成瘾剂量（2021）

Dopesick S01E03

Part 1 Nov. 5, 2021, 11:59 a.m.

我们今日在此要探讨一种
MARTIN: Today, we're gonna talk about
医学状况它被称为突发性疼痛
a medical condition known as breakthrough pain.
我们很好奇为什么在一段旨在推广奥施康定的
RANDY: We were curious as to why nobody says OxyContin
视频中没人提过奥施康定这个词
in a video designed to promote OxyContin.
我已经语无伦次了
PATIENT #1: I'm at a loss for words.
它极大地改善了我的生活
It's just changed my life for the better.
我们只是按他们的要求做的
MARKETER #1: We just did what they wanted.
他们说"拍个公益广♥告♥" 我们就拍了
They said, "Make a PSA," so that's what we shot.
这种药上市才三年
BRIDGET: This drug has only been on the market
却已导致摄入过量的情况
for three years, and there's already been
和犯罪率飙升
a spike in overdoses and crime rates.
普渡制药公♥司♥在为我的患者提供一项伟大的服务
‐ Purdue Pharma is doing my people a great service,
所以愿上帝保佑他们
so God bless 'em for it.
如果有人患有突破性疼痛
What happens if someone has breakthrough pain
且已经服用了40毫克剂量那会发生什么
and they're already at 40 milligrams?
是时候再加倍剂量了
MARTIN: It is time to double the dose again
隆重向各位介绍
as I present to you,
80毫克装药片
the 80 milligram pill.
脉搏体温
RUSSELL: Pulse rate, body temperature,
血压呼吸频率
blood pressure, respiration rate.
这是四个生命体征
These are the four vital signs.
它们能反映出
They indicate the status
身体维持生命机能的状态
of the body's life‐sustaining functions
这些指标偏离标准水平的话
and serve as a basic warning to potential health problems
即表示可能存在潜在健康问题
should these indicators be off standard levels.
但我想说的是
But I would argue
如果我们想确定
that if we want to ascertain
病人的真实健康状况
the true health of our patients,
那么这四个生命体征是不够的
then these four vital signs are not enough
因为他们不能监测疼痛情况
because they do not monitor pain.
通过疼痛表现
From pain,
我们可以立即确定患者是否正在经受痛苦
we can instantly determine if a patient is suffering.
还有什么比疼痛程度
And what better indicator
更能反映出
for the status of a patient's health
病人的健康状况呢
than the level of their pain?
因此我今天在这个大厅里
Therefore, I propose to you here today
向各位提出倡议
in these vaunted halls
医学界必须让疼痛
that the medical community must make pain
成为第五生命体征
the fifth vital sign.
看起来好多了你感觉怎么样
FINNIX: Well, it looks better. How's it feel?
感觉好多了
‐ It feels a lot better.
很好这就是我想听的
‐ Good. That's what I wanna hear.
已经四周了
So it's been four weeks.
你要减少服药剂量了
I wanna taper you off the meds.
周一开始我希望你
See, starting Monday, I want you to...
一天吃一片直到下周一
take one pill a day until the next Monday,
然后就完全停药
and then we're gonna stop altogether.
- 好的 - 行吧
‐ Oh, okay. FINNIX: Okay?
听起来不错
‐ Sounds good.
如果有问题就打电♥话♥给我
FINNIX: And if you have a problem, you call me.
就是你第一次受伤但没做的那件事
You know, like you didn't do when you first got injured?
行吧听你的
‐ Yeah. You're the boss.
没错听我的
FINNIX: That's right. I'm the boss.
尤里卡斯普林斯那边有什么进展吗
So what's the latest with Eureka Springs?
我们找了房♥产经纪人
‐ Oh, we called a realtor.
她在帮我们找房♥子
She's looking for a place for us.
跟你父母谈过了吗
‐ Talk to your folks?
我试着跟我妈谈
‐ Well, uh, I tried to talk to my mom.
进展如何
FINNIX: How'd that go?
他们会觉得我会下地狱
‐ They'll think I'm going to hell,
所以我说什么并不重要
so it doesn't really matter what I say.
你觉得你会下地狱吗
‐ You think you're going to hell?
不会
‐ No.
我从来都不信那些东西
I never believed in none of that stuff,
打小就没信过
even when I was a kid.
那既然这样
‐ Well, then, as far as that goes,
你就没什么好担心的了
you got nothing to worry about.
除非我下地狱
‐ Unless I end up in hell.
没错
‐ Yeah.
没错是这样
‐ Well, yeah, there's that.
我该怎么办
‐ What do I do about 'em?
原谅他们
‐ Forgive 'em.
爱他们
Love 'em.
对他们要有耐心
Be patient with 'em.
这说不准的他们可能会让你大吃一惊
You never know. They might surprise you.
好好过你的生活去吧贝琪
Go live your life, Bets.
有时候你就得放手
Sometimes you gotta let it go.
明白我意思吗
You know what I mean?
去他妈的
BETSY: Fuck this shit.
我们收到报告
‐ We are getting reports
医生们已经通过给病人服药剂量翻倍
that doctors have had a lot of success
成功地缓解了突发性疼痛
treating breakthrough pain by doubling the patient's dose,
这让我们想到也许有种办法
so this got us thinking that perhaps there's a way
能在突发性疼痛开始前起到预防作用
to prevent breakthrough pain before it even begins,
然后这让我们想到了
and, uh, this inspired...
如果患者需要从20毫克甚至40毫克开始服起
Why start someone at 10 milligrams
那为什么要让他们从10毫克开始吃呢
if they really need to start at 20 milligrams, or even 40?
我们不像医生那样
We don't know the needs of a specific patient
了解特定病人的需求所以我们需要
the way their doctor would, so we need to let
让药剂师和护士都知道
physicians and nurses know
他们需要个体化剂量
they need to individualize the dose.
完全正确
‐ This is exactly right.
没错同意
KATHE: Yeah, I agree.
很好迈克尔非常好
It's very good, Michael. Very good.
- 就这么办吧 - 太棒了
‐ Let's move on it. ‐ Great.
谢谢各位
‐ Thank you, everyone.
干得不错
KATHE: Good work.
保罗能留一下吗
Paul, uh, can you stay for a minute?
我想在德国将奥施康定
I wanna look into launching OC in Germany
作为非处方药推上市场
under a relaxed status.
- 德国 - 是的
‐ Germany? RICHARD: Yes.
如果我们能获得宽松的政策
If we can obtain a relaxed status,
在那边就不会受到监管
we'd be uncontrolled there.
但德国监管者比食药监局要严得多
But German regulators are much stricter than the FDA,
而且跟他们打交道非常耗时
and it's very time‐consuming dealing with them.
他们可是你懂的德国人
They're, you know, German.
保罗谢谢你上的地理课
‐ Thank you for the geography lesson, Paul.
我知道德国不是美国
I'm aware Germany isn't the United States.
也许我们在拓展海外市场之前
Perhaps we should focus on shoring up the U. S.
应该先把重点放在美国这边
before we start making foreign moves.
我们会花几个月甚至几年的时间投入在上面
And we'll work on it for months or years,
它又不会长腿跑了
and it won't go anywhere.
现在这样他们不可能同意的
They'll never go for this.
当我跟莫蒂默叔叔说我们应该
‐ Well, that's what Uncle Mortimer said
开♥发♥一种麻醉剂用于治疗中度长♥期♥疼痛时
when I told him we should create a narcotic
他也是这么说的
for moderate long‐term pain.
谢谢你们
Thank you.
非常谢谢
‐ Danke schoen.
如果你们能让这个国家的医生
‐ If you can get these country doctors
将剂量个体化
to individualize the dose,
就能得到个性化奖金
you get the positive side effect
这个积极的副作用
of individualizing your bonus.
好了
All right.
普渡也对骨关节炎
Purdue also just conducted
进行了研究
an osteoarthritis study‐‐
往后传一下研究表明
pass those out for me‐‐ and it says
如果患者每天服用少于或等于60毫克的剂量
that if a patient is on 60 milligrams a day or less,
他们就能不用经受戒断反应的痛苦
they can stop cold turkey without withdrawals.
确保医生要知晓这件事
Now, you make sure you show that to your doctors.
这药真是太神奇了
This drug is just amazing.