The Business of Drugs Season 1 finale recap: Opioids

In the season 1 (and possibly series) finale of Netflix’s The Business of Drugs, host and former CIA agent Amaryllis Fox shifts her attention to opioids, or what is commonly called “the opioid crisis.”  Opioids are derived from poppy flowers, similar to the drug heroin.  However, while this episode still shows us undercover scenes, much of the focus is actually on the pharmaceutical industry, which is decidedly less underground, yet still tied to major drug problems (The Business of Drugs mentions Pennsylvania, Ohio, and West Virginia, but it’s no less happening around the globe, to some degree).

The series notes how people get addicted after being prescribed opioids by medical professionals, but high drug prices can lead to heroin use.  Yasmin Hurd, director at the Addiction Institute at Mount Sinai, tells us about oxycontin, and the potency of oxycodone.  It’s also estimated that someone dies of opioid addiction every 11 minutes, which is a startling figure.  One of the most interesting aspects, though, is hearing from a recovering addict.

The Business of Drugs looks at someone in recovery

Before he was a recovering opioid addict, Ron Bock, Jr. had managed a car dealership.  However, he embezzled money to pay for his addiction, went to prison, and lost his home.  How did this all get started?  After his gastric bypass surgery led to complications, he turned to Oxycontin to ease physical pain, which led to addiction.  To help put things in perspective, author/journalist Sam Quinones reminds us that attitudes toward drug use have always evolved.  As an example, heroin was once considered less addictive than other treatments.

It wasn’t until the Harrison Act that the United States government restricted heroin and other opioids.  Next, The Business of Drugs looks at how Purdue Pharma introduced Oxycontin in 1996, having convinced doctors to prescribe Oxycontin.  The series interviews former Purdue Pharma sales rep Carol Panara, who explains that the company convinced people the drug was for moderate to severe chronic pain, thus assuring more widespread use.

She also mentions the company’s distinctions between physical dependence, tolerance, addiction, pseudo-addiction, while implying that some of these categories may have been exaggerated or blurred, based on a doctor’s discretion (which could vary, based partly on how incorruptible a doctor is).

From medical prescription to the black market

The aforementioned Ron Bock, Jr. says he could easily get Oxycontin, and Xanax, from a corrupt doctor who is now actually in prison.  We also hear from an illegal Oxy dealer called George.  According to George, he had taken the drug once after being shot in the face, didn’t like it, but learned he could sell them from his experience.  Eventual crackdowns led to pills being expensive on the black market, with heroin being cheaper.

The Business of Drugs then delves into how heroin hit the suburbs. The series briefly goes over how the so-called “Xalisco Boys” saw a largely untapped market, and it’s basically likened to a pizza delivery service.  We’re also told about the growth of fentanyl, a surgical anesthetic that is 50 times more potent than heroin (and therefore potentially deadlier).  They even interview a drug cook named Jorge in Sinaloa, Mexico, who shows a potent mix of fentanyl with gasoline.  Jorge says drug profitability will never end, and there’s no evidence that he’s being naïve.

Buyer beware

A Philadelphia drug dealer is briefly interviewed, and he sees himself as simply a supplier of a product, even using the old adage of “Buyer beware.”  To its credit, the episode does further humanize users, interviewing a woman named Tiara, an opioid since she had surgery when she was 18.  According to Carol Panera, Purdue Pharma’s organization partners (like Partners Without Pain and The American Pain Society) were actually sponsored by Purdue.

Joe Cappelli, of Marc J. Bern & Partners LLP, says the pills were marketed as no more addictive than other pain killers, noting that, mathematically, the behavior of opioid manufacturers could merit a $1.6 trillion dollar lawsuit?

On the bright side, Ron Bock, Jr. informs us he has been off of opioids for 9 months.  However, addiction problems obviously persist throughout the world.  In this case, people trusted their doctors, but money ultimately led to corruption and “pill mills.”  It’s not clear if The Business of Drugs will have a season 2, as it has been regarded as a mini-series, and Netflix is not best known for long-running series.  However, there’s little doubt they would have plenty of issues to tackle well into the future.

What are your thoughts on The Business of Drugs and the opioid crisis?  Let us know in the comments!