'PAIN KILLER' EXAMINES DRUG FAMILY'S EMPIRE

Though Not Gripping, A Solid Investigation

Kentuckians seeking fresh insight into the stunning growth and abuse
of the drug OxyContin will want to head right for chapter nine of New
York Times reporter Barry Meier's book, Pain Killer.

There, in 30 fast-turning pages, Meier at least partially fulfills his
publicists' promise of a "journey of discovery."

The chapter barely mentions OxyContin, its trail of addiction in
Appalachia or allegations of corporate profiteering that swirl around
the highly touted -- and vilified -- pain medication today. No need.
Hundreds of other pages do that.

Instead, here, deep in the book, is a remarkable peek into the
ultra-private, fabulously wealthy Sackler family who purchased an
obscure turn-of-the-century Manhattan tonic maker in 1952 and later
turned it into Purdue Pharma, which is now selling a $1 billion of
OxyContin a year.

Meier, a first-rate investigator, uses dusty court files, forgotten
federal hearings and the work of a 1960s magazine writer to portray
the business mind of the late Arthur Sackler, eldest of three brothers.

The Sackler family today is best known -- to the extent that it is
known at all -- for generous support of the arts. Galleries at the
Metropolitan Museum of Art in New York and the Smithsonian Institution
in Washington bear the name. The brothers, two still alive, were also
respected doctors and researchers.

But from the 1940s to his death in 1987, Arthur Sackler was much more.
The picture emerges of a brilliant man torn between medicine and
business. He ultimately chooses the business of medicine.

Sackler by the 1950s built a web of advertising and marketing firms
that catered to the drug industry. He also published ostensibly
independent journals that carried articles on his clients' drugs.

Along the way, Meier postulates, Sackler secretly helped an
arch-competitor create what is now one of the world's biggest drug
market-research firms.

Today IMS Health sells data to drug makers that allow sales
representatives to target doctors already heavily prescribing similar
pills. The use of such-data helped make Kentucky, with its
historically high pain-pill use, a hotbed of OxyContin sales.

"Simply put, Sackler was the godfather of the modern-day drug
advertising industry," Meier writes. Many of his techniques for
pharmaceutical promotion still thrive 50 years later.

Sackler in the 1960s marketed the tranquilizers Valium and Librium,
dubbed "Mother's Little Helper" by the Rolling Stones. "He helped
create a new chapter in American life -- the emergence of the pill as
a quick fix," Meier declares.

Not all of Sackler's tactics appear laudable. Meier relays allegations
of selective research, "planted" news stories and exaggerated claims
for various drugs. Plus, disdain for fussy regulators and nosy
journalists, and, above all, obsessive secrecy.

Finally, Meier mines records from a family battle after Sackler's
death to link him to a payoff scandal that had brought down a federal
Food and Drug Administration official in 1959.

Slowly, a disturbing business blueprint emerges. At that point, the
author deftly leaves his readers to ponder any similarities with the
charges of marketing hype leveled today against Purdue Pharma.

Not everything in Pain Killer is so rewarding. In what feels like a
forced effort, the author struggles to develop two "real life"
characters. They are:

. Lindsay Myers, a high school cheerleader and OxyContin addict from
Pennington Gap, Va. -- not far from Harlan, Ky., where she sometimes
goes to score pills. Myers darts in and out of many chapters, along
with her frantic mother, who lurches between denial and dismay. The
reader never gets to know her, but then really doesn't need to; her
story does little to answer the question: Why OxyContin?

. Art Van Zee, an idealistic 55-year-old physician who ventures into
Appalachia from Vanderbilt University in the mid-1970s and never
leaves. Van Zee is a more credible character, perhaps because his
lonely war against OxyContin is by now nationally known. If nothing
else, Van Zee and other graying liberals around him, including his
lawyer-activist wife, Sue Ella Kobak, serve as a reminder that social
advocacy didn't completely die with the '60s.

On the other hand, Pain Killer bulges with accounts of shrewd
planning, regulatory missteps, corporate stonewalling and actions by
the "pain movement" that fueled OxyContin's growth and frustrated its
opponents.

The book is also laced with references to Kentucky's place in the
history of pill abuse, ranging from drug experiments performed on
inmates at Lexington's federal prison between the 1930s and 1970s to
"Oxyfest," the huge 2001 statewide drug raid that set off OxyContin
alarms nationwide.

It even revisits the notorious Harlan "pill-mill" of the
now-imprisoned Dr. Ali Sawaf, who essentially filled OxyContin
"orders" from addicts on demand.

Meier also offers morsels of delicious imagery, such as Purdue
executives jetting to Appalachia from upscale suburban Connecticut to
face their rural adversaries over chicken and biscuits at a community
center or coffee at Kathy's Country Kitchen.

And why should one expect less? Meier is a hard-nosed journalist, not
a spinner of soft yarns. His book showcases his ability to ferret out
facts and present them in easily read language.

Nonetheless, Pain Killer just isn't the "gripping read" or
"crime-thriller, medical detective mystery and business exposZ" that
the book jacket claims.

And how ironic. For when asked to comment on the book, Robin Hogen,
Purdue's vice president for public affairs, had one big gripe: the
promotion was "very sensational, very hot" and, he said, inaccurate.

Book marketers, too, it appears, can overreach.

Meier

Charles Camp, Herald-Leader state government editor, has written about OxyContin and was
once a colleague of the author at another newspaper.