Nan Goldin lights a cigarette and takes a puff. “My dealer came here 24 hours a day, seven days a week. I was one of his best customers.” She giggles sarcastically. “He texted me when I was in rehab saying he was having a sale.” He had dropped his prices in the hope of luring her back. She has since deleted his number from her phone and has been out of rehab and drug-free for 10 months.
“I almost didn’t leave this house for three years,” she says. Goldin looks around the living room in her elegant Brooklyn apartment, paintings and photographs dotted around the walls, though none of her own, and Larry the stuffed coyote fixed in a permanent howl by the window.
Her most recent drug experience was very different to the old days, when she became one of the world’s most famous art photographers, capturing herself and those around her getting high, having sex and hanging out in downtrodden homes in the 70s and 80s.
This second experience began with a doctor in Berlin, where she has a second home. In 2014, Goldin was prescribed the potent narcotic OxyContin for painful tendonitis in her left wrist. She promptly became addicted, despite taking the pills exactly as prescribed.
“The first time I got a ‘scrip it was 40 milligrams and it was too strong for me; they made me nauseated and dulled. By the end, I was on 450mg a day,” she says. Eventually she was crushing and snorting them. When, back in New York, doctors refused to supply her any more, she turned to the black market, and to cheaper hard street drugs whenever she ran out of money.
Emerging from a rehab facility in Massachusetts last March, she began reading about OxyContin and realised the branded medicine was prime suspect in the opioid crisis that has ripped through the US over the past 20 years. The epidemic has killed more than 200,000 people so far. Now she is declaring war against members of the secretive US family behind the invention of OxyContin, and behind the ingenious marketing strategy that was used to convince doctors it was harmless and patients that they needed it.
“I don’t know how they live with themselves,” she says. Synthetic opioids mimic the effects of natural opioid drugs (which include opium and heroin), and their use, on prescription, is spreading in the UK and beyond, causing alarm among health experts. (The makers of OxyContin have subsidiary firms in Europe, Asia and Latin America.)
The name Sackler may ring a bell if you’ve walked across the new forecourt at the Victoria & Albert Museum in London, or noticed the arrival of the Sackler Gallery at the Serpentine in 2013. Or if you’ve visited the ancient Egyptian Temple of Dendur in the Sackler Wing of the Metropolitan Museum in New York, seen the Sackler Centre for Arts Education at the Guggenheim or a host of other arts institutions around the world with galleries or wings named after the family.
With charitable foundations on both sides of the Atlantic, the Sacklers, who are based in New York, have donated millions to the arts and sponsored faculties at Yale and many other universities. In each case, the family’s name is displayed prominently as the benefactor. Forbes listed the collective estimated worth of the 20 core family members at $14bn (£10bn) in 2015, partly derived from $35bn in sales revenue from OxyContin between 1995 and 2015.
But few know their wealth comes from Purdue Pharma, a private Connecticut company the family developed and wholly owns. In 1995, the company revolutionised the prescription painkiller market with the invention of OxyContin, a drug that is a legal, concentrated, chemical version of morphine or heroin. It was designed to be safe; when it first came to market, its slow-release formula was unique. After winning government approval it was hailed as a medical breakthrough, which Goldin now refers to as “magical thinking”.
It was aggressively marketed to doctors – many of whom were taken on lavish junkets, given misleading information and paid to give talks on the drug – while patients were wrongly told the pills were a reliable long-term solution to chronic pain, and in some cases offered coupons for a month’s free sample.
Goldin, 64, is incensed that no one in the Sackler family is being held to account. She has created a campaign to try to shame the family into paying for rehab and overdose antidotes instead of patios in art museums. “I’m not asking the museums to give the money back,” she says, “but I don’t want them to take any more from the Sacklers, and I want them to put out statements in solidarity with my campaign.”
A group of friends and activists have been meeting weekly in her apartment in a Brooklyn brownstone, brainstorming ideas for a forthcoming direct-action campaign. She first publicly revealed that she was recovering from opioid addiction last autumn, when she gave a talk in Brazil; then, in December, she wrote about it for the US periodical Artforum, saying of the Sacklers: “To get their ear we will target their philanthropy. They have washed their blood money through the halls of museums and universities around the world.”
In a New Yorker exposé of the family ties last year, Allen Frances, the former chair of psychiatry at Duke University school of medicine, told the magazine: “Their name has been pushed forward as the epitome of good works and of the fruits of the capitalist system. But, when it comes down to it, they’ve earned this fortune at the expense of millions of people who are addicted. It’s shocking how they have gotten away with it.”
Goldin is now hurrying through a modern activist learning curve. “First I wanted to go out with signs and picket a Sackler wing of something, because that’s what we did in the Vietnam war and that’s what we did with Act Up in the Aids crisis,” she says. But she recently discovered social media – “I went on Instagram for the first time three weeks ago,” she says – and realised that petitions are online these days, so has set about organising one, which will be presented in due course to those Sackler family members on Purdue Pharma’s board of directors. She is also now on Twitter, so there is a hashtag campaign, #ShameOnSackler, while her campaign overall is called Prescription Addiction Intervention Now (Pain).
Goldin believes that – aside from the prestige of supporting high culture, rather than addressing the stigma of addiction – the family isn’t directing philanthropy to recovery and prevention because it would be tantamount to accepting culpability.
Three Purdue Pharma executives pleaded guilty in 2007 to federal criminal charges that they misled regulators, doctors and patients about OxyContin’s risk of addiction and its potential to be abused. The company settled for a record $600m. But no members of the Sackler family were charged or mentioned.
In 2010, after the showdown with regulators and many civil lawsuit settlements – and with the original patent on OxyContin due to expire – Purdue tweaked its product to make it harder to snort and was more explicit in its marketing about the risks of addiction.
There are rival drugs on the market, but OxyContin is widely considered to be ground zero in the US opioid epidemic. The federal agency, the Centers for Disease Control and Prevention, reported in 2017 that 91 people are dying every day in the US from drug overdoses, 60% of which involve opioids. Deaths from prescription opioids have quadrupled since 1999.
In the past five years, as prescriptions for opioids fell in response to the crisis, Americans didn’t shake the habit or seek rehab; they turned to heroin instead. Four out of five people in the US who try heroin today started with prescription painkillers, according to the American Society of Addiction Medicine. Then street heroin started being secretly cut with the dangerous synthetic opioid fentanyl.
An overdose of fentanyl killed Prince in 2016, but last year medical documents showed that he had first become dependent on prescription opioids – they mentioned oxycodone, the generic version and main active ingredient of the branded pill OxyContin. The family of Tom Petty revealed at the weekend that the singer’s death last October was caused by an accidental overdose with a cocktail of prescription drugs and pain pills, including oxycodone and fentanyl.
“People are dropping like flies. I overdosed on fentanyl, but survived,” Goldin says. She eventually sought help from a doctor she knew from the first time she got clean from hard drugs, in 1989. Before going into rehab this time, she detoxed at home. As she notes, there are many different types of rehab, and the care and therapy you receive after detoxing from the actual substance is just as important.
“They look at the person’s underlying problems,” says Goldin. Potent opioids created a generation of addicts, with mass overprescribing in the US healthcare system. But many old-school street-drug addicts, as Goldin once was, turned to drugs originally as an escape from childhood trauma, loneliness, depression or poverty. She speaks of the doctors and therapists who helped her overcome her addiction as “kind”.
In rehab last year, she also had to shake a long-term dependence on benzodiazepines – one of the most well-known brand names for such sedatives is Valium. The company that became Purdue Pharma was started in 1892, but then expanded by three brothers, Arthur, Mortimer and Raymond Sackler, in the 1950s. All three are dead now. Arthur died in 1987, before OxyContin was invented, but he had once been responsible for brilliant advertising and marketing campaigns for drugs owned by other companies – most notably Valium – that focused on selling doctors and the public on using such “wonder” drugs for an inordinate variety of ailments.
Goldin herself “was put on Valium when I was 19 because I was ‘anxious’”, she says. “That’s how widely it was prescribed.”
After Goldin’s article in Art Forum, Arthur’s daughter, Elizabeth Sackler, wrote a letter to the periodical, which will go online on 1 February, noting that her father’s one-third stake in Purdue was sold by his estate to his brothers shortly after his death and that neither she nor her children have “benefited in any way” from it, or from the sale of OxyContin. She calls Purdue Pharma’s role in the opioid crisis “morally abhorrent”.
But although Goldin admires the Elizabeth A Sackler Center for Feminist Art at the Brooklyn Museum, she notes that it was the marketing prowess of Elizabeth’s father, in his approach to Valium, that provided a model for Purdue’s pushing of OxyContin. “She’s not off the hook,” says Goldin.
The 10 months since she left rehab have been hard. “But I can’t go back [on drugs], I’ll die. I’m staying clean for my doctor, for myself, for activism and the sake of other addicts. I feel that in my soul, it would be devastating if I relapsed. When I first went to treatment in 1989, I was motivated by the fact that Lou Reed and Dennis Hopper had gotten clean.”
As a former drug abuser, Goldin in particular should not have been prescribed OxyContin as she was in a known high-risk group. “The brain remembers,” she says.
Her campaign is “a call to arms, to fans of Prince, fans of mine, directors of art museums, doctors, anyone who has lost someone to opioids or knows someone who is struggling, which includes most people in America now, musicians and artists, a call for solidarity.”
Goldin has not been taking many pictures recently, although she took some self-portraits while she was addicted to OxyContin, and some pictures of her drug gear. She has been drawing and painting, and in a small room next to the living room is a self-portrait, with her distinctive auburn curly hair and flinty look, but with the mouth sewn shut. “I painted that over the new year, it was how I felt at the time. I was lonely,” she says. She is looking forward to making a documentary on the opioid crisis. The project is in its earliest stages, but she says she got into photography originally, as a teen, because she wanted to make films. The closest she got at her creative peak was her many slideshows, most famously The Ballad of Sexual Dependency.
She is also known for photo-graphing the drag queens she lived with for three years in the 70s. “They were so vivid, so beautiful, so funny. The humour ran riot. I think humour is one of life’s survival mechanisms; it was another level and I was in love with them, and I didn’t analyse, I was just living,” she says. And snapping. She has always said that her camera was merely an extension of her arm, although the undeniable craft in her framing, and the raw intensity, elevates it from documentary to art.
She captured such intimacy – sometimes awful intimacy – around the sex, the highs, rows, domestic violence and half-naked hanging out that was a way of life for her and her friends, many of whom she has now outlived by decades. But she points out that she would show her subjects their pictures and they could ask her not to publish them if they didn’t like them. “Integrity, integrity, integrity,” she says. That word brings her back to the opioid crisis.
“Purdue Pharma has no integrity, it’s the opposite, the evil manipulation of vulnerable people. It’s disgusting,” she says.
Goldin lights another cigarette and takes a swig of ginger ale. Her oil painting may have its mouth sewn shut, but the flesh and blood Nan Goldin will be heard.
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