Dopesick review: Ambitious drama masterfully shows the human beings caught up in America’s opioid crisis

A deserving subject is not always the same thing as a good drama. Few subjects are more worthy of representation than America’s epidemic of opioid addiction, driven by Purdue Pharma’s drug Oxycontin. Starting in the mid-1990s, Purdue, owned by the Sackler Family, set about making their new “slow release” opioid the most popular pain relief drug in the US, claiming that it was less addictive than other drugs in the same class. Beginning with industrial mining and logging towns, where chronic pain from injuries was more common, the drug spread out across the country. Within a few years it was obvious Oxycontin was causing an uptick in crime and a wave of desperate addicts, but even now, a quarter of a century later, the recriminations are playing out in American courts. Millions of lives lie ruined in the drug’s wake.

How can something so sprawling be rendered on the small screen? A conventional approach would be to turn it into a courtroom drama or a detective-style investigation. The eight-part miniseries Dopesick, adapted by the Empire co-creator Danny Strong from a book of the same name, is more ambitious than that. It aims to explore the scandal from the Sacklers down, opening with the development of the drug in the 1980s, to show how greedy bosses and avaricious sales reps were able to hijack the good intentions of doctors all over the country. Given the size of its canvas, Dopesick is a remarkable achievement, which clearly lays out the facts of the slow-burning tragedy, with lots of helpful date reminders, without losing track of the human stories behind it.

It would be easy for something like this to drift, but a gifted cast lets the narrative skip between the Sacklers, the sales reps, the enforcement agencies and the end users without becoming incoherent. With the exception of the villainous Sacklers, especially the rasping Richard Sackler (Michael Stuhlbarg, channelling a missing Addams Family character), these are all human beings. The vital relationship in this first episode is between the young Virginia miner Betsy Mallum (Kaitlyn Dever) and her family doctor, Samuel Finnix (Michael Keaton). This is a small, conservative town, not somewhere Betsy can easily come out as gay. She needs the money from mining to move away; when she hurts her back in an accident, more than her income is at stake.

Oxycontin’s success was built on the way it was sold not simply as an effective drug, but almost a moral imperative; what kind of a doctor would deny their patients this relief? Dever, best known for her role in the coming-of-age comedy Booksmart, gives another subtle, sympathetic performance here, while Keaton gives a muted worldliness to a good-doctor role that might otherwise have risked cliché. If they are Dopesick’s emotional core, they are not the only strong performances. England’s own Will Poulter is believably cocksure as a young sales rep, Billy Cutler, sent to smooth-talk Finnix into the new wonder drug, while Rosario Dawson and Peter Sarsgaard are crusading DEA agent Bridget Meyer and prosecuting attorney Rick Mountcastle, respectively.

Although the script has occasional minor lapses, as when Mountcastle announces he is “just here to see justice done”, on the whole, it is admirably tight, helped by direction that trusts the viewer to fill in a few blanks. The palette is grey, the action played out in dull meeting rooms and dull towns, where Oxycontin offered an escape as well as a release.

In one almost-wordless scene we see Meyer getting her marriage annulled. When the documents are signed, she and her now-ex husband share an awkward farewell hug. The gesture conveys a world of hope, love and disappointment. A less competent production would not have bothered with this detail, but Dopesick understands that the opioid scandal was about compassion, and the ways in which it was twisted by malign corporate interests, with the help of powerful chemicals, into causing more harm. There are many kinds of sympathy, and many kinds of pain.