The Sacklers are one of the richest families in the world, known for their lavish donations to the arts and the sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing a blockbuster painkiller that was the catalyst for the opioid crisis. Keefe begins with the three doctor brothers, Raymond, Mortimer and Arthur, who weathered the poverty of the Great Depression and appalling anti-Semitism. Working at a barbaric mental institution, Arthur conducted groundbreaking research into drug treatments, devised the marketing for Valium, and built the first great Sackler fortune. Forty years later the template he created to sell Valium was employed to launch a far more potent product: OxyContin.