Emmy frontrunner Dopesick finds new meaning as big-pharma opioid crisis settlements soar

With Teva and Allergan Pharmaceuticals paying over $6.6 billion in settlements to communities harmed by the US opioid crisis, Hulu miniseries and Emmy frontrunner Dopesick, has found new meaning.

American drama miniseries Dopesick, based on the novel Dopesick: Dealers, Doctors and the Drug Company that Addicted America by Beth Macy, focuses on the epicentre of the United States struggle with opioid addiction. Created by Danny Strong, the series stars an ensemble cast including Michael Keaton, Kaitlyn Dever, Rosario Dawson and Peter Skarsgard. Here's the trailer for the series:

From the boardroom meetings of the Sackler family, to a distressed Virginia mining community and to the hallways of the DEA, Dopesick lays bare the origins of the opioid crisis from a variety of perspectives, and it all leads back to Purdue Pharma and OxyContin.

But before that, a very important question,
 

Why are we talking about opioids and why does it matter to you? Simply: every painkiller that you buy over the counter, or are prescribed by your doctor to get rid of the 'pain' - after a tooth extraction, for menstrual cramps, or even a headache - is an opioid.

Now you must be wondering, with a drug so potent, so addictive and so very dangerous, it couldn’t possibly be easily accessible, let alone prescribed by doctors at all…

Before the problem blew out of proportion, opioids were only prescribed for short-term pain, such as post-surgery or for people with painful terminal illnesses. 

In 1980, the New England Journal of Medicine published a four-sentence letter written by Jane Porter and Hershel Jick, MD, describing addiction-related outcomes for the Boston University Medical Center’s patients who had been prescribed opioids. The letter states that out of the 11,000+ patients who received opioid medications, only two of them ever developed a dependence on the drug, and only one of these was a major dependence. It went,

The letter was brushed off by Jick entirely. That was until Purdue Pharma, the manufacturer of prescription opioids, began to cite the letter as evidence for the safety of OxyContin.

Purdue Pharma is a 132-year-old pharmaceutical company owned by the super-rich Sackler family that first broke big for developing the painkiller Contin and its successors MS Contin and the infamous OxyContin. Upon its release in 1995, OxyContin was hailed as a medical breakthrough, a long-lasting narcotic that could help patients with moderate to severe pain.

However, at the end of the day, OxyContin was a manifestation of an opioid named Oxycodon, which was already established as being highly addictive and a Schedule I drug under the United Nations Single Convention of Narcotic Drugs 1961.

So, how exactly was it that Purdue managed to market such an addictive opioid as a prescription pain med?
 

And of course, it worked. By 2001, prescriptions for OxyContin generated more than $1.5 billion a year and accounted for 80% of the company’s revenue. Sales escalated from $44 million (3,16,000 prescriptions dispensed) in 1996 to a 2001 and 2002 combined sales of nearly $3 billion (over 14 million prescriptions).

From 1990 to 1999, the total number of opioid prescriptions grew from 76 million to approximately 116 million, which led to them becoming the most prescribed class of medications in the United States. And it was all because Purdue’s foundations for OxyContin’s safety and efficacy was based on lies and fraudulent marketing.

Not only was the controlled-release formula easy to get past by crushing and snorting for drug abusers, the efficacy rates of OxyContin’s pain-relief rates were also falsified data and didn’t work for as long as claimed. Which only meant that prescription patients kept going back for more, increasing their dosage with every visit to the doctor, gradually and very unconsciously falling prey to addiction. 

According to The New York Times, a copy of a confidential Justice Department report shows that federal prosecutors investigating the company found that Purdue Pharma knew about “significant” abuse of OxyContin in the first years after the drug’s introduction in 1996 and concealed that information. But they did nothing because,

The report also cited emails showing that Purdue Pharma’s owners, members of the wealthy Sackler family, were sent reports about abuse of OxyContin.

According to the Drug Enforcement Administration (DEA) inappropriate use of OxyContin became a concern in 2000, and by 2001 it had reached "levels of abuse never before seen".  In 2000, over 10,000 people were treated in emergency rooms for "drug abuse episodes" involving drugs containing oxycodone. By 2007, the number had jumped to over 42,800.

And thus, the opioid crisis that ravages the United States and permeates the rest of the world took roots. As of 2019, the most recent year for which data is available,

Opioid overdoses have since killed 70,000 people. That is more than ten times the number of US military members killed in the post-9/11 'War on Terror' in Iraq, Afghanistan, Syria and Pakistan (or just a fifth of civilians killed in the same countries).

But amid all the deaths that ravaged the United States, Purdue never owned up to anything. They maintained that OxyContin was a perfectly safe, perfectly legal product (being used illegally). 

Despite the DEA's attempts at putting an end to their activities and the infamous West Virginia settlement in 2004, Purdue insisted that they couldn’t help it if people abused OxyContin. Their only goal was to get it into the hands of people who needed it for medicinal reasons, as prescribed by a doctor, to help alleviate pain.

The Sackler family, riding a decade and a half of OxyContin profits, oversaw a company that brought them $3.1 billion annually with a 30 percent market share. They had a net worth of $14 billion in 2015 and made Forbes “Richest Families in America”, and were celebrated for it. 

It was only in March this year that the Sacklers were slapped with a bunch of lawsuits by a coalition of attorney generals that ended in a $6 billion settlement and Purdue declared bankruptcy. However, the deal granted "releases" from liability for harm caused by OxyContin and other opioids to the Sacklers, hundreds of their associates, as well as their remaining empire of companies and trusts.

In short, no jailtime for the Sacklers. Only a payout to release them from any opioid crisis-related liability. Meanwhile, to this day, the Sacklers sit comfortably on their mountains of blood money and deny any wrongdoing. 

While big-pharma companies like Teva and Allergan agree to billion-dollar settlements to make amends for their roles in the opioid crisis, the Sacklers enjoy their diplomatic immunity.

Now, the next time you pop that painkiller, think about what opioids do to you.

Hulu's Dopesick offers a nuanced viewing of the opioid crisis and sheds light on Purdue's heinous malpractices. It has been nominated for 14 Emmys for this year's ceremony and is the current frontrunner.

Dopesick is available to stream on Disney+ Hotstar.