Review: 'Dopesick' Will Leave You Heartsick - and Furious

by Kilian Melloy

EDGE Staff Reporter

Wednesday October 6, 2021

'Dopesick'
'Dopesick'  (Source:Hulu)

Remember the so-called "deaths of despair" that seemed to be ravaging America's heartland a few years ago? One driving factor was opioid addiction, which, from the way it was sometimes discussed, seemed like a symptom of some sort of larger socio-economic malaise.

In large part, the opioids were the malaise, though, and not simply a response to a changing world wracked by globalization and Americans' loss of prospects for prosperity. A major contributor to such addition issues was the relentless and deceptive marketing by pharmaceuticals company Purdue of its narcotic painkiller Oxycontin, a drug that, according to the New York Times, was at the heart of "a public health crisis that led to the deaths of more than 500,000 people nationwide."

How did Purdue — and the Sackler family, which owned the company — manage to perpetrate something that amounts to a national drug-pushing scheme? This is a complex, multi-pronged story that's addressed in creator Danny Strong's eight-episode miniseries "Dopesick," which is based on the book of the same title by Beth Macy.

Skipping back and forth across decades, the series shows how a novel labeling of the drug in 1996 — it was touted as being "less addictive" than other narcotic painkillers thanks to a coating that acted as a time-release mechanism, thus preventing a "high" that might get people hooked — was used to coax skeptical doctors. (The series also depicts an FDA medical review officer, Curtis Wright, as having helped the company write the claim, before then approving the label... before departing the FDA to work for Purdue in a highly-paid position.)

The problem with that claim? Drug users looking for a quick high soon figured out how easy it was to circumvent that time-release coating by sucking or scraping it off, grinding the pills to powder, and then either snorting or injecting them. Another problem: Opioids are addictive, period. Even people taking the drug as directed were getting hooked... and dying.

That label is just the start. The series also shows other tactics the company and its army of sales reps used to seduce and, when necessary, strong-arm doctors into overprescribing the painkiller — everything from the usual swag and office visits to threats of lawsuits against pharmacies and hospitals if they should "deny" the public the benefits of Oxycontin's pain-reliving properties.

The series details a host of other deceptive practices as well, from sleek phrases like "breakthrough pain" to a promotional video in which the name of the drug was hardly even used. There were also blood charts designed to confuse the drug's efficacy over time, pain charts that presented a friendly face to physicians and patients alike, and a host of articles citing a bogus medical "study" that turned out not to be a study at all, and the entire operation is depicted as having been carried out with deliberate and calculated precision.

Eventually, law enforcement — like DEA agent, and later Deputy Director, Bridget Meyer (Rosario Dawson) and Assistant Attorney General Rick Mountcastle (Peter Sarsgaard) — start to catch on that something is not right: Certain crimes, like theft and prostitution, are skyrocketing in small towns, right along with drug overdoses. What's more, the towns in question seem to be places where most workers perform hard physical labor.

It's in one such town, a mining community in Virginia, where we meet Dr. Sam Finnix (Michael Keaton), who becomes a case study in a sincere, dedicated doctor being hoodwinked into thinking he's helping his patients "get their lives back" when, in fact, he's getting them hooked. Dr. Finnix cares for the residents like they were his own family. That's understandable, given how many of the townspeople Dr. Finnix delivered as babies and has seen grow up to enter the mines themselves — people like Betsy (Kaitlyn Dever), who prides herself on her ability to work as hard as anyone, but who has to hide her relationship with another women from her religious parents. When Betsy suffers a back injury, she becomes the show's go-to for illustrating how hard-working people became hooked, then suffered the indignities associated with an all-consuming addiction.

Pharma reps Billy (Will Poulter), an ambitious young man with a troubled conscience, and his co-worker Amber (Phillipa Soo), who is even more ambitious than Billy but far less disturbed by ethical worries, provide a means for understanding the pharmaceutical firm's foot soldiers in a campaign of rapacious predation.

Then there's the Sackler family themselves, celebrating a rising tide of profits without any evident regard for the harm Oxy is causing. Richard Sackler (Michael Stuhlbarg), cold and disliked even by his own relatives, masterminds the firm's every move. Step by step, he meets obstacles and red flags with the same bottom-line obsession, endlessly preaching a gospel of "curing pain," but, in practice, looking only for ways to increase sales.

The series shows us people struggling against a system that rewards wrongdoing, and whose own lives are impacted: One character's marriage unravels, while another faces cancer knowing that the drugs the doctors are offering for post-surgical pain management could be worse than the disease. A third major character becomes an addict after a car accident, and loses everything. But such personal dramas take a back seat to the series' own meticulous work of laying out its case, bit by bit, with the care of any prosecutor. As it does, expect your rage to grow and your disgust to mount.

Perhaps the most loquacious and potent description of what Oxycontin did to people comes when a doctor, doing his best to fight the tide of addiction, explains the drug in the following terms: "Once you take it, it changes your brain chemistry. You're in so much pain without it, you think you're going to die."

"Dopesick" is a tale of bad faith, indifference to human suffering, greed, cronyism, and shameless lies that are continually glossed over with bigger and more damaging lies. It's no wonder that ardent Trump ally Rudy Giuliani makes a small, but significant, showing in the course of the series; this truly is a story of our times.


"Dopesick" streams on Hulu starting Oct. 13.

Kilian Melloy serves as EDGE Media Network's Associate Arts Editor and Staff Contributor. His professional memberships include the National Lesbian & Gay Journalists Association, the Boston Online Film Critics Association, The Gay and Lesbian Entertainment Critics Association, and the Boston Theater Critics Association's Elliot Norton Awards Committee.