世纪犯罪（2021）

要不然你可能就醒不过来了
Or you may not wake up in the morning.
几乎没一次，病人听到这个都会停下来
Almost inevitably, these patients would stop,
直勾勾的看着我说“大夫
and look me in the eye, and say, "Doc,
没事儿
that's okay.
这种痛苦我根本就不想活下去了“
I can't live with the pain I have."
他让我妻子又用回了那些药
He gets her back on all these medications,
马上的我的妻子就变了
and immediately she was dissociative.
浑浑噩噩像行尸走肉一样
She was lethargic all the time.
但是Webster医生拒绝
But Dr. Webster refused
听我们这些家属的话
to listen to the family.
我的孩子们，我自己都尝试过
My children, I tried.
后来有一天开家庭会议我们就说
We would call up and say,
必须要告诉医生我妻子
We need to get a message to Dr. Webster
现在的状态并不好
that he--that Carol is not in a good way.
在病人和其家属之间关系是
There was always some tension between the family
一直有些紧张的
and my patient,
对于我来说困难的是
and my effort to try to find a way
我很努力地想在她和
to help her with her pain
她的家人之间构建一个
within a reasonable framework
平衡合理的方案
of what her family would accept
来缓解我病人的痛苦
was a challenge.
他根本就不关心
He didn't spend really any time with her
我的妻子啥状况
on a monthly basis.
药都是他助理发的
He had PAs that were doling out medicine.
这个货根本就不关心诊所咋样
Webster wasn't minding the store.
他每天就是全国飞
He was traveling around the country,
到处去推销阿片类药物
and he was promoting the use of opioids.
这都是为了钱
It was money.
为了满足他的野心
It was ego.
当我们去构建治疗方案的时候
Whenever we're looking at providing a treatment,
我们总会下意识的考虑比较潜在风险
we're always looking at the potential risk
和潜在的伤害
versus the potential harm,
但是阿片类药物
and opioids can provide
相比潜在伤害更多的是潜在的好处
more potential benefit than the potential harm.
在距离康涅狄格州首府
10,000 miles from its headquarters
一万英里的地方
in Connecticut,
普渡制药遇到了
Purdue Pharma sought the solution
火烧眉毛的情况
to a pressing production problem.
因为公♥司♥的产品太成功
The company was so successful
鸦♥片♥都用完了
that it was running out of opium. （你们美国人了不得啊）
为了满足像无底洞一样的市场需求
To find enough supply for the soaring demand,
普渡向那个以“不辣眼”出名的公♥司♥
Purdue turned to a company famous
伸出了贪婪的小手
for its promise of "no more tears."
就在这一刻
In just this one moment,
你的孩子就像天使一样干净纯粹
your baby is getting even more than clean.
这味道，这泡泡
The scent, the lather.
就连这小小的泡泡
Even the tiny bubbles of a Johnson's bath
都将这体验提高了一档
are helping to enhance the experience.
强生公♥司♥
Johnson & Johnson,
他们把品牌打造成了那种
They have this brand
一说名字就想起来儿童沐浴露
that makes people think of baby shampoo,
爽身粉啊，还有其他的母婴产品
and talcum powder, and wholesome products.
但是实际上他们也是鸦♥片♥危机的罪恶源头之一
But they are also the kingpin in the opioid crisis.
强生不只是
Johnson & Johnson wasn't just
自己销♥售♥并且还推广
selling its own opioids and promoting them
这些阿片类产品在我们不需要的时候使用
for conditions where we shouldn't use them,
他们吹捧长♥期♥使用
promoting long-term use,
高剂量使用
high-dose use.
强生公♥司♥还为普渡
Johnson & Johnson was also supplying Purdue
以及美国其他制♥造♥阿片类药物的企业
and all of the other opioid manufacturers
提供鸦♥片♥
in the United States with the opium
这也是为什么美国
that was making it possible for the U.S.
会被毒品淹没的原因
to be flooded with opioids.
传统提取鸦♥片♥的方法是
The traditional way to extract
你在罂粟表皮上划几个口子
opium is you lance the poppy head.
然后派几个人过来
Then someone goes through the field,
往下刮这个汁儿
scraping off the opium sap.
这种需要大量的人工
And it's very labor-intensive.
但是在塔斯马尼亚，强生公♥司♥是真的牛皮
But in Tasmania, what Johnson & Johnson did
他们直接机械化作业
was to really industrialize the process,
搞了个玩意儿叫罂粟毁灭者
creating a product called concentrate of poppy straw.
原理就是在罂粟汁液
They would basically cut the whole plant
最饱满的日子口
at a certain point where it's richest
直接连根儿拔起
in the alkaloids,
然后进行加工提纯把鸦♥片♥搞出来
and then process the straw to get the opium out.
强生公♥司♥还对这种植物
Johnson & Johnson also genetically altered
进行了基因改造
the nature of the plant
培育出了超级粟
to create a super poppy, （NMD我们的超级稻救人命，你们的超级粟要人命）
这种超极粟里全是二甲基吗♥啡♥
that was surging with thebaine,
羟考酮里必不可少的一种成分
a narcotic in oxycodone.
为了加速塔斯马尼亚当地的农民
To persuade Tasmanian farmers
不种土豆种罂粟
to switch from potatoes to poppies,
强生许诺了这些农民
J&J offered luxury vacations
谁的收成最好谁就能享受
and awarded prizes-- Mercedes and BMWs--
豪华假期和种植小能手奖
to farmers
一辆全新的奔驰或者宝马
who could produce the most potent crop.
没过多久，塔斯马尼亚这七万四千英亩的地上
Soon, 74,000 acres of Tasmania were devoted
就种满了大烟
to opium.
强生公♥司♥还说服了美国政♥府♥
J&J lobbied the U.S. government
让他们的产品不受限制的进入美国市场
for unlimited access to American markets
还印了一种叫“找寻真我”的小册子来
and promoted its product in a brochure
推广他们的产品
called "Finding Relief."
在美国本土，普渡制药就利用这来自塔斯马尼亚的大烟
In the United States, Purdue used the opioids from Tasmania
制成了淹没美国的奥施康定
to flood the country with OxyContin.
但是这种药片不只是拿来止痛
But the pills weren't just for pain.
这些药从医生的手里
They were being diverted from doctors
流入了瘾君子的针管
to people looking for a heroin high.
从90年代中期开始
From the mid-'90s,
这些药代们不愿意
the company's sales reps weren't willing or able
或者说没能力去发现身边存在的药物滥用现象
to recognize the abuse that was happening all around them.
现在回忆过去仔细想想
Looking back and reflecting on it,
普渡制药的所作所为
what Purdue also did to their benefit--
说实话我觉得是某种策略
and I sincerely think it was probably a strategy--
当他们雇佣别人的时候
was when they hired people,
他们会从其他公♥司♥聘请代表
they hired representatives from other companies
这些公♥司♥不卖♥♥阿片类药物
that didn't sell opioids.
在我看来
They didn't like to have people,
他们并不想雇那些一看过去
from what I've seen, come in to their company
就能知道手底下不干净
that was preexposed to the problems
像是滥用啊这种
with abuse diversion and things like that.
你跟上我思路了吧？
You see what I'm saying?
关于成瘾这个事儿我们第一时间被灌输的是
The number one thing we were taught about addiction was,
都在手册上写着
in the package insert, it says,
延迟吸收奥施康定
Delayed absorption of OxyContin
会大大的减少成瘾的可能性
is believed to reduce the abuse potential."
我满脑子都是这句话
That sentence was pounded in.
我又把这句话灌进大夫脑子里
I pounded it in doctors' heads.
延迟吸收奥施康定
Delayed absorption of OxyContin
会大大的减少成瘾的可能性
is believed to reduce the abuse potential."
一遍一遍一遍一遍又一遍
Over and over and over and over and over.
延迟吸收奥施康定
Delayed absorption of OxyContin
会大大的减少成瘾的可能性
is believed to reduce the abuse potential."
我还会告诉他们
And I would always let them know it,
“如果没有审核过的话
you know, "Nothing gets in these package inserts
根本就不会印在手册里
that hasn't been reviewed,
特别是被药监局审查过
you know, excruciatingly by the FDA."
从奥施康定面试的
From the inception of
那一刻开始
the launch of OxyContin,
我们就告知我们的药代
we focused our salesmen's attention
重点放在那些
to physicians whose practice--