Hulu's Dopesick is technically a drama, but really it's a horror. Because at the heart of the limited series is the premise that anyone, even the most cautious of patients, can become addicted to opiates.
In the first episodes of the fictional show, viewers are taken to the heart of Appalachia, where almost every household is supported by the coal mines. Even Kaitlyn Dever's character Betsy is a coal worker, mining alongside her father and other men who had watched her grow into an amiable, young woman with aspirations that went beyond her small town.
And then, in a matter of moments, any chance of achieving those dreams are taken away. She's injured in a coal-mining accident and prescribed OxyContin by the well-meaning Dr. Finnix (Michael Keaton), quickly turning her into a shell of the human she once was.
Fast forward a few years and a slew of civil servants are investigating the significant uptick in addiction and overdose cases. Peter Sarsgaard, John Hoogenakker and Jake McDorman are working for the Department of Justice, while Rosario Dawson's character is an agent for the Drug Enforcement Agency. They respectively interview addicted high school students across the northeast, follow up on pharmacy robberies and quiz Purdue Pharma over their marketing.
They hit their fair share of roadblocks in their respective investigations but come to the same conclusion: Appalachia isn't the only region hit hard by opiates. This drug infiltrated every corner of the United States, taking down suburban moms, medical professionals and teenagers along the way.
In a series of interviews with E! News, the cast candidly discussed the subject, sharing how their participation in the Hulu limited series impacted their view of the American health care system, addicts and more.
For Sarsgaard, he realized that the opioid epidemic isn't being taken as "seriously" as it should be. The actor, who is married to Maggie Gyllenhaal, recalled being prescribed medication following a "very minor surgery."
He remembered, "Afterwards, the doctor actually told me, ‘I'm going to prescribe you some ibuprofen, and also give you some fun stuff.'"
Since filming Dopesick, he has a greater understanding of the gravity of the situation. "How much pain you personally can deal with is obviously up to you but I think that we all have to examine our relationship with pain," he explained. "On the other hand, doctors should be saying, ‘Okay, you call me if you have a really, really, really hard time, and I will talk you through how to take something that might help you.' The ‘fun stuff' is not the way to talk to a patient about it."
Hoogenakker has a different relationship with the subject, as his wife is a holistic health counselor. He said that researching the opioid epidemic has led him to grapple with questions of whether it's "fair to ask Americans to take more responsibility for the drugs that they put in their bodies," especially when the agencies responsible for regulating drug companies have "failed."
"I think the answer to the question is: It's imperative that we find the time. It's imperative that we take ownership over our bodies and our health," he reasoned. "Because the government is fallible and pharmaceutical companies are governed by the bottom line."
McDorman added that it's not just underprivileged communities that are afflicted by addiction. The Greek actor said that prior to this project, he wouldn't have thought that he could become hooked on OxyContin, but now, "when I get prescribed the medication, specifically a painkiller, my first thought is: I better be careful with this… This is dangerous."
In a way, Hoogenakker, Keaton and more signed on to the project with the hope of righting the wrongs of Big Pharma. Because, as Hoogenakker told E! News, entire communities were "maligned in service of pharmaceutical profits."
The actor, who was born and raised in North Carolina, reasoned that people feel far removed from the opioid epidemic, because addicts have been painted in such an extreme light. Beth Macy, who wrote the book the series is based on, previously told CBS News, "In those early years, [pharmaceutical companies] were always blaming the overdose deaths, the skyrocketing crime, especially in these distressed, rural areas, on the people that were misusing their drugs."
In light of these tactics, Hoogenakker said, "setting that record straight and kind of giving viewers of the show the opportunity to see themselves portrayed as falling prey to opioid addiction is something that I think is very, very important. When you see victims as not being that far removed from your own life experience, you're able to sort of internalize the problem and take it more seriously."
Likewise, Keaton said that part of the appeal of this project was being able to represent those who are unable to speak for themselves, particularly because he grew up in a community similar to the ones depicted in Dopesick.
"I think [the stigma] is eroding and I think people are way more aware of things now but there's still a stigma about addicts and underprivileged people, frankly," the Birdman actor explained. "Often rural people are depicted as less than, not as sophisticated, not as smart or hot," but the opioid epidemic reached beyond the Appalachian mountains, he said: "It's everywhere."
Executive producer and writer Danny Strong was more explicit in discussing the impact of Purdue Pharma's OxyContin. He described the company's promotion of the medication as "manipulation, lies, influence peddling, deception."
"They profited from it, you know? They made billions and billions of dollars off of this deception," Strong said. "And they were able to continue it for over two decades."
Will Poulter portrayed a Purdue Pharma salesman and as he prepared for the role, the Brit said, "It was disturbing to learn how purposeful and methodical the introduction of this drug was to the market."
"Along the way, they were vilifying the people affected by addition," he reflected. "To learn all that was quite a discovery, but it certainly made me want to be involved in the telling of this story."
According to NBC News, the pharmaceutical company pleaded guilty to three felony counts over the handling of its addictive prescription painkiller OxyContin in October 2020, which includes "defrauding the federal government by misleading regulators about its efforts to restrict overprescribing of the drug and to violating anti-kickback laws by paying doctors to write more OxyContin prescriptions."
None of the members of the Sackler family, which owned Purdue Pharma at the time of the lawsuits, were charged. Moreover, in September, NBC News reported, that a federal judge "said that he would approve Purdue Pharma LP's bankruptcy reorganization plan that will resolve thousands of lawsuits and shield the Sackler family from future opioid litigation."
Even after the 2020 settlement, opioid addiction is still a problem, with opioid-involved death rates increasing by over 6 percent from 2018 to 2019, according to the Centers for Disease Control and Prevention. But, as Hoogenakker said, "If Dopesick plays a part in waking people up to that, we will have done our work."