In the mid-20th century psychiatrist Arthur Sackler had what would prove to be a revolutionary insight about pharmaceutical advertising: While other forms of medical science were making huge strides, the advertising of those drugs was stuck in the past, “even as the new drugs it promoted were changing the world” (28). That realization led Sackler to switch careers, and he soon led an advertising campaign for an antibiotic called Terramycin. In selling the drug Sackler emphasized direct contact with doctors, including advertising in medical journals, postcards, and visits from salesmen; this revolutionary approach made the drug incredibly successful. Sackler’s strategy became relevant to this story when applied to Valium, a tranquilizer that was pitched as a panacea for stress, regardless of the root causes of that stress—much as OxyContin was later advertised for pain treatment, decades later, by the company Sackler founded: Purdue Pharma.

Throughout the book Quinones details how Purdue refined and expanded Sackler’s pioneering approach, which helped Purdue overcome a longstanding mistrust of opiates and made OxyContin into a runaway success. In the 1980s the concept of pain was changing; doctors came to see patients as having a right to be free from pain, and the makers of drugs like OxyContin benefitted hugely from this shift.