Hulu’s ‘Dopesick’ Diagnoses the Evolution of the Opioid Crisis With Riveting Detail

Alci Rengifo

The opioid crisis has been a topic of discussion for so long that that it just lingers in the background now, especially in the wake of the pandemic. For some it’s a simple story of people getting hooked on pills. Hulu’s new eight-part limited series “Dopesick” tackles the very scope of how the crisis began and who the key players were, while still giving space to the tragic human suffering in its wake. Like many stories about drug running, this is a crime report involving cartels and dealers. Unlike the average true crime drama however, the cartel is a massive corporation and the dealers are its sales representatives. Based on the book “Dopesick: Dealers, Doctors, and the Drug Company that Addicted America” by journalist Beth Marcy, here is a subject that does deserve a lengthy TV treatment. Every episode skillfully charts how corporate ambition led to the development of OxyContin then trickled down into a wider wave of addiction.

The narrative swings between the mid-1990s and early-2000s. In the ‘90s a doctor named Dr. Samuel Finnix (Michael Keaton) lives a quiet life at ease in a rural Virginia mining town. He’s probably the most trusted guy in the community. His clinic is constantly treating injuries endured by those who work the mines, like Betsy (Kaitlyn Dever), a young woman following in her family’s footsteps. Many miles away at Purdue Pharma, a powerful and rich family is undergoing inside battles for prominence. Presumptive and restless heir Richard Sackler (Michael Stuhlbarg) wants to prove his worth and embarks on a grand scheme to develop a wonder drug to treat pain. The result is OxyContin. The opioid-derived painkiller launched in 1996, with the first major target being America’s rural zones since this is where many injuries are reported from physically laborious jobs. Among the ranks of Purdue’s eager sales reps is Billy Cutler (Will Poulter), who along with his numerous colleagues, is given instructions on how to peddle “Oxy” to potential clients, promising that the drug is less addictive than any other medication. His first score is with Finnix, who soon discovers the painkiller’s potency and dangers. Cut to the 2000s when a DEA agent, Bridget Meyer (Rosario Dawson) and US Attorney Rick Mountcastle (Peter Sarsgaard), lead investigations into Purdue’s abuses and human toll.

“Dopesick” ranks alongside absorbing narcotic chronicles like “Traffic,” where all of the characters and scenarios link into one larger idea. Creator Danny Strong of “Empire” structures the series as three genres in one package. First, there’s the story of corporate corruption, set inside boardrooms and offices, where Sackler and his lackeys develop how to sell OxyContin to the world, even as his own family members doubt his abilities, mostly due to his oddball behavior. It’s a portrait of industrious ambition without scruples. When doctors begin to report that patients’ pain is returning after twelve hours, Purdue brains simply come up with terms like “breakthrough pain,” advising clients to simply increase the dosage. A creepy bit of visual evolution throughout the shows how new pills with larger doses keep being produced, showed off at board meetings like brilliant new art. Like Michael Mann’s “The Insider,” about Big Tobacco hiding the truth about nicotine, “Dopesick” warns about the immorality of science for profit. Billy starts off full of ambition, learning every trick taught to lure in a client. His co-worker, Amber (Phillipa Soo), has even less of a conscience. They are initiated into a world where doctors are invited to luxurious retreats or where you learn a receptionist’s favorite flowers to get into a potential big buyers’ office. 

The other story is one of suffering and addiction. Here the series does a fine job balancing smaller details with its powerful, wider view of how OxyContin began its spread in small town America. Betsy comes from a conservative home of church-going parents, Diane (Mare Winningham) and Jerry (Ray McKinnon), who don’t want to face the fact that their daughter is a lesbian. When Betsy injures her back at the mines, Finnix prescribes OxyContin and a whole spiral ensues. Not only does Betsy become an addict, but so does Finnix when he tries the wonder drug after a sudden car accident. The series becomes a harrowing contrast between the slick, money-hungry corporate world peddling Oxy and the lives of people like Betsy, who breaks up with her girlfriend and dives into the local underworld of dealers and addicts. In a way even more striking is the transformation of Finnix, played by Keaton as a warm, kind man suited for rural living reduced to a mess because of his addiction. He begins the series as everyone’s idea of a respectable, small town doctor and near the end is smashing his furniture around looking for a hidden stash of pills.

More tedious yet no less riveting is the third section running in parallel to the other two, where the DEA and US Attorneys uncover the growing scope of OxyContin addiction and Purdue’s cynical methods. The Sacklers, an old and wealthy clan, have no qualms about flexing their muscles on politicians and government institutions. One reason Purdue was able to operate for so long without oversight is because the FDA approved it with a seal of agreement that OxyContin was “less addictive” than the average prescription opioid. Mountcastle and fellow U.S. attorney Randy Ramseyer (John Hoogenakker) enter the shocking labyrinth of how a giant company covers all of its bases, from carefully citing dubious sources to setting up shell companies and buying experts. Rosario Dawson’s fierce DEA Agent Meyer learns some hard lessons when she takes on the Sacklers and realizes how precious and dangerous political influence can be. This subject matter has been explored before in documentaries like Alex Gibney’s “The Crime of the Century,” but good drama has a way to truly drive home all of its implications.

“Dopesick” is gripping and challenging, even when it strays a bit in some of its approaches. Michael Stuhlbarg is mostly eerie as Richard Sackler, but can also overplay his more “mad scientist” moments, as when he dramatically stands before a map to proclaim his plans of getting into the German market, spreading into Europe and “healing the world.” Yet the other small details do work well, even the side stories involving divorces, cancer scares and broken romances, because they all happen under the shadow of the larger story. In particular, we see how addiction can ruin family relationships, love lives and careers. Even for the lawyers and agents, pursuing a case this big can intrude into their personal lives in serious ways. It also helps the engaging rhythm that among the series’ director roster is a master like Barry Levinson and sharp talent like Michael Cuesta. Their keen approach is needed, because this is not an easy story with clear victories. Half a million Americans have died from the opioid crisis. Purdue just last year was granted a bankruptcy plan that will protect the Sacklers’ wealth and even provide legal immunity. Maybe a show like this is the only real judgement possible in a world ruled by such interests. 

“Dopesick” begins streaming Oct. 13 with new episodes premiering Wednesdays on Hulu.