Over a twenty-year stretch, half a million people have died from opioids, according to the CDC. And one of the crisis’s major killers is OxyContin, which earned the already-wealthy Sackler family billions of dollars.

Even though the family’s firm, Purdue Pharma, is now in bankruptcy proceedings and ordered by courts to pay billions in penalties and compensation, members of the Sackler family remain immune to prosecution—and far from penitent.

“They have never apologized, and because they get to pay that settlement money over nine years, they will end up richer than they are right now,” said Beth Macy, whose 2018 book “Dopesick” is the basis for a new Hulu series of the same name. “They’re giving up $4.5 billion of their own cash, which sounds like a lot, but we know it’s going to take at least $120 billion to start to turn this [epidemic] around. It’s not satisfying at all to me.”

However, Macy believes that the series, which debuted on Friday, will give the Sacklers the trial by public they “should” have gotten. She says that showrunner and “Dopesick” co-writer Danny Strong took not only her book but many other books and newspaper articles to conjure his eight-part screenplay, with co-authorship from Macy, which is based on the first third of Macy’s book.

Beth Macy

Strong said that even as production was underway, he was continually revising the screenplays as more documents were leaked to he and Macy, and more sources came forward.

“At one point I rewrote a scene two days before we shot it, and it was in the last week of production because new information had come to light,” Strong said of the protean nature of the script of “Dopesick.” “It was a thrilling sort of process.”

“Dopesick” comprises eight episodes, and has several “main” characters throughout its rather large universe. Michael Keaton portrays Dr. Samuel Finnix, a small-town Appalachian family doctor who sees the opioid epidemic firsthand. One of his patients is Betsy Mallum (Kaitlyn Dever), whom he has known since childhood and who now labors in the coal mines.

And at the top of the opioids pyramid is the Sackler family itself. Michael Stuhlbarg portrays Richard Sackler, who is not only the scion of the wealthy family but the braintrust behind putting the family fortune behind OxyContin, a blockbuster drug whose addictive properties are overlooked by the FDA.

And then there are those government officials who seek justice. Among them are Bridget Meyer (Rosario Dawson), a no-nonsense DEA agent who pushes up against an established paradigm that perhaps doesn’t take women seriously—even as her career affects her home life. And in between Meyer and the company are assistant U.S. attorney Randy Ramseyer (John Hoogenakker) and prosecutor Rick Mountcastle (Peter Sarsgaard), who are out to press charges against the Sackler family, and who seek Purdue whistleblowers to help them make the case stick.

“We see in the show how reps from Purdue have been basically given talking points and a [product] label that was massaged by the FDA to get a very powerful opioid on the market,” said Hoogenakker, a native of North Carolina. “OxyContin does serve a purpose, but not for everything under the sun. Not for an ankle injury, not for wisdom teeth.”

“There’s also the [question of] does the government have the individual citizen’s best interest in mind, or does it have the best interest of the big corporations?” added Sarsgaard, who has appeared in projects as diverse as “Garden State” and the upcoming “Batman” reboot. “I think the role of lobbyists in D.C., and the power they end up wielding, is one of the problems that needs to be addressed.”

British actor Will Poulter (“The Revenant,” “Detroit”) portrays Billy, another key character whose job is as a Pharma sales rep. Billy pushes OxyContin hard to doctors, especially in economically struggling Appalachia. Although he rakes in the cash thanks to closing so many sales, Poulter’s modulated performance throughout the series shows that Billy is tormented: He knows that OxyContin is dangerous, yet how can he argue with such tremendous commissions he makes by aggressively marketing it to small-town doctors?

“As far as looking at how the Purdue reps figure into this story, Danny covered that pretty brilliantly,” said Poulter. “I think retrospectively you look at what was once kind of spoken about as influence and salesmanship, and it looks a lot more like coercion and bribery.

“And in the case of Purdue’s promotion of OxyContin, we’re talking about an entirely fraudulent campaign.”

 

Danny Strong

 

Poulter’s scenes with Keaton, who plays the small-town doctor, are magnetic. Watching Poulter go from a salesman who cares nothing other than closing a deal to a man horribly conflicted is Shakespearean in its arc. Even when he perhaps knows it’s better to find another job, Billy just can’t help himself.

“He’s a good guy, but I think he’s a young, impressionable dude as well,” Poulter said. “I have no doubt that some really well-meaning people entered that space, but there is kind of no getting away from the fact that people were participating in a very problematic culture” at Purdue, he said.

“Dopesick” was shot in and around Richmond, Virginia, commencing late last year. This enabled the cast and crew to film near those Appalachian communities that have been so devastated by the opioid epidemic.

“It’s typical of the sort of areas that companies like Purdue were targeting,” said Poulter. “These are areas where a lot of hard-working American citizens are involved in high-intensity manual labor jobs, and the risk of injury—and, in turn, the need for pain relief—is very, very high.”

Thanks to covid, and before vaccines were readily available, the actors at that time had to perform with one another behind plexiglass to halt the spread of potential infection. This ran counter to fostering the esprit de corps that is so necessary to film a show of this magnitude, but the cast members soldiered on in the best tradition of their chosen profession.

“What’s remarkable is I can’t remember the last time I was on a set where there was such a sense of community spirit,” Poulter said, adding that this was helped not only by the complement of amazing actors but the incredible hospitality the production encountered in Virginia.

“I’m certainly glad we were taking all those precautions, but [ours is] an industry where you need to learn about each other based on your physical queues,” added Hoogenakker. “And that occurs off-camera as well. During covid that’s something that necessarily went by the wayside.”

“But we both like hiking. We hung out a lot on the trail,” added Sarsgaard, with whom Hoogenakker shares so many key scenes in the series.

Sarsgaard said he has a relative who has fought opioid addiction, which made his participation in “Dopesick” that much more important.

“One of the big issues that I took away from this experience was there is a fundamental breakdown in the relationship between patient and doctor—that so few people had the family doctor anymore,” Sarsgaard said. “A lot of times that relationship is [with] a stranger, or it’s someone that is more like an authority figure rather than someone you’re close with—someone you don’t want to disappoint.”

Added Hoogenakker: “There’s a great, almost a laugh line in the show, when they’re trying to expand the market for OxyContin in Germany, and one of the [characters] says, ‘It’s bizarre, the Germans actually see pain as part of the healing process.’

“But it is! And it’s totally foreign to the way we’re brought up. That’s something we approach in the show.”

Danny Strong, the screenwriter and showrunner, said he was greatly motivated to showcase in “Dopesick” not only that Purdue lied about how addictive its drug was, but that the lie was enabled by government agencies and abetted by the Sackler family’s singular pursuit of money at the expense of all else.

“This con, that began in the eighties, was so outrageous and so offensive that I thought we’ve got to dramatize this,” he said. “Because when you see it, there’s nothing casual about it. It was done in the most machiavellian, deceptive way possible.

“I think it shows it’s sociopathic. There’s a heartlessness to it that is unlike anything I’ve seen before.”

“It should be a bipartisan issue because there’s almost no one in America that hasn’t had to deal with this,” added Beth Macy, the author of the book “Dopesick” who also co-wrote several of the Hulu show’s scripts with Strong. “The problem is we still have a treatment gap [wherein] of all the people with opioid use disorder, only about twelve percent of them were able to access treatment. And some of that treatment doesn’t follow the science.

“Danny calls the show the trial that America never got,” she said, “which I think is perfect.”

“The show ends in 2007, and certainly this story continued,” Strong said. “It still continues to this day.”

“Dopesick” started streaming on Hulu on Friday.