Names were important to Arthur from the beginning -- historical legacies: political leaders, artists, and cultural giants. As Keefe puts it, Erasmus pushed its own prescriptions:
This country was theirs for the taking, and in the span of a single lifetime true greatness could be achieved. They spent their days at Erasmus surrounded by traces of great men who had come before, images and names, legacies etched in stone.
This outlook would deeply influence the Sackler philanthropic purpose over the decades, as they gave generously to cultural and scientific institutions -- the one stipulation being that the Sackler name was prominently displayed as the benefactor. It's probably no stretch to assert that such achievable 'greatness' is the common thread that runs through the American patrician aristocracy.
Long before Purdue Pharma became the scourge of an industry that has heaps of ethical questions to answer for, with the introduction of their 'magical' reconfiguration of morphine that dramatically enhanced its potency in the form of Oxycontin, the Sackler family began its dynastic rise with the introduction of other manufacturer's 'miracle' drugs. Arthur, through his McAdams ad agency, helped Pfizer come up with a big hit in antibiotics, specifically the Sigmamycin, which was touted as,
the antibiotic formulation with the greatest potential value and the least probable risk . . . highly effective-clinically proved new, multispectrum synergistically strengthened Sigmamycin particularly for the 90% of the patient population treated in home or office where sensitivity testing may not be practical.
But John Lear, senior editor of The Saturday Review, called out their claims in a 1959 piece, "Taking the Miracle Out of Miracle Drugs." The Sackler fraud is clear from the beginning, as doctor testimonials included in the package are revealed to be fake. Even Ralph Nader's Public Citizen's Health Research Group found the ads hyperbolic. However, Lear and Nader do place Sackler's dishonesty in the context of an industry-wide problem.
Keefe sees this deception as the beginning of the pattern that the Sackler brothers will establish to sell their drugs in the future in an industry rife with charlatans. Former presidential candidate and crime crusader Senator Estes Kefauver from Tennessee, a kind of forerunner to Frank Church, convened U.S. Senate Antitrust and Monopoly Subcommittee hearings to look into growing public complaints about muscle practices and phony claims:
The initial purpose of the hearings had been to focus on monopolistic pricing in the pharma industry. But once Kefauver and his staff started calling witnesses and asking them questions, the inquiry reoriented to the more profound and widespread problems of deceptive drug marketing.
The Sacklers, themselves an insulated mystery to investigators, proved to be pioneers of such deception.
Later, Arthur, Mortimer and Raymond worked together at Creedmoor Hospital, a state psychiatric facility in Queens, where, Keefe writes, "Visitors would see patients roaming the grounds, confined in white straitjackets, like a vision from an etching by Goya." There, the brothers introduced innovations in psychiatric care, including the use of histamines that allowed some patients to leave the institution -- in some cases, for the first time in years.
But the most important work that came from their time at Creedmoor, and which had the greatest transformative development in their careers was the introduction of 'miracle' drugs, arguably just as important to today's current pharmaceutical psychiatry as Oxycontin became for pain-killing, that the Sackler doctors administered at the hospital -- Thorazine, Librium, and, later, Valium. Keefe writes that Thorazine "was precisely the sort of antipsychotic silver bullet that the brothers had envisaged." And, he adds, "Arthur didn't handle the advertising for the drug, but he might have: Smith, Kline's slogan was that Thorazine keeps "patients out of mental hospitals." The argument goes that Thorazine helped lead to deinstitutionalization.
When drug manufacturer Roche came out with the tranquilizer Librium ("a portmanteau of "liberation" and "equilibrium"), they called on Arthur Sackler to work his magic with ads. Ka-chong lights lit up. Writes Keefe,
When Roche conducted clinical trials on Librium, the company enthusiastically concluded that the drug could treat an astonishing range of afflictions. Anxiety. Depression. Phobias. Obsessive thoughts. Even alcoholism. With each new "indication," the potential market for the drug expanded.
This 'miracle' expansion, which sounded so much like the quack offerings of frontier medicine men selling from wagons, deeply influenced the brothers Sackler's later marketing of Oxycontin, pushed as another all-purpose 'miracle' drug. In addition, Keefe notes, "Before he agreed to promote Librium and Valium, he had struck a deal with Roche in which he would receive an escalating series of bonuses in proportion with the volume of drugs sold." Sackler would later reward their own salespeople with "unlimited" bonuses based on sales.
Roche was so impressed by Arthur's advertizing prowess that they put him in charge of pushing Valium, another tranquilizer that Roche saw as an improvement over Librium. The problem was that Librium was "doing gangbusters business" and Roche had to figure out how they would introduce Valium without affecting the sales of Librium. No worries. As Keefe details,
What Arthur's team at McAdams had to do was convince the world-both doctors and patients-that actually the drugs were different. The way to do this was to pitch them for different ailments. If Librium was the cure for "anxiety," Valium should be prescribed for "psychic tension." If Librium could help alcoholics stay off the bottle, then Valium could prevent muscle spasms.
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