This book follows three generations of the Sackler family as they make their fortune, spread their wealth around via conspicuous philanthropy, and then find themselves defending their name from the fallout of their actions. Keefe creates in-depth profiles of each of the Sacklers, using their own words as well as firsthand accounts from their friends, associates, and employees, to trace their evolution as people as well as pharmaceutical advertisers. The writing is compelling and increasingly enraging, especially as the account moves into the OxyContin years; with an avalanche of damning facts, the book lays bare the Sacklers’ singleminded pursuit of profit even as their culpability in the nation’s opioid crisis becomes impossible to ignore.