A scene from the Hulu drama series Dopesick depicting a character refusing pain medication has prompted backlash from addictions and pain experts who feel the show is stigmatizing opioid treatment for acute pain.
Last week, Hulu tweeted a scene from Dopesick that shows the character Randy Ramseyer—an assistant U.S. attorney investigating OxyContin maker Purdue Pharma—in bed following prostate surgery.
Asked by a nurse how bad his pain is, Ramseyer responds that it’s “about 1,000” on a scale of 1 to 10. But when the nurse offers Ramseyer 20 milligrams of OxyContin, he refuses, saying, “I don’t want Oxy. Just give me some Tylenol.”
“The medication almost made its way to Randy, but he knew how dangerous it was,” Hulu tweeted.
Beverly Schechtman, an advocate for chronic pain patients who herself has Crohn’s disease, said the clip “doesn’t really make any sense.”
“It’s not like this huge dose that’s going to automatically turn someone into someone who has an addiction, but that’s the way they portray it,” she said. “I think it actually adds stigma, not just of pain patients, but people with addiction.”
VICE News reached out to Hulu for comment but did not receive a response.
Dopesick tracks the story of how Purdue Pharma’s marketing of OxyContin, which downplayed the drug’s potential for addiction, led to widespread overprescribing and fueled the first wave of the opioid crisis.
And while that actually happened, Schechtman told VICE News there’s been an “overcorrection” in recent years, where patients are fearful of taking opioids and doctors don’t want to prescribe them, even when they’re medically necessary.
Schechtman pointed to one study that followed patients with no previous experience with opioids post-surgery; misuse was identified in 0.6 percent of them. A similar study concluded that “individual risk of long-term opioid use in opioid-naive surgical patients is low.”
William Amarquaye, a clinical pharmacist at Brandon Regional Hospital, said the majority of people who receive opioids after surgery don’t go on to have opioid use disorder.
“They’re using these minor numbers and blowing them up to say that anyone could become addicted,” he said, noting that patients are assessed for risk factors, including mental-health and substance-use issues.
Amarquaye said people shouldn’t inherently fear using opioids to treat pain or receiving pharmaceutical fentanyl while getting medical treatment.
While he said it’s good the show is exploring how corporate greed led to a public health crisis, “We need a balance because if you focus on that too much, it drowns out other important voices, like pain patients who need that medication.”
Kate Roberts, a clinical social worker who works at the University of North Carolina Substance Treatment and Addiction Recovery program, said the Dopesick clip also promotes unhealthy ideas about tolerating pain.
“Watching him struggle through the pain puts forward this idea of masculine stoicism. ‘Oh, I’m going to overcome this risk of addiction by stoically living through pain.’”
It’s something she’s encountered both in patients and her own family; she said her father recently fell behind on pain meds following a surgery because he was worried about becoming dependent.
She also said a key component to recovering from surgery is moving around—which is much more manageable with pain treatment.
“Roughing through it actually is not going to help you. You’re going to stay in bed, you’re going to develop worse symptoms,” she said.
Schechtman, who is vice president of the Doctor Patient Forum, an advocacy group, said the stigma around pain medication extends to prescribers.
“Doctors are terrified… They are scared to prescribe because the DEA is going after them,” she said.
As a result, she said she’s heard from numerous patients, including people who’ve had major surgeries or have cancer, who are still not receiving pain medication. In one case, a chronic pain patient who would show up to Don’t Punish Pain rallies, bought illicit painkillers and died because they contained fentanyl.
Both Schechtman and Robertson said people with a substance use disorder also often have their pain minimized when receiving care because of the perception that they just want access to opioids.
“I’m not saying overprescribing is right. I know there was overprescribing,” Schechtman said.
“But what they’ve done has devastated our medical system and I don’t know how long it will ever take to come back from this.”
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