by Matt Kauffman ‘23

In recent years, entertainment media, including Hulu’s miniseries Dopesick based on Beth Macy’s book, and Patrick Radden Keefe’s investigative work Empire of Pain, has exposed the ugly truth behind the opioid epidemic in America. Purdue Pharma and its owners, the Sackler family, have faced massive public scrutiny recently after their cover-up and exploitation of the effects of their narcotic painkiller OxyContin were revealed.

The drug, introduced in 1996, was originally developed for major injuries, but the threshold for usage was lowered several times to treat less severe pain. Drug representatives aggressively marketed OxyContin to doctors in rural areas to take advantage of blue-collar workers that experienced more frequent injuries due to laborious jobs.

Dopesick, starring Michael Keaton as Dr. Samuel Finnix, a small town physician, offers a semi-fictionalized version of the opioid epidemic in rural Appalachia, following the affected communities, the Drug Enforcement Administration (DEA), two U.S. Attorneys in Virginia, and the Sackler’s themselves. Hulu’s miniseries combines the emotional, gripping aspects of a drama with the grim reality of the crisis. The show depicts how Purdue drug representatives targeted doctors in rural areas to prescribe OxyContin to a poor working-class that often endured injuries as a result of their work. Many of these people became addicted as the drug’s time-release coating failed to help with their pain, prompting Purdue to invent and abuse new terminology like “breakthrough pain” to justify prescribing higher doses.

Not only did Purdue ignore the high addiction rate to OxyContin, but the company also used it to its advantage, constantly manipulating doctors and regulators to have a favorable view of the drug to continue prescribing the drug to addicted patients. They also were found to have used a fraudulent graph with a compressed y-axis to give the appearance of less extreme levels of OxyContin in the bloodstream compared to other narcotics.

Although Dopesick incorporates fictional elements, it remains all too real. Rural areas in Appalachia continue to be hammered by drug addictions and overdoses never present before the introduction of OxyContin. Misled doctors began to overprescribe and “pain clinics” began to pop up in different states, where doctors would prescribe the narcotic for relatively minor issues. Rehab centers went from mostly alcoholics and cocaine users to “90% Oxy,” according to the show.

Empire of Pain describes the dissolution of the Sackler family’s morals in gripping detail. Patriarch Arthur Sackler started working as a doctor in a mental institution in New York during the 1930s and ventured into the pharmaceutical industry, searching for better ways to treat mental illness instead of locking up patients and using electroshock therapy.

Arthur blended his medical degree and experience as a doctor with a natural talent for marketing and became wildly successful in the pharmaceutical industry. In the 1960s, he was put in charge of advertising for Librium and Valium, two tranquilizers used to treat an array of ailments from anxiety to alcoholism. Sackler used his sizable influence as the head of a medical newspaper to promote the drugs that would prove to become incredibly lucrative. Valium eventually became the first drug in the world to rake in $100 million. 

However, Sackler and his colleagues concealed many of the two drugs’ harmful side effects from the public, including addiction. Roche Pharmaceuticals, the company that manufactured both tranquilizers, also deliberately concealed a study that raised concern about the potential for addiction, a marketing tactic that would become Richard Sackler’s trademark during the promotion of OxyContin decades later.

Purdue was purchased by Arthur and his brothers in 1952. At its zenith, it was a wildly profitable if not morally questionable corporation, but in the past 20 years, it has dissolved into a soulless corporation that manufactures lethally lucrative drugs at the expense of the people it is supposed to help. Since 1999, more than 500,000 people have died from prescription painkillers, heroin, and illicit fentanyl. Alex Gibney’s documentary sums up this tragedy in its title: The Crime of the Century. 

In the face of thousands of lawsuits due to the downplaying of OxyContin’s addictiveness and their general guilt for much of the opioid epidemic, Purdue Pharma declared bankruptcy in 2019 and will likely have to pay over $4 billion in settlements. 

The Sacklers have adamantly denied any wrongdoing or fault for the epidemic. The family has escaped jail time and has an estimated net worth of $13 billion. However, last year, a federal judge rejected a settlement that would have granted the Sackler’s immunity from further lawsuits in exchange for a $4.3 billion settlement.