Series / Dopesick

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

— Richard Sackler

Dopesick is an American drama miniseries created by Danny Strong. It is based on the non-fiction book Dopesick: Dealers, Doctors, and the Drug Company that Addicted America by Beth Macy. Dopesick focuses on the epicenter of America's struggle with opioid addiction across the U.S., specifically the drug Oxycontin. It takes place over several years, from the drug's development and launch in the early to mid-90s to legal action taken against Purdue Pharma in the 2000s. The main cast is:

• Dr. Samuel Finnix (Michael Keaton), a medical doctor in Finch Creek, a small town in Virginia, who starts prescribing Oxy to his patients
• Betsy Mallum (Kaitlyn Dever), a young coal miner in Finch Creek who starts taking the drug after injuring herself at work and slips into addiction
• Bridget Meyer (Rosario Dawson), a DEA agent who starts looking into Purdue in the 90s when she sees how people are getting addicted to it on the streets
• Rick Mountcastle (Peter Sarsgaard) and Randy Ramseyer (John Hoogenakker), a pair of federal prosecutors from Virginia who start building a case against Purdue in the 2000s
• Billy Cutler (Will Poulter), a Purdue sales rep who pushes the drug to doctors, including Dr. Finnix
• Richard Sackler (Michael Stuhlbarg), the head of R&D and of marketing, and later president, of Purdue Pharma who led the development and distribution of the drug

The first three episodes of the eight-episode series were released on October 13, 2021 on Hulu.

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This miniseries provides examples of:

• Addiction Displacement:
  • The AA leader and the medical board both hold the opinion that suboxone and methadone treatment for opioid abuse is merely replacing one addiction with another.
  • Sadly, many prescription opioid abusers — including Betsy — end up turning to heroin when Oxycontin becomes difficult to obtain.
  • Betsy tries to replace Oxycontin with prayer and exercise. It doesn't take.
  • As Dr. Finnix learns first-hand, even standard rehab isn't very effective in treating opioid addiction because the drug alters the brain's chemistry in ways alcohol and narcotics like cocaine do not, making such time-limited stays ineffective and often resulting in multiple relapses for the addict or, as stated above, turning to heroin as a substitute.
• Addled Addict:
  • Betsy causes an explosion in the mine she works in when her addiction prevents her from reading a vital safety meter properly.
  • Dr. Finnix's nurse turns him in to the police after he nearly kills a patient while under the influence of Oxycontin.
• The Aggressive Drug Dealer: Of the FDA-approved variety, Richard Sackler, Purdue sales reps Billy and Amber, and the nurse who treats Randy after his surgery. Of the illegal variety, Walt encourages Betsy to start using heroin.
  • There's also the woman who shows up at addiction support group meetings to sell oxycontin to people attempting to kick. She's easily one of the most contemptible people in the story, and that's saying something.
• Arc Words: Pain. At the start of the series, its oft-repeated by Richard Sackler as something that he wants to eliminate with OxyContin. Towards the end of the series, it gets mentioned a lot again to describe the negative effects the drug has on those who take it and those close to them.
• Army of Lawyers: In every meeting, Purdue Pharma is represented by a sea of white, suit-wearing lawyers and executives.
• Beleaguered Bureaucrat: Many agencies that should have stopped Purdue are unwilling or unable due to budget cuts, short staffing, and lacking the ability to enforce their decisions. It also makes them highly prone to corruption, since many of them let Purdue off the hook with the promise of getting cushy jobs with them later.
• Beware the Nice Ones: The Appalachian anti-Oxycontin coalition, including Dr. Art Van Zee and Betsy's mother, considers accepting a donation from Purdue Pharma until the soft-spoken nun Sister Beth Davies chimes in.
  Sister Beth: So you wanna take their payoff to shut us all up, you go ahead. But if you do that, I will quit this coalition right here and now because I would rather burn in hell than take a penny of their blood money.
• Big Bad: Richard Sackler is portrayed in this series as the true mastermind of Oxycontin. Bridget Meyer in particular focuses specifically on bringing Richard down, fantasizing about confronting him with all the loss and pain he has caused.
• Big, Screwed-Up Family: The Sacklers seem to enjoy two things above all else: making even more money, and squabbling with each other.
• Binge Montage: Dr. Finnix gets one.
• Bittersweet Ending: Years of hard work by the DEA and the U.S. Attorneys results in criminal convictions against Purdue and some top executives, resulting in a $600 million fine, as well as a relabeling of Oxycontin and a greater public awareness of the dangers of opioids. However, Richard Sackler and other members of the Sackler family avoid any direct consequences, and hundreds of thousands of people have died as a result of opioid addiction. Bridget Meyer points out that these initial legal victories open the door for future lawsuits and criminal charges against the Sacklers in the future.
• Black Sheep: One of Richard Sackler's possible motivations is that he's disliked and not taken seriously by the rest of the family, and creating a bestselling drug is his attempt to gain their respect. He manages to sway Kathe Sackler into siding with him by pointing out that, as a lesbian in a rich, conservative family, she's a bit of a black sheep, too, and that he respects her for being who she is.
• Blaming the Victim: The Sackler policy is to blame "abusers" for being addicted to Oxycontin, even though they know that said abuse is a direct result of their drugs being highly addictive.
• Blatant Lies: All over the place with Purdue, whether it's downplaying the addictive nature of the drug, using extremely flimsy research to support said claims, switching the narrative from dangers about the drug to blaming people for becoming addicts and then doctors for over-subscribing, or outright lying about the drug's effectiveness and falsifying medical data behind the FDA's back.
• Capitalism Is Bad: Capitalism contributed to the marketing of OxyContin and the resulting opioid crisis. Purdue Pharma was forced to aggressively push Oxy due to them sinking a ton of money into its development that would have caused them to go bankrupt if it didn't turn out to be immensely profitable. They are able to avoid regulatory scrutiny by offering regulators high-paying jobs at their company if they approve their drugs with minimal push-back. It also shows how the drug was used as a quick-fix for injuries suffered by working class people who risk losing their jobs if they take the necessary time off to properly recover from injuries sustained in the line of work.
• Coming-Out Story: Betsy comes out as a lesbian to her mother, who pretends to not hear her. Later on, her mother apologizes to her and offers to make breakfast for a future girlfriend, fearing that her rejection caused Betsy to start abusing Oxycontin. Betsy assures her that this isn't what caused her drug addiction.
• Company Town: The primary industry in the fictional Finch Creek, Virginia is coal mining.
• Composite Character: Most of them. Billy and Amber are composites representing the duelling perspectives on selling Oxycontin. Dr Finnix and Betsy are composites reflecting the "everyday" impact of addiction on doctors and their patients. Bridget Meyer is also a composite of many DEA agents. The only major characters that aren't composites or fictional characters are Rick Mountcastle, Randy Ramsayer, John Brownlee, and the Sacklers.
• Cool Old Guy: Dr. Sam Finnix is a kind doctor who cares deeply about his patients, is accepting of Betsy being gay, encouraging her parents to accept her too,^note particularly notable in Appalachia in the 1990s and helping people in his community even after losing his medical license due to drug abuse. He's also played by Michael Keaton, which makes him cool by default.
• Corporate Conspiracy: Purdue Pharma, led by Richard Sackler, conspires to lie about and cover up Oxycontin's addictive qualities and its role in the national opioid epidemic.
• Corrupt Corporate Executive: Richard Sackler and the entire Sackler family.
• Crazy Homeless Person: Betsy seeks out Walt, her old drug dealer, in a homeless encampment. He has gone from a functioning Oxycontin dealer living in a run-down house to a heroin addict living in a tent, far more addled and twitchy than we saw him last.
• Creepy Physical: The Florida pill mill doctor gets handsy with Betsy and suggests that she could pay for her prescription with something other than money.
• Deadpan Snarker: A Purdue executive tries to charm Sister Beth Davies before a meeting, who shuts it down with a smile on her face.
  Sister Beth: That's wonderful that you know other nuns. It makes me feel a closeness to you I have never before experienced.
• Descent into Addiction: All over the place, notably Betsy, Dr. Finnix, and Elizabeth-Ann.
  • Elizabeth-Ann is a recurring background character with a particularly tragic arc when her appearances are pieced together. She begins as an insecure young teenager concerned about not getting her period yet and trying to fit in, witnesses her friend die of an overdose at a party, indiscriminately prostitutes herself from her car to pay for her Oxycontin addiction, and ends up at a homeless encampment for heroin addicts. Dr. Finnix is able to reach her and help her get clean.
• Determinator: The DEA's Bridget Meyer (to the point that her marriage falls apart) as well as assistant US attorneys Rick Mountcastle and Randy Ramseyer.
• Determined Doctor: Though Dr. Finnix has lost his medical license, Sister Beth Davies tells him that he still is fundamentally a doctor at his core and encourages him to help heal others. He falters when he learns that Betsy had died of an overdose, but he starts driving many of his other former patients to and from a suboxone clinic in an old school bus, allowing them to get clean from Oxycontin. The Distant Finale shows that he has regained his medical license and continues to work to treat addiction.
• Distant Finale: The final scenes of the series skip from 2006 to 2021, the year of its release, to show Sam Finnix having regained his medical license and treating other addicts.
• Dr. Feelgood: The pill mill doctor that Betsy visits in Florida, among others. The Purdue sales reps refer to them as "whales" due to the high amounts of revenue they bring in.
• Drugs Are Bad: Poorly-regulated and misleadingly-labeled opioids are bad.
• Every Man Has His Price: Numerous people who should have picked up on or stopped Purdue's practices, in both the FDA and law enforcement, were paid off with high-ranking positions in the company or taking them on as clients after they went into private practice, as in the case of Maine's U.S. Attorney Jay McCloskey. Richard Sackler has a noticeable moment of concern when told that the Randy, Rick, and John Brownley can't be bought off the way so many others have.
• Foregone Conclusion:
  • Due to the non-linear structure, the failure of Paul and Bridget's marriage is revealed before their first meeting.
  • Also, OxyContin turns out to be highly addictive and will create an opioid epidemic that will end and ruin countless lives across the country.
• Four Eyes, Zero Soul: Richard Sackler has a rather strange-looking pair of glasses. He doesn't wear them all the time, just when he's being particularly evil.
• Functional Addict: Dr. Finnix is one initially, but his nurse starts to realize something is wrong. The truth comes out after Dr. Finnix is so altered that he injures a patient during a routine procedure.
• Gayngst: Betsy struggles with anxiety, depression, and addiction. She assures her mother that being rejected when she tried to come out as a lesbian didn't cause her addiction, but she also admits in AA that Oxycontin helped numb her social anxiety.
• Getting High on Their Own Supply: Local drug dealer Walt works with Betsy to get Oxycontin to sell and to use himself. Also applies to Dr. Finnix, who diverts many of the pills he prescribes to his patients to take himself.
• Germanic Depressives: Richard Sackler pushes hard to get OxyContin approved in Germany, which he is unable to accomplish due to their stricter regulations, but also because, "the Germans have a different attitude towards pain. They believe it's part of a healing process."
• Godzilla Threshold: Betsy's parents are deeply homophobic; her father states outright that Betsy telling them she was gay would be the worst possible thing she could ever do. But when they realize how bad Betsy's addiction has become and organize an intervention, they ask her former girlfriend to be there in the desperate hope that they can all get through to Betsy.
• Going Cold Turkey: Very difficult if not impossible to do with opioids, due to the intense withdrawal symptoms, which are referred to with the eponymous term dopesick. The best option for quitting is usually drugs like suboxone and methodone, which are opioids that satisfy cravings and prevent withdrawal while not not having the same risk of addiction or abuse that other opioids have.
• Golden Mean Fallacy: This seems to be the mentality of many regulators, who seem to be under the opinion that every crackdown on Purdue must be accompanied by an equally large concession to them. This is best exemplified when the FDA changes Oxycontin's label to include a black box warning, while also adding language to the label approving the drug for long-term use and allowing Purdue to continue to market the drug for moderate pain.
• Hate Sink: Amber. Though she's far from the most powerful or instrumental person in the rise of OxyContin, she is so smug, self-satisfied, and completely unconcerned about the effects of the drugs. Even when Billy presents her with evidence of the addictiveness of the drugs, she dismisses it and says that the victims "deserved it", and openly makes clear that she doesn't care.
• Heel–Face Turn: Billy sells the drugs and pushes them on medial professionals with no issue, but starts to become deeply concerned when he sees the effects it has on people and how sales reps are instructed to act.
• Heroic BSoD: Bridget Meyer completely breaks down when she reads an obituary for a boy she had confronted outside of a pill mill clinic and tried to mentor years ago, indicating he died of an Oxycontin overdose outside of a pharmacy.
• Hope Spot:
  • Bridget Meyer gets one when her team is able to uncover evidence that Oxycontin is killing people taking it as prescribed. Purdue Pharma executives convince the FDA, already fed up with Meyer's abrasive approach, to disregard the information.
  Bridget Meyer: I got you. I FUCKING got you.
  • Betsy's mother finally accepts that her daughter is a lesbian, encouraging her to find a girlfriend and offering to cook them both breakfast once she does. Betsy then calls her ex-girlfriend to restart the relationship, only to find out that she’s already moved on with someone else and has even had a child. Betsy is distraught and this combined with her ongoing addiction causes her to go back for one last hit of drugs before she weans off them, only for her to die of an overdose.
  • A variation: When Dr. Finnix summons Billy to visit him in rehab, in-universe, Billy hopes this is an opportunity to apologize to Dr. Finnix, and, out-of-universe, Dr. Finnix appears to have gotten sober. Instead, Dr. Finnix asks Billy if he can get him any Oxycontin pills.
• Karma Houdini: While Purdue Pharma and some of its executives face consequences thanks to the DEA and the U.S. Attorneys, Richard Sackler, the man most responsible for the misery in the show, remains unscathed.
• Lack of Empathy: While all the executives have this to some extent, Richard Sackler's borders on outright sociopathy, as he never shows any remorse or concern for the thousands dying from his drugs. When told of growing concerns about the addictiveness of Oxycontin, he insists on "hammering the abusers" and finds a crackpot doctor peddling a theory of "pseudo-addiction".
• Loophole Abuse: Purdue Pharma takes every opportunity to twist the facts to sell Oxycontin as non-addictive: citing misleading studies, messing around with the formatting of scientific blood charts, and pointing to ambiguous wording on its FDA label.
• Married to the Job: Bridget Meyer prioritizes her investigation into Purdue Pharma over her marriage, which ultimately leads to her divorce.
• May Contain Evil: Purdue Pharma pushes Oxycontin as being less addictive than other highly-addictive opioids, despite containing the same basic drug. This is because of their use of the Contin system, which supposedly delivers the dose gradually over an extended period of time and shouldn't give the instant rush the Oxycodone would get otherwise. However, this doesn't work at all and Oxycontin is just as addictive as any other opioid.
• Mental Health Recovery Arc: The series follows Dr. Finnix's descent into addiction and his subsequent recovery with the help of rehab, therapy, and suboxone treatment.
• Middle-Management Mook: Richard Sackler promotes one of the lesser executives at Purdue, just before shit hits the fan legally, allowing Sackler to avoid any direct consequences.
• Not in My Backyard!: Dr. Finnix runs into this obstacle when trying to open a suboxone clinic his town.
• Off the Wagon:
  • Betsy and Dr. Finnix get on and off. Dr. Finnix succeeds in the long term, but poor Betsy has a final, fatal fall-off right before beginning suboxone treatment.
  • A former secretary from Purdue intends to testify, but has to back out when the stress causes her to relapse.
• Only in Florida: Many addicts, including Betsy and Walt, travel to Florida to acquire more drugs, since the state's loose enforcement of medical regulations allows Dr Feelgoods and pill mills to operate freely.
• Period Piece: For both the late 90s and mid-2000s.
• Perilous Marriage Proposal: Paul proposes to Bridget right after she finds out about an overdose. While this is technically good news, she also gets promoted right after her proposal, which puts her on the path that ultimately results in their divorce and Bridget falling into despair.
• Predatory Big Pharma: The show depicts the Corporate Conspiracy of the Sackler family as they push to get mainstream recognition of their drugs and flood the market by paying off doctors and pharmaceutical reps. This is contrasted against cases in states like West Virginia that show the deadly effect the prescription of these extremely addictive drugs.
• Promoted to Scapegoat: When it becomes clear that the Purdue Pharma executives will actually be facing some legal consequences, Richard Sackler, having been advised to distance himself from the company, steps down as president and promotes Michael Friedman to the position so this will happen on his watch.
• Real Men Love Jesus: Rick Mountcastle is one of the lead investigators and a devout Christian.
• Recovered Addict: Dr. Finnix, with the help of rehab, therapy, and ongoing suboxone maintenance, gets to this point and is able to help Elizabeth-Ann and others to do the same.
• Refuge in Audacity: After being told that the Justice Department in DC would not support criminal charges against Purdue executives, U.S. Attorney John Brownlee bursts into a conference room full of Purdue executives and announces they're all indicted anyway. It works.
• Rich Bitch: Amber. She justifies pushing addictive Oxycontin in poor rural communities and scaring small-town pharmacists into stocking it on the basis that they're hicks who don't matter anyway. She later claims to have come from such a background herself, making her a Boomerang Bigot.
• Screw the Rules, I Have Money!/Screw the Rules, I Have Connections!: The M.O. of Purdue Pharma, who lean on and collaborate with the FDA using their connections to push OxyContin. On the rare occasion that they fail to get the rules changed in their favor, they disregard them, like going ahead and using a misleading graph in marketing after the FDA had explicitly prohibited them from doing so.
• Simple Country Lawyer: Randy Ramseyer has a heavy accent and folksy demeanor that he plays up to disarm the people he interviews during the investigation, covering up that he's a highly-skilled investigator and determined prosecutor.
• The Sociopath: Though it's never made fully clear what makes Richard Sackler tick, this is one possibility.
• Spicy Latina: Bridget is played by the Latina Rosario Dawson and is very aggressive and short-tempered when it comes to the case, with some of her bosses even wanting her to not be as directly involved due to her more abrasive attitude.
• Staging an Intervention: Betsy's parents and girlfriend stage an intervention with the help of the local AA leader.
  • Dr. Finnix gets one, more forcibly, when his nurse goes to the police to report that he injured a patient while under the influence of Oxycontin and was hoarding pills.
• Sunk Cost Fallacy: One of the reasons that Richard Sackler pushes OxyContin so hard is that he spent a lot of money on its development that he wants to recoup.
• Swiss-Cheese Security: Purdue Pharma claims that Oxycontin is less prone to abuse than other opioids because of its special time-release coating. Walt instructs Dr. Finnix to suck on the pill for about a minute and then wipe the coating off on his sleeve so the pill can be crushed and snorted to get a quicker high.
• Those Two Guys: Rick Mountcastle and Randy Ramseyer have their moments.
• Title Drop: During a court scene in Episode 4, "dopesick" is used as a term for the pain an addict feels during withdrawal.
• Token Good Teammate: Billy Cutler is one of the few Purdue employees to have any discomfort in their practices and to question the rhetoric others either believe without question or don't care about as long as they can make sales.
• The Topic of Cancer: Randy spends a brief period in hospital getting treatment for prostate cancer and getting surgery to remove it. He also sees first-hand how doctors try to force Oxy on patients.
• Trademark Favorite Food: Fried chicken for Dr. Finnix. Billy tries to get on his good side by bringing him KFC.
• Tragic Dream: Betsy's dream of moving out of Finch Creek and to Eureka Springs. It leads to her overworking and getting a back injury. Looking to help her facilitate that dream, Dr Finnix prescribes her Oxycontin. This leads to her getting addicted and, after years of attempted recovery followed by relapses and a further slide into crime, she dies by overdose.
• Unwitting Instigator of Doom:
  • Dr Finnix cares very much for Betsy, telling her that he delivered her himself and is extremely kind and understanding when she comes out to him. He even tells her that he'll help her financially to get her out of town. She declines his help, but asks him to help speed up her recovery from a bad back injury so she can make enough money to leave. He prescribes her Oxycontin, relying on the information that it's safe. She gets addicted, her relationship breaks down, and, after a long and hard battle, she dies from the addiction.
  • Dr. Hershel Jick, who once sent a 5-sentence letter to the editor of a medical journal reporting an observation that less than 1% of patients given opiates while hospitalized become addicted. This letter, which was just an informal analysis of a very small and specific dataset, was nonetheless touted by Purdue Pharma as a major, rigorous scientific study proclaiming the safety of opioids for the general public as part of their marketing campaign pushing the drugs on doctors and patients, leading to the opioid crisis. When Jick finds out about this years later, he's mortified.
• Victim-Blaming: When they can no longer deny the epidemic of addiction, Purdue execs change the narrative around the drug, blaming addicts for their abuse of it and insisting that the drug is fine for everyone else.
• Wham Line:
  • Mountcastle and Randy find that the Porter-Jick "study" used by Purdue to tout the "proven" safety of Oxycontin is actually a single-paragraph letter containing an anecdotal observation about patients prescribed opioids while hospitalized. The medical journal that published it originally has since added a note to its online publication stating the letter was "heavily and uncritically cited" and providing more context.
  • Finnix telling an associate he's up to 400 milligrams a day.
• Wicked Cultured: The Sacklers are fond of art, and both collect for themselves and donate large amounts of money to art museums, which they use to both launder their reputation and host their business meetings. The final episode shows several art museums rejecting the Sacklers' patronage once their public reputation hits rock bottom.

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