(Hulu’s Dopesick)
How much does it take for us to trust what we hear?
Surely, we all know people who will believe every headline they see, or any claim made in any given online comment. But when we assert that we only believe facts, how much further do we go? What is the price of our belief? Is it numbers, graphs, or academic studies? Word from authority? Perhaps, if enough of the right people are saying something, we don’t feel inclined to question it. But what happens when misinformation runs so far, and so deep, that we cannot trust the people who we rely on for our health and safety?
Danny Strong’s Dopesick aired on Hulu in 2021, presenting a dramatized depiction of the peak of the United States’ opioid epidemic, specifically addressing how the spread of oxycodone as pain medication led to unprecedented rates of addiction and overdose. The series follows multiple players in the lawsuit against Purdue Pharma, the pharmaceutical corporation that marketed oxycodone (branded as ‘OxyContin’), to thousands of doctors across the United States. Each episode dissects the various ways in which Purdue Pharma distorted medical findings, evaded verification, and falsified claims to convince doctors and public officials that their drug, a Schedule II narcotic, was essentially non-addictive.
The primary basis of Purdue Pharma’s marketing of OxyContin was that it, unlike other opioids, was ‘essentially non-addictive’. They backed these claims with approved FDA labels, referenced clinical studies, and graphs of the drug’s ‘time-release’ technology, asserting a slow and steady release of the drug into the bloodstream.
(Hulu’s Dopesick – the charts Purdue Pharma marketed as depicted in the series)
The FDA label, we learn, was essentially bribed out of the FDA medical review officer, Curtis Wright IV, who left the FDA shortly after to start working for Purdue Pharma. The graph of the time-release system was revealed to contain misleading scales with uneven spacing–making the release of the drug look extremely steady, when in reality it spiked in the bloodstream like most drugs. The FDA had allegedly prohibited Purdue Pharma from using this graph for marketing purposes, but this was simply ignored, and it was able to fool doctors across the United States.
The most damning piece of misinformation from Purdue Pharma had to be the primary study the company referred to as evidence that ‘less than 1% of patients get addicted to OxyContin’. This publication was cited as a medical article published by Dr. Herschel Jick and Jane Porter. In the series, the lawyers taking down Purdue Pharma notice that this article is widely referenced by researchers and practitioners, but are unable to find it in any medical journals, even after extensive amounts of research.
When they do find it, the other shoe drops–it wasn’t a clinical trial of any sort. It was a letter to the editor from Jick and Porter, who worked in a hospital and observed that very few of their patients developed an addiction to the medications they were receiving in a controlled setting like theirs. As one could guess, this was likely due to the clinical setting where doses were administered by doctors, not any non-addictive characteristics of the drugs. Jick was not even aware that the company was using his note to market certain opioids as less addictive.
Dopesick is a fictional depiction of these events, but the crimes it covers are very real. It is undoubtedly terrifying that so many licensed professionals and public officials validated and implemented treatments that were grossly inappropriate to make accessible, and became so devastating to the people they were prescribed to. Without any means of communication with other medical experts, without easily accessible archives of medical papers, without proper surveillance of Purdue Pharma’s marketing strategies, practitioners opted to believe what they saw—and vulnerable members of the American populace paid the price. Between 1999 and 2021, more than 200,000 people died from prescription opioid-related overdoses in the United States.
An inevitable effect of the internet in the modern era is that it is extremely easy to spread misinformation rapidly. However, what we rarely acknowledge is that simultaneously, it is much easier to investigate misinformation. Whole archives of medical studies, event footage, government documents, and much more can be found online. Discoveries made across the world can be communicated with a few clicks. Knowledge is becoming democratized in a way that was previously inconceivable.
Perhaps, we no longer have to simply believe people in authority, or assume that claims from proclaimed experts are automatically credible. We can look for details, investigate origins of claims, gather expertise from multiple sources and perspectives. Maybe, with the digitization of knowledge, we have the power to prevent massive corporations, and other forces with money and influence, from deceiving, manipulating, and abusing the public for the sake of power and capital.
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