Dopesick: A perspective on the American opioid crisis
Opioid misuse has become one of the leading causes of death in the United States, killing more people over the last year than car accidents and gun fatalities combined. While the recent spike in overdoses and drug misuse can be linked to the covid-19 pandemic, the origins of the opioid crisis reach back to the 1980s. Hulu’s new mini-series, Dopesick, dramatizes the origins of this epidemic and the role Perdue Pharma played in America’s addiction to opioids. The show, based on Beth Mary’s non-fiction bestseller of the same name, links Perdue’s development and marketing of Oxycontin with the impacts of the new drug on members of an Appalachian mining town and investigations into the company’s actions years later.
Dopesick opens in 1986 when Richard Sackler (Michael Stuhlbarg) proposes a new kind of “slow-release” opioid, one designed to be non-addictive and safe to prescribe for long-term use. This substance, originally framed as a revolutionary wonder-drug liberating Americans from chronic pain, quickly proved to be an avenue for Sackler to generate success for Purdue Pharma — and for himself. Through false promises that Oxycontin was non-addictive and marketing that pushed the need to rescue patients from long-term pain, Purdue’s sales reps were able to convince doctors of the necessity of Oxycontin.
Members of the Drug Enforcement Administration (DEA) notice that almost all of their cases link to Oxycontin in some way, launching investigations into Perdue. These investigations reveal to viewers the many ways Perdue was able to manipulate doctors and patients into overbuying and overprescribing Oxycontin. Despite a continuous string of lawsuits against Perdue starting in 2004, all requiring Perdue to pay for programs aimed at discouraging drug abuse and supporting addicts, the numbers of overdose deaths and Oxycontin sales continue to rise.
As the legal game of cat and mouse plays out, the fictionalized characters of Dr. Samuel Finnix (Michael Keaton) and Betsy Mallum (Kaitlyn Dever) represent the thousands of doctors and patients whose lives were affected by Purdue’s predatory marketing practices. Betsy spirals into addiction following a prescription from Finnix made in good faith to help her get back to work after a mining accident. After being told that she should be able to quit taking cold-turkey without adverse side effects, Betsy causes another accident at her job while in the midst of withdrawal. Betsy illustrates how easy it is for patients to slide from pain relief, to dependency, to addiction without accurate information and support.
Between April 2020 and 2021 more than 100,000 Americans died of drug overdoses, almost 30% more than the previous year. As addiction rates and demand for Oxycontin rises, users are turning to more lethal if more easily accessible drugs like heroin or illegally manufactured pills that are often laced with fentanyl. The risk of overdose increases when opioids are mixed with other drugs, especially depressants such as alcohol and benzodiazepines, both of which saw an increase in use during the pandemic.
While Dopesick’s finale promises the hope of treatment for opioid addicts and justice for the victims of Perdue and the Sackler family, the reality is more complicated. Just over a month before Dopesick premiered, Purdue Pharma was officially dissolved in a bankruptcy settlement. The Sackler family has agreed to pay over $4.5 billion over nine years, most of which is planned to go towards addiction treatment and prevention initiatives. Still, the total dollar value to cover the cost of the opioid epidemic (prescription costs, treatment, social services, etc.) is estimated in the trillions of dollars — far more than the Sackler family has agreed to pay. Many also criticize the settlement for protecting the Sackler family. Moving forward, the family will not be held responsible for any of Perdue’s opioid-related liability, despite their involvement in the strategies that made Perdue such a predatory marketing machine.
Following two harrowing years of the Covid 19 pandemic, doctors everywhere are spread thin and many patients have been managing pain for longer than necessary due to having to put off elective surgery. The rates of mental health conditions, especially anxiety and depression have also risen over the last year, correlating with a rise in opioid and benzodiazepine prescriptions. Skyler Health can offer doctors the tools, information, and protection from liability they need to feel confident that they are prescribing these drugs safely and are providing the best care for their patients.
No one should have to live in pain when there are methods of treatment available, but pain management should not come at the price of addiction. Skyler Health recognizes this and has been innovating new treatment protocols to help make sure people who are prescribed opioids have the support they need. Convenient teletherapy makes information and support accessible, especially for those in the rural areas like Appalachia that were targeted by Perdue and remain some of the most heavily affected. Skyler Health’s protocols focus on preventing dependence by creating individualized programs with members and their prescribers to manage their opioids and benzodiazepine safely over the long term. AI tools, 24/7 access to care, and specialized expertise in medication tapering also help those fighting addiction by helping to prevent relapse.
Though many of the characters are fictionalized, the characters of Dopesick illustrate the importance of access to proper medication tapering assistance and accurate information. Looking toward the future, Skyler Health hopes to be an example of how to provide the best care for those suffering from pain, mental illness, and addiction.
