Pain Husters. It ain’t Dopesick
As a therapist who, during the early stages of the opioid crisis, saw the change happen in front of my eyes, I'm sensitive to the reality of the early days of the epidemic. Once 80mg OxyContin hit the streets, my heart sank as more and more of my clients became dependent on OxyContin prescribed to them for a sports injury or sciatica. Very few were the typical addict I was used to. They reminded me of my mom or dad or my sister. They told me their doctor didn't tell them how the medication would change their lives…for the worse.
At the time, doctors thought the new long acting opiates like OxyContin were less addictive than old ones like Percocet or Vicodin. How did this happen? There's a long history of the "next best painkiller" that's safer than its predecessor. Have we learned nothing? Bayer introduced Heroin in the late 19th century as a cough suppressant and doctors were told it was safer than morphine. They also sold aspirin.
Hard to believe, but doctors were duped by pharma sales reps who had an unethical motive to push inaccurate research about their new drug's potential for addiction. Sadly, some (not all) doctors knew better but prescribed them anyway to get lucrative kickbacks, and greedy sales reps were paid by the amount of prescriptions they sold.
This story is the basis of Pain Hustlers, starring Emily Blunt, Chris Evans and directed by David Yates (Harry Potter). It's loosely based on The Hard Sell, a book by Evan Hughes about the true story of Insys Therapeutics and a fentanyl spray medication called Subsys. I highly recommend reading the book; although for the movie, the names of the drug reps at Insys were changed and some characters are composites of the reps in the book. That's Hollywood.
And that's what Pain Hustlers is. It's a Hollywood depiction of one of the many villains in an insidious epidemic from which we are still reeling.
I saw an advance screening of the movie recently at the Toronto Film Festival (TIFF). As Hollywood movies need to be, it was entertaining; but as a witness to the crisis and losing dozens of clients to fatal overdoses still fresh in my mind, I squirmed in my seat as the TIFF audience laughed at the greed of Liza Drake (Blunt) and Pete Brenner (Evans) as they became successful in selling their product and their paychecks rose in zeros. It reminded me of Wolf of Wall Street; Pete Brenner is a lot like Jordan Belfort. According to Hughes' book though, the real life Brenner was more of a slimeball than Chris Evan's character. Insys VP Of Sales Alec Burlakoff created a music video for a hyped sales conference and in the video, wore a foam costume in the shape of the Subsys fentanyl spray canister as he danced to a rap song about the drug.
At about the halfway point in the movie, the audience became more subdued, then silent. The plot turns from crazy sales meetings and parties showing a drunken rep defecating in a kitchen sink to the harsh reality of how their product started to kill people. Disturbingly, the message they tried to shift to was ersatz; it seemed uninformed and trite.
It didn't show the devastation as I remember it. It was a concerted effort but I had difficulty with the transition from the humorous 'cha ching' first half to the serious second half; but then, how often do movies get it right? The book is often better and in this case, it is.
Emily Blunt's superb acting was a highlight and we were shown a ludicrous amount of lying, coercion, denial and greed which can be humorous in its absurdity but nothing is funny about fentanyl.
On October 27 when Netflix releases Pain Hustlers, watch it with the mindset that it is a Hollywood movie. If you want a better take on this era of big pharma greed, watch Dopesick starring Michael Keaton. It's a better binge that breaks your heart, as this story should.
