成瘾剂量（2021）

Dopesick S01E07

Part 5 Dec. 9, 2021, 10:57 a.m.

told us when he started to see problems,
最早是2000年初
at the very earliest was the beginning was 2000.
普渡制药是在2000年4月上旬...
It was in early April of 2000 that Purdue was--
我们是直到2000年3月才知道有滥用的情况
We didn't learn of the abuse until March of 2000.
保罗·戈登海姆
普渡制药首席医疗官
也就是说普渡制药的三大高层
So we have Purdue's top three executives
都在国会面前发过誓
all proclaiming to Congress under oath
说他们直到2000年才知道有药物滥用的情况
that they didn't know the drug was being abused until 2000,
直到杰·麦克洛斯基当时的缅因州检察官
when US Attorney from Maine, Jay McClosky--
现在在普渡制药任职
Who now works for Purdue.
告诉他们的药品滥用的情况
informs them that it's being abused.
好的明白了就是说2000年是他们的官方口径
Okay, got it, so the year 2000 is their official marker?
-是的 -这又怎样呢
- Yeah. - So what?
我的天呐
Oh, my good God.
里克·曼卡索是在笑吗肯定是好消息
Is Rick Mountcastle smiling? This ought to be good.
我们有多篇新闻报道
So we got numerous newspaper articles
还有寄给这几个人的邮件
and emails sent to these exact guys
可以证明他们早在1997年就知道药品滥用的情况
that shows that they were informed of abuse as early as 1997.
和他们在国会上做的证词相反
Contradicting their congressional testimony.
我们可以起诉普渡制药的三大高层
We can charge Purdue's top three executives
向国会说谎并且合谋欺诈
with lying to Congress and conspiracy to defraud.
好吧
Okay.
我们去起诉这群混♥蛋♥吧
Let's indict these assholes.
在我看来他们会因为要坐牢
My gut is they're going to be so scared shitless
而吓得面如土色
of going to prison--
他们可能会出♥卖♥♥♥赛克勒家族的人
They just might flip on the Sacklers.
我想也是
Think they just might.
恭喜兄弟们你们的案子立住了
Well, congratulations, boys. You just made your case.
药监局
我让你们过来是因为有大量有关
I asked you here because there have been rampant tales
全国范围内药品滥用和倒卖♥♥的传言
of abuse and diversion across the country.
药监局认为是时候介入了
The FDA feels it's time to intervene.
我们知道确有药物倒卖♥♥的情况
We understand there's been some diversion,
但换掉我们的警示标签的惩罚过重了
but changing our warning label is overly punitive.
问题不是药
It's not the drug that's the problem,
问题是滥用药物的瘾君子
it's--it's the addicts who are abusing it.
辛西娅单把我们拉出来承担此事责任不公平
And, Cynthia, it is not fair to single us out on this issue.
远藤杨森泰华制药都在卖♥♥阿片类药物
Endo, Jansen, Teva are all selling opioids.
你们没有换掉他们的警示标签
You're not changing their warning labels.
那是因为他们的药代表不会让医生
That's because their sales reps aren't telling doctors
做智齿手术或是为头疼
to prescribe a dangerous narcotic
开有危险性的麻醉剂
for wisdom teeth surgery, or headaches.
或许除了换掉标签
Perhaps there are other actions to be taken
这么严厉的措施外还有别的选择
besides something as drastic as a label change.
我们愿意做出些让步
There are concessions we're willing to make.
比方说
Like what?
首先我们会把160毫克的药片下市
For starters, we'll be taking the 160 off the market.
-我想你们肯定得这么做 -没错
- I think you absolutely should. - Right.
但这不能改变我们在警示标签上的立场
But that won't shift our position on the warning label.
标签肯定要换
It will be changed.
药监局对上市药物采取的最严重警告
出现在说明书最前端
警告医生和患者药物的潜在重大安全性
我们在认真考虑给你们黑框警告
We're seriously considering giving you the black box warning.
他们打算干什么
They what?
他们或许会给新标签上加黑框警告
They might add a black box warning to the new label.
这是除了召回外最糟糕的情况
That's the worst thing that could happen except for a recall.
我知道好吗爸爸我知道
I know, I know, Dad. Okay? I know.
你终于马失前蹄了
Well, you finally did it.
你飞得离太阳太近了
You flew too close to the sun.
是啊我猜你现在肯定很高兴
Yeah. I bet you're happy now.
你说什么
Excuse me?
这肯定不好受
Oh, it must've been difficult,
看你儿子比你更加成功
see your son more successful than you ever were.
你是因为亚瑟才有了这家公♥司♥
You only had this company because of Arthur.
这个家族里所有人
Everything anyone has
拥有的所有东西都是拜亚瑟所赐
in this family is because of Arthur.
都是他的智慧换来的
It all came from his brain.
你唯一能做的就是卖♥♥必妥碘
And all you could ever do is sell Betadine.
然后我终于做了件大事我
Then I finally did something. Me.
比你和亚瑟所能想象的更伟大
And it was bigger than anything you or Arthur ever dreamed of.
是吗但你似乎忘了你和亚瑟之间
Oh, but you seem to be missing a key difference
最大的不同之处
between you and Arthur.
是什么
What's that?
他绝不会得到黑框警告的惩罚
He never would've gotten a black box warning.
赛克勒博士
Dr. Sackler,
《美国医学协会》杂♥志♥
the "Journal of the American Medical Association"
认为你谎报事实
thought you misstated the facts
过度夸大药品的药效
by overstating the effectiveness of the drug
对其副作用却轻描淡写
and understating the side effects.
你遵照他们的要求
You complied with their request
修改了广♥告♥的内容
by making edits on the advertisement
才得以让广♥告♥审批通过
which then got the ad approved,
接着你却在其他杂♥志♥里刊登了
but then you went on and printed the original ad
原先带有扭曲事实的广♥告♥
with the misstated facts in other journals.
议员《内科医学年鉴》
Senator, the "Annals of Internal Medicine,"
拥有杰出的成员接受了这些观点
with an eminent board, accepted these opinions.
《美国医学协会》杂♥志♥
"The Journal of the American Medical Association,"
同样拥有杰出的成员没有接受这些观点
with an equally prominent board, did not accept them.
因此我们面对的问题
Therefore, what we were dealing with here
只是不同观点而不是扭曲事实
was a difference of opinion, not a misstatement of facts.
或许...
Perhaps...
这能为我们创造一个潜在的机会
this could potentially create an opportunity for us.
何不问问看标签是否能写
Why not ask if the label could say
该药品可以长♥期♥使用
the drug can be used for an extended period of time?
你真的觉得药监局会同意吗
You really think the FDA would allow that?
别逗了
Come on.
我担心他们会撤掉所有
I'm worried that they're going to pull all the language
关于药品不易上瘾的字眼
about the drug being less addictive.
是啊我也担心
Yeah, I am too.
争取保留"不易上瘾"的措辞非常关键
Fighting to keep "less addictive" is crucial,
但我们得做出些牺牲来达到这一目标
but we need to give a little to do it.
现在标签上写的是"不易上瘾"
Right now, the label says "addiction is rare,"
或者我们可以提议改为"据悉药品不易上瘾"
so maybe we offer, "addiction is reported to be rare."
这主意不错
That's not bad.
我们需要保留能给中度疼痛开药的权利
We need to be able to keep prescribing for moderate pain.
那"长♥期♥使用"呢
What about "extended period of time"?
这能把整个不利形势逆转为
That could turn this whole fiasco
对销♥售♥更有利的局面因为
into a financial win because
病患们可以在更长的时间内服用它
patients will be on it for longer periods.
也许终身服用
Perhaps indefinitely.
我只是觉得这对药监局来说不太现实
I just think it'll be a bridge too far for the FDA.
但很可能他们并不能意识到
But it's possible they won't be aware
给我们通过的是什么权利
of exactly what they'd be giving us.
如果他们要给我们加上黑框警告
And if they're going to slap us with a black box warning,
至少得给我们点好处
they should at least give us something.
喂
Hello?
喂贝琪我是塞缪·芬尼克斯
Hey, Bets, this is Sam Finnix.
我以为你死了
I thought you were dead.
不没有我还在和这药作斗争
No, no. I'm still fighting this thing.
我也是
Me, too.
贝琪
Bets...
我很抱歉为你开了这个药
I'm so sorry I ever prescribed that drug for you.
我要是知道会伤害你的话绝不会给你开
I never would've done it if I thought it would hurt you.
我向你保证我真的不知道
I promise you I didn't know.
你当然不知道
Of course you didn't.
那家公♥司♥骗了所有人
That company's been lying to everybody.
听我说我要告诉你我给你打电♥话♥的原因
Listen, I'm going to tell you why I called you.
我一直在琼斯维尔看一个医生
I've been seeing this doctor in a clinic in Jonesville.
他...他在我身上尝试的新药
He's--he's started me on this new drug
对我起了作用
that, uh, has helped me.
我的药瘾减轻了很多
I mean, my cravings are way, way down.
是什么药