01x02 - Breakthrough Pain

Episode transcripts for the TV show, "Dopesick". Aired: October 13, 2021 - present.*
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American drama miniseries created by Danny Strong based on the nonfiction book Dopesick: Dealers, Doctors and the Drug Company that Addicted America by Beth Macy.
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01x02 - Breakthrough Pain

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Richard, you vastly overspent,

and it's not unreasonable
that we would be upset.

It'll work. I promise you.

The FDA created a special label

to say that it's less addictive.

I would never prescribe a
narcotic for moderate pain.

That f*cking label caused everything.

This drug has only been on
the market for three years,

and there's already been
a spike in overdoses.

Our community is ground zero

for a growing national catastrophe.

We're gonna do everything we can

to hold someone accountable.

But you got all these people.

They almost never
mention OxyContin by name

in the video promoting OxyContin.

RANDY: And this video is the first
major introduction of OxyContin.

Prove they're lying about
the dangers of the drug

and that they're selling it anyway.

I can't lose my job.

I gotta make enough
money to get out of here.

There's a new drug.
The FDA said it's safe.

[TENSE MUSIC]

♪ ♪

Do you solemnly swear that
you will correctly transcribe

to the best of your
ability all of the testimony

given by each and every
witness testifying in the matter

now pending before this grand jury

and that you will keep
secret and divulge to no one

any of the proceedings of this
grand jury, so help you God?

I do.

[DRAMATIC MUSIC]

♪ ♪

PROFESSOR: It takes
to years for a new drug

to complete the journey from
inception to the marketplace.

♪ ♪

If OxyContin had failed
when it launched in ,

what would have been the consequences?

Purdue Pharma would
have lost $ million

with no significant
product in the pipeline.

BETH: Big day, right?

First sets of numbers coming in?

I'm sure they'll be fine.

♪ ♪

And how much damage would that
have inflicted on Purdue Pharma?

It likely would have
sunk the entire company.

They're not bad.

We can do better.

How's our video testimonial coming?

MICHAEL: A bit slow.

The drug is so new,

there's not a lot of people who
can testify to it at this point.

- Then find some.
- Yes, sir.

RICHARD: Physicians need to know

it can take its place next to penicillin

as one of the most important
in the history of medicine.

Let's hold more weekend seminars

to explain to physicians

how truly revolutionary this drug is.

It's your favorite pharma rep.

If he's gonna bribe you for access,

you should get more than flowers.

How about a mani-pedi next time?

Yes, please.

And your present, Doc,

is a pen with a titration chart in it.

- Oh.
- There you go.

Thanks.

- Think I'd rather have flowers.
- [LAUGHS]

So now that you bought
your way into my office,

what do you need?

- Can we sit for a minute?
- Sure.

I wanted to extend an
exciting invitation your way.

Purdue want to invite you
to an all-expenses paid trip

to Scottsdale, Arizona,
at a five-star resort

to hear pain experts
discuss new treatments.

Even allowed to do that?
Isn't it illegal or something?

Oh, you kidding me?
No, it absolutely is.

All the pharmas do it, and,
you know, these seminars,

they're a lot of fun, and
they're very informative.

Mm. I can't.

I've got... I've got a full practice,

even on weekends.

- Too many folks.
- Right.

But the seminar would be an
extension of your work here.

There'll be a lot of pain experts,

and you'll walk away
with some great tips.

Take your wife, you know?

Two of you could have
a relaxing spa weekend.

My wife passed away from
ovarian cancer, so...

- Oh, my God.
- SAMUEL: Yeah.

- I'm sorry.
- SAMUEL: Yeah.

It's all right. It's all right.

Well, um, I'll keep
checking in with you.

And, uh... think about Scottsdale.

[CHUCKLING] Sure.

It'll be fun, Doc.

[TENSE MUSIC]

♪ ♪

Hey, Logan.

I've been wanting to check on you.

Wanna take a look at that shoulder.

LOGAN: Doing the same.

Still can't lift it
more... much more than that.

Pains the shoulder something awful.

Yeah.

LOGAN: Been more than six years, Doc.

Yeah, I know. I know.

Hey, there's a new medication
I might want you to try.

What kind of medication's that?

When a patient first takes OxyContin,

it can be very effective.

The patient often feels like

their life has been
instantly transformed.

[BANGING]

Unfortunately, the drug didn't
always work as Purdue claimed.

Oh, how so?

[GROANING]

♪ ♪

So we've been getting some
complaints from patients

and doctors that the drug
isn't lasting hours.

People are waking up in the
middle of the night in pain.

Our entire FDA approval
is based on the fact

that it's a -hour drug.

Insurance companies and
hospitals won't cover it

if it doesn't last the full hours.

How did this happen?

Well, we always knew
it was a possibility

that the drug wouldn't last hours.

The Puerto Rico testing
only hit at %...

The FDA only requires a % threshold.

Thank you.

That will be all.

[SOFT TENSE MUSIC]

♪ ♪

Don't worry.

We'll figure this out.

It's an excellent drug.

♪ ♪

[DOOR SHUTS]

PERSON: You've got your mother
worried sick about you, Richie.

Well, our patent expired.

Dad would be dead without a replacement.

Because ear wax just
isn't good enough for you.

Forgive me for trying to...

make us more than the Betadine family.

I know, I know, you've
got grand ambitions,

but I am concerned you're
going to become Icarus.

♪ ♪

If OxyContin does what I think it can,

then it's gonna be bigger

than anything Uncle Arthur ever dreamed.

[EERIE MUSIC]

Richie...

Arthur is dead.

♪ ♪

When Roche hired Arthur
Sackler to market value,

he needed to find a way to
separate it from Librium.

So Arthur devised a
specific medical condition

called psychic tension.

Where Librium was taken for anxiety,

you would need a much
stronger medication

for psychic tension.

And thus, Valium became

the number one
tranquilizer on the market

by creating the condition
known as psychic tension.

Now, we have created
the greatest painkiller

in the history of human civilization...

and all we have to do to
ensure the world gets it

is to figure out a medical condition

that would require an
OxyContin patient...

to double their dose.

♪ ♪

MARTIN: Today we're gonna
talk about a medical condition

known as breakthrough pain.

Neither common nor rare,

breakthrough pain is
a specific type of pain

that breaks through the -hour cycle.

Yeah, I've had several complaints...

or should I say questions...

about the drug not lasting hours.

All right, what you need to do

is tell your doctors that their patients

are experiencing breakthrough pain.

But we have an effective solution

that will allow their patients

to get a full night's
sleep on OxyContin.

All they have to do is double the dose.

So if they are on milligrams,

they double the dose to .

If they're already on
, they double to .

♪ ♪

[INDISTINCT CHATTER]

Hey, if this drug isn't
working like we say it is,

doctors are gonna stop prescribing it.

Then maybe you should
start selling Viagra.

Thanks for the help.

Look, the and milligrams

are two and four times
more expensive than the .

So if we can convince
doctors to double their doses,

we will be doubling our paychecks.

Yeah, I get that, but...

what if it doesn't work?

No drug is going to work
perfectly for every patient,

and that's not our problem.

- Our job is to sell.
- [SCOFFS]

Then I guess we double the dose.

Yeah.

Doc, I was able to get some information

on the -hour issue,

and, uh, it's not uncommon.

What your patient's experiencing
is breakthrough pain,

and it can happen hours nine and ten,

especially if the
pain is uniquely acute.

Breakthrough pain.

I've never heard of breakthrough pain.

BILLY: You really haven't?

Well, it's a... it's a term used

primarily by, uh... by
pain specialists, you know?

And the solution is... is simple.

You, uh... you just double the dose.

So if they're on milligrams,

you know, you bump them up to .

Oh, no, no, no.

No, that's... that's too
strong for a narcotic.

I'll just switch her to Percocet

or low-dose morphine pills.

Doc, I wouldn't do that.

Tho... those dr*gs,
you know, they're not...

they're not non-addictive in
the way that... that OC is.

And it's perfectly safe
to... to double the dose.

You're telling me that your drug

is the only drug in the world
that can help my patients?

BILLY: Well, ye... I mean, I'm saying...

I'm saying it's your
best option, you know?

Have you had a number of patients

with... with breakthrough pain issues?

Well, I guess I just got one.

I don't know, I've only got
four people on it, Billy.

Right, but they're
all doing great, right?

Yeah, it's been very
effective, actually.

BILLY: See? There you go.

I... I'd stay away from morphine, Doc.

You know, it's not, uh,
it's not anymore.

Teddy Roosevelt isn't president.

Well, Teddy Roosevelt
wasn't president then either,

but I get your point.

Uh, okay.

Yeah, I guess morphine
would probably be too strong

for her back injury anyway.

♪ ♪

Hello?

Uh, so... sorry, Doc.

I think you cut out there.

I think doubling her up to
milligrams will do the trick.

Just... just give it a try.

All right, I'll let you go.

Bye.

MICHAEL: So, um, there's a new issue.

A number of doctors
have the misconception

OxyContin is less
powerful than morphine,

when, as you know, it's
much more powerful, and, uh,

the confusion has started
to come up more frequently.

RICK: What are some of the side
effects associated with morphine?

Difficulty breathing,

sedation, coma, and death.

And is OxyContin more
potent than morphine?

Yes.

Its active ingredient,
oxycodone, is twice as potent.

And thus twice as dangerous.

I think it would be extremely dangerous

at this early stage in
the life of this product

to, um, clarify for physicians

that our drug is stronger than morphine.

So we do not plan to
do anything about that.

[DARK MUSIC]

And I agree with you.

Well, you'll be happy to know

you're not the first person who
can't sleep through the night.

That's not uncommon.

So we've got two options.

We can, uh, switch you
to a different medication.

No, I... I don't wanna switch.

This works better than
anything I've ever used before.

Okay, well, option two is I can
double your dose to milligrams.

But if that doesn't work,
we'll switch to something else.

And if you're still having a hard time

sleeping through the night, you call me.

And if you don't call me, girl...

Then you'll call me.

That's correct.

So how's those moving
plans of yours coming along?

Uh, I don't know.

Maybe I just keep my head down

and figure it out in a year or so.

You know, when Shelly told me,

"I want to move to Finch Creek,"

I thought, "Finch Creek?

Are you nuts? Finch Creek?"

I mean, I'm from this little town

in southwest Pennsylvania.

That's like New York City
compared to Finch Creek.

I loved it the minute I got here.

Best decision I ever made.

So if you wanna move to Eureka Springs,

you just go ahead and dive
in the deep end and do it.

[TENSE MUSIC]

All right?

You can always come back.

Can I always move back?

♪ ♪

Thanks, Doc.

Bye.

♪ ♪

RICK: Can you just confirm
that you're the ad agency

that made the I Got My
Life Back promotional video?

AD EXEC: Yes, that was ours.

RANDY: After reviewing
it, we were curious

as to why nobody says "OxyContin"

in a video designed
to promote OxyContin.

- They don't?
- RICK: No.

There's maybe one mention, minutes.

Everyone just says either, uh,

"the pain medication"
or "the pain medicine."

You got people tying themselves
up not to say OxyContin.

Now, why is that?

I don't remember, and
that sh**t was years ago.

Uh-huh.

And it's important our clients know

we won't disclose
internal communication.

And it's important that you know

that we have subpoena power.

So you can either answer
our questions here,

or you can answer 'em under oath

in front of a grand jury
in Roanoke, Virginia.

Which is beautiful this time of year.

You see, guys, right now,
we view y'all as witnesses,

but that can quickly change to suspects.

Look, this was all a
long time ago, okay?

But we might've been given instructions

that they didn't want the participants

to say the name of the medication.

Why not?

If I recall, the original concept

wasn't to promote OxyContin.

They just wanted us to do

a public service
announcement for pain relief.

That might've been why
Purdue didn't want anyone

to name a specific drug.

But there are titles at
the end that say OxyContin.

And it's written at
the bottom of the screen

the exact milligrams each patient's on.

You need to clarify this issue.

We were given instructions
to add the OxyContin graphics

after the sh**t while we
were editing the video.

So it started out as a PSA,

and then somewhere in the
post-production process,

it became a promotional
video for OxyContin?

Is that what happened?

AD EXEC: We just did what they wanted.

They said, "Make a PSA,"
so that's what we sh*t.

Then in post, they said
"Add the OxyContin titles,"

so we did.

So who at Purdue Pharma gave
you these specific instructions?

♪ ♪

BROWNLEE: Oh, let me guess.

They had no names of any
upper-level Purdue executives

- tied to the video.
- No, sir.

Purdue went to great lengths
to make sure there were

no executives' fingerprints on anything.

RICK: Like I said, that's
where it gets murky,

but we'll keep digging.

Won't be our entire case,

but it could be great in
terms of proving fraud.

Or at least get a
judge to grant us access

to all Purdue's internal files.

BROWNLEE: Well, you better
find something big, and fast,

because we've got a situation

that might shut this whole thing down.

I just got a call from Main Justice.

The Deputy Attorney
General wants us to go to DC

to discuss this case with him.

That's... that's unusual
this early in the case.

I know.

If I'm getting calls,
it must mean that someone

with a lot of influence really
doesn't like what we're doing.

When does he wanna meet with us?

In two weeks.

You ever met James Comey in person?

No. What's he like?

He's very tall.

I'm gonna need more on this video

if we're gonna keep this
case open, you got it?

Find me something good.

[ENGINE WHIRRING]

♪ ♪

[WHEELS SQUEAKING]

♪ ♪

[INDISTINCT PA ANNOUNCEMENT]

♪ ♪

Thanks, all, for coming out to
North Carolina for this operation.

Everyone on this list
participated in a video

entitled I Got My Life Back.

This video could be a
key piece of evidence

in proving Purdue committed fraud

in the promotion of OxyContin.

To better ascertain the
details of the video,

we'll interview each
of them simultaneously.

Give them less of a chance
to coordinate their stories.

♪ ♪

PERSON: What do you want?

I'm Rick Mountcastle with
the federal government.

[KNOCKING]

- Can I help you?
- Yes, ma'am.

My name's Randy Ramseyer.

I work for the government.

Why? What's wrong?

So in the video you sh*t

where you're taking the
medication OxyContin...

Yeah, I... I was taking
it for a... a injury.

And I noticed you... you didn't
actually call it OxyContin.

I was told it was a public service
thing for chronic pain sufferers

to be more comfortable
taking pain medication.

Every now and then, I would slip up,

- and I would say OxyContin.
- Well, yeah.

And they would say, "Don't say that.

Say 'the pain medicine.'"

Did the producer ask you not to say

- the... the name OxyContin?
- That's right.

He... he didn't want me to say
"opioid" or "opiates" either.

- What'd he ask you to say?
- Uh, "medication."

"Pain... pain medication."

- RICK: Pain medication?
- Yeah.

But they told me when I was done

that I was real natural.

I can't imagine how hard that would be,

sitting in front of a
camera trying to be normal.

[BOTH LAUGHING]

Oh, no. He d*ed a few years ago.

Oh, I hate this gravel.

And was it drug-related?

Oh, yeah, he was oxy-cuted.

Who asked you to participate
in the video in the first place?

My doctor did, Dr. Alan Spanos.

Oh, Alan Spanos.

Dr. Spanos. Dr. Spanos.

He... he prescribed OxyContin and...

♪ ♪

[MUMBLING] Yeah, he...

- RICK: You all right?
- PERSON: Uh-huh.

Yeah, yeah.

Uh...

♪ ♪

RICK: And who reached
out to you initially?

It was an ad agency from New York.

And when you were approached,

was it for a video to promote OxyContin?

No, they said it was a
public service announcement

for pain management
and general opioid use.

Were you surprised that a
public service announcement

that you asked your
patients to participate in

ended up being a bait and switch

to promote OxyContin?

I thought the video
was still very useful.

Well, we've been
interviewing your patients,

and some of them are
clearly addicted to dr*gs.

As you may know, one of
them d*ed of an overdose.

Another one appears
to be well on his way.

, doctors were sent a video

with you promoting OxyContin.

And it now appears that these pills

are a lot more dangerous
than that video claims.

Does that bother you?

What I'm here to do is to cure pain,

and I shall use everything
in my arsenal to do just that.

Pain has been wildly
undertreated in this country,

and opioids have been
unfairly maligned for years.

OxyContin has worked
miracles for my patients

who have suffered for years

and who are now getting
their lives back.

RANDY: Okay, okay.

So we got a fraudulent
video of people being told

not to discuss the exact drug

that they're in the video to promote.

Mm-hmm, should definitely be enough

for Comey to let us keep going.

Unless he's already made up his mind.

Would you resign if he shut us down?

No. You?

No.

I'd be pissed, though.

- You got another ketchup?
- [PHONE RINGING]

Yeah. Hold on quick.

Hello. This is Randy Ramseyer.

REGINA: Uh, hi, this is Regina Carter.

You... you left a note at my apartment.

Yes, that was me.

Uh, I'm an assistant U.S. attorney,

and I was hoping that
I could interview you

regarding a video that you
were in about five years ago.

REGINA: Okay.

Uh, when... when could we come see you?

Well, we were hoping
as soon as possible.

We could come by tonight.

- REGINA: Tonight?
- Yep.

We're just wrapping up a dinner.

Rick, could you get the check?

And we will, uh...
we'll head on over there.

We'll be over there in
about the next , .

REGINA: Listen, what happened with me

was the pill stopped working
'cause my tolerance grew,

and doctors just kept
doubling my dosage.

I was eventually taking
milligrams a day.

Started falling asleep at work,

lost my job,

my car,

then my house.

I had to declare bankruptcy.

I am so sorry to hear that.

How did you... how'd
you stop taking the drug?

I weaned myself off.

Hardest thing I ever did.

But I thought, "If I don't
get off this medicine,

I'll end up dead."

And when you realized you were addicted,

did you go back to Dr.
Spanos to discuss...

Hell no, I never spoke
to that man ever again.

They used us in that video.

I helped a company make
billions selling dr*gs.

I mean, we were all pawns,

making people think the
drug was non-addictive.

And I can't help but
feel guilty about that.

Ma'am, you are not responsible for this.

You are a victim; they lied
to you, they lied to you.

Companies like this, they
buy their way out of trouble.

Black kids selling weed
go to jail for decades.

Well, that's why we're here.

I'm sorry to interrupt.

Is there a restroom in the lobby?

REGINA: Yeah.

[SOLEMN MUSIC]

♪ ♪

♪ ♪

[QUIET MUSIC]

PETER: Here you go.

[SIGHS] Thanks, Peter.

PETER: Sure.

♪ ♪

PAUL: God, it's so cool
that you're a DEA agent.

I still can't believe it. [CHUCKLES]

So, um, you have your g*n on you?

Mm-hmm. Pretty much always.

Where do you keep it?

♪ ♪

I never thought feeling a g*n

pressed against my
leg would turned me on.

Most guys are weirded
out by my firearms.

Oh?

They don't wanna date someone
with a "masculine" job.

I research Senegalese mineral rights

for the state department.

Everybody's job is more masculine.

I bet you were the hottest
mineralogist in high school.

That's a good use of mineralogist.

Why did you ask me out?

I think you might be one of the most

strikingly beautiful
women I have ever seen.

♪ ♪

[MUFFLED GASPING]

Good morning.

Good morning.

I don't want to be too
aggressive, but, um,

wanna grab dinner tomorrow night?

Oh, well, yeah, I'd...
I'd love to, as well,

but I'm... I'm gonna be
leaving town for a few days.

Oh. Okay.

How about right when I get back?

Yeah, great.

- Coffee?
- Yes.

- Yeah.
- Yeah.

[FOREBODING MUSIC]

♪ ♪

Initial consultation's .

Then you come in every
days for your refill for .

Do I meet with a doctor
for my refill appointment?

Only if you want to,

or you can just pick
up your prescription.

Um, the doctor is booked
till next Thursday,

so you can fill those
at home if you like.

Is there any way that I can
meet with a doctor today?

I have really bad shoulder pain.

So does everyone else.

Have a good day.

PERSON: Hey! [STRUGGLING]

- Hey!
- You piece of sh*t!

- BRIDGET: Hey!
- [GRUNTS]

BRIDGET: Come on!

Don't you f*cking move.

Come on.

Have you ever heard
of the cr*ck epidemic?

It was big in poor
neighborhoods in the s.

Huge portions of the Black population

were hooked on cr*ck.

I grew up in D.C. during this time,

and there was this convenience
store across the street

from my grandma's apartment.

And the parking lot was a warzone.

People selling dr*gs,
k*lling each other.

My grandma got mugged three times.

This was how I grew up, Lucas.

Watching my friends die from dr*gs.

If you continue on this path,

you're going to end up just like them.

Is your grandma okay now?

She's fine.

Thanks for asking.

I didn't want her money. I was...

I was trying to steal her prescription.

How do you know she had one?

LUCAS: She came out of the pain clinic.

That's where everyone gets
their Oxy prescriptions.

BRIDGET: And what would you do with it?

There's a girl in my
class, eighth grade.

And she's got this older
brother that makes fake IDs,

so we use it to get
the prescription filled.

Take half and sell the other half.

How many kids in your
school are on OxyContin?

I don't know.

Maybe half.

♪ ♪

Now how about here? Any pain?

Nope.

If I lift higher, does that hurt?

[CHUCKLES] Don't feel a thing.

And you... and you feel like
you have full range of motion?

Yeah. Just like before.

You think the drug lasted hours?

- Well, I didn't time it.
- How about sleep?

Any problems sleeping through the night?

No, it worked like a charm.

I actually went bowling last week.

I didn't think I'd ever
get to go bowling again.

I appreciate it, Doc,

Sure about this, Doc?

I'll take you to any
steakhouse in the state.

Uh-uh, I'm sure as can be.

Mmm, look at that pie.

You can't b*at the
chicken here at Nancy's.

- BO: What can I get you, Doc?
- Hey, Bo.

You know what I like.

- BO: For you?
- Uh, I'll have the same.

SAMUEL: You and your dad close?

Um, not really.

He's a writer and a professor.

Brother writes short
stories, so they're close.

- Mom's a poet.
- Really?

BILLY: Yeah.

I'm sort of the, uh, Roger
Clinton of the family.

Huh.

Well...

I'm sure they're very proud of you.

Yeah.

So, um, you ever think
about dating again, or...

Nah. No interest.

Well, you should come to our
weekend seminar in Scottsdale.

Mm.

They're a ton of fun, and
it's all expenses paid,

and a ton of interesting women there.

Mm-hmm.

Doctors, nurses, pain specialists.

Russell Portenoy is gonna speak.

- He is?
- Yeah, he's the main speaker.

You know, when Shelly
was in the hospital,

I read some of his articles, and, uh,

they really helped.

Gotta say.

Do me a favor if you think of it.

Uh, mention to him that,
uh, I'm really grateful.

So thank you.

Come to the seminar in Scottsdale

and tell him yourself.

[TENSE MUSIC]

♪ ♪

Hey, Mom?

DIANE: Yes, dear?

I think there's something
we should talk about.

DIANE: Okay.

Uh...

This may be hard for you to hear, but...

[CLEARS THROAT]

I like girls.

I always have.

Not just as friends.

And I know... I know Dad
is gonna be real upset,

but maybe you could talk to him

and tell him that nothing's
gonna be different.

I'm... I'm still the same person.

I promise I am.

I just...

I can't live like this anymore.

I just wanna be myself.

I'm sorry, dear.

Did you say something to me?

No.

♪ ♪

[ELVIS PRESLEY'S "BLUE
CHRISTMAS" PLAYING]

GRACE: How much those run you?

I'm ready.

For what?

I want to do it.

I want to move to Eureka Springs.

ELVIS: ♪ Blue, blue, blue Christmas ♪

Are you kidding me?

I've been feeling a lot
better this past week.

And I realized you were right.

Coal's a job. It's... it's not a life.

I want my life with you.

ELVIS: ♪ You'll be doing all right... ♪

Your face is so pretty, Bets.

It should never be covered in soot.

ELVIS: ♪ But I'll have a blue,
blue, blue, blue Christmas ♪

♪ ♪

SINGER: ♪ She rides to the sun too ♪

♪ Lights fade as she casts her spell ♪

♪ ♪

RICK: Hey, Bridget. We
heard this was your spot.

Oh, what the f*ck?

Hey, Bridget. Great to see you again.

How's your divorce coming?

It's finalized. Want a drink?

Uh, neither of us drink.

Not surprised.

RICK: You don't have to be like this.

We're on the same side.

[SCOFFS]

I'm helping you.

I'm saving you from wasting your time.

The FDA, Justice, the doctors,
they all want their dr*gs.

And big pharma will
spend everything they can

to make sure that they get them.

And this is just gonna
keep going and going

till we're all just one big
pill-popping zombie nation.

Have you seen Purdue's
I Got My Life Back video?

- Sure.
- It's a fraud.

They were told it was
a PSA when they sh*t it.

And several of those
participants became addicted.

Few of them are dead or close to it.

[SIGHS]

You know who'd be interested in that?

Sarah Miller and Judy Cohen.

Sarah Miller, Judy Cohen.

At the DOJ's office
of consumer litigation.

Well, I thought they
were all conspirators

in the upcoming zombie apocalypse.

Not everybody.

Now, that was my tip for the day, boys,

so if you can both kindly f*ck off,

I'd certainly be better off for it.

Thank you, Bridget.

I'm sorry about your divorce.

PERSON: I'm at a loss for words.

It... it... it... it almost makes
me want to tear up a little bit,

but I... it... it's just
changed my life for the better.

I'm coming home with energy to spare.

Just to have the evening to
do things with was unheard of.

[PHONE RINGING]

- We've been having problems with Purdue from the get
-go.

- Like the label?
- Like the label.

So when Curtis Wright approved

the original FDA label,
was there internal pushback?

SARAH: Oh, yeah.

Diane Schnitzler emailed him that

Purdue's "less addictive"
claims sounded like bullshit.

RICK: What was Mr. Wright's response?

He said, "Actually, Diane,
this is literally true."

So Curtis Wright is the
FDA medical review officer

who approves an unprecedented
label for Purdue.

And then he goes and
he works for Purdue.

So do you think there's
quid pro quo with Purdue

to grant such generous wording?

Yeah, well, I get that it has
the appearance of corruption,

but it's possible there wasn't.

What Curtis Wright did is
the way the industry works.

It's a revolving door

where as soon as people
leave the government,

they go and work for the exact
people they were regulating

for five times the
money, and it's all legal.

What appears to be corruption

is simply how the system works.

Here's an ad, says patient
only needs two pills a day,

but the drug often didn't last hours.

So how does an ad like this

get through the FDA approval process?

You'll have to ask Ronald Reagan.

Does he work for Purdue now too?

No, but when he gutted the FDA,

they went from policing big
pharma to being at their mercy.

employees are responsible
for , promotional items.

How do they grant proper oversight?

Just give me five minutes.

It works as an honor system.

Drug companies are
supposed to be honest.

- [LAUGHS]
- I know.


So if a company was
being criminally dishonest

in its promotional marketing,

what would you charge them with

if... if fraud was too high a bar?

JUDY: Sarah?

Can you all give us a moment?

If it were me, I'd charge
them with criminal misbranding.

Never heard of that before.

SARAH: Most people haven't.

It's perfect for this because
you don't have to prove

the misbranding caused the overdoses

or pin it on an individual,

just that the company
misbranded the drug.

[DRAMATIC MUSIC]

♪ ♪

Thank you.

You're welcome.

I want more hot water.

More hot water? You're already boiling.

I think that's enough.
All right, sweetheart?

You stick your tongue out at me?

Let me take that. Oh, I got it.

I got your tongue. It's pretty good.

[PHONE RINGING]

Okay. Shh, shh, shh.

What do you got?

PERSON: Nothing good.

Main Justice doesn't
like the pharma case.

But wait... wait... wait
a minute, wait a minute.

Do you know why?

Seems pretty early to
pull the plug on me.

PERSON: I don't have details.

Just that Comey doesn't like the case.

All right, got it. Thanks.

LEE: What's wrong?

DAG wants to shut my pharma case down.

Isn't that a little fast?

I always knew there was a chance

we might get shut down by Main Justice.

It's pretty crappy if you ask me.

I wouldn't say "crappy"
when we go to Comey.

He doesn't like that kind of language.

No, that's Ashcroft.

I heard he dressed Comey down
one time for saying "turd."

Comey tells us the case
is off, I'm gonna say,

"Well, that's one big turd burger, sir."

[LAUGHS]

So, uh, listen, day after we get back,

I gotta have surgery.

I'm gonna be out for a week.

You okay?

I have prostate cancer.

It took 'em a minute to
find it, but it's fine.

They don't think it spread.

Just, uh... just need a week.

I'm so sorry, Randy.

Just take two weeks off, or
three, as long as you need.

No, I just need a week.

Is it okay if I pray for you?

- Right now?
- I could.

Oh, no. No, it's all right.

It's not really my thing.

Thank you, though.

I just want to see if
I can find some napkins.

[PRAYING INDISTINCTLY]

Okay, so just let me handle this.

Even if Comey says we're dead,
it doesn't mean we're dead.

Then what does it mean?

It means we're dead.

JAMES: Getting some complaints
about your investigation.

That it's out of control.

[DRAMATIC MUSIC]

Well, that's just not true, sir.

We... we've been doing this
whole thing by the book.

These guys are behaving like pros.

And this is a very
serious issue that warrants

all the attention we've been giving it.

Serious?

Well, how serious does chicken get?

- Chicken?
- Chicken, sir?

Yes, chicken.

What do you... what
do you mean by chicken?

RANDY: Do you mean, like,

chicken the food or
chicken you're scared?

Like you... you're a chicken?

Chicken, the food.

Why are you investigating
the chicken guy?

Colonel Sanders?

No, Frank Perdue.

Oh, no, sir. No, no, no, no.

Uh, we are not
investigating Perdue Farms.

We are investigating Purdue Pharma.

It's... it's spelled
differently, I think.

Yeah, it's spelled with
a "U" instead of an "E."

Yeah, Purdue Pharma.

No, it's the company that
manufactures OxyContin.

It's not the... the, um...
it's not the chicken people.

Well, my staff must
have been misinformed.

Well, perhaps whoever's
complaining about us

is trying to get you off our track, sir.

And for good reason. It's early days.

We already have substantial leads.

Manipulative advertising,
false claims about addiction,

overdoses are skyrocketing
while Purdue continues to lie

about the drug's safety to doctors,

to patients, and the FDA.

We have a major case here.

♪ ♪

Well, then go make your case.

[UPBEAT FUNKY MUSIC]

SINGER: ♪ Yeah ♪

♪ Can you feel it, baby? ♪

SINGERS: ♪ Ooh ♪

SINGER: ♪ I can too ♪

SINGERS: ♪ Ooh ♪

♪ ♪

♪ Ooh ♪

♪ ♪

♪ Ooh ♪

SINGER: ♪ I'm gonna
swing, come on, swing ♪

SINGERS: ♪ Ooh ♪

SINGER: ♪ Come on,
swing, c-come on, swing ♪

STAFF: Hey, can I offer you

a complementary OxyContin bucket hat?

Uh, no.

Maybe one of our compact discs?

- No, thanks.
- All right.

- Hey, well, enjoy your day.
- Okay, thanks.

BILLY: Dr. Finnix, so
glad you could make it.

- SAMUEL: Thanks.
- Hell of a spread, right?

Oh, you bet.

I wasn't lying to you.

No, you weren't.

Um, I wanted to introduce
you to Dr. Russell Portenoy.

- Pleasure to meet you.
- Oh, no.

The honor's all mine. Believe me.

You're very kind.

Uh...

I feel a little silly,
to be honest with you,

but I actually brought your book down

and I wonder if you'd sign it for me

over the weekend if you have a chance.

Are you kidding? It'd be my honor.

- All right, great.
- Great.

Well, look, don't let us
get between you and the food.

- Don't miss out on that lobster.
- SAMUEL: All right, Billy.

And, uh, we'll see you shortly.

- We're just over here.
- SAMUEL: All right.

All right, Doc.

We're honored that you'd take a break

from your busy schedules to
spend the weekend with us,

and... as well as...

the country's leading
independent pain organizations.

We have representatives from
the American Pain Foundation,

the National Foundation
for the Treatment of Pain,

American Chronic Pain Association,

the American Pain Society,

and the American
Academy of Pain Medicine.

[APPLAUSE]

But to start us off, we wanna begin

with the foremost pain
specialist in the country.

He is co-chief of the Pain
and Palliative care Service

at Sloan-Kettering,
Dr. Russell Portenoy.

[APPLAUSE]

[TENSE DRAMATIC MUSIC]

This is truly a special moment

in the history of pain care.

Hospitals, doctors, think
tanks, and even the FDA

are rethinking the very
nature of pain treatment.

And what we've learned is
that opioids, certain kinds,

are not nearly as addictive
as they have been perceived.

Narcotics can be abused

and are not appropriate
in all instances.

But when properly prescribed by doctors,

they almost never lead to addiction.

[APPLAUSE]

In most immediate-release opioids,

blood plasma levels spike
between euphoria and pain.

But OxyContin's time-release system

causes blood plasma levels

to have fewer peaks and valleys,

creating a plateau effect,

which results in less euphoria
and less potential for abuse.

And did... did doctors
attend these weekend seminars?

Yes, many of them did.

BILLY: This is Dr. Samuel Finnix.

Runs a patient care
practice in Appalachia.

And, Drea here, we stole
from Johnson and Johnson

and she, uh, she runs the South.

Covers multiple Southern
territories for us.

It's an honor to meet you.

Nice to meet you.

I'm from a small town in Alabama,

so I know how important
the local doctor is.

SAMUEL: Yeah.

Have you been prescribing
OxyContin to your miners?

To a few, yeah.

Yeah, it's been... it's been effective.

And what occurred at these events?

Doctors were often
co-opted by Purdue Pharma.

You should do a talk with Dr. Finnix.

I bet people would love
to hear about his patients.

BILLY: Great idea. Yeah,
well, what do you think?

No, I... I can't really get up
and speak in front of people.

DREA: Oh, please. You're
far more impressive.

You're on the front lines.

Just think how incredible it would be

if the story of a coal town

could help change lives
all over the country.

Absolutely. And I mean, it'd be easy.

You know, I'd be
asking you the questions

so you don't have to embellish anything.

Just, uh, tell people
what you're seeing.

It'd be wonderful for these city boys

to see how us country
folks get things done.

Yeah. Well, uh, sure.

Okay, I guess.

You're gonna ask me the questions?

Absolutely. I'll be right with you.

All right, well. See how that goes.

So, uh, Dr. Samuel Finnix,
tell us, what kind of ailments

do your patients typically have?

Many of my patients are miners,

so I see back injuries,
shoulder lacerations,

broken hands, things like that.

And you would say, in your experience,

pain is part of everyday
life in the mines?

Yes, it is. Yes.

I... I have, um, uh,
firsthand experience of pain.

My father was diagnosed
with a rare form of cancer.

Oh, I'm sorry.

BILLY: Thank you. Which he survived,

but watching him suffer through that

was one of the... the hardest
things that I've been through.

You also have firsthand experience

with that kind of pain, right?

I do, yeah.

Uh, my wife had cancer, um,

and, uh, well, she passed
away; she didn't make it.

I'm so sorry.

Purdue's drug, MS Contin,

was very helpful to her in
her final days, wasn't it?

It was. It was... it was helpful.

That's why I wanted to try OxyContin

on my patients because, uh,
I don't want them to suffer.

If there's a drug out there

that can help them, well,
then I-I want to try.

And the patients are wanting
to try it, too, right?

Heck yeah, they are.

[APPLAUSE]

I know most people don't, you know,

they don't think about us
up there in the mountains.

Uh, but these people,

you know,

when this country needed
to build airplanes,

uh, during World w*r II overnight,

where... where do you
think that steel came from?

The bridges we drive across,
the high rises you live in,

stadiums where we all watch football,

that's all... that's steel.

And steel comes from coal.

Um, I'm probably talking too much.

Am I talking too much?

No, please, please.

And who do you think digs
that coal out of the...

out of the mountains in the hollows?

My patients do.

It's dangerous work, and...

they risk their lives every day

to keeps the lights
on in places like this.

To keep the lights on in the big cities.

Keep the lights on in your fine homes.

And, uh, they carry the burden

of building this nation on their backs,

and they deserve to do it without pain.

So if this drug can
help these good folks

have a better life and
feed their families,

well, then Purdue Pharma
is doing these people,

my people, a great service, so...

God bless them for it.

[CHEERS AND APPLAUSE]

- Were you nervous?
- Yeah.

Oh, well, you didn't look nervous.

- You were incredible.
- Would you excuse me?

You were absolutely incredible.

I've been to hundreds
of these, and seriously,

I've never been so moved.

- Oh, thank you.
- Really appreciate it.

Hey, Daniel. Do you mind if I steal

the star of the weekend
for just a few minutes?

Of course not... thank
you. Nice talking to you.

Nice talking to you.

I have to tell you,
you spoke for the people

that don't often get a
voice in this country.

Well, look, thanks for
getting me up there.

Oh, it was beautiful.

You know, Purdue has a speaker's bureau.

They'd be lucky to
have you. Is this okay?

SAMUEL: Yeah. What's that?

Oh, we pay speakers to go to
events like this around the country.

They get $ to $ , for a speech.

Those speakers get paid?

Oh, yeah. It's not a secret.

You should think about it.

You were great up there.

That guy's amazing.

Mm. Yeah.

He's, uh... he's really special.

And I'm sorry about your dad.

Is he okay now?

Yeah, I, uh...

I made that up.

My, uh... my dad never had cancer.

[PIANO MUSIC PLAYING]

[LAUGHS]

Wow.

This is the first time

that I've ever wanted to f*ck you.

[BOTH LAUGHING]

Huh.

You, uh... you want to
do something about that?

Oh, oh, William, I don't think so.

But just because this is the first time

doesn't mean that it's the last.

♪ ♪

Once a month, you could have
a fun weekend for yourself

and you'd get to see my big smile

if it wouldn't bother you too much.

[LAUGHS]

Oh, I don't think seeing your
smile would bother anyone.

[LAUGHS]

BETSY: [PAINED MOANING]

I thought you said it was working.

BETSY: It was.

I'll be right back.

There are many cases where a higher dose

loses its effectiveness fairly quickly

because the patient
develops a tolerance.

BETSY: [RETCHING]

[TENSE PERCUSSIVE MUSIC]

♪ ♪

[PANTING]

[BREATHING HEAVILY]

PROFESSOR: This makes the
user increase their dose again

at a fast rate.

And is that dangerous?

Absolutely.

It's one of the reasons
why overdose rates

are so much higher on OxyContin.

MICHAEL: These are the new numbers,

and you'll see a significant difference

from the initial rollout figures.

RICHARD: Better.

Really great job, Richie.

That's really great.

Yes, yes, there's been a definite
improvement in the sales figures.

We also found doctors who
attended the weekend seminars

have been writing twice
as many prescriptions

as doctors who don't.

Then we should throw
more weekend seminars.

But, um, more significantly,
doubling the dose

not only solved the
breakthrough pain issue,

it increased our bottom line,

since manufacturing a
milligram or milligram

is almost the same
cost as a milligram.

This is bringing in revenue

at a much faster rate than projected.

There's a scenario I've
been concerned about.

And what is that, my dear cousin?

Well, what happens if
someone has breakthrough pain

and they're already at milligrams?

The sales reports from
last quarter were terrific,

so much so that I am pleased to announce

that we will be launching
a brand-new product.

Ladies and gentlemen, it is
time to double the dose again

as I present to you
the -milligram pill.

[APPLAUSE]

Whoo!

[MAZZY STAR'S "SHE'S MY BABY"]

[ROCK MUSIC]

♪ ♪

MAZZY STAR: ♪ She's my baby ♪

♪ She belongs to me ♪

♪ But yesterday she
walked home all alone ♪

♪ Everybody else looks at my baby ♪

♪ Then they wander over to me ♪

♪ But baby's feelin' bad today ♪

♪ She said she's
thinkin' of goin' away ♪

♪ And I'm cryin' ♪

♪ And my body's flyin' ♪

♪ But I remember you ♪

♪ She's my baby ♪

♪ Ain't that something? ♪

♪ But I know ♪

♪ She belong... she belongs to you ♪

♪ ♪

[MUSIC FADES]

[SUSPENSEFUL MUSIC]

♪ ♪

[ROOSTER CROWING]
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