Painkiller, Producer: Chris Hatcher, Director: Peter Berg, English, Netflix series in six episodes, August 2023.

The opening series of short high-frequency sounds at regular intervals induces a sense of anxiety and suspense in the audience, drawing them into the acclaimed Netflix series Painkiller. Created by Micah Fitzerman-Blue and Noah Harpster, Painkiller is based on a New Yorker article “The Family That Built the Empire of Pain” and also on the book, Pain Killer: An Empire of Deceit and the Origin of America’s Opioid Epidemic, by Barry Meier. A few minutes into the first episode of this fictionalised series, the viewers realise that their anxiety is caused not by these spine-chilling sounds, but by the deafening and unnerving sounds of silence, occurring in the intervals between them, that unravel the events that follow.

The silence highlights the doings (mostly misdeeds) of Purdue Pharmaceuticals over the final two decades of the 20th century. Their actions led to what is today recognised as an “opioid crisis” in the United States, with over 300,000 people losing their lives by overdosing on prescription painkillers. Purdue Pharma is infamous as one of the first few pharma companies to successfully tap into an unexplored medical market, promising to alleviate chronic pain and improve overall well-being. The magic pill for the purpose was OxyContin, an opioid recklessly over-prescribed by US doctors for any and every kind of chronic pain. The series explores the relentless marketing that led to this new relationship with prescription drugs, organically and seamlessly changing common attitudes and the discourse around pharmaceuticals. Pain, in this discourse, was transformed from being an affective element that naturally accompanies life after injury or disease into an easily eliminated hindrance to a productive life of the highest quality. This discourse was now medicalised, draped between the coloured coats of the opioid.

Transformation of medication

The makers of the series effectively explore the locus where the market meets medicine, redefining pain and well-being as absolute binaries, with well-being alchemised into a tiny tangible circular pill. Through the process, a certain sense of pleasure is linked to taking the drug, as the antonym to pain. Purdue became the leading pharmaceutical manufacturer of opioids in the US, riding on the promise of an escape from pain and a move towards pleasure. A drug initially given to those in the last stages of cancer was transformed into an everyday supplement to escape pain. Pain was not something to be tolerated; it had to be overcome. This pill, which you had never known you needed, was shown to give fresh meaning to life. The web series does a remarkable job of projecting the drug as its central figure, highlighting the harm it caused, while showcasing the extreme steps Purdue Pharma took to save its golden goose.

Richard Sackler, chief patriarch of Purdue Pharma (played by Matthew Broderick), is woken up by his auditory anxiety only to find that the sounds originated from one of the many smoke detectors in his mansion. He tries to get rid of this annoyance, by throwing out fruit, brooms, and everything else that he can get his hands on. Aiming at the circular machine on the ceiling, Sackler manages to silence the detector. The sounds and silences, however, recur constantly throughout the series; symbolising the lives cut short by OxyContin. The intervals between the sounds get longer, making moments of stillness uncomfortably eerie. The pause beautifully leads its audience to Simon and Garfunkel’s 1964 hit song “The Sound of Silence” which lays out the premise of the series. The series title follows, looking uncannily similar to the logo of Purdue Pharma.

Painkiller explores the changing discourse around OxyContin from the multiple perspectives of Richard Sackler and Purdue Pharma, of the women recruited to sell the medication to doctors (all men) banking on their youth and sex appeal, and of investigator Edie Flowers (Uzo Aduba). In addition, the social aspects of addiction and its effect on the familial fabric are seen through the life of a mechanic, Glen (Taylor Kitsch). Glen gets addicted to OxyContin after it is prescribed for a severe back injury. Users like Glen soon see an increased tolerance towards the drug, transforming it from a pain-pill to a desperate necessity. The dosage is initially increased under prescription, though the subsequent overuse is passed off as a wilful act. as an independent act. Dependence on the drug organically increases as the plot develops, with the characters finding themselves compulsively snorting the powdered pill. At this point, the series explores power disparity –– showcasing how powerful giants like Purdue Pharma, shamed by the media for manufacturing the drug, target individuals from under-privileged backgrounds, labelling them “substance abusers”. Medication is thus transformed from a healthcare product to a commodity, using distinct marketing strategies and subtle messages to drive sales, ending in “voluntary” abuse by individuals.

The form

The narrative moves between multiple perspectives, adding to the existing scholarship on intersections of disability and media studies. The series presents itself as an additional commentary to movies on drug abuse released during the same period –– such as Danny Boyle’s Trainspotting (1996) and Darren Aronofsky’s Requiem for a Dream (2000). Unlike the limitations of films, the form of a limited series allows for a more in-depth understanding of the problem once labelled an epidemic in the United States.

Engaging further with the form, lensing is strategically used to enhance the thoughts of individuals occupying different powerful positions, as in Sidney Lumet’s 12 Angry Men (1957). Similarly, the social and psychological effects of the drug on the user are explored by clever use of the aperture, permitting the desired fluctuations of visual focus and blurriness, allowing the audience a glimpse of reality from the drug user’s point of view. A particular mise-en-scène has the shock value that Rembrandt’s painting “The Anatomy Lesson of Dr Nicolaes Tulp” brought to the non-medical community, and deserves a special mention. This is when the audience is subjected to seeing close to a dozen undigested pills accumulated in the gut of those succumbing to OxyContin overdoses. The increasing frequency of bodies appearing in black bags for post-mortem is compared to a conveyor belt, indicating the magnitude of the harm caused. And if the fictional narrative fails to communicate the seriousness of the problem, the film makers rely on an unconventional use of the “disclaimer”. Every episode begins with a reminder, by family members of those who succumbed to the drug, that the series may be fictional for dramatic purposes, but the pain it caused to real people is far more than any story can tell. Such a method may impel the audience to perceive such fictional works more seriously, by communicating the enormity of injustice that the victims and their families have had to go through.

Conclusion

The series provokes the audience to question the role of a “settlement” when those with deep pockets are taken to court. It makes one wonder if justice is ever served when courts agree to such monetary compromises. It pushes one to think about how language strategically evolves to conceal; especially when pharmaceutical companies are driving this change. It brings to the surface the ethical questions of taking advantage of patients who are vulnerable, by generating new illusions of wellbeing.

Painkiller also shakes the notions of absolute trust in doctors, a profession that once provided credibility based on its taking the Hippocratic oath. It shows us how medical practice gets effortlessly derailed by the idea of “making it” within the larger economic system.

The series leaves us with the sound of silence.