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Beth Macy's 'Dopesick' gets the TV streaming treatment


How do you get the country to pay attention to a public health crisis that's been killing people in record numbers - a crisis everybody knows about, but that seems almost impossible to stop? Could a TV series help? Journalist Beth Macy is the author of "Dopesick," the critically acclaimed 2018 bestseller that shed light on the origins and the course of this country's opioid epidemic, focusing on a small town in Virginia and moving through central Appalachia. That book was part of the source material for an eight-episode series premiering on Hulu on October 13. Beth Macy is also one of the executive producers, and she's with us now to tell us more about it.

Beth Macy, welcome. Thank you for joining us.

BETH MACY: Thanks for having me, Michel.

MARTIN: You know, I was just looking at the preliminary data released by the Centers for Disease Control. It shows that a record number of Americans died last year from drug overdoses, more than 93,000 people. That's the highest number of overdose deaths ever recorded in a 12-month period. That's according to the National Institute on Drug Abuse. And most of those deaths were from opioids. You have been reporting on this for years. And when you see a number like that, when you hear a number like that, what is it - what comes to mind?

MACY: So many families that I've gotten to know, so many people that I've met who are in jail because of crimes they committed because of their addictions that began, many of them, with OxyContin. And what it mainly just makes me ache for is the fact that we have an 88% treatment gap in America, which means that people with opioid-use disorder, only 10 to 12% of them got treatment in the last year. So we have so much work to do. The problem only got worse during the pandemic. And still, I think a lot of folks don't really understand how it is we got here.

MARTIN: And that's what your book did it. It connected the dots for people who aren't aware of the story. I mean, the series kind of lays it out. It shows how aggressively OxyContin was marketed to doctors who were prescribing it for legitimate pain. There's a scene early in the series where doctors describe what sales representatives told them about the drug. And I just want to play a short clip.


UNIDENTIFIED ACTOR #1: (As character) The sales rep said the drug was different because it was basically non-addictive.

UNIDENTIFIED ACTOR #2: (As character) Had you ever heard of a non-addictive opioid?

UNIDENTIFIED ACTOR #1: (As character) No, sir, I had not.

UNIDENTIFIED ACTOR #2: (As character) And did he tell you what percentage of patients became addicted?

UNIDENTIFIED ACTOR #1: (As character) That was the key to the whole sales pitch.

UNIDENTIFIED ACTOR #3: (As character) He said less than 1% became addicted.

UNIDENTIFIED ACTOR #4: (As character) Less than 1% would become addicted to OxyContin.

UNIDENTIFIED ACTOR #1: (As character) He said less than 1%. He called it a miracle drug.

MARTIN: You know, obviously the series is fiction, but your book was not. Is this true? Is that - was it, in fact, marketed in that way, in a deceptive way that misled prescribers about the effects of the drug?

MACY: Absolutely. And they have pleaded guilty twice, first in '07 and again more recently in 2020, to breaking the law, to lying about the dangers of the drugs and to misbranding it. And the show really unravels the very many different threads, and they're all pulled from the statement of facts in the 2007 settlement agreement. We interviewed former employees at Purdue, former sales reps. We have Richard Sackler saying, you know, when it first comes up that it's - that crime has, you know, gone through the roof in Appalachia, you know, it's him saying, hammer the abusers. They are the criminals, you know, not us.

And so there was just - as we were working on this show, more and more documents were coming out. Some documents were leaked to us, but then others were just part of these very in-depth legal filings from attorneys general in New York and Massachusetts that we were also able to pull from.

MARTIN: So the series creates characters, but I take it these are based on people that you really reported on.

MACY: Absolutely.

MARTIN: And it's - of course, it's a marvelous cast. I mean, you know, it has to be said. Michael Keaton plays Dr. Samuel Finnix. He's one of the central characters, a doctor who sees his patients becoming addicted in droves. And one of the other, I think, really compelling characters is this young woman who worked in the mines. I mean, she's a coal miner named Betsy, played by Kaitlyn Dever. She's an - she has an accident. She visits Dr. Finnix for pain relief. From there, her parents slowly watch this addiction develop, and it's just very heartbreaking to watch. And your book also opens with the parent of somebody who is battling addiction. Could you just talk about why is it that people who had these difficult, physical jobs, like, why were they the targets?

MACY: Purdue purposely targeted, like, rural Maine, southwest Virginia, eastern Kentucky, West Virginia - places where there were a lot of workplace injuries. And why did they do that? They did that because they had the data showing that doctors in those areas already were pretty comfortable prescribing opioids - Lortab, Percocet, Vicodin, things of that nature. And so they took the data, the prescribing data that they purchased, and they went to doctors in those areas and flipped them to OxyContin.

MARTIN: You know, as you pointed out, there's been a criminal case against the creators of OxyContin. Nobody from the Sackler family got prison time. What are your thoughts about that?

MACY: It's enraging. I mean - and you almost go, how could this be that they've - the company that they micromanage, that they ran has pleaded guilty to all these crimes, and still, Richard Sackler can say in court, we have no responsibility; my family has no responsibility; my drug was not the cause of the opioid crisis? You know, he doesn't even know, he says, how many people have died. Like, he can't even be bothered to learn that well over a half a million Americans have died of opioids. And it's infuriating, frankly, because we both know that there are plenty of people in jail for, like, simple possession charges or charges because they were dealing to support their habit, which began with the Sacklers' drug.

MARTIN: Forgive me for sort of putting you on the spot here, but is there any - do you see any glimmer of hope in any of this?

MACY: I am hopeful that once people start understanding how we have all been stigmatizing people who use drugs, that maybe our systems will catch up with that. I've actually just spent the last year and a half writing a follow up book to "Dopesick" that's coming out next year. And it's all about people who are meeting people where they are because so many people have been stigmatized for so long, that they're afraid to go to the hospital. They're afraid to go to the doctor because they were treated so poorly last time they went. And so you're seeing people dying of things like endocarditis at home - end-stage endocarditis - dying alone because they've been treated so poorly at a hospital.

And based on my new research, the thing to do is to go where they are and to meet them where they are. And that might mean giving them clean, sterile needles to use until they're ready for treatment because there's no family in America now, I dare say, who doesn't at least know somebody who's been impacted with this. And it's a hard story to kind of grasp.

MARTIN: The whole purpose of your book was basically to lift up the stories of people who you felt had been forgotten, who were not being listened to even when they were crying out for help.

MACY: Yeah.

MARTIN: And I just wondered, you know, what were your thoughts about translating this to a TV series? Did you hesitate at all? Did you feel that it might help?

MACY: I absolutely am praying it helps. You know, a lot of people read the book. It was a bestseller. But more people might watch it. And one of the reasons I wanted to be so involved in it, including in the writers room, you know, where we were outlining and then writing the scripts, is that I wanted to make sure that the victims' voices were centered in the story.

So, like, one of the nicest things a reader has ever said to me after I gave a talk - and she was a person in recovery. She said, until I read your book, I didn't realize that I was part of a bigger story. I thought I was just, you know, a failure. She said something different, but I can't say that on NPR.

But I'm hoping that if the show presents the story accurately, poignantly, fairly, more Americans will come to understand why we are here where we are now while, you know, the guy they used to work with at Subway is in jail, but Richard Sackler and no Sackler has had to sell a piece of jewelry or an artwork or boat or home or a sixth or seventh home. And it's just not fair, and we've been blaming the victims instead of the people that perpetrated this.

MARTIN: "Dopesick" is an eight-part series set to premiere Wednesday on Hulu. We've been talking with journalist and author Beth Macy, who wrote the book on which the series is based. It's called "Dopesick (Dealers, Doctors, And The Drug Company That Addicted America)." Beth Macy is also an executive producer of the series. Beth Macy, thanks so much for talking with us today.

MACY: Oh, it was great to catch up with you, Michel.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

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