All language subtitles for dopesick.s01e03.1080p.web_.h264-cakes

Today,
we're gonna talk about

a medical condition
known as breakthrough pain.

We were curious as to
why nobody says OxyContin

in a video designed
to promote OxyContin.

I'm at a loss for words.

It's just changed my life
for the better.

We just did
what they wanted.

They said, "Make a PSA,"
so that's what we shot.

This drug has
only been on the market

for three years,
and there's already been

a spike in overdoses
and crime rates.

‐ Purdue Pharma is doing
my people a great service,

so God bless 'em for it.

What happens if someone has
breakthrough pain

and they're already
at 40 milligrams?

It is time
to double the dose again

as I present to you,

the 80 milligram pill.

‐ Whoo!

Pulse rate,
body temperature,

blood pressure,
respiration rate.

These are the four vital signs.

They indicate the status

of the body's
life‐sustaining functions

and serve as a basic warning
to potential health problems

should these indicators
be off standard levels.

But I would argue

that if we want to ascertain

the true health
of our patients,

then these four vital signs
are not enough

because they do not
monitor pain.

From pain,

we can instantly determine
if a patient is suffering.

And what better indicator

for the status
of a patient's health

than the level of their pain?

Therefore, I propose to you
here today

in these vaunted halls

that the medical community
must make pain

the fifth vital sign.

Well, it looks better.
How's it feel?

‐ It feels a lot better.

‐ Good.
That's what I wanna hear.

So it's been four weeks.

I wanna taper you off the meds.

See, starting Monday,
I want you to...

take one pill a day
until the next Monday,

and then we're gonna
stop altogether.

‐ Oh, okay.
Okay?

‐ Sounds good.

And if you have
a problem, you call me.

You know, like you didn't do
when you first got injured?

‐
Yeah. You're the boss.

That's right.
I'm the boss.

So what's the latest
with Eureka Springs?

‐ Oh, we called a realtor.

She's looking for a place
for us.

‐ Talk to your folks?

‐ Well, uh, I tried
to talk to my mom.

How'd that go?

‐ They'll think
I'm going to hell,

so it doesn't really matter
what I say.

‐ You think
you're going to hell?

‐ No.

I never believed
in none of that stuff,

even when I was a kid.

‐ Well, then,
as far as that goes,

you got nothing to worry about.

‐ Unless I end up in hell.

‐
Yeah.

‐ Well, yeah, there's that.

‐ What do I do about 'em?

‐ Forgive 'em.

Love 'em.

Be patient with 'em.

You never know.
They might surprise you.

Go live your life, Bets.

Sometimes you gotta let it go.

You know what I mean?

Fuck this shit.

‐ We are getting reports

that doctors have had
a lot of success

treating breakthrough pain
by doubling the patient's dose,

so this got us thinking
that perhaps there's a way

to prevent breakthrough pain
before it even begins,

and, uh, this inspired...

Why start someone
at 10 milligrams

if they really need to start
at 20 milligrams, or even 40?

We don't know the needs
of a specific patient

the way their doctor would,
so we need to let

physicians and nurses know

they need to individualize
the dose.

‐ This is exactly right.

Yeah, I agree.

It's very good, Michael.
Very good.

‐ Let's move on it.
‐ Great.

‐ Thank you, everyone.

Good work.

‐

Paul, uh, can you stay
for a minute?

I wanna look into launching
OC in Germany

under a relaxed status.

‐ Germany?
Yes.

If we can obtain
a relaxed status,

we'd be uncontrolled there.

But German regulators are
much stricter than the FDA,

and it's very time‐consuming
dealing with them.

They're, you know, German.

‐ Thank you
for the geography lesson, Paul.

I'm aware Germany isn't
the United States.

Perhaps we should focus
on shoring up the U. S.

before we start
making foreign moves.

And we'll work on it
for months or years,

and it won't go anywhere.

They'll never go for this.

‐ Well, that's what
Uncle Mortimer said

when I told him
we should create a narcotic

for moderate long‐term pain.

Thank you.

‐ Danke schoen.

‐ If you can get
these country doctors

to individualize the dose,

you get
the positive side effect

of individualizing your bonus.

All right.

Purdue also just conducted

an osteoarthritis study‐‐

pass those out for me‐‐
and it says

that if a patient is
on 60 milligrams a day or less,

they can stop cold turkey
without withdrawals.

Now, you make sure
you show that to your doctors.

This drug is just amazing.

All right, now,
for a little bit of fun news,

management knows how hard
you all have been working.

And, you know, we wanna do
a little something

to say thank you,
so I am pleased to announce

that Purdue is starting
a sales competition

called the Toppers Contest.

The sales rep
with the highest grosses

from each region

is gonna get
an all‐expense‐paid trip

to Bermuda.

All right,
so everybody get out there,

you keep selling,

and someone in this room
is gonna end up

with one hell of a tan.

Don't be offended
when I tell you,

I would jam a knife
into your carotid artery

to win that trip.

‐
Okay. Well, how about this?

We double our dose
and we partner up.

So if I win,
you're my plus‐one.

And if you win, you take me.

‐ Or I'll go with you
if you win.

And if I win,
I'll go with someone else.

How about that?

‐ Yeah, I mean, that's not
really what I was going for.

‐ Oh, Billy,
I think you're a riot,

but I only fuck really hot guys
and really rich guys.

And you are
neither hot nor rich,

but you are fun.

Sort of sweet when you're not
being a fucking douche,

so let's just be friends, okay?

'Cause this one‐sided
sexual tension

is getting tired.

‐

I mean, can we be friends
who fuck on the trip to Bermuda

if I win the contest?

‐ Well, I'll consider it.

Maybe it's time for an upgrade
from that piece of shit.

‐ I just gotta
individualize the dose.

This is beautiful, Doc.

‐ Yeah, it's one
of my favorite spots.

You know,
Drea Price keeps asking me

if you're gonna come
to Orlando.

‐ She does?

Yeah.

She sure liked ya.

‐ Huh.

‐ Why don't you come down,
take her on a‐‐

take her on a date
or something?

‐ A date?

I wouldn't remember
what you do on a date.

‐

‐ I don't know
what I'd even talk about.

‐ Well, you just talk about,
you know‐‐

well, I don't know, actually.

I'm not a expert
in these matters, but‐‐

‐ Do you have a girlfriend,
or what?

No. No.
‐ No?

‐ Well, there's this sales rep,
actually, who's hot as hell.

Loves to torture me.

‐ She like you?

‐ Definitely not, no.
‐

‐ But she flirts with me
just enough

to keep me going, you know?

‐ Yeah.

Here's an idea.

Maybe you could find a girl
who actually likes you.

‐ That sounds awful.

‐ Mmm, boy.
Look at this. Mmm.

‐ Doc.
Yeah?

‐ I was gonna
run something by you.

Would you ever start
your patients on a higher dose?

If their pain was
especially strong,

would you start 'em
at 20 milligrams

instead of, say, 10?

‐ Nah.

If I had 'em on 10
and if I had to,

I'd just bump 'em up.

‐ Right.
Why?

‐ No, no reason.

I was just, uh, curious,
you know?

How are your patients doing
on Oxy?

‐ Good, good.

I'm trying to, uh, you know,
taper one off.

She has no pain.
Her pain's gone.

‐ You don't need to taper her.

Actually, a new study
that I just read said that

if they're taking anything
less than 60 milligrams a day,

they can stop
without withdrawals.

I'll send it to you.

‐ Nah.

I'd rather have her taper,
just to be safe.

Hey, Grace.

I don't think
I'm gonna make it tonight.

What the hell
are you talking about?

I'm already
at the Rattlesnake.

‐ No, I know. I know.
I just‐‐

I‐I'm not feeling too great.

‐ Are you sure there's not
somethin' going on?

'Cause you're acting
really strange.

No. No, Grace.

Nothing's going on.
I just‐‐

I'm not feeling great,
all right?

Okay.
Well, let me know
if you need anything.

‐ No. I don't.

All right, fine. Bye.
‐ Bye.

Shit!

Shit! Fuck!

‐ I'd been living with pain
for so long,

but then almost overnight,
I got my life back.

‐ As shown in Exhibit 1A

of the "I Got My Life Back"
promotional video,

Purdue manipulated
basic facts of the drug,

claiming it is
essentially nonaddictive

when it clearly was.

And these participants involved

were deceived
into participating,

being told it was a PSA
for pain relief

instead of an advertisement
for OxyContin,

and many of them are now
addicted or dead from drug use.

So we request access to all
internal marketing materials,

research, and testing data

to determine
if there are other deceptions

as flagrant as the exhibit
currently for the court.

‐ Your Honor,
statements made by counsel

in no way even resemble
the facts.

My client is aware

there have been
addiction issues

in this part of the world,

but blaming Purdue Pharma
for this

is like blaming Budweiser
for a drunk driver.

It is the fault
of the drug abuser

and not of the manufacturer.

The scope of the subpoena
is overly broad,

and the information contained
in their request is privileged.

‐ Your Honor, if there is
no liability, then‐‐

‐ What these local lawyers
don't seem to understand

is that there is
a national pain movement

that is far bigger
than my client and its drugs.

Renowned pain organizations

have not only endorsed
my client's medication,

but the general use
of increased opioid treatment.

My client should be given
a Nobel Prize,

not a subpoena for materials.

‐ I actually tend to agree.

Not on the Nobel Prize part.

The scope of the request
is too wide

as it currently stands.

You need to bring me
something more compelling

than a single video
for such a broad request.

‐ That video
should have been enough.

‐ Hey, we'll find more.

We knew it wasn't
gonna be easy.

‐ Hey, good luck
in surgery tomorrow.

And I know it's gonna go great.

‐ Thanks.
I'll be back in a week.

‐ Hey, you take
as much time as you need.

All I need's a week.

‐ Hey, sweetie.

You did good.

‐

The doctor told me
it went really well.

‐ Oh, good. Good.

Hey there.
How you feeling?

Oh, a little‐‐
uh, not too good.

‐ Are you in a lot of pain?

‐ Yeah. Yeah.
I'm feeling some pain.

‐ How would you
describe your pain?

Scale of one to ten?

‐ Mm, about a thousand.
Got it.

We are gonna go ahead

and give you
20 milligrams OxyContin.

It will significantly reduce
your level of pain.

‐ Do you have anything
besides OxyContin?

‐ Why 20?
Why not 10?

‐ It's standard
to individualize the dose

for the patient's needs.

‐ I don't want Oxy.

‐ We don't have anything
as effective.

It is completely safe.

‐ Just‐‐just give me
some Tylenol.

‐ I'm gonna go ahead

and have you guys
look at this pamphlet

on painkillers.

They're very safe now.

‐

Hi, Randy.
Surgery went well.

Your margins look clean,
but I'll know for sure

once the, uh, pathology
comes back.

‐ Right.

‐ How are you feeling?

‐ Patient's refusing OxyContin.

He only wants Tylenol.

‐ It won't be strong enough.

Pain's the new
fifth vital sign.

It's the top priority
of this hospital.

We manage it.

‐ Do you have
a strong non‐opioid?

‐ We could go with
1,200 milligrams of Motrin.

It'll knock the edge off,
but it doesn't last 12 hours.

‐ Well, neither does OxyContin.

‐ That'll be fine.
He'll do Motrin.

‐ Jermaine.

Break‐in at a rural pharmacy,
officer shot.

Guy took only four bottles
of OxyContin and nothing else.

I saw a pain clinic in Kentucky

that looked like
a junkie drive‐through.

What were you doing
in Kentucky?

It's where
I get my hair done.

‐ The fuck, Bridget?

You could get in serious shit
for this.

‐ Hey, I'm just
making observations

and bringing it
to the appropriate authorities.

‐ Look, I get it, okay?
I get it.

But what's the next move?

‐ You tell me.

‐ Well, if this were cocaine,
you'd try to prevent

the smugglers from bringing
the drugs into the country

and target local dealers
to bust larger syndicates.

Correct?
‐ Correct.

‐ I don't need a sting
operation to find the drugs

because I know
exactly where they are.

Where?
‐ They're in every pharmacy
in the country.

So I can't call in
the Coast Guard

to protect our borders

because the drugs
are already here.

So who do I bring
a major case against?

Some dickhead with a truck?

A shithole pain clinic
in Kentucky?

‐ I don't know, okay?
I don't know.

But something
is happening here.

A single prescription drug

is filling up jails
in rural areas.

‐ Find me a cartel

and I'll call in
the Coast Guard,

but right now,
this is a local crime issue.

Uh, Mr. Wayton?

Bridget Meyer, DEA.
We spoke on the phone.

Yeah. Hey.

‐ What's going on?

We're gonna put in
a higher counter,

tougher to jump over.

Third break‐in this year,

and all they ever take's
the Oxy.

‐ You ever think about
not carrying the pills?

‐ Tried, but they told me
I'd get sued if I did that.

‐ Who told you that?

‐ That woman from Purdue.

‐ What did the Purdue rep say?

She acted like she was
helping me out, you know?

Like she was my good friend
offering advice.

She said if I refused
to dispense her drug,

that doctors and patients
could sue me,

and the lawsuits could
put me out of business.

Either way, I'm screwed.

‐ Do you have her name?

‐ Fuck.
No, no, no.

You've got to get
your patients off Vicodin.

I've got one multiple studies
from different pain foundations

that show Vicodin is terrible
for their liver.

Mm‐hmm.

What‐‐I don't have any change.

‐ Bridget Meyer, DEA.
Please exit the car.

‐ I have to call you back.

I'm so sorry
about the change thing.

I get hit up in my car a lot.

‐ I'd like to ask you
some questions

about break‐ins at pharmacies
in the area.

‐ Well, I didn't do it.

I would never risk
scratching my new Manolos.

‐ You're not a suspect, ma'am.

Several of the pharmacists
complained they were told

they had to carry OxyContin
when they didn't want to.

‐ Who told them that?
They said you did.

They said you threatened them
with lawsuits.

‐
Oh, what?

Oh, you're fucking kidding me.

Um, no. No.
I tried to help them.

I told them doctors
and patients could sue them.

I never said anything
about my company.

‐ Well, they took it
as a threat from you.

They felt
they were being bullied

into carrying a drug
they didn't wanna carry.

‐ Well, I'm not surprised
they were confused.

They're pretty stupid
down here.

That's what happens
when you fuck your sister.

‐ Were you instructed
to threaten these pharmacies

by your employers?

‐ No.

And I have to go.

‐ I just have
a few more questions.

‐ Do I have to answer them
by law?

‐ No, you do not.

‐
Then you have

a great day, ma'am.

Good to see you.
Thank you for having us.

Oh, of course.
Nice to see you.

‐ Glad you could come.

Check out Richard.

I didn't know
he knew how to smile.

‐ It's a smile of relief
he didn't sink the company.

I don't know if I'm happier
we have a potential blockbuster

or annoyed
he actually pulled it off.

‐ Hmm, I heard everyone
at the office hates him.

Mm.

Can't stand him.

You know, he didn't even know
what oxycodone was

until I told him,

and now
he micromanages everyone

like he's God's gift
to medicine.

‐ He's gonna make a toast.

Theresa and I
would like to toast

the opening of the
Sackler Institute at Cornell

as we make our family

the most philanthropic
in America.

Thank you, Mortimer.

I'd also like to toast
our host, my son, Richard,

for his tireless work on
our latest product, OxyContin.

It's only been out
a few months,

and it's already
a major breakthrough

in pain management.

So to Richard.

To Richard.

Hi. How are you?

Your numbers
are good,

but they can be even better.

Just keep pushing your doctors
to individualize the dose,

and I will keep checking in.

Thank you.

Good Unch.

Good boy. Good boy.

‐ Dad hates it when you
bring him into the office.

‐ Then, uh, don't tell him.

‐ Is Unch short for something?

What's going on?

‐ Uh, so...

Uh, Germany isn't gonna work.
‐ Why not?

‐ We have to prove OC has
minimal abuse liability,

and we‐we can't
make that claim.

That's‐that's just
negative thinking.

Can't we run
another long‐term trial

to get more data?

‐ I wasn't aware there were
any long‐term trials.

Dr. Richard,

even if we could get OxyContin
designated uncontrolled,

it's highly likely
it will be abused in Germany

under that classification

and then be reclassified
as controlled.

God damn it, I'm sick

of all these fucking noes!

I want a yes.

‐ Germany isn't like the U. S.

We can't maneuver
around their laws.

You're wasting a lot of time
on something

that will get revoked.

‐ It's also cultural.

The Germans don't believe
in opioids.

They believe suffering
is part of healing.

Um, hey, Paul,
will give us a minute?

Richie.

It's going great.

It really is.

The drug has turned a corner.

We're on an upswing.

You and Beth
should take a trip.

Relax.

You haven't had a break
in years.

Go spend some time
with David and girls.

There's no time
for a break.

There is no break.

There will never be a break.

Look, I‐I know
I can be hard on people,

but can you think
of any greater venture

to help humanity

than curing pain?

We need to get this drug
into Germany.

Please, John, just...

don't give up so fast.

‐ Okay.

Okay. We'll‐we'll keep trying.

‐ Thank you.

We got lucky
with the weather, buddy.

No doubt.

It's just nice to get
out and get away from things.

Oh, amen.
I could just sit here

and stare at the river,
to be honest.

Pretty crazy world,
these days there.

Oh, Lord. Lord.
Oh, it's a mess.

‐ You know, you read about
or heard about

any of these programs

if you think
someone's a homosexual,

they‐‐they're gonna
pray away the gay?

You ever hear of them?

‐ Oh, yeah.
I've heard of that.

Yeah.
‐ Why?

I got a friend up
in Greensboro.

He's thinking
of sending his kid to one.

What, you saying
they don't work or something?

‐ It's snake oil business.

I mean, prayer is good,

but it's not gonna do any more
or less for that

than it would
for anything else.

‐ Well, not to be
a Bible thumper, Doc,

but if you had a kid like that

and you believed
in the good word,

you'd wanna do something to try
to help 'em, wouldn't you?

‐ Yeah, except most all
the research says

that's just, you know,
how people are born.

It's who they are.

‐ Research, huh.
Yeah. Yeah.

‐ I don't know. Maybe.

My cousin's got a kid
who's, uh,

maybe that way.

Just, uh, goes against about
everything he believes in.

‐ Why don't you tell
your cousin

just to‐‐
just think for a minute

about how hard it is
on that kid.

‐ I don't know
if he can let it go, Doc.

Sure he can.

He can just remind himself
that his love for his kid

is bigger than anything else
in the world.

‐

He sure does love that kid.

Sure does.

You feeling all right?

‐ Yeah, I'm fine.

Just tired.

Well,
you don't have a fever.

Jer, dinner's up.

‐ Mm‐hmm.

Bless us, oh Lord,
for these are gifts,

which are boundless,
oh Lord. Amen.

So did you catch anything?

‐ Well, a couple of trout.
Not worth, uh, keeping, though.

‐ And Finnix?
‐ Oh, no.

He wasn't really interested
in fishing.

He seemed, uh, more interested

in talking about
his friend's gay kid.

‐ And why would he do that?

‐ I don't know.
Have to ask him, I guess.

Sure made a big deal
about it, though.

Said how research shows
people are born that way,

so on, so forth.

That's the, uh, city boy
still in him.

‐ He's been here for 40 years.

‐ Well, I guess he ain't
a true believer, then, is he?

The worst thing that, uh,
a parent could hear is that...

Our kid is, um,

queer or gay or lesbian

or whatever they say now.

It'd kill me if you were, Bets.

It'd absolutely kill me.

‐ Well...

I guess you're dead, then.

‐ You got something
to say to me,

or you want old Doc Finnix
to say it for you?

‐ I just said it.

Didn't you hear me?

And what about you?

You hear me this time?!

‐ You don't raise your voice

to your mom in my house,
you hear me?

‐ You don't have
to worry about that,

'cause I'll leave, Dad.

You won't ever have to look
at your queer kid ever again.

‐ Well...

I think that's best.

‐ No!
Fine.

I'll leave this weekend.

‐ You do that.
No, Jer. No.

You don't have to go anywhere.

‐ No, I do.

I'm not wanted here.

‐ No.
She doesn't have to leave!

I don't care.

I don't care.

I don't care.
I really don't.

Jerry, I don't care.

Oh, shit. Oh, shit.

Did you check
the methane monitor?

Betsy, did you check
the methane monitor?

‐ Yeah.

Yeah, it's all clear.
It's all clear.

Help!

‐ Did you read
the methane monitor?

‐ Of course I did.

How's Eddie?

‐ Go ahead.

‐ They, uh, think he's gonna
lose his right arm.

What was the number?

On the readout,
before the explosion?

‐ Um...

‐ Was it above a four?
‐ No.

When the levels are that high,
the machine just shuts down.

And we both know

it sometimes gets disabled,

which is why
you're there to check it.

‐ Was dust
obscuring the readout?

‐

‐ Just‐‐just tell the truth.

‐ Uh...

there might have been.

‐ Do you realize that men
might be dead 'cause of you?

That it's possible
this mine will close?

Do you know how much damage
you have done?

‐
I don't understand.

What?
What don't you understand?

‐ I don't‐‐

I don't understand
what's happening to me.

‐ Gracias.
Hey, I want some of that.

‐ Yeah?

‐ Oh, it's really good.

‐ Mmm!

‐ You wanna jump in?

Yeah, I can do that.
‐ Hold on. Hold on.

Sorry.

‐ This is fucking great.

‐ Um, it's work. Is that okay?
‐ Yeah, go ahead.

No problem.
‐ Okay.

Hello?

Hi. Agent Meyer?

This is Mike Wayton
from Wayton's Pharmacy.

I don't know if you're
still investigating

the guy that broke in here,
but they got him.

‐ Oh.
Where did they catch him?

In his bathtub.

He was dead from an overdose.

His little girl
in the next room.

I tried not to sell that stuff,
but those people‐‐

‐ Um...
Bridget!

I'm‐‐I'm so sorry.
Uh, I‐I gotta go.

Thank you, um...

and I promise you,
it is not your fault.

I appreciate that.

‐ You want some more?
‐ No, I'm okay.

You, uh, want
to stop here, take a look?

Yeah, right here.

‐ How many kids in your school
are on OxyContin?

‐ Maybe half.

Bridget.

Down here.
‐ Oh.

Are you okay?
‐ Yeah, I'm fine.

Uh, I know we've only been
dating for nine months,

but I have never
been with someone

that I respected

and admired and cared for

and loved
as much as I love you.

You're my hero,

and I would be so honored

if you would be my‐‐my wife.

‐ Oh, my God.

‐ Yes?
Yes!

Yes! I'm sorry. I'm so sorry.

‐ Don't apologize. Here. Wait.
‐ Oh, my God!

You think you got it?
‐ Wait, I got it. Oh, my God!

Oh, my gosh!

‐
‐ Okay.

‐ You asked to speak
to me, sir?

‐ Stay out
of Diversion's domain.

You made a presentation,
and we listened.

But in no way did this
give you the right

to start
an independent investigation.

‐ I understand, sir.

And I immediately gave
everything I uncovered

to Diversion,
but I believe we must pursue.

‐ Why?

‐ Agent Spellman told me

that the reason we can't pursue
an OxyContin case

is that there is no cartel
to go after.

The drug is here legally

and opioids are now
widely accepted

in the medical community.

But I believe
I found the cartel.

‐ Oh, you have?
Yes, sir.

I even have their address.

201 Tresser Boulevard,
Stamford, Connecticut.

That's the main headquarters
of Purdue Pharma.

They are the makers
of OxyContin,

and they are the cartel, sir.

They are lying to doctors
and patients

about the dangers of the drug,
and they are forcing pharmacies

to carry it with threats
of lawsuits if they don't.

And the FDA is
an unwitting coconspirator

because they issued Purdue
a warning label

that gives them cover to say
that the drug is less addictive

than other opioids
when it's clearly not.

‐ Could the FDA be colluding
with Purdue?

It's possible.

The individual who approved
this highly unusual wording

on the warning label
now works for Purdue.

‐ Really?
Yes, sir.

Curtis Wright.
We need to act now.

We have to go after
Purdue Pharma now, sir.

Right now.

How attached are you
to your service pistol?

‐ Why do you ask?

‐ Diversion agents aren't
allowed to carry firearms.

‐ Are you transferring me?

‐ No.

No, I'm promoting you.

I'd like you to be
deputy director

of the diversion division.

They need someone with balls
over there.

‐ I accept.

‐

Congratulations, Bridget.

I believe you're now
the highest ranking woman

in the DEA.

‐ Thank you.

Oh, hey, Doc.

This is Rick Mountcastle,
U. S. Attorney's office.

See, uh, we wanna ask you
a few questions

about a case
that we're working on.

‐ Sure.

‐ So Randy described a scenario
in which his nurse

was quite forceful
about him taking OxyContin.

Is that standard?

‐ What do you mean?

‐ I mean, is there
some sort of hospital policy

to push OxyContin?

‐ The hospital can now get sued
if the patient felt

that we didn't manage
their pain properly.

Or they can write us
a bad review online,

which would cause the staff
to be rebuked by management.

Nurses have been fired
over online reviews.

‐ Is that just this hospital?

‐ No. All across the country.

Internet has really
changed things.

‐ Online reviews
have caused a shift

in national opioid prescribing?

‐ How are you feeling?

‐ I'm a little better.

I appreciate it, Doc.
Thank you.

‐ All right.
Well, I'll check back in.

The older nurses hate it.

All the opioids.

‐ I wanted to show you this.

Pain societies have
infiltrated the hospital rooms,

and they love their pamphlets.

I never heard that phrase
before today,

and now it's everywhere I look.

Thank you all
for coming.

I'm Roger Thurby from the
Appalachian Pain Foundation.

We're here tonight to discuss
opioids in our community.

We know they've been getting
a lot of attention lately

and there's been some folks
struggling with addiction,

so we decided to gather experts
on the situation

and discuss it publicly.

First, I'd like
to turn the microphone over

to Ms. Barbara Mullins,
who's on the editorial board

of the "Journal of Pain."

Thank y'all
for having me here tonight.

Opioid abuse is
certainly growing,

but it's important
to distinguish between abusers

and legitimate pain patients
who need these medicines.

So is this a consensus?

Pills aren't the issue,
it's the addicts abusing them?

‐ Absolutely, but I also
think it's important

the pharmaceutical industry
does a better job

working with law enforcement

to keep these products
out of the hands of abusers.

They have some responsibility
here too.

‐ Uh, my sciatica was so bad

I couldn't even get up
in the morning.

And right when I finally
get back to normal,

I'm terrified my drugs
are gonna be pulled

'cause of these junkies.

Absolutely not, ma'am.

We are doing everything
in our power

to make sure
you get your medication.

Yes, sir, in the back.
‐ Hi.

Um, I've been hearing
from some folks

the real problem is,
OxyContin is

much more addictive
than its maker claims.

‐ Is there any truth to that?
‐ No, it's a misconception.

Vicodin is actually
being abused

at a much higher rate
of its total sales.

That's right.
Much higher.

And actually, Vicodin is
potentially bad for your liver.

I personally wouldn't use it.

‐ I wouldn't either.

It has addictive qualities,

whereas less than 1% of people
become addicted to OxyContin.

‐ Hey. How you feeling?
‐ I'm good. I'm good.

How y'all doing?
‐ Good. We missed ya.

Hey, the guys are
in the conference room.

Get in here and talk
to these maniacs.

‐ Pain Society has been
pushing them for years,

and once pain became accepted
as the fifth vital sign, yeah,

J‐Co went from anti‐opioid
to pro‐opioid.

‐ Hey, Gregg!
Hey.

‐ Conversation sounded like
a barrel of laughs.

Mind if I grab a sarsaparilla
and join y'all?

‐

Brother,
when you said one week,

you really meant it.

‐ Randy, how are you feeling?

‐ I think I just might be
in the clear.

Everything's negative.

‐ That's wonderful news.

‐ So what have we got
on these pain foundations?

Totally legit, right?

Just a bunch
of straight shooters.

‐ Yeah.
Humanitarians of the year.

Uh, started with the
Appalachian Pain Foundation.

Pulled their tax returns,
and you were spot‐on, Rick.

In 2000, they got a $20,000
grant from Purdue Pharma

to literally start
their organization.

‐
What tipped you off?

‐ When they were
pushing OxyContin

and trashing Vicodin.

‐ Subtle.

‐ Did you find
Purdue connections

with other pain societies?

‐ Gentlemen,
it is time to buckle up.

The American
Pain Society claims

to be
an independent medical group

representing physician
pain specialists,

but it receives a sizable
portion of its funding

from the drug industry,

including significant grants
from Purdue Pharma,

who are one
of the biggest beneficiaries

of the society's
successful effort

to make pain
the fifth vital sign.

Purdue also spent heavily

to subsidize the American
Academy of Pain Medicine

and, in 1997,

spent $500,000 to underwrite
the work of a joint committee

formed by these two groups,
which issued a report

urging the broader use
of powerful narcotics.

Now, Purdue also
contributed generously

to patient advocacy groups,

like the National Foundation
for the Treatment of Pain

and the American
Chronic Pain Association,

but in effect, they helped fund

an entire network
of pain groups

that represented themselves
as independent,

but all heavily promoted
the use of opioids.

Uh, permission to approach
the bench, Your Honor?

Now, you might recognize
this pain chart,

as, uh, it's in hospital rooms
and doctor's offices

all across the country.

It's from the organization
Partners Against Pain,

which is ostensibly
an educational alliance

dedicated to the treatment
of pain,

but, in fact,

it is fully funded and run
by Purdue Pharma.

It is 100% Purdue‐owned.

In effect,
it's Purdue's shadow company,

which has infiltrated

hospital rooms
and doctor's offices

as a stealth tool
to prompt pain discussions

between doctors, nurses,
and patients

with the goal
of prescribing more opioids‐‐

‐ Objection. Conjecture.

Purdue has never hidden
its relationship

with Partners Against Pain.

‐ Then why not put Purdue
Pharma on these pain charts

instead of
a different company name?

Your Honor, th‐‐

‐ Proceed.

Partners Against Pain
also has a website

masquerading
as a patient advocacy group

to guide pain sufferers
to specialists,

but every specialist
that it sends you to

is a doctor with a very high
rate of prescribing OxyContin.

So pain societies
partially or fully funded

by Purdue Pharma and other
pharmaceutical companies

are de facto propaganda
divisions for big pharma.

The deception is so effective
that some sales reps at Purdue

thought they were using
independent data

when they were quoting studies
from the American Pain Society

with slogans like, "Pain is
the fifth vital sign."

And, of course,
the solution for pain

is always, always
an increased use of opioids.

And it's an increase so high
in the last five years

it's at levels not seen

since the run‐up to the
Harrison Narcotics Tax Act...

of 1914.

Thank you, Your Honor.

‐ Permission granted
to release requested documents

relating to marketing,
research, and distribution.

‐ All right.

Go get 'em, Boss.
‐

‐ I know you all are dying
to know the results

of the Toppers Contest.

All right, but before
I name the winner,

I just have to say

what an incredible quarter
you had.

"Individualize the Dose"
got a huge number of doctors

to start at 20 milligrams,
and some at even 40!

You guys fucking rock!

All right, but there can
only be one winner.

And this quarter, it is...

Todd Brunward.

‐ Fuck yeah! Come on!

All right.
All right.

Todd, Todd sold

$767,000 worth of OxyContin,

one of the highest
in the nation.

Todd, come up here.

Tell everybody how you did it.

‐ Um, well, you know,
it was all hustle

and determination.

Yeah, I went to every doctor
on my IMS sheet

and, uh, told them
what we got here.

He's such a liar.
He didn't hustle shit.

‐ What do you mean?
‐ He has a whale.

One doctor running a pill mill.

‐ What's a pill mill?

‐ It's a doctor
who overprescribes like crazy.

It's a total gold mine
if you can land one.

Todd works a few hours a month,

then plays video games
and smokes pot all day.

It is so unfair
that he wins with a pill mill.

‐ Yeah.

Shouldn't he report a doctor
for something like that?

‐ He'd probably get fired
if he reported him.

‐ So Purdue want whales?

‐ Oh, sure.

You don't wanna
shut a whale down.

You wanna reel it in.

Sam.
‐ Hey.

Oh!

Oh, I can't tell you
how happy I am to see you.

It's been way too long.
Way too long.

‐ Yeah, you look wonderful.

‐ Oh, come on.
‐ What'd you do?

I sometimes think about you
all holed up in that house

and it just breaks my heart.

It's not
what Shelly would want.

‐ Well, it's her fault.

She's the one that dragged me
down to the mountains.

Yeah, but she knew
you'd follow her.

‐
Yeah, she did.

‐ Do you ever regret it?
‐ Regret what?

Spending all
those years in Appalachia?

Top of your class at Duke,
a fellowship at Johns Hopkins.

It's pretty heady stuff.

‐ Yeah. That's pretty good.
‐ Yeah.

‐ No.

I like it down there.

Yeah, I mean, it's not exactly
the life I had planned,

but it's been good.

It's good.

Until your sister left.

‐ I miss her too.

But you got
a lot of years still.

Uh, yeah.

That's kinda...

kinda why I wanted
to come up here

and visit with you, Barbara.

Uh...

You know, this whole idea

of, uh, dating again,

I mean, it's really, you know,
odd just saying dating.

But...

I don't know.

First of all,
it makes me feel...

guilty.

Like I'm doing wrong by Shelly,
you know?

‐ What, did you meet someone?

‐ I don't know.

Maybe.

Aww.

Sam, if you spend
the rest of your life

locked away in that house,

you will be doing
a great disservice

to that spitfire you married.

‐ But is it really okay?

‐ You're using your pain
as an excuse not to live.

But it's time
to start living again.

Hello?
‐ Hey.

‐ Well, be still my heart.

Is this my knight
in shining armor?

‐ Oh, well, yeah, I guess.

‐ Please tell me
I'm gonna see you in Orlando

in a few weeks.

‐ Yeah, well, uh,

actually,
that's why I'm calling.

I, you know, wanted to know
if, uh, you still wanted me to.

Well, of course, I do.
‐ Well, good. Good.

‐ Yes, and you're gonna
make another speech,

and you're gonna
get paid for it this time.

Bring your swim trunks.

‐
Oh, all right.

Well, I don't know if‐‐
not sure I got any,

but I'll, uh‐‐I'll swing by
and pick some up.

Hey, can you‐‐
I'm gonna call you‐‐

call you a little later.

I gotta take this call here.

Yes. All right.
See you Wednesday.

‐ All right.
Looking forward to it.

Hello?

Dr. Finnix,
where are you?

‐ I'm in D.C.
I'm visiting Shelly's sister.

Well,
you gotta come back.

There was an explosion
at the mine.

‐ How‐‐how bad?

Everyone's alive,

but a bunch
are at the hospital.

Betsy Mallum is in bad shape.

‐ Okay. All right.
I'm on my way.

‐ Morning.
Morning.

‐ Big truck
for just a couple boxes.

‐ They're drowning us
in paperwork.

‐ This isn't half of it.

‐ Oh, Lord.

‐ It's gonna take us
over a year

just to catalog all this.

‐ And they'll keep
selling pills the entire time.

‐ So we've been talking
to the German regulators,

and we just keep hitting
a brick wall.

Why did you have to pick

the hardest country
in the world

to get a drug uncontrolled?

‐ Follow me.

I'm, uh, sorry to bother you,
but would you mind giving me

a few minutes alone
with my brother?

The reason why I want to get
relaxed status in Germany

is precisely because

they do have the strictest
regulations in Europe.

If we get Germany uncontrolled,

even if the status
is eventually revoked,

it will serve as a gateway
to the rest of Europe,

which will then open us up to
the majority of global markets.

No one in the history
of this family

will ever come close

to accomplishing
what we're gonna do.

We're going to cure the world
of its pain.

‐

‐ So unfortunately,
the x‐rays show

you've got four broken ribs.

‐ Yeah. I saw it there.

Thank you very much, Doc.

‐ Uh, Dr. Finnix,
please don't rush.

This is a real injury.
I know.

I know, yeah.

I'm just in a little bit
of a hurry here.

‐ On a scale of one to ten,
how would you rate your pain?

‐ What is that?

I don't have my, uh‐‐
my readers.

It's a pain assessment chart.

Oh, I've never seen
one of those.

I don't know.

Five, six. Call it a five.
I don't know.

All right.

I'm gonna start you
at 20 milligrams of OxyContin.

‐ 20?

I usually start my patients
at, uh, 10.

‐ Well, I like
to individualize the dose.