‘Dopesick’ Episode 1 Recap/Ending, Explained – The Birth of OxyContin

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A wealthy philanthropist takes pride in his acts of social service. He tells people that he is helping them to improve their lives. But hidden behind his work is a sinister motive. A motive to satisfy his narcissistic pride? Dopesick, an American miniseries, examines the length of a man’s insanity as he believes he is revolutionizing the American Medical Industry.

The term “industry” in medicine is threatening enough to understand what happens when a “pill” is introduced to create a market rather than cure people. Based on a true story, Dopesick revolves around introducing an opioid, Oxycontin, designed to treat moderate pain for long-term use. Purdue Pharma sells it as a miracle drug to end the epidemic of suffering and redefine the nature of pain. However, this, in turn, brought upon the country an opioid epidemic.

Dopesick is an eight-episode miniseries created by Danny Strong that stars Michael Stuhlbarg, Michael Keaton, and Peter Sarsgaard in prominent roles. It is based on a non-fictional book, Dopesick: Dealers, Doctors, and the Drug Company that Addicted America, written by Beth Macy.

The narrative occurs in concurrent timelines, prominently in 1996, when Oxycontin was introduced to the market, and in 2002 when the DA started an investigation.


‘Dopesick’ Episode 1 Recap

In 1986, the patent for Purdue Pharma’s most prestigious drug, MS Contin, was expiring soon. It accounted for 25% of their total sales. A young heir and ignored member of the Sackler family, Richard Sackler (Michael Stuhlbarg), proposed a new opioid. He wanted to use MS Contin’s extended time-release system to design a new opioid, Oxycontin, to treat moderate pain for long-term use. The problem? The doctors won’t prescribe an opioid for long-term pain. Thus, Richard had to create a market to sell his magnum opus? How?

US officials Rick Mountcastle (Peter Sarsgaard) and Randy Ramseyer (John Hoogenakker) opened an investigation on Purdue Pharma in 2002. In 2005, front of the grand jury, the prominent doctors described their first interaction with Purdue Pharma’s sales rep. Through their expertly designed campaign, Purdue Pharma repeatedly explained to doctors that their Oxycontin was non-addictive. According to the sales pitch, less than 1% of its users develop an addiction.

When Rick asked Dr. Samuel Finnix (Michael Keaton) if more than 1 percent of his patients became addicted to OxyContin, he nodded briefly. With subtle grief and guilt on his face, Dr. Finnix began his story.


Dr. Samuel Finnix – Finch Creek Health Clinic

Originally from Southwest Pennsylvania, Samuel Finnix settled in a small mining town in Eastern Kentucky near the Appalachian Mountains. Finnix was a celebrated member of the small-knit community whose primary profession was mining. Due to their laborious job, the devoted miners often got injured doing their labor-intensive work. Hence, they looked up to Finnix for medical care and attention.

In 1996, Purdue Pharma Sales Representative Billy Cutler (Will Poulter) approached Finnix to convince him to prescribe OxyContin to his patients. As soon as Finnix learned about a new drug for chronic and moderate pain, he made it clear that he would never prescribe a narcotic for moderate pain. But Billy insisted. He pitched in that the new drug based on the old Contin system was not addictive. OxyContin addiction affects less than 1% of the population, and Bill had an FDA-approved special label to back up his claims. Finnix mentioned his suspicions and expressed that he had never seen an FDA label like this on a Class 2 narcotic.

However, the motive of a highly experienced sales force was to eliminate the reasons for doubt. Bill used the magical words “FDA approved” and “Delayed Absorption” to convince Finnix to prescribe OxyContin.

In the mining town, a young girl Betsy Mallum (Kaitlyn Dever), injured her back. She had her blind faith in Finnix and eventually became one of the first users of OxyContin.


The Investigation

In 2002, District Attorney John Brownlee was appointed to Abingdon, Virginia. As soon as he took charge, John informed his juniors, Rick Mountcastle and Randy Ramseyer, that he believed in righteousness and justice, no matter what the consequences would be. Looking at DA’s bold approach, Rick and Randy brought up OxyContin.

Randy explained that about four months ago, he noticed an unusual pattern. Almost every case over the last three years was related to OxyContin. Listening to their plight, John gave permission to the investigators to plunge further.

The investigators visited the deputy director of the diversion division, Bridget Meyer because the DEA was actively investigating Purdue Pharma last year. Bridget told them that the FDA label caused the whole breakdown in the system. It was the first time when the FDA labeled a Class 2 narcotic as less addictive. The same suspicion Dr. Samuel Finnix had.

But why did the FDA approve the drug if it was addictive?


Rigging the System

Bridget interrogated Karen Moles from the Food and Drug Administration and found out about Curtis Wright, the medical review officer who approved OxyContin.

In 2002, Karen told Rick and Randy that some people in the FDA department didn’t believe that Prude’s claim for OxyContin was valid. But since no studies were conducted on the drug, they didn’t have any evidence. Purdue agreed to a Class 2 classification for OxyContin, and believed it could be abused. They argued that there was no need to test the drug when they had already agreed to the facts. On Purdue’s claim, the FDA approved an unprecedented label without testing. But why would the FDA do that?

Karen Moles revealed that review officer Curtis Wright probably had a deal with Prude. 2 years after the drug hit the market, Curtis resigned from the FDA and joined Prude Pharma as executive director of medical affairs. The guy who approved the drug ended up working for the company that made billions out of it. Rigged enough? And Why?


Richard Sackler – The Mastermind of Dopesick

Michael Stuhlbarg played Richard Sackler as an insecure person looking for validation. His own family, a home to skillful geniuses and entrepreneurs, looked down upon Richard. They ignored his existence, and thus Richard lived in the shadows, probably. Feeling the necessity to prove his worth, Richard brought up the new drug. He did everything in his power to create a market for it.

Richard began DopeSick Episode 1 as a philanthropist and saint who wanted to save the world from an epidemic of pain. He made promises to revolutionize the American medical community. But in all his pursuit, he was looking for validation, a moment of praise from the Slacker Family. He wanted them to understand his worth, and to satisfy his narcissistic demon, Richard created an opioid epidemic through OxyContin.

Richard spent 40 million dollars on the development of OxyContin. The Mortimers shared their concern at the board meeting that if OxyContin didn’t sell or run afoul of the FDA, Richard would be responsible for sinking the entire company. To make OxyContin a blockbuster drug, he doubled the sales force. His sales rep sold OxyContin to mining, farming, and logging centers where folks often got injured doing physical jobs. And their weapon was an FDA label.

Probably, Richard bought off Curtis Wright to get a unique label from the FDA department. He knew that if the drug failed, the company would shatter into pieces. Richard was laser-focused on making it the most significant drug in the world, and he was ready to play dirty to fulfill his narcissistic dream. He created an epidemic that cost human lives.

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Dopesick is a 2021 television miniseries created by Danny Strong. It is based on actual events and revolves around the Opioid Epidemic in America.

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Shikhar Agrawal
Shikhar Agrawal
I am an Onstage Dramatist and a Screenwriter. I have been working in the Indian Film Industry for the past 12 years, writing dialogues for various films and television shows.

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