1 00:00:01,950 --> 00:00:02,968 If fraud was too high a bar, 2 00:00:02,992 --> 00:00:04,220 what would you charge him with? 3 00:00:04,244 --> 00:00:06,222 I'd charge them with criminal misbranding. 4 00:00:06,246 --> 00:00:08,682 Permission granted to release requested documents 5 00:00:08,706 --> 00:00:11,685 relating to marketing and distribution. 6 00:00:11,709 --> 00:00:13,229 [suspenseful music] 7 00:00:13,253 --> 00:00:14,730 They're drowning us in paperwork. 8 00:00:14,754 --> 00:00:16,607 I'm promoting you. 9 00:00:16,631 --> 00:00:18,108 I'd like you to be deputy director 10 00:00:18,132 --> 00:00:19,610 of the Diversion Division. 11 00:00:19,634 --> 00:00:20,903 I accept. 12 00:00:20,927 --> 00:00:23,697 The worst thing that a-- a parent could hear 13 00:00:23,721 --> 00:00:25,824 is that her kid is, you know, queer. 14 00:00:25,848 --> 00:00:27,493 It'd kill me if you were, Bets. 15 00:00:27,517 --> 00:00:29,119 I guess you're dead, then. 16 00:00:29,143 --> 00:00:31,539 Do you realize that men might be dead 'cause of you? 17 00:00:31,563 --> 00:00:33,749 I don't understand what's happening to me. 18 00:00:33,773 --> 00:00:35,793 If we get Germany uncontrolled, 19 00:00:35,817 --> 00:00:39,004 it will serve as a gateway to the rest of Europe. 20 00:00:39,028 --> 00:00:40,464 Please tell me I'm gonna see you 21 00:00:40,488 --> 00:00:42,007 in Orlando in a few weeks. 22 00:00:42,031 --> 00:00:45,052 SAMUEL: That's why I'm calling. I was- 23 00:00:45,076 --> 00:00:47,745 20 milligrams of OxyContin. 24 00:00:59,841 --> 00:01:01,485 TEEN: Got it. TEEN: Hey, dude. 25 00:01:01,509 --> 00:01:03,070 TEEN: Hi, how are you doing? TEEN: What's your in on? 26 00:01:03,094 --> 00:01:04,613 TEEN: 80. TEEN: Bam. 27 00:01:04,637 --> 00:01:06,115 TEEN: Oh, fuck. TEEN: Yeah. 28 00:01:06,139 --> 00:01:07,366 TEEN: Cheers to that. 29 00:01:07,390 --> 00:01:08,867 TEEN: Hey, hey, what you doing, man? 30 00:01:08,891 --> 00:01:10,244 I was just gonna pop it. 31 00:01:10,268 --> 00:01:11,704 TEEN: No, man. You gotta snort 'em. 32 00:01:11,728 --> 00:01:12,871 Here, I'll show you. 33 00:01:12,895 --> 00:01:14,248 TEEN: What the fuck's your problem? 34 00:01:14,272 --> 00:01:15,791 TEEN: Elizabeth Ann, are you in? 35 00:01:15,815 --> 00:01:17,167 It hits way faster. 36 00:01:17,191 --> 00:01:18,586 TEEN: Are you sure, man? TEEN: Trust me, yeah. 37 00:01:18,610 --> 00:01:20,004 TEEN: 'Cause, we've popped them normal before. 38 00:01:20,028 --> 00:01:21,880 Did Purdue say it was easy for someone to bypass 39 00:01:21,904 --> 00:01:24,300 the time-release coating on an OxyContin pill? 40 00:01:24,324 --> 00:01:26,635 No, Purdue claimed the coating 41 00:01:26,659 --> 00:01:28,554 was difficult to get around, and therefore, 42 00:01:28,578 --> 00:01:32,433 OxyContin would be unappealing to abusers. 43 00:01:32,457 --> 00:01:34,893 Was the coating difficult to dissolve? 44 00:01:34,917 --> 00:01:38,647 No, it was very easy. 45 00:01:38,671 --> 00:01:41,442 All you had to do is dissolve it in saliva 46 00:01:41,466 --> 00:01:43,861 and then scrape it off. 47 00:01:43,885 --> 00:01:46,530 And then the abuser would have immediate access 48 00:01:46,554 --> 00:01:48,907 to the full 12-hour supply. 49 00:01:48,931 --> 00:01:51,893 They just crush it off then snort it. 50 00:01:53,436 --> 00:01:56,290 TEEN: Yeah! TEEN: Oh, here we go! 51 00:01:56,314 --> 00:01:58,292 TEEN: Holy shit. TEEN: Fuck yeah. 52 00:01:58,316 --> 00:02:01,295 - I think I'm getting a chubby. - [all laugh] 53 00:02:01,319 --> 00:02:03,631 TEEN: Where's, uh, where's Elizabeth Ann? 54 00:02:03,655 --> 00:02:05,174 TEEN: Elizabeth Ann? 55 00:02:05,198 --> 00:02:06,175 - Hey! - TEEN: What the fuck you doing? 56 00:02:06,199 --> 00:02:07,551 Get your ass over here. 57 00:02:07,575 --> 00:02:10,620 Hey, it's good. Don't worry. 58 00:02:12,538 --> 00:02:13,956 TEEN: Go, you're up next. 59 00:02:16,793 --> 00:02:18,628 TEEN: First time is the best time. 60 00:02:25,218 --> 00:02:28,781 Yeah! [Laughter] 61 00:02:28,805 --> 00:02:32,034 [Elizabeth sniffing] Yeah! 62 00:02:32,058 --> 00:02:34,161 TEEN: Oh, shit. TEEN: Hey, hey! 63 00:02:34,185 --> 00:02:36,080 [tense music] 64 00:02:36,104 --> 00:02:37,081 TEEN: All right, I'm up next, right? 65 00:02:37,105 --> 00:02:39,166 TEEN: Yeah, you got to see... 66 00:02:39,190 --> 00:02:41,251 [whooping] 67 00:02:41,275 --> 00:02:45,071 [distorted, indistinct chatter] 68 00:02:54,414 --> 00:02:57,351 [Elizabeth screaming] 69 00:02:57,375 --> 00:02:59,353 Oh, my God. Oh, my God. 70 00:02:59,377 --> 00:03:00,938 Don't you fucking die, Ryder! 71 00:03:00,962 --> 00:03:02,356 TEEN: You're gonna be all right, don't worry about it. 72 00:03:02,380 --> 00:03:03,482 TEEN: Let's take him to his mom's house. 73 00:03:03,506 --> 00:03:04,775 TEEN: We can't go to his mom's house! 74 00:03:04,799 --> 00:03:06,151 Can we take him to a fucking hospital? 75 00:03:06,175 --> 00:03:07,861 We can't take him to a hospital. 76 00:03:07,885 --> 00:03:09,113 TEEN: Get him out of there. 77 00:03:09,137 --> 00:03:11,615 ELIZABETH: What should we do? 78 00:03:11,639 --> 00:03:14,493 Oh, John, don't die, please. 79 00:03:14,517 --> 00:03:18,706 TEEN: Fuck, come on. ELIZABETH: Please. 80 00:03:18,730 --> 00:03:21,083 - What the fuck is that? - They didn't have any ice. 81 00:03:21,107 --> 00:03:22,793 - Is that a fish? - TEEN: It's frozen. 82 00:03:22,817 --> 00:03:24,253 It'll wake him up. 83 00:03:24,277 --> 00:03:29,550 ♪ ♪ 84 00:03:29,574 --> 00:03:30,968 TEEN: Wake up. ELIZABETH: Why? 85 00:03:30,992 --> 00:03:32,660 Wake the fuck up. 86 00:03:34,620 --> 00:03:35,830 Fuck! 87 00:03:38,541 --> 00:03:39,810 Let's get out of here. 88 00:03:39,834 --> 00:03:41,437 ELIZABETH: No, wait, we can't leave him here! 89 00:03:41,461 --> 00:03:43,772 TEEN: Come on! ELIZABETH: We can't leave him! 90 00:03:43,796 --> 00:03:45,733 TEEN: Elizabeth Ann! 91 00:03:45,757 --> 00:03:46,859 Come on! 92 00:03:46,883 --> 00:03:53,890 ♪ ♪ 93 00:04:13,910 --> 00:04:17,538 [engine roaring] 94 00:04:19,582 --> 00:04:22,627 [heavy metal music playing on radio] 95 00:04:34,055 --> 00:04:35,389 BETSY: Here. 96 00:04:38,351 --> 00:04:40,829 - What the fuck is this? - These are fucking 10s. 97 00:04:40,853 --> 00:04:43,415 ER doctor was on to me. 98 00:04:43,439 --> 00:04:45,959 Only gave me four days' worth. 99 00:04:45,983 --> 00:04:48,653 God damn it. What the fuck? 100 00:04:50,696 --> 00:04:52,925 - I'ma be really sick tomorrow. - WALT: Yeah, and I'm not? 101 00:04:52,949 --> 00:04:54,384 You're the fucking drug dealer! 102 00:04:54,408 --> 00:04:56,118 Why is this on me? 103 00:05:05,962 --> 00:05:07,564 WALT: And what about Florida? 104 00:05:07,588 --> 00:05:09,549 We can hit one of the pain clinics. 105 00:05:12,301 --> 00:05:15,155 BETSY: That's too far. We'll get fired. 106 00:05:15,179 --> 00:05:16,657 Yeah, well, we got nowhere else to go 107 00:05:16,681 --> 00:05:18,325 'cause you keep burning up all the God damned ERs. 108 00:05:18,349 --> 00:05:21,453 - I'm not good at this. - They don't believe me. 109 00:05:21,477 --> 00:05:22,871 That's why it's gotta be Florida, okay? 110 00:05:22,895 --> 00:05:24,081 They don't care down there. 111 00:05:24,105 --> 00:05:26,023 We can get whatever the fuck we want. 112 00:05:30,278 --> 00:05:31,529 I can't go. 113 00:05:33,823 --> 00:05:35,300 I can't go. 114 00:05:35,324 --> 00:05:36,684 All right, then get the fuck out. 115 00:05:38,369 --> 00:05:40,055 BETSY: What? WALT: I said, get the fuck out! 116 00:05:40,079 --> 00:05:42,266 BETSY: Jesus Christ, Walt. 117 00:05:42,290 --> 00:05:46,103 [engine revving] 118 00:05:46,127 --> 00:05:47,169 Fuck! 119 00:05:51,883 --> 00:05:53,110 SAMUEL: How about right here? 120 00:05:53,134 --> 00:05:55,571 - Oh, yeah. - It's--it's--it's getting worse. 121 00:05:55,595 --> 00:05:56,989 Yeah. 122 00:05:57,013 --> 00:05:59,074 Can't even wake up without a pill anymore. 123 00:05:59,098 --> 00:06:00,909 SAMUEL: Yeah. You're taking them twice a day? 124 00:06:00,933 --> 00:06:03,036 PATIENT: Yeah, but where does that help? 125 00:06:03,060 --> 00:06:06,582 SAMUEL: Okay, you're having pain even when you don't take it. 126 00:06:06,606 --> 00:06:09,960 - Oh, 100%. - But I want off of this stuff. 127 00:06:09,984 --> 00:06:11,086 SAMUEL: Yeah. 128 00:06:11,110 --> 00:06:13,088 I'm--I'm either falling asleep all day 129 00:06:13,112 --> 00:06:14,423 or thinking about the next pill. 130 00:06:14,447 --> 00:06:15,966 Mm-hmm, okay. 131 00:06:15,990 --> 00:06:19,303 Well, we're just gonna taper you off there, buddy. 132 00:06:19,327 --> 00:06:20,679 PATIENT: We--we tried that. 133 00:06:20,703 --> 00:06:23,056 Yeah, I know, we're trying again. 134 00:06:23,080 --> 00:06:24,182 I'm gonna lower your dose 135 00:06:24,206 --> 00:06:27,185 from 80 milligrams down to 40, okay? 136 00:06:27,209 --> 00:06:29,396 And if you're experiencing any withdrawal symptoms, 137 00:06:29,420 --> 00:06:32,649 I'll cut that with some Xanax, okay? 138 00:06:32,673 --> 00:06:34,568 We'll get this right. 139 00:06:34,592 --> 00:06:37,029 How many pills do you have left in that bottle? 140 00:06:37,053 --> 00:06:38,822 PATIENT: A few. A few here. 141 00:06:38,846 --> 00:06:41,283 SAMUEL: Okay, just leave the bottle on the table there, 142 00:06:41,307 --> 00:06:44,870 and, uh, we'll lower your dose here, buddy. 143 00:06:44,894 --> 00:06:47,497 All right. 144 00:06:47,521 --> 00:06:50,125 We'll get you feeling better, okay? 145 00:06:50,149 --> 00:06:51,126 It'll be all right. 146 00:06:51,150 --> 00:06:52,568 PATIENT: Thanks, doc. 147 00:06:56,280 --> 00:06:59,217 [tense music] 148 00:06:59,241 --> 00:07:06,248 ♪ ♪ 149 00:07:25,142 --> 00:07:27,245 We are so proud to be honoring 150 00:07:27,269 --> 00:07:29,373 my great brother, Arthur Sackler, 151 00:07:29,397 --> 00:07:32,376 into the Medical Advertising Hall of Fame. 152 00:07:32,400 --> 00:07:35,462 [applause] 153 00:07:35,486 --> 00:07:39,967 In many ways, Arthur Sackler invented medical advertising. 154 00:07:39,991 --> 00:07:42,135 He was the first to realize 155 00:07:42,159 --> 00:07:45,639 it wasn't patients who decided what drugs they took. 156 00:07:45,663 --> 00:07:47,891 It was their doctors. 157 00:07:47,915 --> 00:07:51,353 Shunned by Madison Avenue for being Jewish, 158 00:07:51,377 --> 00:07:54,815 he formed his own company specifically targeting doctors 159 00:07:54,839 --> 00:07:57,442 with articles from scientific journals 160 00:07:57,466 --> 00:08:01,321 and studies from medical societies. 161 00:08:01,345 --> 00:08:03,949 Sure, sometimes the societies 162 00:08:03,973 --> 00:08:07,911 and the experts were financed by Arthur. 163 00:08:07,935 --> 00:08:09,329 [laughter] 164 00:08:09,353 --> 00:08:11,331 JONATHAN: Who do you think is the bigger asshole? 165 00:08:11,355 --> 00:08:13,733 Uncle Mortimer or Uncle Arthur? 166 00:08:16,318 --> 00:08:18,672 - C, all the above. - [Jonathan chuckles] 167 00:08:18,696 --> 00:08:20,340 Not only changed the way medicine 168 00:08:20,364 --> 00:08:22,050 is marketed in this country; 169 00:08:22,074 --> 00:08:25,721 It changed the medical industry forever. 170 00:08:25,745 --> 00:08:28,748 [indistinct chatter] 171 00:08:31,459 --> 00:08:32,811 BETH: Your uncle was good. 172 00:08:32,835 --> 00:08:34,295 RICHARD: For his time. 173 00:08:37,131 --> 00:08:38,108 Hmm. 174 00:08:38,132 --> 00:08:39,943 This one's missing the zombies 175 00:08:39,967 --> 00:08:43,447 that valium turned some patients into. 176 00:08:43,471 --> 00:08:46,366 He got away with it. - Barely. 177 00:08:46,390 --> 00:08:49,411 But it made him rich. 178 00:08:49,435 --> 00:08:53,105 Beth, darling, would you give us a few minutes, please? 179 00:08:54,523 --> 00:08:56,233 Sure. RAYMOND: Thank you. 180 00:08:59,653 --> 00:09:01,238 You had to do it, didn't you? 181 00:09:03,949 --> 00:09:05,010 Do what? 182 00:09:05,034 --> 00:09:08,388 You had to say it was non-addictive. 183 00:09:08,412 --> 00:09:10,474 - Dad, even the FDA-- - Oh, please. 184 00:09:10,498 --> 00:09:12,768 Call notes are starting to come in that patients 185 00:09:12,792 --> 00:09:14,603 are showing signs of addiction. 186 00:09:14,627 --> 00:09:17,731 Just a few pockets of West Virginia. 187 00:09:17,755 --> 00:09:19,107 It's cultural. 188 00:09:19,131 --> 00:09:21,860 All those hillbillies do is get addicted. 189 00:09:21,884 --> 00:09:25,739 - And Maine and Kentucky. - All our phase one states. 190 00:09:25,763 --> 00:09:28,116 If it becomes accepted that more than 1% 191 00:09:28,140 --> 00:09:30,035 become addicted, it's dead. 192 00:09:30,059 --> 00:09:31,411 And one year of strong sales 193 00:09:31,435 --> 00:09:34,372 isn't gonna make up for the 40 million you spent. 194 00:09:34,396 --> 00:09:37,125 [suspenseful music] 195 00:09:37,149 --> 00:09:40,170 Any suggestions? 196 00:09:40,194 --> 00:09:42,422 Take a page from Arthur's playbook. 197 00:09:42,446 --> 00:09:44,049 Get an expert who'll tell doctors 198 00:09:44,073 --> 00:09:46,468 the truth of our wonder drug. 199 00:09:46,492 --> 00:09:48,095 We've got Russell Portenoy. 200 00:09:48,119 --> 00:09:52,224 No, I'm thinking someone more aggressive, 201 00:09:52,248 --> 00:09:56,269 especially if your 1% claim is, um, hmm. 202 00:09:56,293 --> 00:09:59,189 What's that medical term? 203 00:09:59,213 --> 00:10:00,673 Fucking bullshit. 204 00:10:02,508 --> 00:10:03,676 Fine. 205 00:10:06,053 --> 00:10:08,532 We'll find an aggressive expert. 206 00:10:08,556 --> 00:10:12,202 No, the--the osteoarthritis was truly debilitating, 207 00:10:12,226 --> 00:10:14,037 and nothing seemed to work until I realized 208 00:10:14,061 --> 00:10:15,914 that the patient needed something strong enough 209 00:10:15,938 --> 00:10:17,791 to stop the breakthrough pain. 210 00:10:17,815 --> 00:10:20,502 So I started the patient on methadone, 211 00:10:20,526 --> 00:10:22,295 and she was back to normal within just a few days. 212 00:10:22,319 --> 00:10:24,840 Methadone? 213 00:10:24,864 --> 00:10:27,050 You said find me aggressive. 214 00:10:27,074 --> 00:10:30,137 He has a theory called pseudo addiction, 215 00:10:30,161 --> 00:10:33,414 which basically means addiction doesn't exist. 216 00:10:36,834 --> 00:10:38,353 Who is this guy? 217 00:10:38,377 --> 00:10:39,813 David Haddox. 218 00:10:39,837 --> 00:10:41,731 He went to dental school but now heads 219 00:10:41,755 --> 00:10:43,984 the Pain Management Department at Emory. 220 00:10:44,008 --> 00:10:47,320 A--a fitting progression. 221 00:10:47,344 --> 00:10:48,624 MICHAEL: You wanna meet with him? 222 00:10:50,764 --> 00:10:52,951 God, yes. 223 00:10:52,975 --> 00:10:55,662 So you really feel opioids are under-prescribed? 224 00:10:55,686 --> 00:10:57,247 For decades. 225 00:10:57,271 --> 00:10:59,708 Now, the Porter/Jick study is exactly right. 226 00:10:59,732 --> 00:11:03,485 Under the proper care, opioids are totally safe. 227 00:11:05,529 --> 00:11:08,675 I--I recently read a theory of yours, 228 00:11:08,699 --> 00:11:12,220 which is why I-- I wanted to meet. 229 00:11:12,244 --> 00:11:13,329 DAVID: Thank you. 230 00:11:14,997 --> 00:11:17,976 Let me guess: Pseudo addiction? 231 00:11:18,000 --> 00:11:20,520 - Correct. - How'd you come up with- 232 00:11:20,544 --> 00:11:22,838 mm, uh. 233 00:11:24,340 --> 00:11:28,695 Where did you discover pseudo addiction? 234 00:11:28,719 --> 00:11:33,366 Yeah, so I was, um, so I was, uh, was working 235 00:11:33,390 --> 00:11:35,702 with a 17-year-old leukemia patient 236 00:11:35,726 --> 00:11:38,371 who showed classic signs of addiction. 237 00:11:38,395 --> 00:11:40,165 And yet we upped his medication, 238 00:11:40,189 --> 00:11:41,917 and he was fine. 239 00:11:41,941 --> 00:11:44,044 Turns out that he wasn't addicted at all. 240 00:11:44,068 --> 00:11:46,046 It was that that underlying pain 241 00:11:46,070 --> 00:11:47,797 hadn't been properly treated. 242 00:11:47,821 --> 00:11:49,549 [inquisitive music] 243 00:11:49,573 --> 00:11:53,386 So pseudo addiction means 244 00:11:53,410 --> 00:11:56,306 that, uh, 245 00:11:56,330 --> 00:12:00,727 addiction symptoms are, in actuality, 246 00:12:00,751 --> 00:12:03,647 the symptoms of untreated pain? 247 00:12:03,671 --> 00:12:05,190 That's correct. 248 00:12:05,214 --> 00:12:08,735 Yeah, taking away a patient's medication isn't helping them. 249 00:12:08,759 --> 00:12:10,820 It's torturing them. 250 00:12:10,844 --> 00:12:13,657 What they need is more medication, 251 00:12:13,681 --> 00:12:15,200 and then these supposed 252 00:12:15,224 --> 00:12:18,495 addiction symptoms will quickly go away. 253 00:12:18,519 --> 00:12:21,331 So-, 254 00:12:21,355 --> 00:12:25,085 so do you think all addiction 255 00:12:25,109 --> 00:12:30,048 is, in actuality, pseudo addiction? 256 00:12:30,072 --> 00:12:32,259 In relation to medication? 257 00:12:32,283 --> 00:12:33,635 Yes. - Huh. 258 00:12:33,659 --> 00:12:36,179 DAVID: I look in those rare instances when a patient 259 00:12:36,203 --> 00:12:37,722 truly is an addict; 260 00:12:37,746 --> 00:12:40,558 That's not the fault of the drug or the doctor. 261 00:12:40,582 --> 00:12:44,145 No, the patient was most likely a drug addict to begin with 262 00:12:44,169 --> 00:12:46,982 due to genetic defects. 263 00:12:47,006 --> 00:12:49,317 - What about cigarettes? - [David chuckles] 264 00:12:49,341 --> 00:12:51,569 Addiction or pseudo addiction? 265 00:12:51,593 --> 00:12:55,532 Yeah, smoking--smoking is definitely pseudo addiction. 266 00:12:55,556 --> 00:12:57,182 It's all in their heads. 267 00:13:04,315 --> 00:13:06,608 How would you like to work for Purdue Pharma? 268 00:13:11,488 --> 00:13:14,426 [inquisitive music] 269 00:13:14,450 --> 00:13:21,457 ♪ ♪ 270 00:13:33,135 --> 00:13:34,303 RANDY: Morning, boss. 271 00:13:36,513 --> 00:13:38,349 RICK: Still no update on the funding? 272 00:13:39,933 --> 00:13:41,703 Well, good morning to you too, Randy. 273 00:13:41,727 --> 00:13:43,913 How's Jennifer? The kids? 274 00:13:43,937 --> 00:13:45,790 RICK: Sorry, good morning. 275 00:13:45,814 --> 00:13:46,982 Nailed it. 276 00:13:49,443 --> 00:13:52,047 You know, it seems pretty darn odd 277 00:13:52,071 --> 00:13:53,965 if these FBI guys won't grant us 278 00:13:53,989 --> 00:13:56,301 a small amount of resources. 279 00:13:56,325 --> 00:13:57,844 Could just be, as my son would say, 280 00:13:57,868 --> 00:14:00,472 a dysfunctional government. 281 00:14:00,496 --> 00:14:02,724 Your son's four, Rick. 282 00:14:02,748 --> 00:14:05,393 Feeling a little inadequate right now. 283 00:14:05,417 --> 00:14:06,770 Good morning, guys. 284 00:14:06,794 --> 00:14:08,271 RANDY: Morning. - What's up? 285 00:14:08,295 --> 00:14:10,690 KAREN: Still haven't heard back from the Medicaid office, 286 00:14:10,714 --> 00:14:13,151 and Dr. Jick's office finally called me back and said, 287 00:14:13,175 --> 00:14:14,944 "The doctor's unavailable." 288 00:14:14,968 --> 00:14:17,572 Unavailable? Today? 289 00:14:17,596 --> 00:14:19,932 - Nope. - She said unavailable, period. 290 00:14:24,103 --> 00:14:26,206 RECEPTIONIST: Yes, I told you, Dr. Jick is unavailable. 291 00:14:26,230 --> 00:14:27,457 Well, I've called multiple times, 292 00:14:27,481 --> 00:14:28,833 and I'd just like an explanation 293 00:14:28,857 --> 00:14:31,044 as to why Dr. Jick refuses to speak to me. 294 00:14:31,068 --> 00:14:32,295 RECEPTIONIST: He said he's very busy, 295 00:14:32,319 --> 00:14:33,737 but I'll leave a message. Thank you. 296 00:14:38,742 --> 00:14:40,869 Well, this just got interesting. 297 00:14:43,038 --> 00:14:44,099 JOHN: So what's the latest? 298 00:14:44,123 --> 00:14:45,225 Well, as you know, 299 00:14:45,249 --> 00:14:47,268 Purdue aggressively pushed the drug 300 00:14:47,292 --> 00:14:48,728 as non-addictive with the phrase 301 00:14:48,752 --> 00:14:50,397 "less than 1% get addicted." 302 00:14:50,421 --> 00:14:53,566 That figure comes from the Porter/Jick study 303 00:14:53,590 --> 00:14:57,070 that was done by Dr. Hershel Jick at, uh... 304 00:14:57,094 --> 00:14:59,447 - Boston. Boston University. - RICK: Boston University. 305 00:14:59,471 --> 00:15:01,533 JOHN: Well, let me guess, it's that the fraudulent study 306 00:15:01,557 --> 00:15:03,201 that was secretly funded by Purdue? 307 00:15:03,225 --> 00:15:04,953 Just like the pain study? RANDY: Well, that's one theory. 308 00:15:04,977 --> 00:15:08,873 We actually called Dr. Jick to discuss it with him, 309 00:15:08,897 --> 00:15:12,085 but something very interesting occurred. 310 00:15:12,109 --> 00:15:14,570 He wouldn't get on the phone with us. 311 00:15:18,615 --> 00:15:19,843 Well, nothing says suspect 312 00:15:19,867 --> 00:15:22,929 quite like an unanswered phone call. 313 00:15:22,953 --> 00:15:25,723 If that 1% study is indeed fraudulent, 314 00:15:25,747 --> 00:15:29,060 it's a home run in proving criminal misbranding. 315 00:15:29,084 --> 00:15:30,353 Yeah, and if you can find 316 00:15:30,377 --> 00:15:31,855 the high-level Purdue exec that oversaw it... 317 00:15:31,879 --> 00:15:33,231 Could indict them for fraud. 318 00:15:33,255 --> 00:15:36,526 - Yeah, that's right. - It sounds like a great lead. 319 00:15:36,550 --> 00:15:38,862 Yeah, this case is starting to take up so much time. 320 00:15:38,886 --> 00:15:40,113 That's right. 321 00:15:40,137 --> 00:15:41,489 RANDY: We need more funding for prosecutors 322 00:15:41,513 --> 00:15:43,158 for our non-Purdue cases. JOHN: Yeah, I know, I know. 323 00:15:43,182 --> 00:15:45,076 I mean, why won't the FBI or the DEA 324 00:15:45,100 --> 00:15:46,536 give us additional funding? 325 00:15:46,560 --> 00:15:48,037 You know, I don't know. 326 00:15:48,061 --> 00:15:50,832 Maybe they're not, uh, connected to the issue. 327 00:15:50,856 --> 00:15:52,292 You know what you should do, you should try 328 00:15:52,316 --> 00:15:53,877 the Virginia State Police. 329 00:15:53,901 --> 00:15:55,587 Try Virginia Medicaid Fraud Unit. 330 00:15:55,611 --> 00:15:57,755 They'll get it. And you know, the more we find, 331 00:15:57,779 --> 00:15:59,048 the more it opens up those coffers. 332 00:15:59,072 --> 00:16:01,426 Yeah, but it, it just-- it is really difficult 333 00:16:01,450 --> 00:16:03,386 to find anything without the proper resources. 334 00:16:03,410 --> 00:16:04,929 I mean, I knew we'd be outspent, 335 00:16:04,953 --> 00:16:06,389 but I did not expect 336 00:16:06,413 --> 00:16:08,391 to not have access to the most basic things, 337 00:16:08,415 --> 00:16:09,893 like high-speed computers and scanners. 338 00:16:09,917 --> 00:16:12,604 JOHN: Look, guys, I--I get it, trust me. 339 00:16:12,628 --> 00:16:14,439 But we just keep pushing, all right? 340 00:16:14,463 --> 00:16:16,483 - Yeah. - We'll see where it goes, sir. 341 00:16:16,507 --> 00:16:18,818 JOHN: All right, boys. You can enjoy your lunch. 342 00:16:18,842 --> 00:16:20,153 RICK: Thank you. JOHN: Keep me posted. 343 00:16:20,177 --> 00:16:22,489 Oh, Randy. - Sir? 344 00:16:22,513 --> 00:16:24,699 Uh, how you doing, health-wise? 345 00:16:24,723 --> 00:16:26,659 I actually just had my one-year scan, 346 00:16:26,683 --> 00:16:29,329 and I am cancer-free. 347 00:16:29,353 --> 00:16:31,897 - Yeah, he's good. - JOHN: That's great news. 348 00:16:37,194 --> 00:16:40,006 BRIDGET: OxyContin is becoming the leading cause 349 00:16:40,030 --> 00:16:41,925 of overdose in the country. 350 00:16:41,949 --> 00:16:44,385 Newspapers are filled with arrests in rural areas 351 00:16:44,409 --> 00:16:48,056 where crime directly related to the drug is skyrocketing. 352 00:16:48,080 --> 00:16:49,641 Isn't Diversion and local authorities 353 00:16:49,665 --> 00:16:51,184 supposed to deal with these crime issues? 354 00:16:51,208 --> 00:16:53,895 Yes, but what makes this so overwhelming 355 00:16:53,919 --> 00:16:56,105 for law enforcement is the sheer ease 356 00:16:56,129 --> 00:16:58,691 with which users can get access to the drug. 357 00:16:58,715 --> 00:17:02,612 I mean, they are available in every pharmacy in the country. 358 00:17:02,636 --> 00:17:04,697 What do you feel is the best approach? 359 00:17:04,721 --> 00:17:06,533 I think the most effective way 360 00:17:06,557 --> 00:17:08,451 to solve this problem 361 00:17:08,475 --> 00:17:10,954 is to limit the drug's use for severe pain only. 362 00:17:10,978 --> 00:17:14,499 It is a very strong narcotic that is being prescribed 363 00:17:14,523 --> 00:17:17,418 for issues such as basic dental work and even headaches. 364 00:17:17,442 --> 00:17:20,088 If it was no longer allowed for moderate pain, 365 00:17:20,112 --> 00:17:21,422 then overnight, 366 00:17:21,446 --> 00:17:23,967 millions of pills will be off the streets. 367 00:17:23,991 --> 00:17:25,843 What about the millions of legitimate pain patients 368 00:17:25,867 --> 00:17:27,303 that will lose access to the drug? 369 00:17:27,327 --> 00:17:30,431 If they have severe pain, they will not lose access. 370 00:17:30,455 --> 00:17:33,560 But this recent practice of opioid use for moderate pain 371 00:17:33,584 --> 00:17:37,647 is causing a startling new wave of crime and addiction. 372 00:17:37,671 --> 00:17:40,650 The role of the FDA is to make sure medicine is safe. 373 00:17:40,674 --> 00:17:43,278 And when this drug is taken as prescribed, 374 00:17:43,302 --> 00:17:46,155 this medicine is safe. 375 00:17:46,179 --> 00:17:48,056 And I disagree. 376 00:17:51,935 --> 00:17:54,080 CYNTHIA: Anecdotes about abuse and crime 377 00:17:54,104 --> 00:17:56,332 are not a scientific analysis of the drug's safety. 378 00:17:56,356 --> 00:17:58,918 They're tales of addicts abusing pharmaceuticals, 379 00:17:58,942 --> 00:18:00,336 which happens with all opioids. 380 00:18:00,360 --> 00:18:04,007 So until you can prove the drug itself is dangerous, 381 00:18:04,031 --> 00:18:06,241 I don't see how we can put restrictions on it. 382 00:18:11,997 --> 00:18:14,392 [tense music] 383 00:18:14,416 --> 00:18:15,626 Okay. 384 00:18:16,918 --> 00:18:20,356 Well, you're not gonna take action, 385 00:18:20,380 --> 00:18:25,028 then I will call in Purdue, discuss it with them directly. 386 00:18:25,052 --> 00:18:27,471 I think you should. - I will. 387 00:18:33,894 --> 00:18:36,080 And your warning label that this drug 388 00:18:36,104 --> 00:18:38,333 is somehow less addictive 389 00:18:38,357 --> 00:18:40,251 is total bullshit. 390 00:18:40,275 --> 00:18:43,320 You should look into changing that immediately. 391 00:18:47,783 --> 00:18:49,260 BILLY: Why would you start him on 20 milligrams 392 00:18:49,284 --> 00:18:51,304 when 40 milligrams sounds like it's gonna be more effective? 393 00:18:51,328 --> 00:18:53,598 KANE: Hey, yo, Teddy. RILEY: Yo. 394 00:18:53,622 --> 00:18:55,350 BILLY: Right, that's why you keep titrating 'em up 395 00:18:55,374 --> 00:18:57,852 until all there's left to say is thank you. 396 00:18:57,876 --> 00:19:01,147 I managed to scrounge up a couple of Hokies tickets 397 00:19:01,171 --> 00:19:02,482 if you're interested. 398 00:19:02,506 --> 00:19:06,069 You are the hardest-working nurse in the state. 399 00:19:06,093 --> 00:19:08,488 All right, you deserve a spa weekend. 400 00:19:08,512 --> 00:19:12,325 Listen, I think win or lose, we go to the bar. 401 00:19:12,349 --> 00:19:13,910 That's--that's what I've been saying. 402 00:19:13,934 --> 00:19:16,329 Individualizing the dose is everything. 403 00:19:16,353 --> 00:19:18,081 BOTH: ♪ I work ♪ 404 00:19:18,105 --> 00:19:22,335 ♪ I work, I work ♪ 405 00:19:22,359 --> 00:19:24,420 ♪ I work, baby ♪ 406 00:19:24,444 --> 00:19:27,131 ♪ I work, I work ♪ 407 00:19:27,155 --> 00:19:28,633 KANE: ♪ I'll get the job done ♪ 408 00:19:28,657 --> 00:19:30,677 BOTH: ♪ I work ♪ 409 00:19:30,701 --> 00:19:32,887 ♪ I work, baby ♪ 410 00:19:32,911 --> 00:19:35,139 DAVID: Which means that most symptoms of addiction 411 00:19:35,163 --> 00:19:37,767 are, in reality, untreated pain. 412 00:19:37,791 --> 00:19:40,144 And the cure for pseudo addiction 413 00:19:40,168 --> 00:19:42,355 is that the patient needs more medication. 414 00:19:42,379 --> 00:19:44,440 MICHAEL: More than 100,000 physicians, 415 00:19:44,464 --> 00:19:46,401 almost half of all doctors in the country 416 00:19:46,425 --> 00:19:49,195 will be sent pseudo addiction pamphlets. 417 00:19:49,219 --> 00:19:51,364 Give one to any doctor if their patients 418 00:19:51,388 --> 00:19:55,243 show signs of addict-- sorry, pseudo addiction. 419 00:19:55,267 --> 00:19:57,578 Questions? Yes. 420 00:19:57,602 --> 00:20:00,748 Last week, I had a doctor tell me he had two patients 421 00:20:00,772 --> 00:20:03,084 taking way more pills than he prescribed. 422 00:20:03,108 --> 00:20:04,252 Like, he was very worried 423 00:20:04,276 --> 00:20:05,712 they were addicted to the medication. 424 00:20:05,736 --> 00:20:06,921 No, no, no, no, it sounds like 425 00:20:06,945 --> 00:20:09,132 your physician's actually under prescribing. 426 00:20:09,156 --> 00:20:10,550 No, he's not. 427 00:20:10,574 --> 00:20:12,468 They're already taking 80 milligrams a day. 428 00:20:12,492 --> 00:20:14,595 Look, if I tell them that they're pseudo addicted 429 00:20:14,619 --> 00:20:17,014 and need to be bumped up to 160 milligrams, 430 00:20:17,038 --> 00:20:18,391 he'll just kick me out of his office. 431 00:20:18,415 --> 00:20:21,978 Now that is a defeatist attitude. 432 00:20:22,002 --> 00:20:26,190 Dr. Haddox is giving us innovative concepts, 433 00:20:26,214 --> 00:20:29,736 and he deserves respect and appreciation for his expertise. 434 00:20:29,760 --> 00:20:34,198 Uh, ma'am, if people are living with unnecessary pain, 435 00:20:34,222 --> 00:20:35,408 and they're being stigmatized 436 00:20:35,432 --> 00:20:37,744 when the solution is right in front of them- 437 00:20:37,768 --> 00:20:41,497 if people are suffering, they need a higher dose. 438 00:20:41,521 --> 00:20:44,524 [applause] 439 00:20:48,487 --> 00:20:51,490 [upbeat music playing] 440 00:20:56,161 --> 00:20:59,182 Hey, I'm Sandra. 441 00:20:59,206 --> 00:21:00,725 BILLY: Hey. Billy. 442 00:21:00,749 --> 00:21:02,977 So, um, which territories do you cover? 443 00:21:03,001 --> 00:21:05,772 - Uh, Virginia. - Appalachia mostly. 444 00:21:05,796 --> 00:21:08,149 Wow, lucky you. 445 00:21:08,173 --> 00:21:09,692 Excuse me. Paula. 446 00:21:09,716 --> 00:21:13,946 Hey, are you, uh, checking into the hotel right now? 447 00:21:13,970 --> 00:21:17,033 - No, I'm going home. - They just fired me. 448 00:21:17,057 --> 00:21:19,035 What? Are you serious? Why? 449 00:21:19,059 --> 00:21:22,079 They said I had inconsistent paperwork. 450 00:21:22,103 --> 00:21:26,042 Oh, my God. Um, I'm sorry. 451 00:21:26,066 --> 00:21:27,752 Don't be. 452 00:21:27,776 --> 00:21:30,379 No, I'm relieved actually. 453 00:21:30,403 --> 00:21:32,507 They all know. 454 00:21:32,531 --> 00:21:34,133 And you know. 455 00:21:34,157 --> 00:21:36,511 [tense music] 456 00:21:36,535 --> 00:21:38,119 Uh, know what? 457 00:21:40,247 --> 00:21:41,891 Okay, Billy. 458 00:21:41,915 --> 00:21:48,672 ♪ ♪ 459 00:21:51,883 --> 00:21:54,862 [unsettling music] 460 00:21:54,886 --> 00:21:57,865 [Radiohead's "Spinning Plates"] 461 00:21:57,889 --> 00:22:02,119 ♪ ♪ 462 00:22:02,143 --> 00:22:03,728 Individualize the dose. 463 00:22:13,113 --> 00:22:14,757 SCIENTIST: As opposed to other drugs, 464 00:22:14,781 --> 00:22:17,635 opioids are uniquely challenging to stop using 465 00:22:17,659 --> 00:22:20,495 because they can change a person's brain chemistry. 466 00:22:25,834 --> 00:22:29,564 But in a desperate effort to end the cycle of dependency, 467 00:22:29,588 --> 00:22:31,399 some people try to quit cold turkey, 468 00:22:31,423 --> 00:22:34,801 but the results can often be disastrous. 469 00:23:00,327 --> 00:23:03,097 A hydrangea? How'd you know? 470 00:23:03,121 --> 00:23:05,349 BILLY: Oh, you know, I have my ways. 471 00:23:05,373 --> 00:23:07,894 Can I, uh, can I see the doc? 472 00:23:07,918 --> 00:23:11,981 Billy, you know he doesn't wanna see you anymore. 473 00:23:12,005 --> 00:23:14,066 Come on, there's gotta be a misunderstanding here. 474 00:23:14,090 --> 00:23:15,776 It's been months. 475 00:23:15,800 --> 00:23:17,802 And I--you know, I miss him. 476 00:23:19,971 --> 00:23:22,658 Well, he cleared his appointments today 477 00:23:22,682 --> 00:23:24,368 'cause he's not feeling well. 478 00:23:24,392 --> 00:23:27,163 I was in the bathroom when you walked in. 479 00:23:27,187 --> 00:23:29,439 Thank you, Leah. - Mm-hmm. 480 00:23:32,943 --> 00:23:35,087 [rhythmic knock at door] 481 00:23:35,111 --> 00:23:36,551 BILLY: It's your favorite pharma rep. 482 00:23:39,699 --> 00:23:41,201 Doc, are you okay? 483 00:23:45,121 --> 00:23:46,665 Never better. 484 00:23:48,583 --> 00:23:50,853 Hi, I just, uh, 485 00:23:50,877 --> 00:23:54,982 wanted to see how you're doing and, uh, 486 00:23:55,006 --> 00:23:57,818 see how you're patients are. 487 00:23:57,842 --> 00:23:59,695 It's been a while. 488 00:23:59,719 --> 00:24:02,555 Have a seat. - Sure. 489 00:24:12,440 --> 00:24:15,127 Let me ask you something, Bill. 490 00:24:15,151 --> 00:24:18,089 Do you ever think that, um, 491 00:24:18,113 --> 00:24:21,592 maybe that miracle drug you're selling, 492 00:24:21,616 --> 00:24:23,135 it's just, you know, 493 00:24:23,159 --> 00:24:26,705 just a tad more addictive than you said? 494 00:24:30,500 --> 00:24:33,896 Uh, that's not what we're hearing. 495 00:24:33,920 --> 00:24:37,817 Um, but there is a condition associated with this, 496 00:24:37,841 --> 00:24:41,278 um, which I--I--I have some information on. 497 00:24:41,302 --> 00:24:44,365 I can share it with you. Um. 498 00:24:44,389 --> 00:24:45,741 Pseudo addiction. 499 00:24:45,765 --> 00:24:49,412 Uh, we're seeing some cases, although rare, 500 00:24:49,436 --> 00:24:52,289 where they show the symptoms of addiction, 501 00:24:52,313 --> 00:24:55,376 but in reality, their underlying pain 502 00:24:55,400 --> 00:24:57,878 hasn't been sufficiently addressed. 503 00:24:57,902 --> 00:25:00,047 Uh. 504 00:25:00,071 --> 00:25:02,091 And--and the solution is simple. 505 00:25:02,115 --> 00:25:06,554 You know, you--you up the dose, and--and their symptoms, 506 00:25:06,578 --> 00:25:10,141 you know, disappear, and-- in time. 507 00:25:10,165 --> 00:25:11,624 Let's have a look. 508 00:25:16,379 --> 00:25:19,358 [unsettling music] 509 00:25:19,382 --> 00:25:23,070 ♪ ♪ 510 00:25:23,094 --> 00:25:26,824 You sell poison, Billy. 511 00:25:26,848 --> 00:25:28,159 - What's that? - SAMUEL: That's all it says. 512 00:25:28,183 --> 00:25:29,785 You sell poison. That's what you do. 513 00:25:29,809 --> 00:25:32,538 That's just poison. 514 00:25:32,562 --> 00:25:33,664 BILLY: No, doc, I- 515 00:25:33,688 --> 00:25:35,482 Yeah, well, it's what it is. 516 00:25:38,401 --> 00:25:41,547 Yeah, it's poison. 517 00:25:41,571 --> 00:25:42,715 I can talk you through it, doc. 518 00:25:42,739 --> 00:25:44,091 It's a new concept. It's all in here. 519 00:25:44,115 --> 00:25:47,636 No, no, these are good, hard-working people. 520 00:25:47,660 --> 00:25:49,263 These are good, hard-working people, 521 00:25:49,287 --> 00:25:51,140 and you have the FDA label this- 522 00:25:51,164 --> 00:25:53,059 Doc, anything in here that you don't understand, 523 00:25:53,083 --> 00:25:54,685 I can talk you through. 524 00:25:54,709 --> 00:25:56,020 [grunts] 525 00:25:56,044 --> 00:25:57,104 [tense music] 526 00:25:57,128 --> 00:25:59,356 All right. Okay. SAMUEL: Get out. 527 00:25:59,380 --> 00:26:01,609 Get out. BILLY: All right. 528 00:26:01,633 --> 00:26:03,027 LEAH: No! Dr. Finnix. 529 00:26:03,051 --> 00:26:06,197 SAMUEL: Get away. 530 00:26:06,221 --> 00:26:07,990 You need to get going. Don't ever come back. 531 00:26:08,014 --> 00:26:09,825 - Doc--doc-- SAMUEL: Get out of here. 532 00:26:09,849 --> 00:26:11,118 BILLY: Doc, please. SAMUEL: Get out of here. 533 00:26:11,142 --> 00:26:13,829 [Billy grunts] 534 00:26:13,853 --> 00:26:15,664 You ever come back on these rounds, 535 00:26:15,688 --> 00:26:16,999 I'll fucking kill you. 536 00:26:17,023 --> 00:26:19,275 Yeah, I'll fucking kill you myself. 537 00:26:21,945 --> 00:26:23,923 LEAH: What's wrong with you? 538 00:26:23,947 --> 00:26:25,674 SAMUEL: Take the rest of the day off. 539 00:26:25,698 --> 00:26:27,009 Go home. 540 00:26:27,033 --> 00:26:33,998 ♪ ♪ 541 00:27:02,277 --> 00:27:04,904 [engine revving] 542 00:27:09,117 --> 00:27:11,470 [engine shuts off] [door thumps open] 543 00:27:11,494 --> 00:27:12,745 [door slams] 544 00:27:47,697 --> 00:27:49,842 Hi. 545 00:27:49,866 --> 00:27:53,179 I didn't know you worked here. 546 00:27:53,203 --> 00:27:54,245 Yeah. 547 00:27:57,832 --> 00:27:59,560 What are you doing in town? 548 00:27:59,584 --> 00:28:02,771 Oh. BETSY: It's been a while. 549 00:28:02,795 --> 00:28:05,506 Oh, I'm just visiting my grandma. 550 00:28:17,143 --> 00:28:19,788 How's Eureka Springs? 551 00:28:19,812 --> 00:28:25,401 - Oh, it's great. - Um, I really love it there. 552 00:28:32,992 --> 00:28:35,262 I like your belt. 553 00:28:35,286 --> 00:28:42,144 Oh, thanks. Um, I made it. 554 00:28:42,168 --> 00:28:43,962 I guess I'm crafting now. 555 00:28:46,506 --> 00:28:47,882 You still quilting? 556 00:28:56,683 --> 00:28:57,892 Um, I... 557 00:29:02,647 --> 00:29:05,626 [sentimental music] 558 00:29:05,650 --> 00:29:11,382 ♪ ♪ 559 00:29:11,406 --> 00:29:13,283 It's good to see you, Bets. 560 00:29:16,202 --> 00:29:18,371 You take care of yourself, okay? 561 00:29:38,474 --> 00:29:41,412 [line trills] 562 00:29:41,436 --> 00:29:44,415 Hey. 563 00:29:44,439 --> 00:29:47,042 I wanna go to Florida. 564 00:29:47,066 --> 00:29:50,254 SINGER: ♪ When I go driving, I stay in my lane ♪ 565 00:29:50,278 --> 00:29:53,132 [spirited rock music] 566 00:29:53,156 --> 00:29:56,468 ♪ But getting cut off, it makes me insane ♪ 567 00:29:56,492 --> 00:29:59,805 [The Offspring's "Bad Habit"] 568 00:29:59,829 --> 00:30:02,725 ♪ I open the glove box, reach inside ♪ 569 00:30:02,749 --> 00:30:05,185 ♪ I'm gonna wreck this fucker's ride ♪ 570 00:30:05,209 --> 00:30:08,022 ♪ Guess I got a bad habit ♪ 571 00:30:08,046 --> 00:30:10,357 Hey, you want a Xanax? 572 00:30:10,381 --> 00:30:11,758 It'll take the edge off. 573 00:30:13,926 --> 00:30:15,386 How much? 574 00:30:17,138 --> 00:30:18,681 Jesus, man, it's a gift. 575 00:30:21,559 --> 00:30:24,538 In the Gulf, we used to say, don't make me offer twice. 576 00:30:24,562 --> 00:30:25,998 BETSY: Okay. WALT: Take this. 577 00:30:26,022 --> 00:30:28,222 It'll make you feel better. BETSY: All right, all right. 578 00:30:30,943 --> 00:30:33,339 I didn't know you were a vet. 579 00:30:33,363 --> 00:30:35,823 Yeah, did two tours. 580 00:30:38,743 --> 00:30:40,161 Shit I saw... 581 00:30:45,041 --> 00:30:47,186 Hey. 582 00:30:47,210 --> 00:30:50,272 Salvation at last. 583 00:30:50,296 --> 00:30:52,941 SINGER: ♪ And your next breath is your last ♪ 584 00:30:52,965 --> 00:30:56,153 ♪ Guess I got a bad habit ♪ 585 00:30:56,177 --> 00:30:58,072 ♪ Of blowin' away ♪ 586 00:30:58,096 --> 00:30:59,823 ♪ Yeah, yeah ♪ 587 00:30:59,847 --> 00:31:01,575 ♪ Got a bad habit ♪ 588 00:31:01,599 --> 00:31:02,910 ♪ Yeah, yeah ♪ 589 00:31:02,934 --> 00:31:04,578 WALT: Told you. [Betsy laughs] 590 00:31:04,602 --> 00:31:06,413 SINGER: ♪ Yeah, yeah ♪ 591 00:31:06,437 --> 00:31:07,831 ♪ Got a bad habit ♪ 592 00:31:07,855 --> 00:31:09,291 ♪ Yeah, yeah ♪ 593 00:31:09,315 --> 00:31:10,959 ♪ And it ain't goin' away ♪ 594 00:31:10,983 --> 00:31:12,711 ♪ Yeah, yeah ♪ 595 00:31:12,735 --> 00:31:14,213 ♪ Yeah, yeah-ah-ah ♪ 596 00:31:14,237 --> 00:31:15,881 ♪ Yeah, yeah ♪ 597 00:31:15,905 --> 00:31:17,508 ♪ Yeah, yeah-ah-ah ♪ 598 00:31:17,532 --> 00:31:19,242 ♪ Yeah, yeah ♪ 599 00:31:31,295 --> 00:31:34,483 DOCTOR: So injury or chronic condition? 600 00:31:34,507 --> 00:31:38,779 - I hurt my back. - Mining incident. 601 00:31:38,803 --> 00:31:40,489 DOCTOR: Okay, I'm gonna need to examine you. 602 00:31:40,513 --> 00:31:42,181 Did the nurse give you a gown? 603 00:31:48,980 --> 00:31:50,314 Here you go. 604 00:32:04,245 --> 00:32:05,955 Uh, bra too, please. 605 00:32:22,513 --> 00:32:24,348 Okay, lift your arms. 606 00:32:31,981 --> 00:32:34,835 Yes, you are definitely gonna need painkillers. 607 00:32:34,859 --> 00:32:37,212 [unsettling music] 608 00:32:37,236 --> 00:32:38,839 Strong ones. 609 00:32:38,863 --> 00:32:42,968 OxyContin, 40 milligrams, twice per day. 610 00:32:42,992 --> 00:32:44,660 Unless you have breakthrough pain. 611 00:32:47,580 --> 00:32:48,873 How does that sound? 612 00:33:00,134 --> 00:33:02,678 Hey, these prescriptions can really add up. 613 00:33:04,514 --> 00:33:06,575 So if you're in a bind, 614 00:33:06,599 --> 00:33:08,935 we might be able to work something out. 615 00:33:14,148 --> 00:33:16,460 - It's f--it's fine. - I have cash. 616 00:33:16,484 --> 00:33:18,069 DOCTOR: No problem. 617 00:33:23,783 --> 00:33:26,702 Fill this out at the dispensary in the back. 618 00:33:41,467 --> 00:33:43,904 God bless the great state of Florida. 619 00:33:43,928 --> 00:33:50,935 ♪ ♪ 620 00:33:57,817 --> 00:34:00,295 DREA: I told you never to call me again. 621 00:34:00,319 --> 00:34:04,383 SAMUEL: Hi, yeah, you know, I'm-- I'm sorry, and I--I, uh, 622 00:34:04,407 --> 00:34:06,635 do want to apologize for-- for what happened. 623 00:34:06,659 --> 00:34:08,095 I'm going through some stuff, Drea. 624 00:34:08,119 --> 00:34:10,889 Watching you fall asleep in the middle of a restaurant 625 00:34:10,913 --> 00:34:12,683 is not my idea of a good time. 626 00:34:12,707 --> 00:34:14,351 SAMUEL: Yeah. DREA: It was humiliating. 627 00:34:14,375 --> 00:34:17,479 I know, I know, I'm dealing with a medical condition, 628 00:34:17,503 --> 00:34:19,439 and, um, in fact, 629 00:34:19,463 --> 00:34:22,651 I was wondering if, you know, possibly you could help me. 630 00:34:22,675 --> 00:34:26,321 Uh, Drea, you don't have samples of OxyContin, do you? 631 00:34:26,345 --> 00:34:29,533 [laughs] No, I don't. 632 00:34:29,557 --> 00:34:31,952 Delete my number. 633 00:34:31,976 --> 00:34:37,249 ♪ ♪ 634 00:34:37,273 --> 00:34:42,963 SINGER: ♪ When this just feels like ♪ 635 00:34:42,987 --> 00:34:48,093 ♪ Spinning plates ♪ 636 00:34:48,117 --> 00:34:50,345 SCIENTIST: The brain is rewired to function normally 637 00:34:50,369 --> 00:34:51,722 when opioids are present 638 00:34:51,746 --> 00:34:53,932 and abnormally when they are not. 639 00:34:53,956 --> 00:34:57,519 And the pain from withdrawal is so overwhelming 640 00:34:57,543 --> 00:34:59,896 that a person can feel like they are literally 641 00:34:59,920 --> 00:35:02,340 going to die if they don't get more drugs. 642 00:35:05,092 --> 00:35:11,700 SINGER: ♪ And this just feels like ♪ 643 00:35:11,724 --> 00:35:14,328 What is the term for the pain an addict feels 644 00:35:14,352 --> 00:35:18,415 when they're in clinical need of their next fix? 645 00:35:18,439 --> 00:35:20,459 It's called dopesick. 646 00:35:20,483 --> 00:35:27,490 ♪ ♪ 647 00:35:45,633 --> 00:35:47,069 RICK: You wanted to speak to me? 648 00:35:47,093 --> 00:35:50,739 RANDY: Uh, there's something very strange going on here. 649 00:35:50,763 --> 00:35:52,491 RICK: What is it? 650 00:35:52,515 --> 00:35:54,868 RANDY: The Porter/Jick study isn't on the internet. 651 00:35:54,892 --> 00:35:56,453 What? 652 00:35:56,477 --> 00:35:58,789 RANDY: Yeah, I mean, it's referenced all over the place. 653 00:35:58,813 --> 00:36:00,582 TIME magazine, Scientific American. 654 00:36:00,606 --> 00:36:02,501 But I--I mean, I can't find the actual study. 655 00:36:02,525 --> 00:36:05,253 Greg can't find it, either. He's been on it longer than me. 656 00:36:05,277 --> 00:36:08,006 Do you find any affiliations between Purdue and Jick? 657 00:36:08,030 --> 00:36:10,258 Paid speeches, consulting, anything like that? 658 00:36:10,282 --> 00:36:11,843 Nothing. 659 00:36:11,867 --> 00:36:14,346 What about Porter? Who's that? 660 00:36:14,370 --> 00:36:17,140 - It's Jick's assistant. - Jane Porter. 661 00:36:17,164 --> 00:36:19,101 There's 10,000 of them. 662 00:36:19,125 --> 00:36:21,436 So the--the famous Porter/Jick study 663 00:36:21,460 --> 00:36:22,979 that's the North Star of the pain movement 664 00:36:23,003 --> 00:36:25,214 to increase opioid use is nowhere to be found? 665 00:36:26,716 --> 00:36:28,360 Bingo. 666 00:36:28,384 --> 00:36:30,445 Hey, yeah, we're calling about a Scientific American article 667 00:36:30,469 --> 00:36:33,740 you wrote in 1990, "The Tragedy of Needless Pain," 668 00:36:33,764 --> 00:36:37,869 in which you referenced an, uh, "extensive study" 669 00:36:37,893 --> 00:36:40,706 that claimed less than 1% of opioid users, 670 00:36:40,730 --> 00:36:42,249 uh, become addicted. 671 00:36:42,273 --> 00:36:45,085 RONALD: Uh, yeah, Porter/Jick. What about it? 672 00:36:45,109 --> 00:36:47,003 Do you have a copy of that study? 673 00:36:47,027 --> 00:36:48,797 RONALD: Uh, I'm not sure. 674 00:36:48,821 --> 00:36:50,465 Uh, have you tried the Internet? 675 00:36:50,489 --> 00:36:53,135 - [chuckles] - Uh, you know, I sure did. 676 00:36:53,159 --> 00:36:54,344 I might've missed it, though, 677 00:36:54,368 --> 00:36:56,763 'cause I only type with my index fingers, 678 00:36:56,787 --> 00:36:58,849 but I hear, uh, JD Salinger did the same thing, 679 00:36:58,873 --> 00:37:01,393 so that kind of helps me out in the self-esteem department. 680 00:37:01,417 --> 00:37:03,145 RONALD: [chuckles] Yeah. 681 00:37:03,169 --> 00:37:04,563 Any medical school will have it. 682 00:37:04,587 --> 00:37:06,773 It's taught all over the country, but, um, 683 00:37:06,797 --> 00:37:09,192 I'm happy to check my notes and call you back. 684 00:37:09,216 --> 00:37:11,069 - Oh, you know what? - I don't mind holding for you. 685 00:37:11,093 --> 00:37:13,864 Um, my boss has been getting on me about this, 686 00:37:13,888 --> 00:37:16,992 and you'd really be helping me out here. 687 00:37:17,016 --> 00:37:18,910 RONALD: Okay. I'll do a quick search. 688 00:37:18,934 --> 00:37:21,079 Thank you. 689 00:37:21,103 --> 00:37:23,665 Oh, Mr. Smarty Pants knows his JD Salinger. 690 00:37:23,689 --> 00:37:25,792 I got it from my book learning, sir. 691 00:37:25,816 --> 00:37:28,628 Thinking of reading Moby Dick next 692 00:37:28,652 --> 00:37:30,338 'cause I love whales 693 00:37:30,362 --> 00:37:34,092 and, uh, reading stories about whales and doing--. 694 00:37:34,116 --> 00:37:36,219 RONALD: Hi, um, yeah, it's right here in my notes. 695 00:37:36,243 --> 00:37:38,638 The Porter/Jick study is in a 1980 issue 696 00:37:38,662 --> 00:37:40,348 of the New England Journal of Medicine. 697 00:37:40,372 --> 00:37:42,684 Do you know which issue exactly? 698 00:37:42,708 --> 00:37:45,228 RONALD: No, that's all I have here, but good luck, okay? 699 00:37:45,252 --> 00:37:47,063 I gotta get going. RANDY: Okay, thank you. 700 00:37:47,087 --> 00:37:49,357 [inquisitive music] 701 00:37:49,381 --> 00:37:50,817 All right. 702 00:37:50,841 --> 00:37:57,848 ♪ ♪ 703 00:38:21,205 --> 00:38:23,225 Been through every issue of a weekly publication 704 00:38:23,249 --> 00:38:26,019 from 1978 to what, 1994, 705 00:38:26,043 --> 00:38:28,980 and we can't find this thing, huh? 706 00:38:29,004 --> 00:38:30,941 So we got TIME magazine, 707 00:38:30,965 --> 00:38:33,610 Scientific American citing it. RICK: Mm-hmm. 708 00:38:33,634 --> 00:38:36,613 Medical schools all across the country teaching it. 709 00:38:36,637 --> 00:38:38,949 RICK: Right. 710 00:38:38,973 --> 00:38:40,867 And yet it appears to be the most famous study 711 00:38:40,891 --> 00:38:42,685 that no one has actually ever seen. 712 00:38:58,033 --> 00:38:59,177 Wh--what's going on? 713 00:38:59,201 --> 00:39:00,846 ERIC: Hi, Betsy. 714 00:39:00,870 --> 00:39:02,722 My name is Eric Miller, 715 00:39:02,746 --> 00:39:05,976 and I'm a member of the AA community here in town. 716 00:39:06,000 --> 00:39:09,354 Everyone in this room is here because we're very concerned 717 00:39:09,378 --> 00:39:12,023 for your health and your safety. 718 00:39:12,047 --> 00:39:14,067 And we have so many things that we want to say 719 00:39:14,091 --> 00:39:16,486 and share with you. 720 00:39:16,510 --> 00:39:18,864 We're all worried about your drug use 721 00:39:18,888 --> 00:39:21,783 and think it's time to seek treatment. 722 00:39:21,807 --> 00:39:23,517 Why don't you sit down? 723 00:39:29,523 --> 00:39:31,775 You lied to me at the station. 724 00:39:33,569 --> 00:39:38,967 Uh, I came here because your mom asked me to. 725 00:39:38,991 --> 00:39:41,052 We're all really worried about you, Bets. 726 00:39:41,076 --> 00:39:42,304 Your daddy and I don't care 727 00:39:42,328 --> 00:39:44,014 about anything other than you getting better. 728 00:39:44,038 --> 00:39:47,684 All that other stuff, Bets, doesn't matter. 729 00:39:47,708 --> 00:39:50,478 Just doesn't matter. 730 00:39:50,502 --> 00:39:54,232 [sentimental music] 731 00:39:54,256 --> 00:39:56,484 ERIC: Your friends and family are worried every day 732 00:39:56,508 --> 00:39:59,195 that you're going to end up in a hospital or dead 733 00:39:59,219 --> 00:40:02,449 or in the back of a police car. 734 00:40:02,473 --> 00:40:04,993 They wanna do everything they can to help you get back 735 00:40:05,017 --> 00:40:07,078 to a place of health, 736 00:40:07,102 --> 00:40:09,772 of just being okay without drugs. 737 00:40:11,607 --> 00:40:13,710 Will you commit to a program? 738 00:40:13,734 --> 00:40:20,741 ♪ ♪ 739 00:40:25,162 --> 00:40:27,682 JERRY: Ple--please, Bets. 740 00:40:27,706 --> 00:40:30,518 Please don't walk out that door, honey. 741 00:40:30,542 --> 00:40:33,521 You--your mama and me, we just- 742 00:40:33,545 --> 00:40:36,358 we just want our little girl back. 743 00:40:36,382 --> 00:40:38,133 Just the way you are. 744 00:40:45,599 --> 00:40:48,703 I'm sorry. 745 00:40:48,727 --> 00:40:52,248 I can't. I can't. 746 00:40:52,272 --> 00:40:55,502 Betsy, if you don't do this, 747 00:40:55,526 --> 00:40:58,320 your family will be forced to turn their back on you. 748 00:41:11,625 --> 00:41:13,961 Grant! Get in here. 749 00:41:17,131 --> 00:41:19,883 - GRANT: What's up? - Guess who's coming to dinner? 750 00:41:22,553 --> 00:41:24,805 Purdue Pharma agreed to meet. 751 00:41:26,557 --> 00:41:28,451 Is Richard Sackler gonna join? 752 00:41:28,475 --> 00:41:29,869 Doesn't say. 753 00:41:29,893 --> 00:41:31,413 Let's see if they give a fuck about safety 754 00:41:31,437 --> 00:41:32,998 or if they're just trying to sell pills. 755 00:41:33,022 --> 00:41:35,625 Uh, look, I--I know 756 00:41:35,649 --> 00:41:38,461 you're newest to Diversion, but as a general rule, 757 00:41:38,485 --> 00:41:40,672 the pharmas don't really care about safety. 758 00:41:40,696 --> 00:41:43,258 They just push as hard as they can until they get slapped. 759 00:41:43,282 --> 00:41:44,300 Then let's bitch slap the shit 760 00:41:44,324 --> 00:41:45,719 out of these motherfuckers. 761 00:41:45,743 --> 00:41:48,263 [inquisitive music] 762 00:41:48,287 --> 00:41:51,266 [Bridget snapping fingers] 763 00:41:51,290 --> 00:41:57,063 ♪ ♪ 764 00:41:57,087 --> 00:41:58,464 [clears throat] 765 00:42:03,302 --> 00:42:04,612 Good afternoon. 766 00:42:04,636 --> 00:42:06,823 I'm Bridget Meyer, deputy director of Diversion. 767 00:42:06,847 --> 00:42:09,492 - I'm Michael Friedman. - Howard Udell and David Haddox. 768 00:42:09,516 --> 00:42:10,869 DAVID: Pleasure. 769 00:42:10,893 --> 00:42:13,329 Is Richard Sackler coming? 770 00:42:13,353 --> 00:42:15,123 Dr. Sackler had a meeting out of state, 771 00:42:15,147 --> 00:42:17,441 but I can assure you, we'll relay every word. 772 00:42:18,859 --> 00:42:21,087 Fine. Let's get started. 773 00:42:21,111 --> 00:42:23,882 Uh, we'd like to start with a, uh, PowerPoint presentation 774 00:42:23,906 --> 00:42:26,301 about the efficacies of OxyContin. 775 00:42:26,325 --> 00:42:27,594 That won't be necessary. 776 00:42:27,618 --> 00:42:29,220 I've seen your promotional materials, 777 00:42:29,244 --> 00:42:31,097 and I'm familiar with your talking points. 778 00:42:31,121 --> 00:42:33,558 So let's get right to the issue at hand. 779 00:42:33,582 --> 00:42:37,103 I've brought you here to talk about addiction and abuse. 780 00:42:37,127 --> 00:42:38,980 Since the launch of your drug four years ago, 781 00:42:39,004 --> 00:42:40,523 it has gotten out of control. 782 00:42:40,547 --> 00:42:41,566 No, I beg to differ. 783 00:42:41,590 --> 00:42:43,151 Uh, you can beg when I finish. 784 00:42:43,175 --> 00:42:46,279 Now, to be proactive, my staff and I have come up 785 00:42:46,303 --> 00:42:48,615 with some practical common sense ideas 786 00:42:48,639 --> 00:42:51,159 that we believe could easily be implemented 787 00:42:51,183 --> 00:42:52,410 and would really help reduce 788 00:42:52,434 --> 00:42:54,579 the widespread abuse of this drug. 789 00:42:54,603 --> 00:42:56,081 We don't believe the drug is being abused, 790 00:42:56,105 --> 00:42:57,916 but we'd be happy to hear your ideas 791 00:42:57,940 --> 00:43:00,359 if you think it would enhance public safety. 792 00:43:02,361 --> 00:43:05,090 Given the growing incidences of drugstore robberies, 793 00:43:05,114 --> 00:43:06,841 it might be useful to reduce 794 00:43:06,865 --> 00:43:09,219 the number of pharmacies allowed to dispense. 795 00:43:09,243 --> 00:43:10,720 This would also help with pharmacies 796 00:43:10,744 --> 00:43:12,305 that don't want to carry the drug 797 00:43:12,329 --> 00:43:17,102 but feel pressured to because of threats of lawsuits. 798 00:43:17,126 --> 00:43:18,877 We'll take it under advisement. 799 00:43:28,846 --> 00:43:29,989 We also thought that 800 00:43:30,013 --> 00:43:32,117 you could limit prescribing privileges 801 00:43:32,141 --> 00:43:35,120 to doctors with training in pain management. 802 00:43:35,144 --> 00:43:37,831 It seems that GPs are prescribing this for things 803 00:43:37,855 --> 00:43:40,375 as frivolous as headaches and toothaches. 804 00:43:40,399 --> 00:43:42,877 The drugs should be limited to pain specialists. 805 00:43:42,901 --> 00:43:45,130 Well, um, that's not only impractical, 806 00:43:45,154 --> 00:43:47,549 it would also deny many legitimate pain patients 807 00:43:47,573 --> 00:43:50,760 access to the drugs, so. 808 00:43:50,784 --> 00:43:54,931 That's verbatim, the FDA's concern. 809 00:43:54,955 --> 00:43:56,349 Do you have them on speed dial? 810 00:43:56,373 --> 00:43:58,518 [tense music] 811 00:43:58,542 --> 00:44:01,104 Excuse me? 812 00:44:01,128 --> 00:44:04,149 Whatever friendly situation you have going on over there, 813 00:44:04,173 --> 00:44:07,068 I assure you, you do not have here. 814 00:44:07,092 --> 00:44:09,612 I want to restrict access to this drug. 815 00:44:09,636 --> 00:44:10,905 It is being overprescribed 816 00:44:10,929 --> 00:44:13,199 and causing patients to become addicted 817 00:44:13,223 --> 00:44:15,785 as well as making it too easily available 818 00:44:15,809 --> 00:44:18,246 for recreational drug users. 819 00:44:18,270 --> 00:44:22,667 Addiction rates, overdoses, and crime is on the rise 820 00:44:22,691 --> 00:44:24,794 across the country because of this drug. 821 00:44:24,818 --> 00:44:28,673 So if you will not take action to curb this problem, 822 00:44:28,697 --> 00:44:30,049 then I will. 823 00:44:30,073 --> 00:44:36,014 ♪ ♪ 824 00:44:36,038 --> 00:44:37,623 We'll take that under advisement. 825 00:44:44,838 --> 00:44:47,758 [indistinct chatter] 826 00:44:49,426 --> 00:44:52,405 [suspenseful music] 827 00:44:52,429 --> 00:44:59,436 ♪ ♪ 828 00:45:08,528 --> 00:45:10,256 RECEPTIONIST: New England Journal of Medicine. 829 00:45:10,280 --> 00:45:11,674 Hi, my name is Rick Mountcastle. 830 00:45:11,698 --> 00:45:12,967 I'm with the US Attorney's office 831 00:45:12,991 --> 00:45:14,594 in the Western District of Virginia, 832 00:45:14,618 --> 00:45:17,263 and I'm trying to locate a study 833 00:45:17,287 --> 00:45:18,681 that you published years ago 834 00:45:18,705 --> 00:45:22,393 regarding opioid addiction by a Dr. Hershel Jick. 835 00:45:22,417 --> 00:45:23,770 Does that ring a bell? 836 00:45:23,794 --> 00:45:25,605 RECEPTIONIST: Oh, yeah. We know Dr. Jick well. 837 00:45:25,629 --> 00:45:27,315 He's been writing us letters for years. 838 00:45:27,339 --> 00:45:28,900 We've published a lot of them. They're good. 839 00:45:28,924 --> 00:45:30,652 - Some people just, you know... - Wait. 840 00:45:30,676 --> 00:45:32,278 RECEPTIONIST: They love to read letters to the Internet. 841 00:45:32,302 --> 00:45:34,739 I'm sorry, uh, you mean, like letters? 842 00:45:34,763 --> 00:45:38,368 RECEPTIONIST: Yeah, yeah. He writes a lot of letters. 843 00:45:38,392 --> 00:45:45,399 ♪ ♪ 844 00:45:47,651 --> 00:45:48,902 RICK: I found it. 845 00:45:58,578 --> 00:45:59,955 That can't be it. 846 00:46:01,790 --> 00:46:03,417 Oh, my God. 847 00:46:05,836 --> 00:46:08,171 Government calls Dr. Hershel Jick. 848 00:46:19,391 --> 00:46:20,392 Afternoon, sir. 849 00:46:28,525 --> 00:46:32,714 Dr. Jick, tell us about your 1980 letter to the editor 850 00:46:32,738 --> 00:46:34,424 at the New England Journal of Medicine 851 00:46:34,448 --> 00:46:37,326 regarding addiction rates and patients taking opioids. 852 00:46:38,660 --> 00:46:42,432 In the late '70s, I built a database of hospital records, 853 00:46:42,456 --> 00:46:45,643 which became known, as it was one of the first. 854 00:46:45,667 --> 00:46:47,937 After reading a newspaper article on addiction, 855 00:46:47,961 --> 00:46:51,733 I decided to calculate how many patients in my database 856 00:46:51,757 --> 00:46:55,695 showed signs of addiction to narcotic painkillers. 857 00:46:55,719 --> 00:46:59,532 Number was shockingly low, less than 1%. 858 00:46:59,556 --> 00:47:01,159 So I wrote up a letter 859 00:47:01,183 --> 00:47:04,162 and sent it to the New England Journal of Medicine. 860 00:47:04,186 --> 00:47:05,747 This letter was based on patients 861 00:47:05,771 --> 00:47:07,915 confined to a hospital setting, is that correct? 862 00:47:07,939 --> 00:47:09,709 Yes. - Mm-hmm. 863 00:47:09,733 --> 00:47:12,628 Is--so is the likelihood of addiction 864 00:47:12,652 --> 00:47:14,005 higher in these same patients 865 00:47:14,029 --> 00:47:16,799 if they were not confined to a hospital? 866 00:47:16,823 --> 00:47:19,844 HERSHEL: That is correct. It wasn't an official study. 867 00:47:19,868 --> 00:47:23,389 It was an observation based on a small group of patients 868 00:47:23,413 --> 00:47:25,725 in a highly controlled environment. 869 00:47:25,749 --> 00:47:28,227 That's why the letter was so short. 870 00:47:28,251 --> 00:47:30,480 - Yes. - It was five sentences long. 871 00:47:30,504 --> 00:47:35,818 ♪ ♪ 872 00:47:35,842 --> 00:47:38,154 How long would an average scientific study 873 00:47:38,178 --> 00:47:39,864 on addiction be? 874 00:47:39,888 --> 00:47:41,741 Between 25 and 50 pages. 875 00:47:41,765 --> 00:47:43,326 Which is more than five sentences. 876 00:47:43,350 --> 00:47:44,535 HERSHEL: Obviously. 877 00:47:44,559 --> 00:47:45,995 Have you ever worked for Purdue Pharma? 878 00:47:46,019 --> 00:47:47,246 No. 879 00:47:47,270 --> 00:47:48,539 RICK: Have you ever consulted for them 880 00:47:48,563 --> 00:47:49,874 or received money from them? 881 00:47:49,898 --> 00:47:54,003 No, I have no affiliation with Purdue Pharma. 882 00:47:54,027 --> 00:47:58,966 Well, are you aware that sales reps at Purdue 883 00:47:58,990 --> 00:48:01,803 cite your letter as a scientific study 884 00:48:01,827 --> 00:48:04,430 to convince doctors that less than 1% of patients 885 00:48:04,454 --> 00:48:07,374 would get addicted to their narcotic OxyContin? 886 00:48:09,709 --> 00:48:11,229 No, I'm not. 887 00:48:11,253 --> 00:48:15,233 And are you aware that your five-sentence letter is cited 888 00:48:15,257 --> 00:48:18,444 as a major study by medical schools all across the country, 889 00:48:18,468 --> 00:48:21,989 and in magazine articles from TIME magazine, 890 00:48:22,013 --> 00:48:26,911 Scientific American as proof that opioids are safe? 891 00:48:26,935 --> 00:48:29,539 I was not aware of that. 892 00:48:29,563 --> 00:48:31,249 Well, I'm gonna tell you what, 893 00:48:31,273 --> 00:48:34,210 there is an entire school of thought espousing opioids 894 00:48:34,234 --> 00:48:36,045 as being practically non-addictive, 895 00:48:36,069 --> 00:48:37,797 and your letter is often cited 896 00:48:37,821 --> 00:48:41,426 as a major source for this thesis. 897 00:48:41,450 --> 00:48:44,637 This particular letter is very near the bottom 898 00:48:44,661 --> 00:48:47,682 of a long list of my published work. 899 00:48:47,706 --> 00:48:49,475 It's simply provides some basic numbers 900 00:48:49,499 --> 00:48:51,727 based on a small group of people. 901 00:48:51,751 --> 00:48:55,815 I have no idea how it became so discussed. 902 00:48:55,839 --> 00:48:57,090 I'll tell you how. 903 00:48:59,801 --> 00:49:04,282 So it became the primary source that opioids are non-addictive 904 00:49:04,306 --> 00:49:07,535 when it was cited in a 1986 article 905 00:49:07,559 --> 00:49:09,203 in PAIN magazine, 906 00:49:09,227 --> 00:49:11,539 which was highly influential in transforming 907 00:49:11,563 --> 00:49:15,001 the perception of opioids from addictive to safe. 908 00:49:15,025 --> 00:49:17,962 And this article was co-authored 909 00:49:17,986 --> 00:49:20,047 by Dr. Russell Portenoy, 910 00:49:20,071 --> 00:49:22,300 who is now a paid spokesperson for Purdue Pharma 911 00:49:22,324 --> 00:49:24,385 and one of the chief medical proponents 912 00:49:24,409 --> 00:49:28,264 for increased use of opioids and OxyContin 913 00:49:28,288 --> 00:49:30,332 in the United States of America. 914 00:49:35,253 --> 00:49:38,065 Halfway home to Abington, baby. 915 00:49:38,089 --> 00:49:40,526 Whoo. Ah. [Rick chuckles] 916 00:49:40,550 --> 00:49:42,528 I'm all about those small victories. 917 00:49:42,552 --> 00:49:43,988 Aw, what do you mean, small victories? 918 00:49:44,012 --> 00:49:45,448 We had a big day. 919 00:49:45,472 --> 00:49:47,033 [phone ringing] - Sure was. 920 00:49:47,057 --> 00:49:49,327 Maybe it'll help us get more funding? 921 00:49:49,351 --> 00:49:50,644 I doubt it. 922 00:49:54,898 --> 00:49:56,149 Rick Mountcastle. 923 00:49:58,818 --> 00:50:02,089 Oh yeah, I remember you, Toby. How're things at the DEA? 924 00:50:02,113 --> 00:50:05,218 [suspenseful music] 925 00:50:05,242 --> 00:50:07,386 Mm-hmm. 926 00:50:07,410 --> 00:50:08,930 Well, it's still early in the case. 927 00:50:08,954 --> 00:50:10,723 We haven't found anything yet. You know what? 928 00:50:10,747 --> 00:50:14,352 I'll tell you what-- it isn't a good time to talk. 929 00:50:14,376 --> 00:50:16,854 Try you another time? Yeah. 930 00:50:16,878 --> 00:50:20,090 It's all right. Great, bye. 931 00:50:25,095 --> 00:50:28,241 DEA wants to know how the pharma case is going. 932 00:50:28,265 --> 00:50:30,826 [sighs] 933 00:50:30,850 --> 00:50:32,453 They have zero interest, 934 00:50:32,477 --> 00:50:34,372 and right when we land something big, 935 00:50:34,396 --> 00:50:37,333 they just--they call us right outta nowhere? 936 00:50:37,357 --> 00:50:39,794 Let's keep this buttoned up. 937 00:50:39,818 --> 00:50:41,820 Just me, you, and Brownlee. 938 00:50:43,822 --> 00:50:45,991 I don't trust anyone on this case. 939 00:50:48,410 --> 00:50:50,680 AA MEMBER: Even after nine years staying sober, 940 00:50:50,704 --> 00:50:53,015 I know I got a disease. 941 00:50:53,039 --> 00:50:56,811 So grateful I can come here every week as a reminder 942 00:50:56,835 --> 00:51:01,691 of what I need to do to stay on my path. 943 00:51:01,715 --> 00:51:05,176 Thank you for sharing, Belle, and you're not alone. 944 00:51:09,055 --> 00:51:11,099 Betsy, would you like to speak? 945 00:51:13,393 --> 00:51:16,497 Do I have to? 946 00:51:16,521 --> 00:51:19,250 ERIC: You might find it helpful. 947 00:51:19,274 --> 00:51:22,295 This is a very safe space. 948 00:51:22,319 --> 00:51:24,714 Just share from your heart, dear. 949 00:51:24,738 --> 00:51:26,615 We're all here to support you. 950 00:51:34,623 --> 00:51:38,603 Okay, um. 951 00:51:38,627 --> 00:51:39,937 I'm Betsy. 952 00:51:39,961 --> 00:51:42,273 ALL: Hi, Betsy. 953 00:51:42,297 --> 00:51:45,568 BETSY: I was prescribed OxyContin 954 00:51:45,592 --> 00:51:49,346 for, uh, a back injury... 955 00:51:51,931 --> 00:51:56,227 And it worked great at first, but... 956 00:51:58,146 --> 00:52:04,569 Then it stopped working, and I needed more. 957 00:52:08,114 --> 00:52:09,783 Here you are, sweetheart. 958 00:52:15,163 --> 00:52:16,247 BETSY: I guess--. 959 00:52:18,750 --> 00:52:25,358 I guess I always felt kinda tense 960 00:52:25,382 --> 00:52:30,303 and uncomfortable around people. 961 00:52:35,100 --> 00:52:40,355 But taking the pills, it was... 962 00:52:43,149 --> 00:52:46,111 It was the first time I felt normal. 963 00:52:49,030 --> 00:52:50,782 In maybe my whole life. 964 00:52:56,788 --> 00:52:57,789 And now... 965 00:53:01,292 --> 00:53:04,980 And now I don't feel 966 00:53:05,004 --> 00:53:07,298 anything at all anymore. 967 00:53:10,635 --> 00:53:13,263 All I think about is getting more pills. 968 00:53:16,182 --> 00:53:18,601 And it can get scary. 969 00:53:39,247 --> 00:53:41,851 Aww, everything's gonna be just fine. 970 00:53:41,875 --> 00:53:44,437 Don't you worry. 971 00:53:44,461 --> 00:53:46,171 How long has it been? 972 00:53:47,922 --> 00:53:50,985 - Two days. - I feel like I'm gonna die. 973 00:53:51,009 --> 00:53:54,947 Oh, honey, it's the worst feeling in the world, 974 00:53:54,971 --> 00:53:56,890 but I can help with that. 975 00:53:58,433 --> 00:54:00,786 You can? - Mm-hmm. 976 00:54:00,810 --> 00:54:04,540 I got 10s, 20s, and 40s. 977 00:54:04,564 --> 00:54:07,001 It's a dollar a milligram, so if you've got $40, 978 00:54:07,025 --> 00:54:11,130 I can give you four 10s right now. 979 00:54:11,154 --> 00:54:15,926 I mean, wouldn't it be nice if all this pain just went away? 980 00:54:15,950 --> 00:54:17,678 Yeah. 981 00:54:17,702 --> 00:54:19,305 Here you go. 982 00:54:19,329 --> 00:54:22,641 [unsettling music] 983 00:54:22,665 --> 00:54:24,018 Thank you so much. 984 00:54:24,042 --> 00:54:25,186 It's gonna be all right, sugar. 985 00:54:25,210 --> 00:54:26,979 Thank you. 986 00:54:27,003 --> 00:54:29,106 I'll see you here next week, all right? 987 00:54:29,130 --> 00:54:36,137 ♪ ♪ 988 00:54:51,069 --> 00:54:52,838 WALT: Hey. - Hey, Walt. 989 00:54:52,862 --> 00:54:54,089 WALT: Doc, how you doing? 990 00:54:54,113 --> 00:54:55,925 - Ah, good, good. - Hey, sorry, I know it's late- 991 00:54:55,949 --> 00:54:57,468 Hey, no, you're all good. 992 00:54:57,492 --> 00:54:58,969 Yeah, I'm gonna need some of that 80s 993 00:54:58,993 --> 00:55:01,305 if you got 'em, or 40s. Whatever you got. 994 00:55:01,329 --> 00:55:03,349 - Yeah, yeah, you're in luck. - I'm newly replenished. 995 00:55:03,373 --> 00:55:04,767 One second. 996 00:55:04,791 --> 00:55:06,060 Now, hey, put that away--put that away. 997 00:55:06,084 --> 00:55:07,418 SAMUEL: All right. Okay, okay. 998 00:55:13,258 --> 00:55:15,402 SINGER: ♪ You feed me ♪ 999 00:55:15,426 --> 00:55:21,724 ♪ To the ♪ 1000 00:55:23,726 --> 00:55:26,956 ♪ Lions, yeah ♪ 1001 00:55:26,980 --> 00:55:28,273 WALT: Doc? SAMUEL: Hey. 1002 00:55:30,191 --> 00:55:31,418 You got it? WALT: All right, I got you. 1003 00:55:31,442 --> 00:55:33,045 All right, now, this is two 12 bags. 1004 00:55:33,069 --> 00:55:34,255 SAMUEL: All right. WALT: All right. 1005 00:55:34,279 --> 00:55:36,215 SAMUEL: Got you here. 1006 00:55:36,239 --> 00:55:37,341 That's good, hey? 1007 00:55:37,365 --> 00:55:39,969 Thanks, thanks. WALT: That's good. 1008 00:55:39,993 --> 00:55:41,220 SAMUEL: All right, how're you doing? You all right? Good? 1009 00:55:41,244 --> 00:55:42,680 - I'm good, man. - SAMUEL: Sorry, sorry. 1010 00:55:42,704 --> 00:55:44,139 I woke you up so late there, man. 1011 00:55:44,163 --> 00:55:45,850 You know--you know how it is. 1012 00:55:45,874 --> 00:55:47,226 Say, doc? SAMUEL: Yeah? 1013 00:55:47,250 --> 00:55:48,769 - You don't look good, man. - SAMUEL: Huh? 1014 00:55:48,793 --> 00:55:50,145 No, I'm not. I'm not. 1015 00:55:50,169 --> 00:55:51,647 No, I know, but do yourself a favor, all right? 1016 00:55:51,671 --> 00:55:55,985 Snort those, crush them up. Snort 'em. 1017 00:55:56,009 --> 00:55:57,194 How do you do that? 1018 00:55:57,218 --> 00:55:58,863 Put them in your mouth, all right, 1019 00:55:58,887 --> 00:56:00,406 for about a minute. 1020 00:56:00,430 --> 00:56:02,616 And then rub off that coating on the outside, 1021 00:56:02,640 --> 00:56:04,660 so make a little mark. 1022 00:56:04,684 --> 00:56:07,872 All right, crush it up, snort it. 1023 00:56:07,896 --> 00:56:09,456 It's gonna hit you way better. 1024 00:56:09,480 --> 00:56:15,212 SINGER: ♪ When this just feels like ♪ 1025 00:56:15,236 --> 00:56:19,967 ♪ Spinning plates ♪ 1026 00:56:19,991 --> 00:56:22,845 ♪ ♪ 1027 00:56:22,869 --> 00:56:24,805 ♪ I'm living ♪ 1028 00:56:24,829 --> 00:56:30,144 ♪ In Cloud Cuckoo ♪ 1029 00:56:30,168 --> 00:56:33,898 ♪ Land ♪ 1030 00:56:33,922 --> 00:56:40,929 ♪ ♪ 1031 00:57:46,202 --> 00:57:50,724 DORIS DAY: ♪ Stars shining bright above you ♪ 1032 00:57:50,748 --> 00:57:52,434 [Doris Day's "Dream a Little Dream of Me"] 1033 00:57:52,458 --> 00:57:56,271 ♪ Night breezes seem to whisper ♪ 1034 00:57:56,295 --> 00:57:58,941 ♪ "I love you" ♪ 1035 00:57:58,965 --> 00:58:04,947 ♪ Birds singing in the sycamore trees ♪ 1036 00:58:04,971 --> 00:58:10,661 ♪ Dream a little dream of me ♪ 1037 00:58:10,685 --> 00:58:12,454 [soft romantic music] 1038 00:58:12,478 --> 00:58:17,584 ♪ Say "Nighty-night" and kiss me ♪ 1039 00:58:17,608 --> 00:58:19,294 ♪ ♪ 1040 00:58:19,318 --> 00:58:23,007 ♪ Just hold me tight and tell me ♪ 1041 00:58:23,031 --> 00:58:25,968 ♪ You'll miss me ♪ 1042 00:58:25,992 --> 00:58:31,640 ♪ While I'm alone and blue as can be ♪ 1043 00:58:31,664 --> 00:58:36,603 ♪ Dream a little dream of me ♪ 1044 00:58:36,627 --> 00:58:38,147 ♪ ♪ 1045 00:58:38,171 --> 00:58:41,734 ♪ Stars fading ♪ 1046 00:58:41,758 --> 00:58:45,821 ♪ But I linger on, dear ♪ 1047 00:58:45,845 --> 00:58:50,367 ♪ Still craving your kiss ♪ 1048 00:58:50,391 --> 00:58:52,119 ♪ ♪ 1049 00:58:52,143 --> 00:58:54,955 ♪ I'm longing ♪ 1050 00:58:54,979 --> 00:58:59,460 ♪ To linger till dawn, dear ♪ 1051 00:58:59,484 --> 00:59:05,549 ♪ Just saying this ♪ 1052 00:59:05,573 --> 00:59:12,264 ♪ Sweet dreams till sunbeams find you ♪ 1053 00:59:12,288 --> 00:59:18,896 ♪ Sweet dreams that leave all worries behind you ♪ 1054 00:59:18,920 --> 00:59:21,523 ♪ But in your dreams ♪ 1055 00:59:21,547 --> 00:59:24,485 ♪ Whatever they be ♪ 1056 00:59:24,509 --> 00:59:28,739 ♪ Dream a little dream of me ♪ 1057 00:59:28,763 --> 00:59:35,770 ♪ ♪ 1058 00:59:57,458 --> 01:00:00,854 ♪ Stars fading ♪ 1059 01:00:00,878 --> 01:00:04,775 ♪ But I linger on, dear ♪ 1060 01:00:04,799 --> 01:00:11,156 ♪ Still craving your kiss ♪ 1061 01:00:11,180 --> 01:00:14,034 ♪ I'm longing ♪ 1062 01:00:14,058 --> 01:00:18,497 ♪ To linger till dawn, dear ♪ 1063 01:00:18,521 --> 01:00:24,711 ♪ Just saying this ♪ 1064 01:00:24,735 --> 01:00:31,343 ♪ Sweet dreams till sunbeams find you ♪ 1065 01:00:31,367 --> 01:00:38,267 ♪ Sweet dreams that leave all worries behind you ♪ 1066 01:00:38,291 --> 01:00:40,853 ♪ But in your dreams ♪ 1067 01:00:40,877 --> 01:00:44,189 ♪ Whatever they be ♪ 1068 01:00:44,213 --> 01:00:48,610 ♪ Dream a little dream of me ♪ 1069 01:00:48,634 --> 01:00:50,821 ♪ ♪ 1070 01:00:50,845 --> 01:00:53,824 ♪ Dream a little dream ♪ 1071 01:00:53,848 --> 01:00:56,577 ♪ ♪ 1072 01:00:56,601 --> 01:01:01,707 ♪ Of me ♪ 1073 01:01:01,731 --> 01:01:05,752 ♪ ♪ 1074 01:01:05,776 --> 01:01:07,653 [rooster crows]