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Part 1: Liberace in Appalachia
Themes
Key
LitCharts assigns a color and icon to each theme in Dreamland, which you can use to track the themes throughout the work.
Pain Management and the Normalization of Narcotics
The Drug Business
Stigma, Shame, and the Opiate Epidemic
Community as a Remedy to Addiction
Summary
Analysis
In New York City in 1951, Arthur Sackler, an adman, meets with Charles Pfizer and Company. Sackler is 39 and a former psychiatrist. Years before, when he finished medical school, Sackler witnessed the medical world undergo huge ideological and technological shifts after WWII, most prominently regarding the emergence of vaccines and antibiotics. In the midst of such huge advancements, Sackler found the medical advertising sector to be lacking. He switched career paths in the 1940s and was hired as an adman at William Douglas McAdams.
Sackler turned to a career in pharmaceutical advertising because he recognized an opportunity to capitalize on the emerging innovations of the medical world, just like the Xalisco Boys recognized an opportunity to capitalize on the growing population of opiate abusers in the mid-1990s.
Themes
Sackler soon takes on Charles Pfizer and Company as a client. The company has recently founded a pharmaceutical research department, which developed a synthetic antibiotic called Terramycin. In a departure from industry norms, Pfizer wants to sell the antibiotic itself rather than indirectly through a drug company. Sackler believes he can create an ad campaign that will make Pfizer a name that doctors will recognize. Pfizer gives Sackler the largest budget for a drug advertising campaign in history, and Sackler creates a campaign based on “frequent contact with individual doctors,” sending salesmen to sell the drug in person at doctors’ offices. Sackler’s campaign is successful: in 1952, there are $45 million in sales of Terramycin. The success of the campaign “marked the emergence of modern pharmaceutical advertising.” During this time, Sackler and his brothers purchase a lesser-known drug company, Purdue Frederick.
Sackler transformed Terramycin from a simple medical treatment into a product, which in turn transformed family doctors into a targeted market of consumers. Sackler’s Terramycin campaign’s emphasis on “frequent contact with individual doctors” would later appear in Purdue’s marketing of OxyContin in the mid-1990s. Outside of the legitimate medical industry, this tactic would later be employed by the Xalisco Boys, who engage in “frequent contact” with potential buyers by dispensing their black tar heroin outside of methadone clinics, which host abundant populations of opiate addicts.
Themes
In 1963, Sackler acquires the right to sell Valium. As with Terramycin, he pushes direct contact with doctors, going so far as to send salesmen to doctors’ offices with free samples. Sackler’s goal is to convince doctors that Valium is safe to prescribe: at this time, such drugs are considered dangerous. Despite becoming the industry’s “first billion-dollar drug,” Valium is found to be addictive during the 1970s. Hoffman-La Roche, from whom Sackler acquired the rights to sell the drug, is accused of hiding the drug’s addictive quality.
Sackler’s advertising tactic of supplying free samples to doctors (potential buyers) will be later employed by the Xalisco Boys, who dispense free samples to build client bases in new cities. Hoffman-La Roche supposedly hiding the addictive quality of Valium foreshadows Purdue hiding the addictive quality of OxyContin decades later.
Themes
Sackler continues to be active in the pharmaceutical industry. He discovers an opportunity to make even more money by encouraging drug companies to fund continuing medical education (CME) courses that doctors take to renew their licenses. Sackler advertises his companies’ drugs at these CME seminars. He dies of a heart attack in 1987, but his life’s work changes the pharmaceutical advertising industry forever by showing “that amazing things can be achieved with direct selling and intensive direct advertising.” Purdue will later use these tactics to sell OxyContin.
As a businessman, Sackler worked to expand his reach by marketing drugs to bigger groups of doctors at CME courses. Sackler’s innovations of “direct selling and intensive direct advertising” would be employed by Purdue in their OxyContin campaign, but also by the Xalisco Boys in their black tar heroin “campaign,” thus drawing a parallel between the emphasis on advertising employed by legitimate and illegitimate drug businesses alike.
Themes
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