by Mahbod Ebrahimi
Graphic design by Brendan Lazar
Painkiller, a recent Netflix drama mini-series, portrays the true story behind the development of the highly addictive drug, OxyContin, and the people who pushed for its popularity. The series elegantly displays how a hunger for money could potentially destroy thousands of lives. At its core, Painkiller is about critical moments leading up to the opioid epidemic and how it could have been avoided, but was not.
The Sackler family, famously known for their big donations to museums and universities, were and currently are the owners of a privately held family business, Purdue Pharma, which is the company behind the development of the prescription painkiller OxyContin. Upon its release in 1995, OxyContin soon became a blockbuster drug and has reportedly generated over 35 billion dollars for Purdue. But OxyContin is no ordinary drug. Its main ingredient is oxycodone, a chemical relative of heroin, which is up to twice as strong as morphine.
Before the launch of OxyContin, doctors were generally reluctant to prescribe strong opioids (except for end-of-life palliative care and some types of cancer) due to the well-established fears of addiction to these drugs. However, Purdue started a massive promotional campaign that aimed to change how doctors prescribe opioids. OxyContin was designed so that people in need of relief from pain could not refuse the prescription, and Purdue strategically recruited attractive sales representatives to persuade and pressure doctors to not only prescribe the drug, but in the highest possible doses. This deliberate and strategic marketing campaign is extensively shown in the mini-series through the lens of two fictional sales representatives (played by West Duckovny and Dina Shihabi) who travel across the US to make sure doctors prescribe OxyContin with the highest possible does, no matter the cost. Painkiller demonstrates the power of marketing and persuasion tactics to its limits, potentially a reason why many people might not trust big pharmaceutical companies.
The Sackler family had to overcome many hurdles before launching OxyContin. One of the major roadblocks was the FDA approval (the administration responsible for drug efficacy and safety before public distribution). At first, a single FDA examiner, Curtis Wright, became a serious roadblock to the drug’s application approval. However, in a mysterious way, Wright soon signed off on the drug’s efficacy and approved OxyContin’s application because of the following statement: “Delayed absorption, as provided by OxyContin tablets, is believed to reduce the abuse liability of the drug.” The words “is believed,” a completely subjective statement, were the anchoring claim from Purdue. It would be mind-blowing how a drug on the scale of OxyContin could be approved without major scientific-based research today. If this fact was not shocking enough, Curtis Wright left the FDA and joined Purdue Pharma one year after approving the application for OxyContin.
Since 1999, over three hundred thousand Americans have died from overdoses related to OxyContin and other prescription opioids1. For many people, prescription painkillers are too expensive or too difficult to obtain, so they turn to heroin1. In fact, according to the American Society of Addiction Medicine, four out of five people who use heroin today started with prescription painkillers.1 In the show, the journey of addiction is shown by the story of the fictional character Glen Kryger (played by Taylor Kitsch), a family man and the owner of a mechanic shop who gets injured on the job. He undergoes surgery, and to relieve his pain, one doctor prescribes him OxyContin. Through six episodes, Glen slowly becomes more and more dependent on the drug. With this addiction, we can see how Glen loses his family, his job, and eventually his life.
In my opinion, Painkiller brilliantly displays the story of greed, corruption, and manipulation. Of how big pharmaceutical companies might only care about their own agenda, which in many cases is making profit, could overrule any ethical standpoints. This point is captured by one of the show’s executive producers Alex Gibney where he says: “I realized that this opioid crisis I’ve been hearing so much about was not just a crisis, it was really a crime”.
References
1-Keefe, P. R. (2017, October 23). The family that built an empire of pain. The New Yorker. https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain
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