REVIEW: Hulu’s Dopesick


Based on the acclaimed book by former Roanoke Times journalist Beth Macy, ‘Dopesick’ covers the opioid epidemic that swept across Appalachia due to the activities of the drug company Purdue Pharma and its morally corrupt owners, the Sackler family.

The miniseries opens in the fictional mining town of  Finch Creek, Virginia. As we’re introduced to mining families and their doctor, played by Michael Keaton, we see how well-intentioned people were misled into prescribing the powerful opiate OxyContin, which was marketed as “non-addictive” and suitable for long term treatment of moderate-to-low pain issues. 

At first OxyContin appears to be a miracle drug, helping the miners deal with debilitating pain and improving their quality of life, which otherwise had been deteriorating after years of hard labor.

But not long after we see the miner families reporting “breakthrough pain” where the pills no longer provide twelve hours of relief. Rather, within half of that timeframe the debilitating pain returned. Purdue Pharma’s answer was to “individualize the dose,”” which meant popping more pills.

Little did the users know that they were developing a tolerance to OxyContin and required more and more for the same relief. Of course, this meant more sales and profit for Purdue Pharma. 

We routinely see juxtaposed scenes of these working class communities in Appalachia and the Sackler family wining and dining in luxury locations as they plot how to drive sales, all while disparaging the “dumb hicks” they systematically make dependent on their drug.

The miniseries also jumps back and forth across a two-decade timeline of federal and state court cases, and investigations by both prosecutors in Virginia and the DEA.

They soon find that Purdue Pharma has secured all legal channels with government collusion in the FDA. The Sacklers are well connected and provide lucrative jobs for those who exit their positions as government regulators, a revolving door between corporate and the state. 

Along with their strong political connections we also see how they train a cadre of salesmen to more effectively manipulate doctors across Appalachia to prescribe OxyContin over other competitors’ drugs.

They built an impressive infrastructure of fake nonprofits, studies, and other bogus science in order to further legitimize OxyContin to doctors and the public. 

As it becomes apparent that Purdue Pharma is nothing more than a legalized drug cartel and communities are ravaged by addiction and social decay due to their drug, the company keeps fending off bad publicity and legal cases from other agencies and prosecutors by blaming drug abusers who engage in “drug diversion.”

We witness the destruction of the featured individuals in the miniseries. Their families do everything in their power to help their loved ones addicted to OxyContin – interventions, prayer circles, rehab, tough love, all to no avail.

Opioid addiction chemically rewires the brain and makes users feel as if they are dying if they don’t continue use. Withdrawal is severe, and only after two years of sobriety can the average person’s brain recover from it. There’s very little free will left in individuals dealing with addiction, they are trapped with the drug. Not to mention what is the quality of life in these working class communities where the good jobs left decades ago?

The common understanding toward addicts is that they are morally sinful, weak-willed, not to be trusted, and deserving of their situation as a result of their poor life choices. This is a convenient narrative to excuse the deterioration of communities across the country which suffer from poverty wage jobs, poor infrastructure, bad health, and denial of all resources.

The drugs treat only the symptoms of historic and systemic problems which have always been to the detriment of working families, while also making rich families like the Sacklers even more rich off the misery of workers.

Psychologism treats and interprets problems generally as ones of the individual, it denies the role of social conditions, as if problems of addiction and mental health are entirely within the control of the individual suffering from these ailments rather than natural responses to harmful conditions workers must live in and which we generally have little to no control over. As we watch working families deteriorate we see the logical conclusion of the pursuit of private wealth at the expense of everyone else. 

A recent documentary released this past year – “Life of Crime, 1984 – 2020” – shows a similar development. Working people doing the best they can with what they have as larger social mechanisms rule over them and infrastructure crumbles. Many fight, but ultimately succumb to forces which exploit them as they struggle to survive. 

The DEA and prosecutors spent decades trying to prove criminal conduct by Purdue Pharma, while fighting FDA bureaucrats, the Department of Justice, and politicians who are in the pockets of the Sackler family (such as Rudolph Guliani, James Comey, and Alberto Gonzales). Despite the best efforts of those who are supposed to protect the general public, the Sackler Family got away with only fines. 

The Sacklers, corporate executives, and the army of salesmen who pushed OxyContin into our communities were never held accountable for their actions. 

We see similar stories in famous depictions of capitalist realism such as The Wire, Serpico, or Dark Water – the justice system takes a long time to deliver any semblance of justice for working people, ultimately failing as these corporations and the rich drag court cases on, paying out inconsequential fines, all the while greedy owners get to keep the vast majority of their illegitimate wealth. Rarely do they face any real consequences. 

The shortcoming of this miniseries is the attempt to show that justice is being served. We can’t expect real working class justice under this system. That can only happen when workers take over. Until then, working families will continue to suffer and die from deaths of despair, as the rich get the occasional slap on the wrist. It’s their government, it’s their economic system.

So long as they remain in power parasites like the Sacklers will continue to face no consequences, when they and their lackeys deserve nothing short of execution for the mass harm they’ve caused.

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