76 pages 2 hours read

Patrick Radden Keefe

Empire of Pain: The Secret History of the Sackler Dynasty

Nonfiction | Biography | Adult | Published in 2021

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Book 2, Chapters 14-16

Chapter Summaries & Analyses

Book 2, “Dynasty”

Book 2, Chapter 14 Summary: “The Ticking Clock”

Patents are a key source of profits for most pharmaceutical companies. The US patent system guarantees drug companies exclusive sales and production rights for a limited period—an exclusivity window that incentivizes profiting as much as possible quickly from a new product. After patents expire, generic versions of the same drug can replace them. Arthur Sackler so resented this practice he published articles about generics being more dangerous in his newspaper, the Medical Tribune.

The development of MS Contin, and Richard Sackler’s new interest in pain medicine, coincided with changes in the medical profession more generally: Doctors no longer saw “pain merely as a symptom of underlying condition and not as an affliction which merited serious clinical attention itself” (175). In 1984, to counter old anxieties about morphine’s addictive properties, Purdue organized and financed a conference, continuing Arthur Sackler’s habit of close and ethically dubious connection between medicine and pharmaceutical companies. The conference was a “carefully orchestrated exercise in validation” (177); it featured doctor speakers who insisted morphine should be the new standard for chronic pain treatment.

By 1990, Richard and his scientists at Purdue were on a quest for new opioid patents. Mortimer’s daughter Kathe would “later

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