What Hulu’s Star-Studded ‘Dopesick’ Gets Wrong About the Opioid Crisis

Every drug war needs a villain. When it comes to the opioid crisis, which ravaged communities like Eastern Kentucky from the mid-’90s to the 2000s, the Big Bad was always Big Pharma—namely Purdue Pharma, who flooded the market with pills and convinced local physicians to prescribe OxyContin in increasingly high doses. This story, which is retold in the new Hulu show Dopesick (based on Beth Macy’s 2018 book), chronicles the introduction of OxyContin to Eastern Kentucky—spearheaded by supervillain Richard Sackler (Michael Stuhlbarg) of Purdue Pharma—in 1996, and the 2007 lawsuit for illegal mislabeling that would bring their misdeeds to light.

The narrative was rather simple: After Purdue sicced its salesmen on physicians, like Dr. Samuel Finnix (played by Michael Keaton), the drugs would make their way to coal miners, street dealers, paupers, and old-timers in Appalachia. Before long, according to law enforcement officials, opioid-related crime, death, and abuse rates skyrocketed, leading politicians to back numerous crackdowns on addicts. Justice Department officials like Det. Rick Mountcastle (a quietly intense Peter Saarsgard) and Randy Ramseyer (John Hoogenakker) were some of the first to investigate not just Purdue but the Food and Drug Administration—which signed off on OxyContin’s safety—and became protagonists, lighthouses in a dark abyss of addiction that locales like Eastern Kentucky may never find itself out of.

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Standing in their way, as Mountcastle and Ramseyer mention repeatedly in the show, are the feds—who might have some stake in the opioid crisis trudging on—the apathy of their superiors who, without sufficient evidence that Purdue lied in their marketing materials, couldn’t make a move, and Purdue’s tactics to circumvent the law (with the blessing of the FDA) at every turn. But, as is the case with the book, Dopesick the TV series is rife with inaccuracies about crime and murder rates and glorifies law enforcement officials who stood to gain mightily without focusing its lens on the ways the reactionary, profit-focused manner the crisis was handled destabilized Eastern Kentucky’s social order.

The show kicks off in 1996, following a strategic turn by the Sackler family from valium to OxyContin, as a steely Stuhlbarg’s throaty and strained Richard declares that Purdue will “redefine the nature of pain.” Purdue Pharma’s plan was to create a new demand for OxyContin by finessing the FDA into agreeing that the drug remained in the body longer than other opioids, and would thus be less addictive than its contemporaries. Sackler is presented as a bottomless, relentless evil that’s not just fighting for familial superiority but against the ghost of his dead uncle, Arthur Sackler, who (as the show notes) basically created the medical advertising market. “If I can stay laser-focused,” he says, staring at an ugly painting, “I think I can make this the biggest drug in the world.” And in this corner stands the crime-fighting troika of Mountcastle, Ramseyer, and Det. Bridget Meyer (Rosario Dawson)—a fictional law enforcement official who doubles as an exposition mill—working tirelessly to bring those capitalist bastards down. In the middle of the opioid ring sits local physician Dr. Finnix and coal miner Betsy (Kaitlyn Dever) who face the realities of dealing and the struggles of addiction in the most visceral and revealing ways.

While the story of how OxyContin was marketed and ultimately infected the disenfranchised population of Eastern Kentucky would seem to make for riveting TV, Dopesick struggles to feel like a persuasive narrative because its cop characters all feel as if they have to justify the chase. It doesn’t take long for DEA agent Meyer to become activated. While looking into an overdose, she begins to reach out to local law enforcement who report that drug-related robberies, overdoses, domestic violence, murders and deaths had all been climbing since OxyContin’s release into Eastern Kentucky’s bloodstream. Those same statistics would be repeated over the course of the seven episodes we received for review—in conversations with other officials, in court, and against Purdue sales reps, as if to drive home the 1:1 relationship between OxyContin and social collapse. The show’s police compare it to the AIDS crisis, the crack epidemic, and unnecessarily allude to the overpolicing of Black and brown weed smokers just within the first two episodes. All of this exposition works to create a sense of need within the audience for the police to step in and do what they do: disrupt, arrest, and incarcerate.

The only problem here is that not only are the rising crime rates mentioned in the book and the show inaccurate, but on the street-level, stopping Big Pharma came second to jailing addicts and profiting from a sensationalized crisis. Writing for The Baffler, Kentucky native Tarence Ray cites a report by Kenneth Tunnell, a former criminal justice professor from Eastern Kentucky University, wherein a police chief from Hazard, Kentucky, claimed that “90 percent of larceny crimes in the area were ‘to get money to buy OxyContin.’” Politicians like Governor Ernie Fletcher got in on the drug war too, remarking, “OxyContin problems are overwhelming the law enforcement communities… Substance abuse is linked to violent crimes… over the past eight years, crime has increased in Kentucky.” Meanwhile others like congressman Harold Rogers launched headline-stealing campaigns such as Operation UNITE (Unlawful Narcotics Investigations, Treatment and Education) that effectively turned neighbors against one another, deputizing citizens and criminalizing what amounted to a public health crisis.

But as Tunnell details, the crime rates politicians and law enforcement officers reported between 1996 and 2003 were often misleading. Crime rates were actually pretty dynamic during this period, falling from 1996 to 1997 before increasing in ’98, decreasing in ’99, increasing again in 2000, falling in 2001, increasing in 2002, and decreasing again in 2003. “Violent crime rates in Kentucky were lower in 2001… than 1996,” Dr. Tunnell found. Yet the persistent myth of the rising crime rate has sustained long enough to infiltrate Dopesick and serves the same purpose: justifying police chasing high-end criminals. But instead of the police vigilantly pursuing Purdue, they mainly created task forces to arrest street dealers, a “nebulous term,” Ray writes, citing the cases of James Baker, who sold an undercover UNITE agent $25 worth of Percocet pills and was sentenced to five years in prison, and 87-year-old Dottie Neeley “who was thrown in jail along with her oxygen tank for selling hydrocodone to a UNITE informant” as somehow fitting the definition.

Unfortunately, the street-level war on opioids is never really seen in Dopesick at all. We witness a few crimes and injustices—a robbery here, a teenage overdose there—that all work to establish a moral rationale for the police stopping Purdue, but never provide a realistic portrayal of the ways police clamped down on addicts.

The result of the drug war might sound familiar: increased funding for prisons and law enforcement, and the incarceration of already-marginalized people like Dever’s character Betsy. Through her performance as the show’s only real, emotionally-resonant character, we get the sense that this crisis directly targets social outcasts—she is a queer coal miner in a puritanical town—but there’s just not enough material for any real investment. Her scenes, along with those of Stuhlbarg’s merciless Sackler, do showcase the show’s potential electricity, but the false narratives and overwrought justifications of the cop story at its center renders Dopesick a bit bland.

The characters within Dopesick don’t feel like characters but parrots of a particular argument for local policing. Its primary investigators are positioned as trustworthy advocates for the people fighting against the federal government to save the lives of addicts in Eastern Kentucky. But because the reality is so staunchly different, and because the OxyContin crisis led to an economic dependence on a carceral infrastructure that it’s still feeling today, the real story of the region’s destabilization is lost to copaganda.

There’s a moment early in the season when Dr. Finnix is sitting in front of a large crowd of physicians who are slowly being pulled into Purdue’s OxyContin sales sect, where the doctor mentions how often other states forget about the hardworking women and men who live and work in the mines, building the country from the fuel produced. They forget about the real people who trudged underground through the soot and smoke in order to keep the U.S. moving through a difficult World War. Dopesick doesn’t make up for this erasure, settling for sensationalism about real-life people dealing with the real-life circumstances of economic and social deprivation that existed there long before opioids accelerated and elevated these issues.