In 1999, two classmates asked me to the fifth grade dance. By 2009, both of them had developed opioid addictions. By 2019, one was sober, and the other was dead from a heroin overdose. The one who died left behind an infant son. “I never gave up on you,” my classmate’s mother posted on Facebook, “but you would not let me help you.” She chose a photo of him from around the time we slow-danced to the Aerosmith song from the Armageddon soundtrack.

The Center for Disease Control and Prevention statistics on opioid overdose deaths start that same year, in 1999. Since then, nearly half a million Americans have died from overdoses on prescription and illicit opioids. Drug overdoses are the leading cause of accidental death in the United States, and opioids are involved in two-thirds of them. Four out of five new heroin users are transitioning from misusing prescription opioids. More than one hundred people are now dying from opioid overdoses in the United States every day.

It’s well established now that the proliferation of prescription opioids, particularly the game-changing painkiller OxyContin, fueled the broader addiction epidemic. You can see the progression of the crisis in the data. The opioid deaths have come in three waves: first a rise in deaths from prescription opioids starting in 1999, followed by a rise in deaths from heroin overdoses beginning in 2010; then an explosion in deaths from dangerous synthetic opioids like fentanyl starting in 2013. For every person who dies, hundreds more are entangled in the criminal justice system, and thousands more are struggling with addiction as their lives fall apart.

The crisis has swallowed entire communities. The primary industry in the town of Oceana, West Virginia used to be coal mining. Now it’s the black-market opioid trade, and the town is nicknamed Oxyana. In a documentary about the town, an opioid addict explains, “If you don’t work in the mines, the only other way you’ve got to make money anywhere close to working in the mines is to sell drugs. If you don’t see somebody getting up in the morning and going to work, they’re selling pills.” Overdoses are common in Oceana, and so too is violence related to the drug trade. A local dentist describes the opioid crisis as a darkness that has descended so heavily on the town that it’s even cast a pall over its natural beauty, a gray shroud over the green mountains.

The life I shared with my classmates was worlds away from Oceana, but the pills are everywhere, from double-wides in rural West Virginia to McMansions in the Texas suburbs. The story of how they became so ubiquitous begins when Purdue Pharma decided to manufacture OxyContin. Emails from a Purdue executive in 1999 demonstrate awareness that there was no evidence that controlled-release opioids were less addictive, and yet the company consistently made this claim in order to get OxyContin on the market and into the hands of as many consumers as possible. Purdue then spent decades downplaying the drug’s abuse potential, despite knowledge to the contrary.

For several years now, Purdue has been dragged through both the formal legal system and the court of public opinion. The public backlash has been ferocious: Americans are now more inclined to place heavy blame on the pharmaceutical industry for encouraging doctors to overprescribe the drugs than on individual drug users for becoming addicted.

Correspondingly, it’s hard to think of an American capitalist dynasty more roundly condemned in recent years than the Sackler family, which owns Purdue Pharma. The family has followed the philanthropic playbook, lavishing art museums and university departments with funds to burnish the Sackler image, but this hasn’t shielded them from popular wrath. Their transgressions are too intolerable, and the contrast between their astronomical wealth and the devastation they’ve left in their wake is too stark to ignore. The Sacklers are intensely private, but with $13 billion at their collective disposal it’s impossible not to picture them lounging on superyacht sundecks while ordinary Americans fill the halfway houses and the morgues.

It’s no surprise then that when news of co-owner Jonathan Sackler’s death broke earlier this week, the reaction on social media was unsympathetic, to put it gently. On the one hand, the role of a single person in orchestrating this crisis shouldn’t be overstated. The deceased was only one member of the family that built and profited from the OxyContin empire, and despite its outsize role, not even Purdue Pharma bears sole responsibility for the calamity. Consider the deindustrialization and austerity that have left places like Oceana vulnerable to an explosion in the pill trade, its people desperate for money and release.

On the other hand, it’s easy to comprehend why the news of Jonathan Sackler’s passing received such a cold reception. With the constant churn of the news cycle, the new distractions, and the fresh terrors, it’s easy for some to forget that the opioid epidemic is still raging. Others are still electrified with grief. Did the Sackler family mourn the loss of their spouse, child, or friend?

The opioid crisis has claimed nearly five hundred thousand lives since 1999. That’s five hundred thousand irreparable tears in the fabric of millions of people’s personal worlds. Not only that, but nearly one-third of Americans know someone who is currently addicted to opioids. That’s more than one hundred million people actively witnessing, at various distances, the slow fade from life to death. Most feel helpless to reverse it, not least because capitalists like the Sacklers prefer to redistribute their money on a thoroughly volunteer basis, starving public services and rendering help hard to find for those without means.

In 2009, the midpoint in this saga so far, another boy I knew died of an opioid overdose. He was sixteen. He’d already established himself as an athlete when he was serendipitously cast in a school musical, where he discovered — as we all discovered, with pride and delight — that he could really sing.

There’s a video of him still up on Facebook from shortly before he died singing a Red Hot Chili Peppers song at an open mic. “I better not leave before I get my chance to ride,” go the lyrics. “All my life to sacrifice.” And sacrifice for what? For $35 billion, $10 billion of it straight to the bank. Hundreds of thousands of lives sacrificed at the altar of profit. That, more than all the museum wings and endowed professorships put together, will be the Sackler legacy.