clock menu more-arrow no yes mobile

Filed under:

Hollywood is missing the big picture on the opioid crisis

From Pain Hustlers to Dopesick to The Fall of the House of Usher, filmmakers are fascinated by the epidemic. But what are they saying?

A woman in an orange suit and a man in a gray suit sit at a table next to one another, smiling at someone across the table.
Emily Blunt and Chris Evans in Pain Hustlers.
Alissa Wilkinson covers film and culture for Vox. Alissa is a member of the New York Film Critics Circle and the National Society of Film Critics.

From its first moments, Pain Hustlers sets out to distinguish itself from the pack of recent series and movies about the opioid crisis with one simple declaration: This is the one that isn’t about the Sacklers.

The family most closely associated with the crisis — due to their company Purdue Pharma’s misleading marketing of OxyContin and the ensuing lawsuits — are at the center of a number of high-profile Hollywood productions, many of which are based on books by journalists. Dopesick is the best of the scripted bunch, a multi-Emmy-winning limited Hulu series that splits its time between Purdue executives and Appalachian victims. There are more, including the Netflix series Painkiller, HBO’s documentary series The Crime of the Century, movies like Ben Is Back and Hillbilly Elegy, and a lot of others. Laura Poitras’s excellent documentary All the Beauty and the Bloodshed, also on HBO, centers on photographer Nan Goldin’s activism against the Sacklers and was among 2022’s best films. Even the most recent Netflix series from horror master Mike Flanagan, The Fall of the House of Usher, is based on the Poe novel but patterned more or less explicitly on the Sacklers.

A person in a bird mask stands near a family portrait.
Mike Flanagan’s The Fall of the House of Usher is pretty clearly about the Sackler family.

Pain Hustlers, based on journalist Evan Hughes’s book, starts with mock-documentary footage introducing us to fictional characters from the story we’re about to watch, most of whom are composites of real people from Hughes’s reporting. Former pharmaceutical executive Pete Brenner (Chris Evans) says, with a touch of nonchalance, “What you need to remember is we’re not Purdue Pharma. We didn’t kill America. This was 2011. Strictly speaking, we’re not even part of the opioid crisis.”

As images of people on stretchers appear on screen, he continues. “You know, Lonafen” — the movie’s fictional opioid, based on the drug Subsys — “was never a street drug. But you know, people hear ‘fentanyl’ and they lose all fucking perspective.”

Perspective is precisely what Pain Hustlers aims to provide, a goal it shares with others that weave together stories of the addicted with the addictors, with varying degrees of success. Pain Hustlers is the story of a single mother, Liza Drake (Emily Blunt), who is living a life of not-so-quiet desperation, strapped for cash and camping out with her daughter and mother in her disapproving sister’s garage. One night, exasperated by her job as an exotic dancer, she plops down at the bar and meets Brenner, who drunkenly offers her a job. Turns out that Zanna, the (fictional, based on Insys) pharmaceutical company where he works, is also in desperate straits. So is everyone who works there. So are the doctors they approach in a barely legal attempt to entice them into prescribing Lonafen to desperate cancer patients. The whole thing reeks of panic, and even when Zanna’s coffers begin to swell, that feeling remains.

Pain Hustlers proclaims that the opioid crisis is at its core a story of American desperation: a desperate medical system that doesn’t work for anyone, a desperate legal system that unevenly applies justice, and desperate people sucked into the orbit who need money or recognition or just to be able to get through the day without wanting to die. Tonally, though, it’s a weird movie, with overtones of Wolf of Wall Street but not quite the same level of commitment to the bit, meaning that Liza comes out as kind of a plucky but misguided heroine with a good heart.

Three people in businesswear stand in an office, their arms reaching toward the ceiling in victory.
Pain Hustlers has some Wolf of Wall Street vibes.

But in telling a story decoupled from the Sacklers, Pain Hustlers does get at something that can sometimes get lost in other media. That media has taken a variety of genre forms: Painkiller plays like a disaster story (and is directed by modern disaster auteur Peter Berg); Dopesick is a prestige drama; Fall of the House of Usher is gothic horror, with overt Succession vibes. Other movies have taken the form of addiction stories, a popular genre for a lot of Hollywood’s history, with middling success. Pain Hustlers feels like one of this year’s wildly popular business-guy movies, a tale of a rise and a fall that takes the suffering into account but has a different sort of arc.

That artists keep messing with genre in telling this story suggests a nation trying to figure out what, exactly, this story even is. What is the crisis ... about? It’s about pain and our handling of it; it’s about desperation. It’s about villains — the Sacklers, or maybe just pain itself — but not the kind who can, or will, be beaten by heroes.

Trying to fit the opioid crisis into a genre arc is especially hard, I think, because Hollywood’s tendency is to point a finger at a single villain and make everyone else victims, and that doesn’t quite work here. It would be heinously wrong to call Purdue, OxyContin, and especially the Sacklers “scapegoats” for the crisis; they are in fact largely responsible for it, thanks to incredible disregard for the lives of others, and should be treated accordingly.

Yet the half-million dead and their grieving families across America aren’t suffering purely because some isolated rich people decided to take advantage of them. The tendency to overwhelmingly focus on the Sacklers risks suggesting that if they could be punished, the problem would be solved. But there’s far more to it than that. This is not a war story.

A group of business people sit in a boardroom.
Michael Stuhlbarg plays Richard Sackler in Dopesick.

That’s why, in the end, All the Beauty and the Bloodshed is such a monumental achievement and still by far the greatest of the current crop of opioid movies. Poitras and Goldin weave together Goldin’s activism and her addiction to opioids with some surprising strands. There’s Goldin’s photographs, particularly The Ballad of Sexual Dependency, in which she chronicled the lives of friends, many of whom died from drugs or HIV-related illnesses. There’s the story of Goldin’s family, and in particular her sister, who was repeatedly institutionalized and died at an early age due, in part, Goldin says, to her parents’ unwillingness to acknowledge what their children needed to flourish.

These are not matters that obviously relate to one another, except that they all happened to Goldin. But the juxtaposition creates meaning, especially framed within Goldin’s (successful) attempts to force major art museums like the Guggenheim and the Tate to remove the Sackler name from their galleries and stop taking money from the family.

A woman in a beret with a drum stands outside some arches. A giant red banner reading “Abandon the Sackler Name” is in the background.
All the Beauty and the Bloodshed is, in part, a film about trying to remove the Sackler name and money from the art world.

The Sacklers, and the kinds of people who profit in Pain Hustlers, can only be successful in the context of a social order that allows them to be. This requires systems that shield perpetrators from consequences, as long as they’re rich enough. It requires a public villainization of addicts. It requires a kind of delirious American optimism bent on burying anything that isn’t optimism, and a celebration of the wealthy. It of course requires a broken medical system that can be morally and ethically bankrupt. All the Beauty and the Bloodshed draws these themes through other sorts of public health crises, whether it’s HIV/AIDS or the (mis)treatment and deaths of queer people, or the immense need for better mental health care.

Poitras’s documentary best captures all of this, putting the crisis into its larger social and, one might say, spiritual roots. A society that pathologizes rather than cares for the weak, that stuffs what’s painful into a closet, can’t help but foster a crisis. Add some highly addictive drugs that stand to make some people very rich and you have a flame held to a puddle of gasoline. Nobody escapes the conflagration.

Pain Hustlers, Painkiller, and The Fall of the House of Usher are streaming on Netflix. Dopesick is streaming on Hulu. All the Beauty and the Bloodshed is streaming on Max.