Arthur Sackler begins a psychiatric residency at Creedmoor hospital, seeking humane alternatives to lobotomy and electroshock therapy.

Arthur joins the McAdams advertising agency and launches Pfizer's Terramycin campaign, revolutionizing the field of medical advertising.

Raymond and Mortimer Sackler are fired from Creedmoor amid Red Scare investigations, and Arthur buys Purdue Frederick for them to run.

Arthur Sackler secretly markets Librium and then Valium for Roche, making Valium the first $100 million drug in history.

Senator Estes Kefauver investigates pharmaceutical industry corruption and forces FDA antibiotics chief Henry Welch to resign.

Purdue launches MS Contin in the United States, generating roughly $170 million per year and proving opioids could be a mass-market product.

Arthur Sackler dies unexpectedly in a hospital, having kept his illness secret from everyone in his family except his third wife Jillian.

Arthur's heirs sell their one-third stake in Purdue Frederick to Raymond and Mortimer for $22 million, a transaction that proves spectacularly shortsighted.

OxyContin officially launches with FDA-approved labeling claiming the drug's slow-release formula reduced its potential for abuse.

Barry Meier publishes the first major New York Times investigation into OxyContin addiction and the overdose deaths linked to the drug.

Three Purdue executives plead guilty to federal misbranding charges in Virginia, shielding the Sackler family from prosecution.

Purdue releases a tamperproof version of OxyContin that cannot be crushed, inadvertently driving dependent users toward heroin.

Patrick Radden Keefe publishes a New Yorker article directly connecting Arthur Sackler's advertising legacy to the OxyContin crisis.

Massachusetts Attorney General Maura Healey names eight individual Sackler family members as defendants in her opioid lawsuit.

Purdue's bankruptcy is formalized, shielding the Sacklers from personal civil liability while their reputation as philanthropists is permanently destroyed.

Empire of Pain opens with the Sackler family's immigrant roots and Arthur Sackler's rise as a pioneering medical advertiser who helped make tranquilizers like Valium into blockbuster drugs. After government investigators probe his ties to the FDA, Arthur's brothers Raymond and Mortimer take over Purdue Frederick and develop MS Contin, the company's first profitable opioid. The next generation, led by Richard Sackler, launches OxyContin in 1996 with FDA-approved labeling that downplays addiction risk, fueling an aggressive national sales campaign. As overdoses multiply and journalists investigate, Purdue uses legal and political connections to suppress consequences, eventually allowing executives to plead guilty while the family escapes prosecution. In the book's final act, an activist movement and multistate litigation expose the family's culpability, but a bankruptcy maneuver shields their personal fortune even as their philanthropic reputation collapses permanently.

The Sackler dynasty from immigrant origins to the opioid reckoning.

Arthur Sackler begins secretly courting fellow doctor Marietta Lutze at Creedmoor while still married with two children.

Marietta Lutze becomes pregnant, forcing Arthur to marry her and acknowledge his second family against his mother's wishes.

Arthur Sackler begins purchasing Chinese antiques and builds an all-consuming art collection that fills his Long Island home.

Arthur donates $3.5 million to bring the Temple of Dendur to the Metropolitan Museum of Art in exchange for extensive naming rights.

Business associate Bill Frolich dies, triggering a dispute over IMS company profits that permanently sours the Sackler brothers' relationship.

Bobby Sackler dies after falling from a window amid struggles with addiction and mental illness; the family never speaks of it publicly again.

Mortimer Sackler's British subsidiary Napp Pharmaceuticals develops MS Contin, a slow-release morphine pill for cancer pain patients.

Arthur endows the Sackler Museum at Harvard and later secures his name on a new Smithsonian building in Washington, DC.

Kathe Sackler proposes using oxycodone with a slow-release mechanism, the foundational concept behind what becomes OxyContin.

Purdue produces a promotional video called 'I Got My Life Back,' featuring patients who credit OxyContin with restoring their quality of life.

Howard Udell instructs staff to minimize written documentation of OxyContin misuse, while his own legal secretary secretly develops an addiction to the drug.

Purdue exploits the Jayson Blair scandal at the New York Times to pressure the paper's public editor into removing Barry Meier from the OxyContin story.

Richard Sackler is deposed in Kentucky's opioid lawsuit and steadfastly defends Purdue's sales tactics without expressing any regret.

Nan Goldin leads a protest inside the Metropolitan Museum of Art's Sackler Wing, dropping OxyContin bottles into the reflecting pool.

The Guggenheim Museum and Tate Modern publicly decline future Sackler funding and cut their institutional ties with the family.

Beneath the headline story of Purdue and OxyContin lies a rich family drama spanning three generations of Sacklers. Arthur's secret double life, his obsessive art collecting, and his lavish philanthropic donations to the Metropolitan Museum of Art and Harvard established a family template of ambition, secrecy, and image management. Internal disputes over a business colleague's estate and the death of a family member from addiction went deliberately unacknowledged, while the next generation developed the concept that became OxyContin and used promotional films to shape public opinion. As public scrutiny mounted, Purdue used media manipulation and aggressive legal tactics to suppress damaging journalism. Finally, artist Nan Goldin transformed personal tragedy into public protest, and her demonstrations at major cultural institutions forced those venues to sever their ties with the Sackler name.

Personal scandals, family fractures, and the cultural campaign against the Sackler name.

Arthur Sackler secretly holds a controlling stake in the Frolich advertising agency, his ostensible rival, concealing a profound conflict of interest.

Arthur Sackler testifies before Senator Kefauver's committee in grandiose terms, successfully preventing the senator from revealing his financial ties to FDA official Henry Welch.

Roche ignores a doctor's published findings on Valium's addictive properties and only agrees to classify the drug as a controlled substance after its patent expires.

Raymond and Mortimer deliberately structure overseas business holdings to legally exclude Arthur from sharing IMS company profits.

Marietta Lutze takes an overdose of sleeping pills in Arthur's office, forcing him to finally agree to grant her a divorce.

Purdue sells MS Contin before receiving full FDA approval and avoids all penalties by appealing directly to the Reagan administration.

FDA official Curtis Wright helps Richard Sackler craft OxyContin's labeling claiming reduced abuse liability, then leaves government to take a job at Purdue.

An explosion at the Napp chemical plant in New Jersey kills four workers; Raymond Sackler denies feeling any personal responsibility for the deaths.

Internal Purdue sales force reports from the late 1990s prove that company leadership knew about OxyContin's addiction risks years before publicly admitting it.

Virginia federal prosecutors build a criminal case against Purdue but face Justice Department pressure that reduces the charges to a single minor offense.

The Sackler family secretly pays millions to the three convicted Purdue executives who pleaded guilty, rewarding them for not testifying against the family.

Nan Goldin nearly dies from a heroin overdose after developing a dependence on OxyContin prescribed for a wrist injury.

Economists studying Purdue's marketing documents discover that states with stricter opioid prescription requirements had dramatically lower overdose death rates.

New York Attorney General Letitia James unearths over a billion dollars in offshore Sackler accounts, exposing the family's strategy of sheltering personal wealth abroad.

Bankruptcy judge Robert Drain bars all future civil litigation against the Sackler family, ruling in their favor on narrow legal grounds despite widespread public outrage.

Empire of Pain is structured around a series of revelations that expose the gap between the Sacklers' public image and private conduct. From Arthur's concealed ownership of a rival advertising agency to his blocked Senate testimony about FDA corruption, the family's early history is defined by secrets that enabled profit at the expense of accountability. The same pattern repeats with OxyContin: internal documents prove the company knew about addiction risks years before admitting it, a friendly FDA official helped craft misleading labeling and then took a job at Purdue, and Justice Department pressure quietly gutted the most serious federal prosecution. The family paid executives to protect them, moved billions offshore to avoid taxes, and used bankruptcy law to escape civil liability. Only the combined force of activist protest, investigative journalism, and tenacious state attorneys general created any form of public reckoning.

Hidden conflicts, buried truths, and the decisions that sealed the Sacklers' fate.