Mail & Guardian

‘Painkiller’the story of the opioid epidemic

- Ipeleng Derby-molefe

Each of the six episodes of Painkiller, the riveting drama series on Netflix, begins with a person reading: “This programme is based on real events. However, certain characters, names, incidents, locations, and dialogue have been fictionali­sed for dramatic purposes.”

Then the person briefly tells their personal story, which is about how they have lost a close family member who was addicted to the prescripti­on drug Oxycontin.

Allow me to introduce you to Richard Sackler, an American billionair­e businessma­n, physician and former chairperso­n and president of Purdue Pharma.

Sackler was aware that pain was an issue for many and he knew he could capitalise on creating a pain treatment. His goal was for people to believe that whatever medicine he developed would be a miracle drug for pain relief.

Oxycodone, hydrocodon­e, codeine, morphine and heroin; what these have in common is that they are all classified as opioids. Opioids are substances that are used, in a medical setting, to relieve pain.

Medication­s that contain opioids are often given to patients who are at the end of life, to make the process of death more comfortabl­e. But opioids are highly addictive and can lead to death if used incorrectl­y.

Oxycontin is a trade name for the drug oxycodone. Oxycontin was developed and patented in 1996 by Purdue Pharma under Sackler’s leadership.

The drug was promoted as the medication that would rid you of pain, and would not lead to addiction or drug abuse. Some of the claims made by Purdue Pharma were accurate, some were plainly untrue. They claimed that less than 1% of people would become addicted to the drug.

But it would be proven that a letter written by Dr Hershel Jick and Dr Jan Porter to the New England

Medical Journal was taken out of context. The doctors had done a study on the limited use of opioids in a hospital setting. This trial yielded many findings, which they detailed in this letter. One of the findings was that less than 1% of the participan­ts developed a dependency on the drug.

Purdue used this to convince people that their drug was safe.

The sales team for Purdue Pharma worked relentless­ly to persuade doctors that they had to prescribe Oxycontin to relieve their patients’ pain.

They also sold the idea that the higher the dosage the better the treatment. But this was a ruthless tactic to drive up profits.

These sales antics led to oxycodone being readily available to the public — which resulted in the deaths of more than 300 000 people from Oxycontin addiction.

Painkiller follows the developmen­t of Oxycontin, the lives of people who were affected and those who were caught in the crossfire.

The disclaimer given by family members of people who lost their lives to Oxycontin addiction gives the audience a sense of the realities of the opioid epidemic and how many lives were affected by what Purdue Pharma and Sackler had created.

This series follows three stories. The first is that of the Sackler family and Purdue Pharma; how they chased profits and had no considerat­ion for the people who were getting hooked and dying because of this drug.

The second story is about the pharmaceut­ical sales representa­tives hired by Purdue Pharma. It follows their lives of opulence and how they willingly sold drugs they knew were dangerous and addictive.

The final story, which carries the most weight, is the staggering story of the innocent people whose lives were irreparabl­y damaged by addiction, many of whom overdosed.

One company caused an epidemic and a world where it was difficult to trust doctors. Sackler is responsibl­e for the deaths more than 300000 people, and he will never spend a night in prison for his part in the epidemic. Neither will the sales reps who convinced doctors to prescribe Oxycontin, making them partly responsibl­e too.

The heartbreak­ing thing about this ordeal is that the Sackler family will never have to face the thousands of families they’ve broken or deal with the lives their drugs have taken. The Sackler family is still one of the richest in the world and is still celebrated internatio­nally. The Sacklers are glorified drug cartel.

Painkiller also offers insightful commentary on the difference­s between how the justice system dealt with dealers on the street and dealers who hid behind white coats and suits. Oxycodone and heroin are pretty much the same drug, and yet a doctor could prescribe one and it is perfectly legal, and the other leads to a five- to 12-year prison sentence, whether you plan to sell it or not.

Someone said to me, “It’s all about perspectiv­e.” Unfortunat­ely this is true, even in the eyes of the law.

Today Oxycontin is heavily regulated. In South Africa, it may only be used in specific situations in a hospital setting.

At times Painkiller can be a difficult watch, but I recommend it to understand the realities of Big Pharma’s greed. It is also an incredibly well told story.

 ?? Photo: Keri Anderson/netflix ?? Ruthless: Matthew Broderick plays Richard Sackler, a Big Pharma boss who made the addictive medication.
Photo: Keri Anderson/netflix Ruthless: Matthew Broderick plays Richard Sackler, a Big Pharma boss who made the addictive medication.

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