Kaitlyn Dever plays Betsy, a young miner who takes OxyContin for a back injury.
In Hulu's Dopesick, Michael Keaton plays Sam Finnix as the kind of family doctor anyone would want taking care of them.
Folksy and smart, he cares enough to stop by an elderly patient's home after work to make sure she's taken her medication. He's still treating adults he delivered as babies in a small Virginia mining town.
But eventually, Finnix winds up in front of a grand jury, ashen and shell-shocked. When a prosecutor asks how his patients reacted to the drug OxyContin, he offers a chilling reply.
"I can't believe how many of them are dead now."
Dopesick is an ambitious, emotional series tackling a sprawling story. It outlines the start of the OxyContin opioid addiction crisis from several angles: doctors and patients using the drug, prosecutors and law enforcement trying to hold OxyContin manufacturer Purdue Pharma accountable, and the drugmaker itself.
Character actor extraordinaire Michael Stuhlbarg plays Purdue Pharma's onetime president Richard Sackler with the creepy intensity of a Bond villain. Disrespected by his relatives and driven to outdo the accomplishments of his uncle Arthur Sackler—who pioneered the marketing strategy for Valium—Stuhlbarg's Richard Sackler pushes the family-owned company to heavily market OxyContin.
As his character explains, OxyContin has a protective coating that time-releases the drug, allowing the company to claim that less than 1% of patients would become addicted to the opioid. Some of Dopesick's most powerful scenes show how Sackler's contentions become marching orders for an army of salespeople intent on getting doctors to prescribe OxyContin instead of competing painkillers—producing a level of profit that would make the Sacklers one of America's richest families.
But the series reveals how those who began to abuse the drug learned to crush the tablets into a powder that could be inhaled and was highly addictive. Eventually, prosecutors noticed that small towns where people hadn't locked their doors for decades were drowning in crime and desperation.
Peter Sarsgaard and John Hoogenakker are appealing as a pair of assistant U.S. attorneys trying to gather enough evidence to prosecute Purdue Pharma executives, sorting through mountains of paperwork and lobbying efforts.
"A few months ago, we caught a doctor selling pills out of his car to an 11-year-old girl ... and when we arrested him, he thanked us," Hoogenakker's prosecutor tells an agent at the Drug Enforcement Administration, played by Rosario Dawson. "At that moment, we knew that what we got going on in coal country is similar to San Francisco at the start of the AIDS crisis ... Our community is ground zero for a growing national catastrophe."
Dopesick also offers an authentic portrayal of the small, working class, predominantly white communities ravaged by the opioid crisis. Lots of TV shows and films have been set in such towns recently, including Netflix's Maid and Hillbilly Elegy, HBO's Mare of Easttown and Showtime's American Rust.
But often areas depicted in such shows can feel relentlessly depressing and deprived. Dopesick excels in outlining a community that is struggling, yet filled with proud and hardworking people who love their town—showing the reality of their circumstance without pandering or stereotypes.
Kaitlyn Dever, in particular, shines as Betsy—a young, closeted gay woman who loves working in the mines alongside her father, though she also yearns to live in a place where she can be herself without fear of being ostracized.
But when a back injury at the mine leads Betsy to take OxyContin prescribed by Dr. Finnix, her fortunes change dramatically.
Adapted by Danny Strong (co-creator of Fox's hit drama Empire) from a nonfiction book by Beth Macy, Dopesick leapfrogs across storylines and time periods in a way that can be a little confusing, despite onscreen graphics showing what year scenes are set in.
Still, Dopesick distills a complicated story into a compelling, heartbreaking series—tallying the human cost of a crisis that started in company boardrooms, earned billions and turned the country upside down in the process.