long, many-faceted one, but Keefe does a good job in helping to keep things straight. A family tree shows how the generations grew; the book is divided into three sections – Patriarch, Dynasty and Legacy; and chapter titles like “Penicillin for the Blues,” “Sell, Sell, Sell” and “The Pablo Escobar of the New Millennium” trace how Purdue spurred the use and misuse of opioids.

In the end, the family ignored a lesson that Keefe says the patriarch, Isaac Sackler, always tried to stress. Though he couldn’t leave them much of a financial inheritance, Keefe says he left them a credo more valuable that needed protection at all costs:

“If you lose a fortune, you can always earn another, he pointed out. But if you lose your good name, you can never get it back.”

Patrick Radden Keefe, author of ‘Empire of Pain’

Part of the St. Louis Jewish Book Festival

WHEN: 7 p.m. on Thursday, Nov. 11

WHERE: The J’s Staenberg Family Complex (gymnasium), 2 Millstone Campus Drive

HOW MUCH: $25 or included with a festival pass

MORE INFO: Visit stljewishbookfestival.org or call 314-442-3299

COVID-19 PROTOCOLS:: The festival will require proof of vaccination or a negative COVID-19 test result within 48 hours entry. Vaccination card or photo accepted, plus photo ID. Masks required at in-person events