Empire Of Pain

A book that gives a lot of opportunity to look at addiction, bias, human greed, government ineffectiveness, anti semitism, ongoing results of the Holocaust, family loyalty/disloyalty, corporate vs private ownership, how lawyers make a lot of money, how business works, creation and destruction of narratives, and much else.

It is a good book for those with a generally critical and especially self critical mind. For those whose worldview aligns with the authors, it will be pretty much pure enjoyment, For those of use whose don't, there will be challenges and soul searching. 

I could somewhat tongue in cheek summarize the book message as.

• Never trust the FDA, (or any other government agency) of approval, disapproval, mandate, etc
• Beware of Jews working hard to become wealthy to create a good name, and show their ability to rise from the Holocaust. 
• If Jews are involved, the sins of the fathers should never be forgotten (unlike Germans, Kennedy's, etc) 
• Big time lawyers that defend Democrats are absolved. Clark Clifford is mentioned, a VERY influential lawyer that defended the Sacklers, but there is no hint as to HOW "influential".
• I believe everyone deserves legal representation, and bigger targets require stronger lawyer defence, and they understand they need to acquire it, and pay huge fees for it. 
• In the case of Trump, "guilty until proven innocent beyond a reasonable doubt" (vs innocent until proven guilty ...) , lawyers pay a high price for defending even a president that the weaponized "justice" department will do anything to convict of SOMETHING (even while he is in office). 

It is reasonably well written, but there is a lot of ink spent on the negative soap opera of the Sackler family that seemed excessive. It instantly brought to mind the Kennedy family for me. and my reading the "Dark Side of Camelot" a long time ago. That book made no attempt at "fairness" either, as many books of this ilk don't, The only way to get anything like a clear picture is if there are multiple books on the same family, company, event, person, etc We all have an agenda, even if we don't want to admit it, and there is always something in the "closet" that can be brought out, sensationalised, or in the case of of information against your agenda, buried. 

Another personal bias. As a Christian,  I'm very pro-Jewish because my Savior is a Jew. Besides that, I have worked with a number of Jews and without exception I have been impressed with their dedication, intellect, and character.  

As I read the book, I kept wondering how many times I REALLY needed to reminded that the Sackler family was Jewish. So the review I chose is from The Jewish Insider . I find it to be a good review, and even though there were others out there that cautioned of the "odor" of anti semitism, the fact that this one didn't, led me to thinking that was less of a factor than it seemed to me. 

I found this quote from that Insider review to be interesting. 

JI: Is the implication that the Sackler family is kind of like a modern American drug cartel?

Keefe: No, I mean, I think [that’s] kind of pushing it too far, and I wouldn’t go that far. I guess this is what I would say: I’ve always been interested in the ways in which illegal drug organizations resemble legal businesses, and I became very interested in some specific ways in which legal Big Pharma practices sometimes resemble those of drug cartels — for instance, offering free samples to an addictive product. In the case of Purdue, they offered these coupons for a free prescription, and that’s something I know because I’ve looked into it at great length. When the Sinaloa cartel decided that methamphetamine was going to be their big new product, they started sending free samples to Chicago so that people would try it. But I think sometimes people get a little carried away with the rhetoric and they try and draw too precise an analogy there. Let’s remember, nobody’s suggesting that the Sacklers, or Purdue, had roving gangs of armed assassins, right? I mean, I think this is a business that did break the law and engage in crime. They pled guilty again in 2020, just a few months ago. So there’s illegality there, but it’s of a different category than the Sinaloa cartel, and I wouldn’t want to suggest otherwise.

Notwithstanding the quoted denial, the comparison to Mexican Drug Cartels in the book, especially relative to some of those drug lords losing all their wealth, while the Sackler family kept much of theirs, was brought up a few times. "Free samples for doctors", as well as trips, dinners, etc are a staple of Big Pharma. The idea that it was "special" with the Sacklers is just specious. 

 The idea that they "got away with it" even though their name has been erased on many of their huge philanthropic donations seemed like a special sort of "not getting away with it". The book made clear that their good name was very important to them. While very few of us outside the elite even have heard of the name, it's destruction was a major goal of the book and the research behind it. 

The laser focus on the Sackler family relative to their supposed "cause" of America's drug crisis was strange, along with the strong denial that our declining culture was not causal. I'm sure Oxy contributed, but it was far from "causal". Causality is notoriously hard to prove. Did someone die OF Covid, or WITH Covid? An important distinction depending on what narrative you want to push. 

Up until reading this book, I didn't have much interest in the origin of Fentanyl, just that it is an extreme problem killing 100K Americans a year at this point, heavily connected with the open Southern border -- although there is a strong push to claim the open border makes no difference. 

 Fentanyl, Where did it all go wrong? Turns out the FDA approved Fentanyl as well ... and again, my bias is involved. My wife needed Fentanyl to control extreme pain from having her spinal column expanded and rods  put in to save her from being paralyzed from the neck down. Should the FDA not have approved it because it could be misused and cause addiction? As much as I believe the FDA to be a corrupt inefficient agency primarily concerned with enriching officials via the revolving door to the drug companies, my answers is no. Inefficiency and corruption in government, private and corporate greed, and people unable to resist addiction are often the price we pay to get helpful drugs. We should work to limit damage, but not at the cost of killing ot submitting people to tortuous pain to protect the addicts. 

I wonder what percentage of people realize that the Nobel Prize is funded by the fortune of Arthur Nobel, the inventor of dynamite? Certainly the number of people killed by TNT and it's derivatives makes the opioid crisis look like nothing in comparison.  

Here is a list of the top explosives manufacturers. Certainly, there are MANY positive uses for explosives, there are also a lot of people killed by bombs of all sorts. Are the explosive manufacturers responsible? Should those companies be hounded like the Sacklers? Should the Nobel Prize be renamed? I say no, but other than being Jewish, why the Sacklers? 

Page 407, "In recent years , some observers have begun to suggest that the opioid crisis was actually just a symptom of a deeper set of social and economic problems in the United States, that suicide and alcohol related deaths were also on the rise, and that all of these fatalities should be understood as part of a larger category of "deaths of despair". 

On page 230 we see: 

"It is a particular hallmark of the American economy that you can produce dangerous products and effectively off-load any legal liability for whatever destruction that product may cause by pointing to the individual responsibility of the consumer".  

The removal of individual responsibility seems more to be a direction of Western civilization than uniquely "American". Naturally the author specifically points out guns ... indirectly asserting that gun manufacturers ought to be sued when their products are used for murder. The removal of personal or government responsibility, and moving it to external sources seems a large part of the books agenda,  

The idea that "deaths of despair" is somehow "caused" by Oxy because there seems to be a statistical correlation is quite naive. Basic statistics teaches the maxim "correlation is NOT causation"! It MAY be a hint, but often a poor one. Increased Ice Cream sales have a positive correlation with drownings. Ice Cream is fortunately not guilty of causation (lese it be banned!!), it is the fact that more people swim and eat ice cream on warmer days that leads to the correlation. 

Can there be a free society without individual responsibility? Should car companies, both domestic and international be held responsible because they produced cars that can exceed 200 MPH? People bought them, and people died. Increasingly, the companies that produce products are the targets of lawsuits because "that is where the money is". We are increasingly beset by paying large sums for insurance against litigation already ... the US legal system is the most expensive in the world, and that is a big contributor to why our medical system is expensive. 

Another admission of personal bias here. Both my wife and I have benefited from Oxy. The original reason for it's invention and approval by the FDA is that it's patented coating allowed it to be released over hours, thus avoiding the initial "hit" that was (and still is) considered a significant risk for addiction. The abuse of Oxy started out as people figuring out that by crushing the pills, they could defeat the timed release mechanism and get the "heroin rush" back. 

My wife's surgeon was especially outraged by her unwillingness to take Oxy for her pain because of fear of addiction based on the idea that "oxy is addictive". It is, if abused, it isn't if used as directed.

Much of the rancor against the Sacklers was their constant attempt to separate the family from Oxy, and their general arrogance (at least as portrayed by the author). In arrogant rich families of all races, religions, national origins, etc that is not at all uncommon. 

The Kennedy family immediately comes to mind, only because of the level their wealth enabled them to influence America. Joe made lots of money in correctly predicting the explosion of liquor sales in the US after prohibition investing accordingly, lots of real estate deals, sometimes shady with Mob connections. He also dabbled in Fascism.  

Kennedy thought solely in terms of economics. Although he said he cared about the fate of Jews and persecuted minorities, in the end he thought they would have to be sacrificed for the greater good of the United States and its allies. Like Hitler, Kennedy believed in a Jewish cabal, which had thwarted him and that was intent on instigating incidents that would draw America into a disastrous war. “To defeat fascism,” Kennedy argued in a memorandum, the United States would “have to adopt totalitarian methods” and strike deals with dictators.

The danger of wealthy privileged families is well known. That Teddy Kennedy was privileged enough to get away with murder. and the name still really didn't suffer, galls me the most relative to the Kennedys.  Perhaps Teddy being denied the presidency was enough punishment in that case. 

For many, the US has become an "Empire of Pain", somewhat because we have become lazy about questioning narratives, and enjoying our own biases without admitting them, even to ourselves. My deep bias is that "Culture Matters", and in our case, especially being "One Nation Under God". We lost God, and we have largely "gone under" as Reagan warned us. Without God, everyone really dies a death of despair. 

Like all technology, drugs are a two edged sword, as are wealth, power, ethnicity. We need to always understand that everything man creates has a dark side.