Painkiller & Dopesick: Why is There Such an Obsession with the 'Pain Medication'?

Produced by Netflix and adapted from the investigative exposé "Pain Killer: An Empire of Deceit and the Origin of America's Opioid Epidemic," the series "Painkiller" officially premiered on August 10th.

The series delves into the opioid crisis sparked by the widespread misuse of OxyContin, a prescription painkiller, across the United States. The critically acclaimed 2021 series "Dopesick" was also based on this event, sparking extensive discussions.

Despite its claims as a pain-relief elixir, why did it become a poison that devastated the entire nation? Perhaps, it's not just physical pain being exploited, but the deeper societal pains at the root of it all.

I

Barry Meier was the first journalist to capture the attention of the American public regarding the issue of OxyContin abuse.

More than twenty years ago, on a spring day, an editor at "The New York Times" heard a story from a pharmacist friend and relayed it to Barry Meier, who was working in the newsroom at the time:

There's a relatively new prescription painkiller called OxyContin, and pharmaceutical sales representatives from the manufacturer are boasting to doctors and pharmacists that this drug uses a time-release formula, making it much less likely to be abused and addictive compared to traditional painkillers. The trouble is, OxyContin has become the most popular street drug. This was Meier's first encounter with the name OxyContin, and he knew nothing about drug addiction or pain treatment at the time.

Meier, a seasoned investigative journalist with a long-standing focus on the intersection of business, pharmaceuticals, and public health, had previously exposed the risks associated with various drugs and medical products. In 2017, he was part of "The New York Times" team that won the Pulitzer Prize for International Reporting.

In 2001, Meier began his investigation into the OxyContin abuse crisis, and by 2003, his investigative exposé had been compiled into a book. However, at the time, this issue failed to garner sufficient attention from the American public, and book sales plummeted after its release.

Meier briefly believed that this was because the frenzy of drug abuse had subsided, and the crisis was coming to an end.

However, twenty years later, the drug crisis in the United States not only remains unresolved but has escalated. In 2017, then-President Trump declared a "public health emergency" in response to the opioid abuse problem. As of 2021, approximately 250,000 people across the United States have died from drug overdoses, and they were using prescription painkillers, legally prescribed by doctors. Among these legal drugs, OxyContin was once the top seller.

The question remains: How did legally prescribed drugs become a poison that devastated the entire nation?

II

OxyContin is an opioid painkiller developed by Purdue Pharma in the United States and approved for use in 1995.

At first glance, it appears to be a small white tablet the size of a fingernail, but it contains two to several times the potent narcotic ingredients of its predecessors, making it highly addictive. It's been described as a "nuclear weapon" in the arsenal of pure narcotics. Purdue Pharma even obtained approval from the U.S. Food and Drug Administration (FDA), claiming that this drug had an "addiction risk rate of less than 1%." Purdue also took advantage of the medical community's push for better pain management. "Pain" has always been something people dread, and in the 1970s and 1980s, there was a transformative movement in Western medicine, urging better and more effective treatment for pain.

In the United States alone, there were millions of patients suffering from chronic pain, with some estimating the number to be in the tens of millions. OxyContin became the weapon of choice in the so-called "war on pain," and Purdue Pharma provided financial support to doctors like Russell Portenoy and hundreds of others, encouraging them to spread the idea that opioid drugs were safe, even in large doses. However, Barry Meier's investigation revealed that these studies were fundamentally flawed.

Some doctors succumbed to the pleas of their patients, acting out of a desire to help or as a stopgap measure, and prescribed addictive doses, unknowingly turning patients into addicts.

III

When bodily pain is abused, perhaps, societal pain is the root cause. This series is not only about medicine and business, but also takes us deep into the zeitgeist and human nature behind the drug tide, allowing us to hear the harmonious resonance of diverse social pain.

As the crisis erupted, Meier asked questions: Why did OxyContin flood the market so quickly? Who was abusing it? Why did they become addicted? Was there anyone helping them?

Through his investigation, he saw energy-starved, crime-ridden cities abandoned by the wayside—hardworking physical laborers who frequently experienced pain were consuming painkillers like candy. When they were replaced by machines, they were forced into a vortex of "unemployment, generations of alcoholism, and drug addiction." Purdue Pharma's "resource package" included numerous political celebrities, including a former mayor of New York City, who used their considerable political resources to work for Purdue.

Through layer-by-layer digging, Meier ultimately uncovered the mysterious Sackler Family behind Purdue Pharma. Since the advent of OxyContin, the Sackler Family has found a lucrative cash cow. In 2000, when OxyContin was at its peak, Purdue's annual sales reached $1 billion, catapulting the Sackler Family onto America's list of wealthy families.

Ironically, as the Sackler Family profited from selling "poison pills," they also donated their bloodstained money to museums, galleries, and medical schools. In this way, the Sackler name became associated with prestigious institutions like the Metropolitan Museum of Art, The Louvre, and The British Museum, adorning their donor walls.

IV

Photographic artist Nan Goldin was also a victim of OxyContin. After overcoming her addiction, she led a series of protests against the Sackler Family and produced the film "All the Beauty and the Bloodshed." This documentary was nominated for the 95th Academy Awards in 2023.

For the average viewer, these stories prompt us to contemplate the technological superstition and human desires hidden behind bodily pain—believing that any symptom can be alleviated with a pill, continually pursuing instant gratification and greater stimulation. It reflects an excessive avoidance of suffering, and an unwillingness to confront and resolve pain, leading to a deepening addiction.

As the series interprets, OxyContin is by no means the first narcotic to be abused. In fact, the history of narcotics is a story of continuously seeking a "miracle drug" that can relieve pain without causing addiction but repeatedly failing to find one.