成瘾剂量（2021）

Dopesick S01E04

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

另外我们会给你减低剂量的兄弟
and, uh, we'll lower your dose here, buddy.
好的
All right.
你会好起来的
We'll get you feeling better, okay?
不会有事的
It'll be all right.
谢谢医生
PATIENT: Thanks, doc.
我们在此非常骄傲地庆祝
‐ We are so proud to be honoring
我的大哥亚瑟·萨克勒
my great brother, Arthur Sackler,
进入医疗广♥告♥名人堂
into the Medical Advertising Hall of Fame.
可以这么说阿瑟·萨克勒是医疗广♥告♥的开创者
In many ways, Arthur Sackler invented medical advertising.
他是第一个意识到
He was the first to realize
服用什么药物并不是病人的决定
it wasn't patients who decided what drugs they took.
而是医生的决定
It was their doctors.
他曾因犹太人的身份而被广♥告♥界拒之门外
Shunned by Madison Avenue for being Jewish,
但他创立了自己的公♥司♥ 专门为医生
he formed his own company specifically targeting doctors
提供来自科学期刊
with articles from scientific journals
及医学协会的研究
and studies from medical societies.
虽然有时这些协会的
Sure, sometimes the societies
专家都是亚瑟资助的
and the experts were financed by Arthur.
你觉得谁更混♥蛋♥一点
JONATHAN: Who do you think is the bigger asshole?
莫蒂默叔叔还是亚瑟叔叔
Uncle Mortimer or Uncle Arthur?
我选C 以上所有
‐ C, all the above.
不仅改变了这个国家
‐ Not only changed the way medicine
医药销♥售♥的方式
is marketed in this country;
更永远地改变了医疗行业
it changed the medical industry forever.
你叔叔很优秀
BETH: Your uncle was good.
对他那个时代来说
RICHARD: For his time.
这个展板怎么没把那些
This one's missing the zombies
吃了烦宁变成僵尸的人放进去
that valium turned some patients into.
- 算他逃过一劫吧 - 不太算吧
‐ He got away with it. ‐ Barely.
但也让他赚得盆满钵满
But it made him rich.
贝丝亲能让我们单独谈谈吗
Beth, darling, would you give us a few minutes, please?
- 好 - 谢谢了
‐ Sure. RAYMOND: Thank you.
你非得这么做对吗
You had to do it, didn't you?
做什么
‐ Do what?
你不得不宣称它不会上瘾
‐ You had to say it was non‐addictive.
- 爸就连食药监局都说 - 得了吧
‐ Dad, even the FDA‐‐ ‐ Oh, please.
已经有诊断书显示
Call notes are starting to come in that patients
病人出现上瘾迹象了
are showing signs of addiction.
仅在西弗吉尼亚的部分地区罢了
‐ Just a few pockets of West Virginia.
文化所致
It's cultural.
那些红脖子除了上瘾什么都不会
All those hillbillies do is get addicted.
还有缅因肯塔基所有我们一♥期♥推进的地区
‐ And Maine and Kentucky. All our phase one states.
如果致瘾率超过1%成为事实
If it becomes accepted that more than 1%
那我们就完蛋了
become addicted, it's dead.
就算一年的销♥售♥业绩拉满
And one year of strong sales
也弥补不了你已经投入的四千万
isn't gonna make up for the 40 million you spent.
你有什么建议吗
‐ Any suggestions?
跟你亚瑟叔叔好好学学吧
‐ Take a page from Arthur's playbook.
找个专家让他告诉医生
Get an expert who'll tell doctors
我们神药的真♥相♥
the truth of our wonder drug.
我们已经有罗素·波特诺伊了
‐ We've got Russell Portenoy.
不行要比他更强势
‐ No, I'm thinking someone more aggressive,
尤其是你宣称的1%
especially if your 1% claim is, um, hmm.
用医疗术语来说就是
What's that medical term?
放狗屁
Fucking bullshit.
好吧
‐ Fine.
我们找个更强势的专家
We'll find an aggressive expert.
骨关节炎简直让人生不如死
‐ No, the‐‐the osteoarthritis was truly debilitating,
什么法子都试过了后来我意识到
and nothing seemed to work until I realized
病人需要作用更强的药
that the patient needed something strong enough
来止住突破性疼痛
to stop the breakthrough pain.
所以我开始给患者服用美♥沙♥酮♥
So I started the patient on methadone,
不出几日她就恢复了正常
and she was back to normal within just a few days.
美♥沙♥酮♥
‐ Methadone?
你说要找强势一点的
‐ You said find me aggressive.
他有个理论称之为假性成瘾
He has a theory called pseudo addiction,
基本上就是不承认上瘾的存在
which basically means addiction doesn't exist.
这家伙是谁
‐ Who is this guy?
大卫·哈多克斯
‐ David Haddox.
他念过牙科学校但现在
He went to dental school but now heads
是埃默里大学疼痛管理部门的负责人
the Pain Management Department at Emory.
挺对口的
‐ A‐‐a fitting progression.
你想见他吗
MICHAEL: You wanna meet with him?
那当然了
‐ God, yes.
您真的认为阿片类药物没有开够剂量吗
So you really feel opioids are under‐prescribed?
几十年如此
‐ For decades.
现在看波特和吉克的研究完全正确
Now, the Porter/Jick study is exactly right.
只要管控妥当阿片类药物也很安全
Under the proper care, opioids are totally safe.
我这两天读了您的论文
‐ I‐‐I recently read a theory of yours,
所以我才想见您
which is why I‐‐ I wanted to meet.
谢谢
DAVID: Thank you.
我猜是假性成瘾那篇
Let me guess: pseudo addiction?
没错您是如何得出
‐ Correct. How'd you come up with‐‐
您是如何发现了假性成瘾的
Where did you discover pseudo addiction?
这个吧我是在接触了一位
‐ Yeah, so I was, um, so I was, uh, was working
17岁有着典型成瘾症状的
with a 17‐year‐old leukemia patient
白血病患者时发现的
who showed classic signs of addiction.
但我们增加了他的药物剂量
And yet we upped his medication,
他也能承受
and he was fine.
结果发现他根本不是成瘾
Turns out that he wasn't addicted at all.
而是潜在的疼痛
It was that that underlying pain
没有得到妥善的治疗
hadn't been properly treated.
所以假性成瘾是说
‐ So pseudo addiction means
呃
that, uh,
成瘾症状其实是
addiction symptoms are, in actuality,
疼痛未得到妥善治疗所出现的症状
the symptoms of untreated pain?
没错
‐ That's correct.
拿走患者的药物无济于事
Yeah, taking away a patient's medication isn't helping them.
只会折磨他们
It's torturing them.
他们需要的是更多的药物治疗
What they need is more medication,
之后那些所谓的
and then these supposed
成瘾症状会很快消失
addiction symptoms will quickly go away.
这么说
‐ So‐‐
您认为所有的成瘾症状
so do you think all addiction
其实都是假性成瘾是吗
is, in actuality, pseudo addiction?
都与药物相关
‐ In relation to medication?
是的
Yes. ‐ Huh.
我观察了那些真性成瘾
DAVID: I look in those rare instances when a patient
患者的罕见案例
truly is an addict;
并不是药物或医生的错
that's not the fault of the drug or the doctor.
不由于某些遗传缺陷患者很可能一开始就是
No, the patient was most likely a drug addict to begin with
个药物成瘾者
due to genetic defects.
那如何解释烟瘾
‐ What about cigarettes?
是真性成瘾或假性成瘾
Addiction or pseudo addiction?
吸烟绝对是假性成瘾
‐ Yeah, smoking‐‐smoking is definitely pseudo addiction.
都是他们构想出的一套
It's all in their heads.
您愿来普渡制药工作吗
‐ How would you like to work for Purdue Pharma?
早啊老板
RANDY: Morning, boss.
资金还是没消息吗
RICK: Still no update on the funding?
你也早啊兰迪
‐ Well, good morning to you too, Randy.
詹妮弗和孩子们怎么样了
How's Jennifer? The kids?
抱歉早安
RICK: Sorry, good morning.
没事
‐ Nailed it.
如果这些联邦调查局的人
You know, it seems pretty darn odd
如果真的一点资源不给我们
if these FBI guys won't grant us
那就太奇怪了
a small amount of resources.
更能就像我儿子说的
‐ Could just be, as my son would say,
成了功能失调的政♥府♥
a dysfunctional government.
你儿才四岁里克
‐ Your son's four, Rick.
能说出这话不简单啊
Feeling a little inadequate right now.