成瘾剂量（2021）

Dopesick S01E02

Part 2 Nov. 5, 2021, 11:59 a.m.

这种药会很出色的
It's an excellent drug.
你妈妈快为你
PERSON: You've got your mother worried sick
担心死了里奇
about you, Richie.
我们的专利过期了
‐ Well, our patent expired.
要是找不到替代品老爸会死的
Dad would be dead without a replacement.
看来你看不上一些蝇头小利了
‐ Because ear wax just isn't good enough for you.
原谅我努力想要
‐ Forgive me for trying to...
让我们比必妥碘家族更辉煌
make us more than the Betadine family.
我懂我知道你有远大的抱负
‐ I know, I know, you've got grand ambitions,
但我担心你会变成伊卡洛斯
but I am concerned you're going to become Icarus.
如果奥施康定能按照我的期望发展
‐ If OxyContin does what I think it can,
会为咱们家创造出
then it's gonna be bigger
亚瑟叔叔连做梦都想不到的价值
than anything Uncle Arthur ever dreamed.
里奇
‐ Richie...
亚瑟已经死了
Arthur is dead.
当罗氏聘请阿瑟·萨克勒进行市场评估时
‐ When Roche hired Arthur Sackler to market value,
他需要把它和"立眠宁"作区分
he needed to find a way to separate it from Librium.
所以亚瑟设计出了一种特殊的医学状况
So Arthur devised a specific medical condition
称为精神紧张
called psychic tension.
既然"立眠宁"是用来治疗焦虑的
Where Librium was taken for anxiety,
那治疗"精神紧张"
you would need a much stronger medication
就需要更强效的药物了
for psychic tension.
因此 “烦宁”就成了
And thus, Valium became
市场上最受追捧的镇定剂
the number one tranquilizer on the market
皆因创造出了这种“精神紧张”的医学状况
by creating the condition known as psychic tension.
如今我们创造出了人类文明史上
Now, we have created the greatest painkiller
最棒的止痛药
in the history of human civilization...
要确保世界懂得它的价值
and all we have to do to ensure the world gets it
我们只需要找出一种
is to figure out a medical condition
能让患者使用双倍奥施康定剂量
that would require an OxyContin patient...
的医学状况
to double their dose.
我们今日在此药探讨一种医学状况
MARTIN: Today we're gonna talk about a medical condition
被称为突发性疼痛
known as breakthrough pain.
既不常见也不罕见
Neither common nor rare,
突发性疼痛是一种
breakthrough pain is a specific type of pain
打破12小时周期的特殊的疼痛
that breaks through the 12‐hour cycle.
对我接到了一系列投诉
‐ Yeah, I've had several complaints‐‐
或者我应该称之为问题
or should I say questions‐‐
说药效持续不了12个小时
about the drug not lasting 12 hours.
好你需要
‐ All right, what you need to do
告诉你的医生他们的病人
is tell your doctors that their patients
正在经历突发性疼痛
are experiencing breakthrough pain.
但我们有个有效的解决方案
But we have an effective solution
可以让他们的病人
that will allow their patients
用奥施康定睡个好觉
to get a full night's sleep on OxyContin.
医生只需要将剂量加倍即可
All they have to do is double the dose.
所以假设他们服用了10毫克
So if they are on 10 milligrams,
那应该将剂量增加到20
they double the dose to 20.
如果之前的用量是20毫克就翻倍到40
If they're already on 20, they double to 40.
嘿如果这个药不像我们声称的
‐ Hey, if this drug isn't working
那样有效
like we say it is,
医生就不会再开这种药了
doctors are gonna stop prescribing it.
那你可能得开始卖♥♥伟哥了
‐ Then maybe you should start selling Viagra.
我谢谢你了
‐ Thanks for the help.
20毫克和40毫克
‐ Look, the 20 and 40 milligrams
比10毫克贵1到3倍
are two and four times more expensive than the 10.
所以呢如果我们能说服医生加倍用量
So if we can convince doctors to double their doses,
我们的工资也会加倍
we will be doubling our paychecks.
我明白但
‐ Yeah, I get that, but...
要是不起作用怎么办
what if it doesn't work?
没有药物会对每个患者都有效
‐ No drug is going to work perfectly for every patient,
这不是我们该担心的
and that's not our problem.
我们的工作是把销量搞上去
Our job is to sell. ‐
那就加倍剂量吧
Then I guess we double the dose.
对
‐ Yeah.
医生关于12小时药效的问题
‐ Doc, I was able to get some information
我帮你问到了
on the 12‐hour issue,
这并不少见
and, uh, it's not uncommon.
病人出现的
What your patient's experiencing
是一种突破性疼痛
is breakthrough pain,
可以发生在第9和第10小时
and it can happen hours nine and ten,
尤其当疼痛特别剧烈时
especially if the pain is uniquely acute.
突破性疼痛
‐ Breakthrough pain.
我从没听说过什么突破性疼痛
I've never heard of breakthrough pain.
您没听过吗
BILLY: You really haven't?
嗯这是一个术语
Well, it's a‐‐it's a term used
是由疼痛专家首先提出来
primarily by, uh‐‐ by pain specialists, you know?
解决办法很简单
And the solution is‐‐is simple.
只需要把剂量加倍即可
You, uh‐‐you just double the dose.
如果患者目前用量为10毫克
So if they're on 10 milligrams,
就增加至20
you know, you bump them up to 20.
不行不行
‐ Oh, no, no, no.
对麻醉剂来说这剂量太大
No, that's‐‐that's too strong for a narcotic.
我还是给她换成止痛药
I'll just switch her to Percocet
或者低含量的吗♥啡♥药片吧
or low‐dose morphine pills.
医生不建议您这么做
‐ Doc, I wouldn't do that.
那些药它们
Tho‐‐those drugs, you know, they're not‐‐
跟我们的药不一样我们的药不会上瘾
they're not non‐addictive in the way that‐‐that OC is.
把剂量加倍是很安全的
And it's perfectly safe to‐‐to double the dose.
你是说你们的药
‐ You're telling me that your drug
是这个世上唯一能帮助我病人的药吗
is the only drug in the world that can help my patients?
呃我是说
BILLY: Well, ye‐‐I mean, I'm saying‐‐
我们是你的上上之选
I'm saying it's your best option, you know?
您那边突破性疼痛的患者
Have you had a number of patients
很多吗
with‐‐with breakthrough pain issues?
刚看完一位
‐ Well, I guess I just got one.
我只有四位患者服这种药比利
I don't know, I've only got four people on it, Billy.
没错但他们吃了都管用对吧
‐ Right, but they're all doing great, right?
对实际上是非常有效
‐ Yeah, it's been very effective, actually.
看吧就是这样
BILLY: See? There you go.
我建议远离吗♥啡♥ 医生
I‐‐I'd stay away from morphine, Doc.
现在已经不是1♥8♥9♥4年了
You know, it's not, uh, it's not 1♥8♥9♥4 anymore.
总统也不是泰迪·罗斯福了
Teddy Roosevelt isn't president.
泰迪·罗斯福当年也不是总统
‐ Well, Teddy Roosevelt wasn't president then either,
但我明白你的意思
but I get your point.
好吧
Uh, okay.
行对于她的背伤来说
Yeah, I guess morphine would probably be too strong
吗♥啡♥也许劲儿太大了
for her back injury anyway.
还在吗
Hello?
不好意思医生
‐ Uh, so‐‐sorry, Doc.
你那儿可能信♥号♥♥不好
I think you cut out there.
我觉得把她的剂量加到20毫克
I think doubling her up to 20 milligrams
就可以了
will do the trick.
试一试吧
Just‐‐just give it a try.
就这样打搅了
All right, I'll let you go.
再见
Bye.
所以有个新问题
MICHAEL: So, um, there's a new issue.
一些医生有种误解
A number of doctors have the misconception
觉得奥施康定没吗♥啡♥强效
OxyContin is less powerful than morphine,
而你也知道它其实更强效而且
when, as you know, it's much more powerful, and, uh,
此类困惑出现的越来越频繁
the confusion has started to come up more frequently.
与吗♥啡♥相关的
RICK: What are some of the side effects
副作用有什么
associated with morphine?
呼吸困难
‐ Difficulty breathing,
镇静昏迷死亡
sedation, coma, and death.
奥施康定比吗♥啡♥更有效吗
‐ And is OxyContin more potent than morphine?
是的
‐ Yes.
其活性成分羟考酮
Its active ingredient, oxycodone,
效力是普通药的两倍
is twice as potent.
因此危险性也加倍
‐ And thus twice as dangerous.