成瘾剂量（2021）

Dopesick S01E04

Part 3 Nov. 5, 2021, 11:59 a.m.

早上好同志们
‐ Good morning, guys.
- 早啊 - 怎么样
RANDY: Morning. ‐ What's up?
还是没收到医补办的消息
KAREN: Still haven't heard back from the Medicaid office,
吉克医生的办公室终于回话了
and Dr. Jick's office finally called me back and said,
说医生没空
"The doctor's unavailable."
没空今天吗
‐ Unavailable? Today?
不是她就说没空就没了
‐ Nope. She said unavailable, period.
是啊我都说了吉克医生没空
RECEPTIONIST: Yes, I told you, Dr. Jick is unavailable.
我打了很多遍电♥话♥
‐ Well, I've called multiple times,
我只想要个解释
and I'd just like an explanation
为何吉克医生拒绝回复我
as to why Dr. Jick refuses to speak to me.
他说他很忙
RECEPTIONIST: He said he's very busy,
但我会转告的谢谢
but I'll leave a message. Thank you.
这下有趣了
‐ Well, this just got interesting.
有什么新进展
JOHN: So what's the latest?
如你所知
‐ Well, as you know,
普渡制药积极宣传
Purdue aggressively pushed the drug
这种药物不会成瘾
as non‐addictive with the phrase
成瘾率不足百分之一
"less than 1% get addicted."
这个数据来自于波特和吉克的研究
That figure comes from the Porter/Jick study
由赫歇尔·吉克医生完成于
that was done by Dr. Hershel Jick at, uh...
- 波士顿波士顿大学 - 波士顿大学
‐ Boston. Boston University. RICK: Boston University.
我猜是普渡制药秘密资助的
JOHN: Well, let me guess, it's that the fraudulent study
欺诈性研究吧
that was secretly funded by Purdue?
- 就像疼痛研究似的 - 只是种说法罢了
Just like the pain study? RANDY: Well, that's one theory.
我们联♥系♥了吉克医生想与他探讨
We actually called Dr. Jick to discuss it with him,
但不尽人意
but something very interesting occurred.
他不接我们电♥话♥
He wouldn't get on the phone with us.
没有什么比不接电♥话♥
‐ Well, nothing says suspect
更让人怀疑的了
quite like an unanswered phone call.
如果成瘾率不足百分之一确实有诈
‐ If that 1% study is indeed fraudulent,
那就是彻头彻尾的犯罪
it's a home run in proving criminal misbranding.
是的如果你们能找到
‐ Yeah, and if you can find
负责监管此事的普渡高层
the high‐level Purdue exec that oversaw it...
就可以告他们欺诈
‐ Could indict them for fraud.
没错这个办法可行
‐ Yeah, that's right. It sounds like a great lead.
这个案子有得耗了
‐ Yeah, this case is starting to take up so much time.
没错
‐ That's right.
我们需要为非普渡案件的检察官
RANDY: We need more funding for prosecutors
- 提供更多资金 - 我懂我懂
for our non‐Purdue cases. JOHN: Yeah, I know, I know.
为何联调局和缉毒局
‐ I mean, why won't the FBI or the DEA
不提供我们额外的资金了
give us additional funding?
我哪知道
‐ You know, I don't know.
也许他们不想蹚浑水吧
Maybe they're not, uh, connected to the issue.
知道你该怎么做吗你该试着接触
You know what you should do, you should try
弗吉尼亚州警署
the Virginia State Police.
联♥系♥弗吉尼亚州医保欺诈组
Try Virginia Medicaid Fraud Unit.
他们会懂的我们找的机构越多
They'll get it. And you know, the more we find,
资金就越丰厚
the more it opens up those coffers.
没错但没有合适的资源
‐ Yeah, but it, it just‐‐ it is really difficult
很难有所收获
to find anything without the proper resources.
我知道我们会超预算
I mean, I knew we'd be outspent,
但我没想到
but I did not expect
我们连最基本的东西都买♥♥不起
to not have access to the most basic things,
比如高速电脑扫描器
like high‐speed computers and scanners.
同志们我理解相信我
JOHN: Look, guys, I‐‐I get it, trust me.
但我们还要加把劲好吗
But we just keep pushing, all right?
我们拭目以待吧先生
‐ Yeah. We'll see where it goes, sir.
行了好好吃午饭吧
JOHN: All right, boys. You can enjoy your lunch.
- 谢谢 - 有消息告诉我
RICK: Thank you. JOHN: Keep me posted.
- 兰迪 - 先生
Oh, Randy. ‐ Sir?
你身体怎么样
‐ Uh, how you doing, health‐wise?
我刚做完今年的体♥检♥
‐ I actually just had my one‐year scan,
我的癌症康复了
and I am cancer‐free.
- 他痊愈了 - 太好了
‐ Yeah, he's good. JOHN: That's great news.
奥施康定正成为美国
BRIDGET: OxyContin is becoming the leading cause
药物过量的主要原因
of overdose in the country.
在与毒品直接相关犯罪率激增的农村地区
Newspapers are filled with arrests in rural areas
报纸上充斥着逮捕和暴♥力♥犯罪
where crime directly related to the drug is skyrocketing.
这些犯罪问题不是
‐ Isn't Diversion and local authorities
应该由缉毒分局和地方当局来处理吗
supposed to deal with these crime issues?
没错但令执法部门更头疼的是
‐ Yes, but what makes this so overwhelming
吸毒者可以
for law enforcement is the sheer ease
轻而易举获取这种药
with which users can get access to the drug.
这种药在镇上每个药房♥可轻松获得
I mean, they are available in every pharmacy in the country.
最好的办法是什么呢
‐ What do you feel is the best approach?
解决此问题
‐ I think the most effective way
最有效的途径
to solve this problem
是限制该药品仅用于重度疼痛
is to limit the drug's use for severe pain only.
这种麻醉剂药效很强
It is a very strong narcotic that is being prescribed
却用于治疗牙痛甚至是头痛
for issues such as basic dental work and even headaches.
如果它不再被允许用于重度疼痛
If it was no longer allowed for moderate pain,
那一夜之间
then overnight,
数百万的药片就会消失
millions of pills will be off the streets.
那数百万合理疼痛却买♥♥不到药的患者
‐ What about the millions of legitimate pain patients
又该怎么办呢
that will lose access to the drug?
如果他们疼痛严重也不会求助无门
‐ If they have severe pain, they will not lose access.
但最近这种使用阿片类药物治疗中度疼痛的做法
But this recent practice of opioid use for moderate pain
引发了新一波的犯罪和成瘾令人发指
is causing a startling new wave of crime and addiction.
食药监局的职责是确保药品安全
‐ The role of the FDA is to make sure medicine is safe.
如果药品是处方药
And when this drug is taken as prescribed,
那这种药就是安全的
this medicine is safe.
我不同意
‐ And I disagree.
这些滥用和犯罪的轶事
CYNTHIA: Anecdotes about abuse and crime
并不是对药品安全性最科学的分♥析♥
are not a scientific analysis of the drug's safety.
都是瘾君子滥用药物的老生常谈
They're tales of addicts abusing pharmaceuticals,
所有阿片类药物都有这种请况
which happens with all opioids.
除非能证明药品本身风险大
So until you can prove the drug itself is dangerous,
否则没有理由限制
I don't see how we can put restrictions on it.
好
‐ Okay.
如果你不采取行动
Well, you're not gonna take action,
我要联♥系♥普渡制药直接和他们沟通了
then I will call in Purdue, discuss it with them directly.
- 那请便吧 - 我会的
‐ I think you should. ‐ I will.
你们的警告标签上说
And your warning label that this drug
这种药不易成瘾
is somehow less addictive
简直一派胡言
is total bullshit.
你们应该立刻调整
You should look into changing that immediately.
你为何要让他服用20毫克
BILLY: Why would you start him on 20 milligrams
40毫克才更有效不是吗
when 40 milligrams sounds like it's gonna be more effective?
- 泰迪 - 呦
KANE: Hey, yo, Teddy. RILEY: Yo.
所以你要喋喋不休地展开攻势
BILLY: Right, that's why you keep titrating 'em up
让他们无话可说只能说谢谢
until all there's left to say is thank you.
我弄了几张橄榄球票
I managed to scrounge up a couple of Hokies tickets
你感兴趣吗
if you're interested.
你是全国最努力的护士了
You are the hardest‐working nurse in the state.
应该好好奖励自己一趟温泉
All right, you deserve a spa weekend.
不管输赢我们都去酒吧
Listen, I think win or lose, we go to the bar.
我也这么说的
That's‐‐that's what I've been saying.
个性化的剂量就是一切
Individualizing the dose is everything.
我忙工作
BOTH: ? I work ?
我忙工作我忙工作
? I work, I work ?
我忙工作亲爱的
? I work, baby ?
我忙工作
? I work, I work ?
我要忙完工作
KANE: ? I'll get the job done ?
我忙工作
BOTH: ? I work ?
我忙工作亲爱的
? I work, baby ?
也就是说大部分的成瘾症状
DAVID: Which means that most symptoms of addiction
是未处理的疼痛所致
are, in reality, untreated pain.
解决假性成瘾的方法
And the cure for pseudo addiction
就是患者需要更多的药物
is that the patient needs more medication.