Black Box Warning
Episode 7 of Dopesick Season 1 is easily the best of the season; an absorbing, shocking chapter that deals with the depths of Purdue Pharma’s corruption. We begin in 1962 with a big revelation. This isn’t the Sackler’s first rodeo when it comes to bending the rules and facing the wrath of the court. Back then, they were grilled by Senator Dodd, who questions the ethics of Purdue Pharma. Unfortunately, as we’ve seen across this season, influential men can be influenced by stacks of cash and that’s what seems to have happened here.
Fast forward to 2002 and Dodd has a “very, very high regard” for Purdue. The thing is, the stacks of evidence are mounting and it’s beginning increasingly difficult to ignore what Oxy is doing.
Rewind a year to 2001 and Betsy continues to slip further into the world of addiction. Diane shows to find her, with the girl in an awful state deep in the depths of a junkie house. “I wanna go home,” She whispers, as Diane scoops Betsy up and takes the girl out of that place. This scene is important, because directly after this we cut to Richard and the gang, excitedly chirping about producing a range of Oxy for children too. Good god.
Thankfully, they’re stopped in their tracks by the FDA wording, which gets alarm bells ringing right the way across the company.
With OxyContin doing the rounds and ravaging town, a lot of flyers begin cropping up too. Diane sees this as a good opportunity to bring Betsy along for the ride. Now, Dr Van Zee happens to be leading the charge here and he wants to take Oxy off the market. In order to do so, he encourages all the residents to sign a petition to take the drug off the market.
The FDA though have plans to put a Black Box warning on the new label. Now Sackler, ever the opportunist, decides to team up with Kathy and get around the wording on the label. As Richard tells them all, they need to “give a little” in order to sway the FDA to their way of thinking.
In exchange for the Black Box warning label, Sackler manages to convince the FDA to approve wording that “addiction is reported to be rare” and they’re allowed to use it for moderate pain. With this new wording, the marketing team can push for greater sales and potentially triple their sales.
Billy Cutler is growing more disillusioned with Oxy by the episode, and here he questions the breakthrough pain and the idea of pushing a drug harder despite the Black Box warning label. In fact, he ends up breaking into his boss’ office and taking training tapes off the shelf.
Billy happens to be one of the top sellers at Purdue too but it’s Amber who talks him around. She’s on course to be the Regional Manager in Louisiana and invites Billy along for the ride. She believes it’s a booming market and wants to use him to make more money. The thing is, Amber doesn’t actually care about him per-se, she only really cares about his credentials as a seller. And it’s clear she’s using his feelings against him.
Art Van Zee heads back to his clinic where Finnix rocks up. Now, Finnix is still taking methadone and combining that with therapy to get over his addiction. This seems to work pretty well, although he still can’t stop thinking about Oxy. According to Art, it take 2 years to get over the addiction fully, as Oxy actually rewires the brain.
Finnix is incredulous, eventually learning that there’s a new drug called Suboxone on the market. Some patients do need to take it for the rest of their lives but it’s a good chance to try something new. He even phones Betsy and suggests she too try this drug to get clean. He apologizes for putting her through this but she simply retorts a “I love you,” as a sign of respect.
That evening, Betsy begins to grow disillusioned with her life. In the car with her mum though, Diane opens up and blames herself for the Oxy addiction. In fact, she outright admits that she heard her that night when she admitted the truth about her sexuality. Diane supports her but in order to live a normal life and not be an addict, Betsy needs to get clean. And this is just what they need to approve the process and take up Finnix on his offer.
Betsy heads back to see her dealer and decides to get “one hell of a send off” before she skips over to Suboxone. The ensuing shot sends her over the edge, and she passes away. When Finnix rings, he learns about Betsy passing away.
In 2002, Bridget continues to push for the FDA and the others to review what Purdue have done. With the autopsy reports, they bring overwhelming evidence of the addictions. Now, the Purdue lawyers do their best to gt around this, claiming it’s “overly simplistic”. In fact, Bridget fights back and claims it’s exhaustive and actually really in-depth. Only, the FDA side with Purdue despite the overwhelming evidence and decides to completely ignore the evidence.
Bridget sits down with her husband later that evening, claiming that her job is destroying her life. Only, he clearly doesn’t know Bridget that well given the job IS her life.
Off the back of this, a divorce is heavily hinted.
In 2006, Randy and Rick continue to work tirelessly to jail the executives at the top. That means Kathy, Richard and the rest of the rotten Sacker family responsible for this. Now, the man behind the approval of the new label is a guy called Curtis Wright. It turns out, a year before the approval process, Purdue rented out a hotel suite in Rockville just down the road from FDA. They spent 3 days together, in close collusion with Wright, to get around the wording. In fact, it would seem that Curtis Wright was the one who actually wrote the warning label itself.
Van Zee’s petition goes absolutely nowhere too. Disgustingly, it made Purdue push their marketing harder. Although they had 10,000 signatures, Rick strikes gold and decides to use the testimonies from the executives instead. Under oath, they confirm that they didn’t know about the addictions until 2000. Only, they were actually informed of abuse back in 1997 through emails, internal documents and the like.
As a smile crosses Rick’s lips, he realizes he can get all three executives on the basis of lying to Congress and conspiracy to defraud. The real kicker here is that they could flip on Richard Sackler and the others to save their own skin.
The trouble is, it looks like Maine justice has been fully corrupted, all the way up to the top. Randy and Rick refuse to hear fellow lawyer Alice’s pleas and instead, head into the meeting and immediately inform Purdue that they’re going to indict Michael Friedman, Paul Goldenheim and Howard Udell on felony charges.
As the episode closes out, we’re left with a chilling thought from Purdue Pharma in the court room: “No law or regulations will ever be able to stop the miracle of modern pharmaceuticals.”
The Episode Review
Dopesick’s penultimate episode heads back on screens, leaving a pretty damning assessment of the opioid crisis in America. Claiming proudly that no laws can affect “modern pharma” is pretty chilling and as we’ve seen across this season, the FDA can be bought out, no matter the cost.
It’s a pretty damning assessment of how far Purdue has been willing to go, and even manages to turn this Black Box warning into something that actually benefits them. It’s pretty shocking and perhaps Betsy’s death was always inevitably going to happen. Her cycle of addiction ultimately comes to a close when the one thing keeping her hopeful – Grace – happens to be with child and ready to live her life.
Oxy has destroyed lives and hearing Purdue high-fiving and fully aware that they’ve dodged a bullet back in 2001 is absolutely shocking and pretty sickening to hear. That’s only made worse of course by the discourse about providing Oxy for children.
Everything here is poised nicely for a dramatic and shocking finale to kick into play next week, and all roads seem to point toward a big conclusion to this story. We’ll have to wait and see where this one goes next though.