Dopesick (2021) s01e02 Episode Script
Breakthrough Pain
- 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 fucking 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 10 to 15 years for a new drug to complete the journey from inception to the marketplace.
- If OxyContin had failed when it launched in 1996, what would have been the consequences? - Purdue Pharma would have lost $40 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 12 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 12-hour drug.
Insurance companies and hospitals won't cover it if it doesn't last the full 12 hours.
How did this happen? - Well, we always knew it was a possibility that the drug wouldn't last 12 hours.
The Puerto Rico testing only hit at 50% - The FDA only requires a 50% 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 12-hour cycle.
- Yeah, I've had several complaints Or should I say questions About the drug not lasting 12 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 10 milligrams, they double the dose to 20.
If they're already on 20, they double to 40.
[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 20 and 40 milligrams are two and four times more expensive than the 10.
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 12-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 10 milligrams, you know, you bump them up to 20.
- 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 drugs, 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 1894 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 20 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 20 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, 40 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 shoot 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 shoot 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 shot.
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 shot 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 died 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 drugs.
As you may know, one of them died of an overdose.
Another one appears to be well on his way.
15,000 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 15, 20.
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 160 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 drugs.
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 gun on you? - Mm-hmm.
Pretty much always.
- Where do you keep it? I never thought feeling a gun 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 500.
Then you come in every 28 days for your refill for 125.
- 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 shit! BRIDGET: Hey! - [grunts.]
BRIDGET: Come on! Don't you fucking move.
Come on.
Have you ever heard of the crack epidemic? It was big in poor neighborhoods in the 1980s.
Huge portions of the Black population were hooked on crack.
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 drugs, killing each other.
My grandma got mugged three times.
This was how I grew up, Lucas.
Watching my friends die from drugs.
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 12 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 beat 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 fuck? - 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 drugs.
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 shot 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 fuck 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 12 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.
39 employees are responsible for 35,000 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 War 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 $500 to $3,000 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 fuck 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 20 milligram or 40 milligram is almost the same cost as a 10 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 40 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 80-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.]
- 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 fucking 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 10 to 15 years for a new drug to complete the journey from inception to the marketplace.
- If OxyContin had failed when it launched in 1996, what would have been the consequences? - Purdue Pharma would have lost $40 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 12 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 12-hour drug.
Insurance companies and hospitals won't cover it if it doesn't last the full 12 hours.
How did this happen? - Well, we always knew it was a possibility that the drug wouldn't last 12 hours.
The Puerto Rico testing only hit at 50% - The FDA only requires a 50% 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 12-hour cycle.
- Yeah, I've had several complaints Or should I say questions About the drug not lasting 12 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 10 milligrams, they double the dose to 20.
If they're already on 20, they double to 40.
[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 20 and 40 milligrams are two and four times more expensive than the 10.
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 12-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 10 milligrams, you know, you bump them up to 20.
- 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 drugs, 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 1894 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 20 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 20 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, 40 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 shoot 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 shoot 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 shot.
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 shot 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 died 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 drugs.
As you may know, one of them died of an overdose.
Another one appears to be well on his way.
15,000 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 15, 20.
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 160 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 drugs.
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 gun on you? - Mm-hmm.
Pretty much always.
- Where do you keep it? I never thought feeling a gun 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 500.
Then you come in every 28 days for your refill for 125.
- 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 shit! BRIDGET: Hey! - [grunts.]
BRIDGET: Come on! Don't you fucking move.
Come on.
Have you ever heard of the crack epidemic? It was big in poor neighborhoods in the 1980s.
Huge portions of the Black population were hooked on crack.
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 drugs, killing each other.
My grandma got mugged three times.
This was how I grew up, Lucas.
Watching my friends die from drugs.
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 12 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 beat 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 fuck? - 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 drugs.
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 shot 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 fuck 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 12 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.
39 employees are responsible for 35,000 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 War 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 $500 to $3,000 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 fuck 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 20 milligram or 40 milligram is almost the same cost as a 10 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 40 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 80-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.]