📖 Empire of Pain

“The opioid crisis is, among other things, a parable about the awesome capability of private industry to subvert public institutions.”

Patrick Radden Keefe, Empire of Pain


This reads like a thriller. The focus on the Sacklers humans involved make it very readable, and among others, the points made that stick out to me are: (1) the playbook for Librium in the 1960s – claiming that withdrawal is not a sign of dependence but intensification of the underlying condition, thus justifying a higher dose of Librium; abuse comes from using the drug in non-intended ways: blame the user, not the drug – was used for Oxycontin decades later. And it worked for the Sacklers again, for decades. (2) the timeline. Oxycontin came into the market in the early 90s, and it was only in 2018 that the more serious repercussions came in when the Massachusetts AG decided to personally name the Sacklers as defendants. The multi-district litigation eventually culminated in the Sacklers stepping down, and a settlement sum in 2021 from Purdue Pharma that exceeded $4b. But, and there is a but, Purdue Pharma had already pled guilty in 2008 for lesser offences (pertaining to how they marketed the drug) and yet, it continued to sell the drug and in the 2010s also entered various other markets.

The number of years this went on for is quite staggering. But investigation and litigation can take time, especially if a litigant manages to get a court order for documents to be sealed/ destroyed upon the resolution of a case. Richard Sackler’s deposition in a settled case was somehow unearthed, and reading a transcript may have less impact. Transcripts cannot convey tone or facial expressions. I was very amused to learn that John Oliver hired actors to play Sackler and read out the transcript.

Some notes from the UK 🇬🇧✈️

  • For some reason, London looks better than we remember it. After some thought, it seems that this is because of (a) better design seen overall e.g. in signages, billboards and in how things work, e.g. transport, supermarkets; and (b) improved cleanliness.
  • Rental bikes come with phone mounts. That is such a kind thing to do for the consumer. [Our country’s rental bikes are not similarly equipped.]
  • We loved that we could be cashless almost all the way on our trip. This streak was broken briefly at Dover Cliffs, where we used cash to pay for the cab ride from the station to the cliffs.
  • Tips can be left by paywave – the shopkeepers rig up a machine on the wall on your way out. Tap to tip.
  • Express travel card on iOS is awesome – I just waved my iPhone for bus and train rides. No need to unlock phone or activate payment page. (For some reason, it didn’t work on my Apple watch. Mobile data sharing also doesn’t work overseas so I could not have used AW without my phone.)
  • The Avanti trains are terribly ventilated. The air was still, and the trains too wobbly. Only on English trains do we suffer travel sickness. Had to go to Boots to get Kwells. We missed the Japanese shinkansen – clean; comfortable; truly fast. (The trains run by other rail providers e.g. ThamesLink aren’t as bad in terms of ventilation.)
  • No. 10 Downing Street is referred to as “No 10” or “No10” in some papers. Very distracting.
  • We watched Single’s Inferno on our Netflix account via a Chromecast that the hotel TV came with.
  • That was a break from my reading material – Crying in H Mart; The Rise and Fall of the Third Reich; Lord of The Rings. [I seem to have become a person who reads several books at once.]
  • Managed to eat gelato in winter: 1) honeycomb; 2) honey & Japanese miso in Cambridge. It was 3°C and windy.
  • We received updates from the pet hotel at 7 or 8 am every morning. It’s nice to wake up to photos and videos of our cat.
  • The Collinson Assistance test clinic at St Pancras gave us our ART results in half an hour.