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如果诈骗的标准太高 If fraud was too high a bar,
你们会怎么起诉 what would you charge him with?
我会起诉他们违法贴假标签 I'd charge them with criminal misbranding.
准许调阅与营销 研究和分销相关的 Permission granted to release requested documents
翻 译 EnsamK
文件的请求 relating to marketing and distribution.
校 对 草草 苏葵
他们要拿文件淹死我们 They're drowning us in paperwork.
我要给你升职 I'm promoting you.
时间轴 树
我要你去管控部做副主任 I'd like you to be deputy director of the Diversion Division.
我接受 I accept.
父母能听到的最糟的消息 The worst thing that a -- a parent could hear
后 期 MythCreator
就是我们的孩子是酷儿 is that her kid is, you know, queer.
如果你是会要了我的命 贝琪 It'd kill me if you were, Bets.
总 监 苏葵
那你是死了 I guess you're dead, then.
你知不知道那人可能会因你而死 Do you realize that men might be dead 'cause of you?
我不知道我是怎么了 I don't understand what's happening to me.
如果能在德国通过 If we get Germany uncontrolled,
它也会为我们打开整个欧洲的大门 it will serve as a gateway to the rest of Europe.
拜托告诉我几周后我们会在奥兰多见面 Please tell me I'm gonna see you in Orlando in a few weeks.
我其实就是为这事打来 That's why I'm calling. I was --
20毫克的奥施康定 20 milligrams of OxyContin.
一年后
-到手了 -你好 伙计 - Got it. - Hey, dude.
-你还好吗 -你吃多少 - Hi, how are you doing? - What's your in on?
-80毫克 -牛逼 - 80. - Bam.
-我操 -真好啊 - Oh, fuck. - Yeah.
庆祝一下吧 Cheers to that.
你干嘛 Hey, hey, what you doing, man?
我要吃药啊 I was just gonna pop it.
不 兄弟 你要用鼻子吸 No, man. You gotta snort 'em.
来 我示范给你看 Here, I'll show you.
你他妈有什么毛病 What the fuck's your problem?
伊丽莎白·安 你来不来 Elizabeth Ann, are you in?
这样上头更快 It hits way faster.
-你确定吗 兄弟 -信我 没问题 - Are you sure, man? - Trust me, yeah.
因为我们之前也是像你们那样嗑的 'Cause, we've popped them normal before.
普渡制药有没有说过很容易去掉 Did Purdue say it was easy for someone to bypass
奥施康定上的缓释层 the time-release coating on an OxyContin pill?
没有 普渡制药声称 No, Purdue claimed the coating
缓释层很难去掉 因此 was difficult to get around, and therefore,
瘾君子们不爱用奥施康定 OxyContin would be unappealing to abusers.
缓释层难溶解吗 Was the coating difficult to dissolve?
不 很容易溶解 No, it was very easy.
只要用唾液就能溶解它 All you had to do is dissolve it in saliva
然后刮掉涂层就行 and then scrape it off.
然后瘾君子们就能立刻体会到 And then the abuser would have immediate access
十二个小时的药效 to the full 12-hour supply.
他们会碾碎药片 用鼻子吸入 They just crush it off then snort it.
-爽死了 -开始吧 - Yeah! - Oh, here we go!
-天哪 -我操 - Holy shit. - Fuck yeah.
我觉得我上头了 I think I'm getting a chubby.
伊丽莎白·安在哪 Where's, uh, where's Elizabeth Ann?
伊丽莎白·安 Elizabeth Ann?
你干嘛呢 What the fuck you doing?
滚过来啊 Get your ass over here.
没事的 别担心 Hey, it's good. Don't worry.
来 你是下一个 Go, you're up next.
第一次永远最爽 First time is the best time.
好样子 Yeah!
这就对了 Yeah!
我操 Oh, shit.
我是下一个吧 All right, I'm up next, right?
还没到你呢 Yeah, you got to see...
天哪 天哪 Oh, my God. Oh, my God.
你别死啊 莱德 Don't you fucking die, Ryder!
你会没事的 别担心 You're gonna be all right, don't worry about it.
我们带他去他妈妈家吧 Let's take him to his mom's house.
我们不能带他去他妈妈家 We can't go to his mom's house!
你就不能带他去医院吗 Can we take him to a fucking hospital?
也不能去医院 We can't take him to a hospital.
把他抬出来 Get him out of there.
我们该怎么办 What should we do?
约翰 别死 求你了 Oh, John, don't die, please.
-他妈的 -求你了 - Fuck, come on. - Please.
-什么情况 -他们没有冰块 - What the fuck is that? - They didn't have any ice.
-这是鱼吗 -冻鱼 能让他醒来 - Is that a fish? - It's frozen. It'll wake him up.
-醒醒 -为什么 - Wake up. - Why?
快醒啊 Wake the fuck up.
他妈的 Fuck!
我们走吧 Let's get out of here.
不 等等 我们不能丢下他 No, wait, we can't leave him here!
-快点 -我们不能丢下他 - Come on! - We can't leave him!
伊丽莎白·安 Elizabeth Ann!
快点 Come on!
为未来加油
给你 Here.
这算什么 都是10毫克的 What the fuck is this? These are fucking 10s.
急诊室医生盯上我了 ER doctor was on to me.
只给我四天的量 Only gave me four days' worth.
我操 怎么回事 God damn it. What the fuck?
-我明天会难受死的 -对啊 我不难受吗 - I'ma be really sick tomorrow. - Yeah, and I'm not?
你才是毒贩 为什么要我去搞药 You're the fucking drug dealer! Why is this on me?
去佛罗里达怎么样 And what about Florida?
我们可以去找个疼痛诊所 We can hit one of the pain clinics.
太远了 我们会被开除的 That's too far. We'll get fired.
是啊 但我们别无选择了 Yeah, well, we got nowhere else to go
因为这里所有的急诊室都盯上你了 'cause you keep burning up all the God damned ERs.
我不擅长这个 他们不信我 I'm not good at this. They don't believe me.
所以我们才要去佛罗里达 好吗 That's why it's gotta be Florida, okay?
那边的人才不管 They don't care down there.
无论我们要什么 他们都会给 We can get whatever the fuck we want.
我不能走 I can't go.
好啊 那就滚 All right, then get the fuck out.
-什么 -我说过了 给我滚 - What? - I said, get the fuck out!
天哪 沃尔特 Jesus Christ, Walt.
操 Fuck!
这里呢 How about right here?
-疼得更厉害了 -好的 - Oh, yeah. It's--it's--it's getting worse. - Yeah.
要是没有药我都起不了床 Can't even wake up without a pill anymore.
所以你现在一天吃两次吗 Yeah. You're taking them twice a day?
是啊 可那能有什么用 Yeah, but where does that help?
嗯 你不吃药也疼 Okay, you're having pain even when you don't take it.
-确实 但我不想继续吃药了 -好吧 - Oh, 100%. But I want off of this stuff. - Yeah.
我每天要不就昏昏沉沉 I'm--I'm either falling asleep all day
或是满脑子想着下次吃药 or thinking about the next pill.
嗯 好吧 Mm-hmm, okay.
好吧 我把你的药量减少些 伙计 Well, we're just gonna taper you off there, buddy.
我们试过了 We--we tried that.
我知道 再试一次 Yeah, I know, we're trying again.
我会把你的药量从80毫克变成40毫克 好吗 I'm gonna lower your dose from 80 milligrams down to 40, okay?
如果你有任何戒断症状 And if you're experiencing any withdrawal symptoms,
我再给你开佳乐定[抗焦虑药] 好吗 I'll cut that with some Xanax, okay?
我们能成功 We'll get this right.
你现在还剩多少药 How many pills do you have left in that bottle?
几片吧 A few. A few here.
把瓶子放在桌上 Okay, just leave the bottle on the table there,
我们会减少你的药量 伙计 and, uh, we'll lower your dose here, buddy.
好的 All right.
你会好起来的 好吗 We'll get you feeling better, okay?
会没事的 It'll be all right.
谢谢 医生 Thanks, doc.
成瘾剂量
第一季 第四集
我们荣幸地在此庆祝 We are so proud to be honoring
我的大哥 亚瑟·赛克勒 my great brother, Arthur Sackler,
进入医疗广告名人堂 into the Medical Advertising Hall of Fame.
从很多方面来说 亚瑟·赛克勒发明了医疗广告 In many ways, Arthur Sackler invented medical advertising.
他首先意识到 He was the first to realize
病人不能决定吃什么药 it wasn't patients who decided what drugs they took.
医疗广告名人堂
而是医生决定 It was their doctors.
他曾因为是犹太人而被广告界拒之门外 Shunned by Madison Avenue for being Jewish,
他创立了自己的公司 专门针对 he formed his own company specifically targeting doctors
在科学期刊发表论文 with articles from scientific journals
和在医学学会进行研究的医生 and studies from medical societies.
当然 有时这些学会 Sure, sometimes the societies
和专家也是亚瑟资助的 and the experts were financed by Arthur.
你觉得谁更混蛋 Who do you think is the bigger asshole?
摩迪莫叔叔还是亚瑟叔叔 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药物的营销方式 Not only changed the way medicine is marketed in this country;
还永远改变了医药行业 it changed the medical industry forever.
你叔叔很厉害 Your uncle was good.
就他那代人来说 For his time.
这块板上没记录 This one's missing the zombies
那些吃了安定变成僵尸的病人 that valium turned some patients into.
-他逃过一劫 -勉强算吧 - He got away with it. - Barely.
但这让他发财了 But it made him rich.
贝丝 亲爱的 你能回避一下吗 Beth, darling, would you give us a few minutes, please?
-当然 -谢谢你 - Sure. - Thank you.
你非得这样做 是吗 You had to do it, didn't you?
做什么 Do what?
你非得宣称这药不成瘾 You had to say it was non-addictive.
-爸 就连药监局... -别提了 - Dad, even the FDA-- - Oh, please.
已经有推销记录反映 Call notes are starting to come in
病人有成瘾迹象 that patients are showing signs of addiction.
只是西弗吉尼亚州的几个地区而已 Just a few pockets of West Virginia.
文化因素罢了 It's cultural.
那些乡下人就是容易上瘾 All those hillbillies do is get addicted.
还有缅因和肯塔基 所有一期项目的地区 And Maine and Kentucky. All our phase one states.
如果被证实多于1%的人上瘾 If it becomes accepted that more than 1%
我们就完蛋了 become addicted, it's dead.
就算一年销售额爆满 And one year of strong sales
也弥补不了你投入的四千万美元 isn't gonna make up for the 40 million you spent.
你有建议吗 Any suggestions?
跟亚瑟叔叔好好学吧 Take a page from Arthur's playbook.
找个专家 告诉医生们 Get an expert who'll tell doctors
我们神药的真相 the truth of our wonder drug.
我们有罗素·博诺伊 We've got Russell Portenoy.
不行 我们要更强势的人 No, I'm thinking someone more aggressive,
尤其是你这个1%的说法 especially if your 1% claim is, um, hmm.
用医学术语来说 What's that medical term?
纯属放屁 Fucking bullshit.
好吧 Fine.
我们找个强势的专家 We'll find an aggressive expert.
骨关节炎真是让人生不如死 No, the--the osteoarthritis was truly debilitating,
什么药都不管用 后来我才发现 and nothing seemed to work until I realized
病人需要的是能够治疗 that the patient needed something strong enough
爆发性疼痛的强力药物 to stop the breakthrough pain.
所以我开始给病人用美沙酮 So I started the patient on methadone,
她几天内就恢复正常 and she was back to normal within just a few days.
美沙酮 Methadone?
你说过找个强势专家 You said find me aggressive.
他有个理论叫假性成瘾 He has a theory called pseudo addiction,
也就是说实际上不存在成瘾 which basically means addiction doesn't exist.
这家伙是谁 Who is this guy?
大卫·哈多克斯 David Haddox.
他上的牙医学院 He went to dental school
但是现在是埃默里大学的疼痛管理部门负责人 but now heads the Pain Management Department at Emory.
专业对口 A--a fitting progression.
你想见见他吗 You wanna meet with him?
当然 God, yes.
你真的觉得阿片类药物没开够剂量吗 So you really feel opioids are under-prescribed?
几十年都是 For decades.
声称成瘾性低于1%的常用销售术语 实际上根本不存在该研究
波特和吉克研究完全正确 Now, the Porter/Jick study is exactly right.
只要谨慎使用 阿片类药物完全安全 Under the proper care, opioids are totally safe.
我最近看到过你的理论 I--I recently read a theory of yours,
所以我才想见你 which is why I-- I wanted to meet.
谢谢 Thank you.
我来猜猜 是假性成瘾那篇吧 Let me guess: pseudo addiction?
没错 你是怎么得出 Correct. How'd you come up with--
你是怎么发现假性成瘾的 Where did you discover pseudo addiction?
我在给一个 Yeah, so I was, um, so I was, uh, was working
17岁的白血病患者治疗 with a 17-year-old leukemia patient
患者呈现出典型的上瘾症状 who showed classic signs of addiction.
我们加大了药量 And yet we upped his medication,
但他没出事 and he was fine.
结果我发现他根本没有上瘾 Turns out that he wasn't addicted at all.
只是潜在的疼痛 It was that that underlying pain
没有得到适当的治疗 hadn't been properly treated.
所以假性成瘾就是 So pseudo addiction means
成瘾症状实际上是 that, uh, addiction symptoms are, in actuality,
-疼痛没有得到适当治疗出现的症状 -没错 - the symptoms of untreated pain? - That's correct.
拿走病人的药物无法帮到他们 Yeah, taking away a patient's medication isn't helping them.
而是折磨他们 It's torturing them.
他们需要的是加大剂量 What they need is more medication,
然后这些所谓的 and then these supposed
成瘾症状很快就会消失 addiction symptoms will quickly go away.
这么说 So--
你认为所有的成瘾症状 so do you think all addiction
都是假性成瘾吗 is, in actuality, pseudo addiction?
与药物有关的成瘾吗 In relation to medication?
当然 Yes.
我观察了那些病人真的成瘾的 I look in those rare instances when a patient
罕见案例 truly is an addict;
那不是药物或医生的错 that's not the fault of the drug or the doctor.
而是因为某些基因缺陷 No, the patient was most likely a drug addict to begin with
患者生来就是瘾君子 due to genetic defects.
烟瘾呢 What about cigarettes?
是真性成瘾还是假性成瘾 Addiction or pseudo addiction?
烟瘾当然是假性成瘾 Yeah, smoking--smoking is definitely pseudo addiction.
都是人们想象出来的 It's all in their heads.
你想来普渡制药工作吗 How would you like to work for Purdue Pharma?
早上好 老板 Morning, boss.
资金还是没进展吗 Still no update on the funding?
早上好 兰迪 Well, good morning to you too, Randy.
珍妮弗怎么样 孩子们呢 How's Jennifer? The kids?
抱歉 早上好 Sorry, good morning.
没事 Nailed it.
如果联邦调查局的家伙 You know, it seems pretty darn odd
一点资源都不给我们 if these FBI guys won't grant us
那就太奇怪了 a small amount of resources.
可能就像我儿子说的 Could just be, as my son would say,
功能失调的政府 a dysfunctional government.
你儿子才4岁 里克 Your son's four, Rick.
我感觉自己太才疏学浅了 Feeling a little inadequate right now.
大家早上好 Good morning, guys.
-早啊 -怎么样 - Morning. - What's up?
医疗补助办公室还是没消息 Still haven't heard back from the Medicaid office,
吉克医生的办公室终于回消息说 and Dr. Jick's office finally called me back and said,
"医生没空" "The doctor's unavailable."
没空 今天吗 Unavailable? Today?
不是 她就说没空 Nope. She said unavailable, period.
对 我跟你说过 吉克医生没空 Yes, I told you, Dr. Jick is unavailable.
我打了好几次电话了 Well, I've called multiple times,
我需要一个解释 and I'd just like an explanation
为什么吉克医生拒绝回复我 as to why Dr. Jick refuses to speak to me.
他说他很忙 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.
最近有什么消息 So what's the latest?
你也知道的 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
声称"不到1%的人会上瘾" "Less than 1% get addicted."
这个数据来自波特和吉克研究 That figure comes from the Porter/Jick study
由赫谢尔·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. - Boston University.
我猜是普渡制药 Well, let me guess, it's that the fraudulent study
暗中资助的欺诈研究吧 that was secretly funded by Purdue?
-就像那个疼痛研究吗 -可能是这样 - Just like the pain study? - Well, that's one theory.
我们其实联系了吉克医生 想跟他探讨 We actually called Dr. Jick to discuss it with him,
但有趣的事情发生了 but something very interesting occurred.
他不愿意接我们的电话 He wouldn't get on the phone with us.
没有什么比不接电话 Well, nothing says suspect
更让人起疑的了 quite like an unanswered phone call.
如果那1%成瘾性的研究确实是造假 If that 1% study is indeed fraudulent,
那就坐实了违法贴假标签的罪名 it's a home run in proving criminal misbranding.
是啊 如果你能找到 Yeah, and if you can find
负责监管的普渡制药高层 the high-level Purdue exec that oversaw it...
就能起诉他们欺诈 Could indict them for fraud.
对 没错 听上去是个很好的线索 Yeah, that's right. It sounds like a great lead.
是啊 这个案子占据了很多时间 Yeah, this case is starting to take up so much time.
-没错 -我们需要为非普渡案件的检察官 - That's right. - We need more funding for prosecutors
-提供更多资金 -对 我明白 - for our non-Purdue cases. - Yeah, I know, I know.
为什么联邦调查局和缉毒署 I mean, why won't the FBI or the DEA
不给我们额外的资金 give us additional funding?
我不知道 You know, I don't know.
可能他们跟这事无关吧 Maybe they're not, uh, connected to the issue.
你知道你们该怎么办吗 You know what you should do,
去联系弗吉尼亚州警署 you should try the Virginia State Police.
弗吉尼亚医保欺诈组 Try Virginia Medicaid Fraud Unit.
他们会懂 我们找的人越多 They'll get it. And you know, the more we find,
资金就越多 the more it opens up those coffers.
是啊 但是没有足够的资源 Yeah, but it, it just-- it is really difficult
很难有收获 to find anything without the proper resources.
我知道我们会超支 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,
比如高性能的电脑和扫描仪 like high-speed computers and scanners.
各位 我了解 相信我 Look, guys, I--I get it, trust me.
但我们还是得继续努力 好吗 But we just keep pushing, all right?
好 我们拭目以待 先生 Yeah. We'll see where it goes, sir.
好了 男士们 去吃午餐吧 All right, boys. You can enjoy your lunch.
-谢谢 -有消息随时提醒我 - Thank you. - Keep me posted.
-兰迪 -先生 - Oh, Randy. - Sir?
你身体状况怎么样 Uh, how you doing, health-wise?
其实我刚做完今年的体检 I actually just had my one-year scan,
我没有癌症 and I am cancer-free.
-那太好了 -真是好消息 - Yeah, he's good. - That's great news.
奥施康定正在成为美国 OxyContin is becoming the leading cause
药监局
滥用药物的主要原因 of overdose in the country.
偏远地区的报纸上全是 Newspapers are filled with arrests in rural areas
与该药直接相关的犯罪率激增报道 where crime directly related to the drug is skyrocketing.
这些犯罪事件不应该是 Isn't Diversion and local authorities
管控部和地方政府来处理吗 supposed to deal with these crime issues?
没错 但是令执法部门头疼的是 Yes, but what makes this so overwhelming
吸毒者可以 for law enforcement is the sheer ease
轻松地获得药物 with which users can get access to the drug.
国内的每家药店都有 I mean, they are available in every pharmacy in the country.
你觉得最好的办法是什么 What do you feel is the best approach?
我认为解决这个问题最有效的办法 I think the most effective way to solve this problem
是将药物限制为极度疼痛才能使用 is to limit the drug's use for severe pain only.
这是一种强麻醉剂 却用来治疗 It is a very strong narcotic that is being prescribed
牙疼甚至是头疼 for issues such as basic dental work and even headaches.
如果限制其在中度疼痛的使用 If it was no longer allowed for moderate pain,
那一夜之间 then overnight,
上百万药片就会从街头消失 millions of pills will be off the streets.
那数百万真正疼痛的患者呢 What about the millions of legitimate pain patients
他们买不到药怎么办 that will lose access to the drug?
如果他们有严重疼痛 也不会买不到药 If they have severe pain, they will not lose access.
但最近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
正在引发令人吃惊的新一轮犯罪和药物成瘾 is causing a startling new wave of crime and addiction.
药监局的作用是确保药物安全 The role of the FDA is to make sure medicine is safe.
这种药物按医嘱服用时 And when this drug is taken as prescribed,
就是安全的 this medicine is safe.
我不同意 And I disagree.
这些滥用和犯罪的传闻 Anecdotes about abuse and crime
并不是药物安全性的科学分析 are not a scientific analysis of the drug's safety.
这是瘾君子滥用药物的说辞 They're tales of addicts abusing pharmaceuticals,
所有阿片类药物都会这样 which happens with all opioids.
除非你证明药物本身是危险的 So until you can prove the drug itself is dangerous,
我认为没必要限制使用 I don't see how we can put restrictions on it.
好吧 Okay.
如果你不采取行动 Well, you're not gonna take action,
那我就去找普渡制药 直接和他们谈 then I will call in Purdue, discuss it with them directly.
-你请便 -我会的 - I think you should. - I will.
你们关于这个药物 And your warning label that this drug
弱成瘾性的警告标签 is somehow less addictive
完全是胡扯 is total bullshit.
你们应该立刻考虑换掉 You should look into changing that immediately.
为什么要从20毫克的量开起 Why would you start him on 20 milligrams
40毫克明明更有效 when 40 milligrams sounds like it's gonna be more effective?
泰迪 Hey, yo, Teddy.
所以你不停地给他们加剂量 Right, that's why you keep titrating 'em up
他们只能跟你说谢谢 until all there's left to say is thank you.
我搞到了几张弗工大霍奇橄榄球队的票 I managed to scrounge up a couple of Hokies tickets
你感兴趣吗 if you're interested.
你是整个州最努力的护士 You are the hardest-working nurse in the state.
你应该享受一个水疗周末 All right, you deserve a spa weekend.
无论输赢 我们都去酒吧 Listen, I think win or lose, we go to the bar.
我一直这么说 That's--that's what I've been saying.
个性化的剂量是一切 Individualizing the dose is everything.
塞缪尔·芬尼克斯
这意味着大多数上瘾的症状 Which means that most symptoms of addiction
实际上都是未治疗的疼痛 are, in reality, untreated pain.
治疗假性成瘾的方法 And the cure for pseudo addiction
是加大患者的药量 is that the patient needs more medication.
超过十万的内科医生 More than 100,000 physicians,
全国大约一半的医生 almost half of all doctors in the country
都会收到假性成瘾的小册子 will be sent pseudo addiction pamphlets.
假性成瘾说明书
如果哪位医生的患者有成瘾迹象 Give one to any doctor if their patients
那就给他们小册子 抱歉 是假性成瘾迹象 show signs of addict-- sorry, pseudo addiction.
有问题吗 请讲 Questions? Yes.
上周有个医生告诉我他的两个患者 Last week, I had a doctor tell me he had two patients
服用了多于处方量的药 taking way more pills than he prescribed.
他很担心 Like, he was very worried
他们已对药物上瘾 they were addicted to the medication.
不 听上去是 No, no, no, no, it sounds like
你的那位医生药开少了 your physician's actually under prescribing.
不 他没有 No, he's not.
他们已经每天服用80毫克了 They're already taking 80 milligrams a day.
如果我说他们其实是假性成瘾 Look, if I tell them that they're pseudo addicted
应该加到160毫克 and need to be bumped up to 160 milligrams,
他会把我揍出办公室的 he'll just kick me out of his office.
这是失败者的态度 Now that is a defeatist attitude.
哈多克斯医生带来了全新的理念 Dr. Haddox is giving us innovative concepts,
我们应当尊重和欣赏他的专业知识 and he deserves respect and appreciation for his expertise.
女士 如果人们生活在不必要的痛苦中 Uh, ma'am, if people are living with unnecessary pain,
解决方案就在眼前 and they're being stigmatized
他们却要被非议 when the solution is right in front of them--
如果人们在受苦 那就要加大药量 if people are suffering, they need a higher dose.
你好 我是桑德拉 Hey, I'm Sandra.
你好 我是比利 Hey. Billy.
那么你负责哪些地区 So, um, which territories do you cover?
弗吉尼亚 主要是阿帕拉契亚 Virginia. Appalachia mostly.
你真幸运 Wow, lucky you.
失陪 宝拉 Excuse me. Paula.
你现在要去入住酒店吗 Hey, are you, uh, checking into the hotel right now?
不 我要回家 他们把我辞了 No, I'm going home. They just fired me.
什么 认真的吗 为什么 What? Are you serious? Why?
他们说我的文书前后矛盾 They said I had inconsistent paperwork.
天哪 真遗憾 Oh, my God. Um, I'm sorry.
没事 Don't be.
我其实松了口气 No, I'm relieved actually.
他们都知道 They all know.
你也知道 And you know.
知道什么 Uh, know what?
好吧 比利 Okay, Billy.
个性化剂量 Individualize the dose.
不像别的药 As opposed to other drugs,
阿片类药物很难戒断 opioids are uniquely challenging to stop using
因为它们会改变人的脑部化学物质 because they can change a person's brain chemistry.
但有人急于摆脱依赖性 But in a desperate effort to end the cycle of dependency,
想一下子彻底戒掉 some people try to quit cold turkey,
结果通常是灾难 but the results can often be disastrous.
芬奇溪诊所
绣球花 你怎么知道我喜欢 A hydrangea? How'd you know?
我自有办法 Oh, you know, I have my ways.
我能见见医生吗 Can I, uh, can I see the doc?
比利 你知道他不想再见你 Billy, you know he doesn't wanna see you anymore.
这其中一定是有误会 Come on, there's gotta be a misunderstanding here.
好几个月了 It's been months.
我想他了 And I--you know, I miss him.
他取消了今天的所有预约 Well, he cleared his appointments today
因为他感觉不舒服 'cause he's not feeling well.
就说你进来时我在厕所 I was in the bathroom when you walked in.
谢谢 丽雅 Thank you, Leah.
你最喜欢的药代表来了 It's your favorite pharma rep.
医生 你还好吗 Doc, are you okay?
好极了 Never better.
我只是 Hi, I just, uh,
想看看你怎么样 wanted to see how you're doing and, uh,
看看你的病人怎么样 see how you're patients are.
好久不见了 It's been a while.
-坐吧 -好 - Have a seat. - Sure.
我来问问你 比利 Let me ask you something, Bill.
你有没有想过 Do you ever think that, um,
你们卖的神药 maybe that miracle drug you're selling,
它有点 it's just, you know,
比你说的更容易上瘾 just a tad more addictive than you said?
我们收到的反馈可不是这样 Uh, that's not what we're hearing.
但有种症状和这个相关 But there is a condition associated with this,
我这里有些信息 um, which I--I--I have some information on.
我可以给你看看 I can share it with you.
假性成瘾 Pseudo addiction.
我们见到了一些罕见的案例 We're seeing some cases, although rare,
患者呈现出上瘾的症状 where they show the symptoms of addiction,
但实际上他们是因为潜在的痛苦 but in reality, their underlying pain
没有得到充分的治疗 hasn't been sufficiently addressed.
解决办法很简单 And--and the solution is simple.
加大药量 他们的症状 You know, you--you up the dose, and--and their symptoms,
就会很快消失 you know, disappear, and-- in time.
我们来看看 Let's have a look.
你在卖毒药 比利 You sell poison, Billy.
-什么 -这上面说的就这意思 - What's that? - That's all it says.
你在卖毒药 你干的就是这个 You sell poison. That's what you do.
这就是毒药 That's just poison.
不 医生 我 No, doc, I--
就是这样 Yeah, well, it's what it is.
对 就是毒药 Yeah, it's poison.
我可以跟你解释清楚 医生 I can talk you through it, doc.
这是新概念 上面都有 It's a new concept. It's all in here.
不 我的病人都是勤奋工作的好人 No, no, these are good, hard-working people.
勤奋工作的好人 These are good, hard-working people,
你们还让药监局贴标签 and you have the FDA label this--
医生 这里面有任何你不理解的 Doc, anything in here that you don't understand,
我都能解释 I can talk you through.
-好吧 -滚吧 - All right. Okay. - Get out.
-滚吧 -好吧 - Get out. - All right.
不要啊 No!
滚吧 Get away.
滚远点 别再来了 You need to get going. Don't ever come back.
-医生 医生 -滚开 - Doc--doc-- - Get out of here.
-医生 求你了 -快滚 - Doc, please. - Get out of here.
你再敢来推销 You ever come back on these rounds,
我就宰了你 I'll fucking kill you.
我亲手宰了你 Yeah, I'll fucking kill you myself.
你怎么了 What's wrong with you?
今天休息 Take the rest of the day off.
回家吧 Go home.
为未来加油
我不知道你在这上班 I didn't know you worked here.
是啊 Yeah.
你在这里干什么 What are you doing in town?
好久不见 It's been a while.
我正准备去奶奶家 Oh, I'm just visiting my grandma.
尤里卡斯普林斯怎么样 How's Eureka Springs?
很好 我很喜欢 Oh, it's great. Um, I really love it there.
我喜欢你的腰带 I like your belt.
谢谢 我自己做的 Thanks. Um, I made it.
我现在做上手工了 I guess I'm crafting now.
你还在缝被子吗 You still quilting?
我 Um, I...
很高兴见到你 贝琪 It's good to see you, Bets.
照顾好自己 好吗 You take care of yourself, okay?
我想去佛罗里达州 I wanna go to Florida.
你想要佳乐定吗 Hey, you want a Xanax?
能让你好受点 It'll take the edge off.
多少钱 How much?
老天 送你的 Jesus, man, it's a gift.
在海湾地区 有句话叫 别让我说第二遍 In the Gulf, we used to say, don't make me offer twice.
-好吧 -吃吧 - Okay. - Take this.
-会让你好受 -好的 好的 - It'll make you feel better. - All right, all right.
我不知道你是个老兵 I didn't know you were a vet.
是啊 外派过两次 Yeah, did two tours.
满目疮痍 Shit I saw...
佛罗里达
总算到了 Salvation at last.
日出汽车旅馆
早跟你说过 Told you.
外伤还是慢性病 So injury or chronic condition?
我伤到背了 因为矿井事故 I hurt my back. Mining incident.
好吧 我得给你做个检查 Okay, I'm gonna need to examine you.
护士给你病号服了吗 Did the nurse give you a gown?
给你 Here you go.
胸罩也要脱 Uh, bra too, please.
举起手臂 Okay, lift your arms.
好吧 你肯定要吃止疼药 Yes, you are definitely gonna need painkillers.
强力止疼药 Strong ones.
奥施康定 40毫克 一天两次 OxyContin, 40 milligrams, twice per day.
除非你有爆发性疼痛 Unless you have breakthrough pain.
你觉得怎样 How does that sound?
这些药不便宜 Hey, these prescriptions can really add up.
如果你手头紧 So if you're in a bind,
我们也许能帮你解决 we might be able to work something out.
没关系 我有现金 It's f--it's fine. I have cash.
没问题 No problem.
到后面的药房取吧 Fill this out at the dispensary in the back.
大沼泽地疼痛诊所
天佑伟大的佛罗里达 God bless the great state of Florida.
我跟你说过别再给我打电话 I told you never to call me again.
我知道 我很抱歉 Hi, yeah, you know, I'm-- I'm sorry, and I--I, uh,
我为之前发生的事道歉 do want to apologize for-- for what happened.
我在克服一些困难 德蕾雅 I'm going through some stuff, Drea.
看着你在餐厅里睡着 Watching you fall asleep in the middle of a restaurant
可不是美好时光 is not my idea of a good time.
-我知道 -让我觉得好丢人 - Yeah. - It was humiliating.
我知道 我有点健康问题 I know, I know, I'm dealing with a medical condition,
实际上 and, um, in fact,
我想请你帮我个忙 I was wondering if, you know, possibly you could help me.
德蕾雅 你有奥施康定的样品吗 Uh, Drea, you don't have samples of OxyContin, do you?
没有 No, I don't.
别再联系我了 Delete my number.
当阿片类药物起效时 The brain is rewired to function normally
大脑重新正常运作 when opioids are present
药物失效 大脑也会失常 and abnormally when they are not.
戒断的痛苦非常可怕 And the pain from withdrawal is so overwhelming
一个人会感觉 that a person can feel like they are literally
再不嗑药就会死 going to die if they don't get more drugs.
这种上瘾者急需用药物 What is the term for the pain an addict feels
来缓解的痛苦 专业术语叫什么 when they're in clinical need of their next fix?
叫毒瘾 It's called dopesick.
你想和我谈谈 You wanted to speak to me?
有件事很奇怪 Uh, there's something very strange going on here.
怎么了 What is it?
波特和吉克研究在网上搜不到 The Porter/Jick study isn't on the internet.
什么 What?
到处都在引用他们的研究 Yeah, I mean, it's referenced all over the place.
波特和吉克医生的研究
时代周刊 科学美国 TIME magazine, Scientific American.
但我找不到研究的原文 But I--I mean, I can't find the actual study.
格雷格也找不到 他找得比我还久 Greg can't find it, either. He's been on it longer than me.
吉克和普渡制药有没有关系 Do you find any affiliations between Purdue and Jick?
-普渡付费请他演讲 咨询什么的 -没有 - Paid speeches, consulting, anything like that? - Nothing.
波特呢 他是谁 What about Porter? Who's that?
吉克的助手 简·波特 It's Jick's assistant. Jane Porter.
这名字满大街都是 There's 10,000 of them.
这么说知名的波特和吉克研究 So the--the famous Porter/Jick study
宣扬疼痛治疗领域要增加 that's the North Star of the pain movement
阿片类药物的使用 居然找不到原文 to increase opioid use is nowhere to be found?
正是这样 Bingo.
你好《科学美国》 我们想找一篇你写的文章 Hey, yeah, we're calling about a Scientific American article
1990年发表 叫"不必要疼痛的悲剧" you wrote in 1990, "The Tragedy of Needless Pain,"
你们引用说是"广泛研究" in which you referenced an, uh, "Extensive study"
发现少于1%的阿片类药物使用者 that claimed less than 1% of opioid users,
才会上瘾 uh, become addicted.
是啊 波特和吉克研究 怎么了 Uh, yeah, Porter/Jick. What about it?
你们有那个研究的原文吗 Do you have a copy of that study?
我不确定 Uh, I'm not sure.
你们在网上查过吗 Uh, have you tried the Internet?
当然 Uh, you know, I sure did.
但我可能找漏了 I might've missed it, though,
因为我只会用食指打字 'cause I only type with my index fingers,
但我听说杰罗姆·大卫·塞林格也这么干 but I hear, uh, JD Salinger did the same thing,
《麦田里的守望者》作者
所以我就并不对此自卑 so that kind of helps me out in the self-esteem department.
是啊 任何医学院都会有 Yeah. Any medical school will have it.
全国都用这份研究教学 但是 It's taught all over the country, but, um,
我很乐意核查一下记录再回电话给你 I'm happy to check my notes and call you back.
我不介意等你核查 Oh, you know what? I don't mind holding for you.
我老板一直催我 Um, my boss has been getting on me about this,
所以你能查到就帮了我大忙 and you'd really be helping me out here.
-好 我快速查一下 -谢谢 - Okay. I'll do a quick search. - Thank you.
真是大聪明 还知道杰罗姆·大卫·塞林格 Oh, Mr. Smarty Pants knows his JD Salinger.
我从书里看到的 I got it from my book learning, sir.
我打算下本看《白鲸记》 Thinking of reading Moby Dick next
因为我喜欢鲸鱼 'cause I love whales
喜欢读鲸鱼有关的故事 and, uh, reading stories about whales and doing--
是的 我的记录里有 Hi, um, yeah, it's right here in my notes.
波特和吉克研究刊登于1980年的 The Porter/Jick study is in a 1980 issue
一期《新英格兰医学杂志》上 of the New England Journal of Medicine.
你知道具体的期号吗 Do you know which issue exactly?
不知道 我就知道这么多 祝你好运 No, that's all I have here, but good luck, okay?
-我得挂了 -好 谢谢你 - I gotta get going. - Okay, thank you.
好吧 All right.
《新英格兰医学杂志》
已经查过了1978到1994年 Been through every issue of a weekly publication
每一期的周刊 from 1978 to what, 1994,
但还是找不到吗 and we can't find this thing, huh?
《时代周刊》 So we got TIME magazine,
《科学美国》都引用过 Scientific American citing it.
全国的医学院都教这个 Medical schools all across the country teaching it.
没错 Right.
但这个据说是最著名的研究 And yet it appears to be the most famous study
没人看过原文 that no one has actually ever seen.
怎么了 Wh--what's going on?
你好 贝琪 Hi, Betsy.
我叫埃里克·米勒 My name is Eric Miller,
镇上毒瘾互助会的一员 and I'm a member of the AA community here in town.
大家来这里是因为我们非常关心 Everyone in this room is here because we're very concerned
你的健康和安全 for your health and your safety.
我们有很多话想说 And we have so many things that we want to say
想和你分享 and share with you.
我们担心你的毒瘾 We're all worried about your drug use
我们觉得是时候治疗了 and think it's time to seek treatment.
不如你坐下吧 Why don't you sit down?
你在加油站撒谎了 You lied to me at the station.
我来是因为你妈妈让我来的 I came here because your mom asked me to.
我们都很担心你 贝琪 we're all really worried about you, Bets.
我和你爸爸 Your daddy and I don't care
只想让你身体变好 about anything other than you getting better.
贝琪 别的事都不重要 All that other stuff, Bets, doesn't matter.
不重要 Just doesn't matter.
你朋友和家人每天都很担心 Your friends and family are worried every day
你会进医院或死了 that you're going to end up in a hospital or dead
或坐进警车 or in the back of a police car.
他们想尽一切办法帮你重回正轨 They wanna do everything they can to help you get back
重回健康 to a place of health,
没有药也能正常生活 of just being okay without drugs.
你愿意加入互助会吗 Will you commit to a program?
求你了 贝琪 Ple--please, Bets.
别离开这里 亲爱的 Please don't walk out that door, honey.
你妈妈和我 我们只是 You--your mama and me, we just--
想让我们的宝贝姑娘回来 we just want our little girl back.
回到你原来的样子 Just the way you are.
抱歉 I'm sorry.
我做不到 I can't. I can't.
贝琪 如果你不戒毒 Betsy, if you don't do this,
你的家人会被迫和你反目的 your family will be forced to turn their back on you.
格朗特 过来 Grant! Get in here.
-怎么了 -猜猜谁要来吃晚餐 - What's up? - Guess who's coming to dinner?
普渡制药同意见面 Purdue Pharma agreed to meet.
理查德·赛克勒要来吗 Is Richard Sackler gonna join?
没说 Doesn't say.
我们来看看他们到底是关注药物安全 Let's see if they give a fuck about safety
还是只打算卖药 or if they're just trying to sell pills.
我知道你是管控部新人 Look, I--I know you're newest to Diversion,
但是通常来说 but as a general rule,
制药公司根本不管安全问题 the pharmas don't really care about safety.
他们只会拼命推销 直到吃苦头 They just push as hard as they can until they get slapped.
那我们就让他们尝尝苦头 Then let's bitch slap the shit out of these motherfuckers.
下午好 Good afternoon.
我是布丽姬特·迈尔 管控部副部长 I'm Bridget Meyer, deputy director of Diversion.
我是迈克尔·弗里德曼 这是霍华德·乌代尔 I'm Michael Friedman. Howard Udell
-和大卫·哈多克斯 -幸会 - and David Haddox. - Pleasure.
理查德·赛克勒会来吗 Is Richard Sackler coming?
赛克勒博士去外地开会了 Dr. Sackler had a meeting out of state,
但我保证 我们会转达每一个字 but I can assure you, we'll relay every word.
很好 那就开始吧 Fine. Let's get started.
我们先用幻灯片展示 Uh, we'd like to start with a, uh, PowerPoint presentation
奥施康定的功效 about the efficacies of OxyContin.
没必要 That won't be necessary.
我看过你们的宣传材料了 I've seen your promotional materials,
我很熟悉你们的话术 and I'm familiar with your talking points.
我们直奔主题吧 So let's get right to the issue at hand.
我是请你们来谈药物的上瘾和滥用 I've brought you here to talk about addiction and abuse.
自从你们的药物四年前上市 Since the launch of your drug four years ago,
它就失控了 it has gotten out of control.
不 我不赞成 No, I beg to differ.
你先等我说完 Uh, you can beg when I finish.
我和同事提前准备和提出了 Now, to be proactive, my staff and I have come up
一些实际性 常识性的想法 with some practical common sense ideas
我们认为可以轻易实施 that we believe could easily be implemented
而且能真正帮助减少 and would really help reduce
范围极广的药物滥用 the widespread abuse of this drug.
我们不认为药物被滥用了 We don't believe the drug is being abused,
但如果你能提高公共安全 but we'd be happy to hear your ideas
我们乐意听你的看法 if you think it would enhance public safety.
鉴于药店抢劫案的发生率增高 Given the growing incidences of drugstore robberies,
如果减少开具 it might be useful to reduce
这种药的药店数量或许会有帮助 the number of pharmacies allowed to dispense.
这也能帮助到那些 This would also help with pharmacies
不愿意卖这种药 that don't want to carry the drug
但迫于诉讼威胁 不得不卖的药店 but feel pressured to because of threats of lawsuits.
我们会考虑的 We'll take it under advisement.
我们还想 We also thought that
你们应该做出开药限制 you could limit prescribing privileges
只有经过疼痛处理训练的医生才能开处方 to doctors with training in pain management.
现在似乎全科医生都能 It seems that GPs are prescribing this for things
给头疼或者牙疼的人开这种药 as frivolous as headaches and toothaches.
药物应该限制为只有专科医生才能开 The drugs should be limited to pain specialists.
这不仅不切实际 Well, um, that's not only impractical,
而且还会让真正疼痛的病人 it would also deny many legitimate pain patients
买不到药 access to the drugs, so.
和药监局的说法一模一样 That's verbatim, the FDA's concern.
你们关系那么铁吗 Do you have them on speed dial?
什么 Excuse me?
不管你和他们的关系有多好 Whatever friendly situation you have going on over there,
我跟你保证 在我这里通通没有 I assure you, you do not have here.
我想限制这种药的使用 I want to restrict access to this drug.
现在该药被超量开具 It is being overprescribed
导致病人成瘾 and causing patients to become addicted
而且有毒瘾的人还能非常轻易 as well as making it too easily available
就拿到药物 for recreational drug users.
全国的成瘾率 过量吸食死亡率和犯罪率 Addiction rates, overdoses, and crime is on the rise
都在因为这种药上升 across the country because of this drug.
如果你们不想办法解决 So if you will not take action to curb this problem,
我会采取措施 then I will.
我们会考虑的 We'll take that under advisement.
《新英格兰医学杂志》
1998年8月20日
新英格兰医学杂志 New England Journal of Medicine.
你好 我是里克·曼卡索 Hi, my name is Rick Mountcastle.
这里是弗吉尼亚西区的 I'm with the US Attorney's office
检察院办公室 in the Western District of Virginia,
我想找一项 and I'm trying to locate a study
你们几年前发表的研究 that you published years ago
赫谢尔·吉克医生关于阿片类药物上瘾的那篇 regarding opioid addiction by a Dr. Hershel Jick.
你们有印象吗 Does that ring a bell?
当然 我们和吉克医生很熟 Oh, yeah. We know Dr. Jick well.
他和我们多年都有书信往来 He's been writing us letters for years.
我们出版了他的很多信件 它们都很好 We've published a lot of them. They're good.
-有人只是... -等等 - Some people just, you know... - Wait.
比起读信更喜欢上网 They love to read letters to the Internet.
不好意思 你是说信件吗 I'm sorry, uh, you mean, like letters?
是啊 他写了很多信 Yeah, yeah. He writes a lot of letters.
我找到了 I found it.
不可能 That can't be it.
天哪 Oh, my God.
检方传唤赫谢尔·吉克 Government calls Dr. Hershel Jick.
下午好 先生 Afternoon, sir.
吉克医生 跟我们说说你1980年 Dr. Jick, tell us about your 1980 letter to the editor
给《新英格兰医学杂志》编辑写的信 at the New England Journal of Medicine
关于病人使用阿片类药物的成瘾率的那封 regarding addiction rates and patients taking opioids.
七十年代末的时候 我建立了医院病例数据库 In the late '70s, I built a database of hospital records,
因为是最早的数据库之一 它很有名 which became known, as it was one of the first.
在报纸上读了药物成瘾的文章之后 After reading a newspaper article on addiction,
我就想统计我的数据库里有多少病人 I decided to calculate how many patients in my database
对麻醉剂止痛药呈现出上瘾症状 showed signs of addiction to narcotic painkillers.
数据低得惊人 不到1% Number was shockingly low, less than 1%.
所以我写了一封信 So I wrote up a letter
寄给了《新英格兰医学杂志》 and sent it to the New England Journal of Medicine.
这封信基于的数据 This letter was based on patients
-仅限住院的患者 对吗 -对 - confined to a hospital setting, is that correct? - Yes.
如果这些患者没住院的话 Is--so is the likelihood of addiction
他们成瘾的可能性 higher in these same patients
是不是会升高 if they were not confined to a hospital?
没错 这不是正式研究 That is correct. It wasn't an official study.
只是在特定环境下基于一小部分患者 It was an observation based on a small group of patients
得出的观察结果 in a highly controlled environment.
所以那封信很短 That's why the letter was so short.
没错 只有五句话 Yes. It was five sentences long.
患者很少出现上瘾症状 致编辑 最近我看了医院39946名患者的数据 11882名患者在住院期间使用了止痛药 但只有四名无成瘾史的患者产生药物依赖 一名对药物严重上瘾 四人中两人使用杜冷丁 一人使用复方羟可酮 一人使用二氢吗啡酮 我们认为尽管医院广泛使用止痛药 但对于无成瘾史的患者来说 极少会出现成瘾症状
一般关于成瘾性的科学研究论文有多长 How long would an average scientific study on addiction be?
25到50页 Between 25 and 50 pages.
-显然不止五句话 -当然 - Which is more than five sentences. - Obviously.
你为普渡制药工作过吗 Have you ever worked for Purdue Pharma?
没有 No.
你是否当过他们的顾问或者收过他们的钱 Have you ever consulted for them or received money from them?
不 我和普渡制药没关系 No, I have no affiliation with Purdue Pharma.
你知不知道普渡制药的药代表 Well, are you aware that sales reps at Purdue
引用你的信件当作科学研究 cite your letter as a scientific study
来说服医生只有不到1%的病人 to convince doctors that less than 1% of patients
在服用了他们的麻醉剂奥施康定之后会上瘾 would get addicted to their narcotic OxyContin?
我不知道 No, I'm not.
你知道你五句话的信被当作 And are you aware that your five-sentence letter is cited
一项重大研究 被全国各大医学院 as a major study by medical schools all across the country,
而且被各大杂志社 从《时代周刊》 and in magazine articles from TIME magazine,
到《科学美国》拿来作为证明阿片类药物安全的证据 Scientific American as proof that opioids are safe?
我不知道 I was not aware of that.
我来告诉你吧 Well, I'm gonna tell you what,
有学派支持使用阿片类药物 there is an entire school of thought espousing opioids
声称这些药物不会上瘾 as being practically non-addictive,
你的那封信经常被引用 and your letter is often cited
作为他们理论的主要依据 as a major source for this thesis.
这封信在我发表的文章里 This particular letter is very near the bottom
简直微不足道 of a long list of my published work.
只是简单地罗列几个 It's simply provides some basic numbers
基于小部分人得出的数据 based on a small group of people.
我不懂为什么它会被这样广泛讨论 I have no idea how it became so discussed.
我来告诉你为什么 I'll tell you how.
在1986年《疼痛杂志》的一篇文章里 So it became the primary source that opioids are non-addictive
这封信成了证明阿片类药物不会上瘾的 when it was cited in a 1986 article
主要依据 in PAIN magazine,
《疼痛杂志》
文章极大地改变了人们对阿片类药物的看法 which was highly influential in transforming
从容易上瘾变为安全可信 the perception of opioids from addictive to safe.
这篇文章的第二作者 And this article was co-authored
是罗素·博诺伊医生 by Dr. Russell Portenoy,
他现在被普渡制药雇佣 成了发言人 who is now a paid spokesperson for Purdue Pharma
罗素·博诺伊医生 斯隆·凯特林癌症研究所
并且是国内提高阿片类药物 and one of the chief medical proponents
和奥施康定使用的 for increased use of opioids and OxyContin
主要支持者之一 in the United States of America.
快到阿宾顿了 宝贝 Halfway home to Abington, baby.
微小的胜利也让人高兴 I'm all about those small victories.
什么 微小的胜利 Aw, what do you mean, small victories?
今天是个大日子 We had a big day.
当然 Sure was.
或许能帮我们搞到更多资金 Maybe it'll help us get more funding?
那可不一定 I doubt it.
里克·曼卡索 Rick Mountcastle.
我记得你 托比 缉毒署怎么样 Oh yeah, I remember you, Toby. How're things at the DEA?
案子还在早期阶段 Well, it's still early in the case.
我们还没有任何发现 We haven't found anything yet. You know what?
现在我不方便说话 I'll tell you what-- it isn't a good time to talk.
下次再说 好吗 Try you another time? Yeah.
没事 好的 再见 It's all right. Great, bye.
缉毒署来问普渡制药的案子了 DEA wants to know how the pharma case is going.
他们之前一点都不感兴趣 They have zero interest,
现在我们刚有点突破 and right when we land something big,
他们就突然冒出来了 they just--they call us right outta nowhere?
我们得收紧口风 Let's keep this buttoned up.
只有你 我还有布朗利知道 Just me, you, and Brownlee.
这案子我谁也信不着 I don't trust anyone on this case.
即使我已经戒毒九年了 Even after nine years staying sober,
我也知道我有恶疾 I know I got a disease.
我很高兴我能每周来这里 提醒自己 So grateful I can come here every week as a reminder
该做什么来保持清醒 of what I need to do to stay on my path.
谢谢你的分享 贝尔 你并非孤军奋战 Thank you for sharing, Belle, and you're not alone.
贝琪 你想发言吗 Betsy, would you like to speak?
我一定得说吗 Do I have to?
这可能对你有用 You might find it helpful.
这里很安全 This is a very safe space.
只需倾诉你的心声 亲爱的 Just share from your heart, dear.
我们都是来帮助你的 We're all here to support you.
好吧 Okay, um.
我是贝琪 I'm Betsy.
你好 贝琪 Hi, Betsy.
医生给我开奥施康定 I was prescribed OxyContin
因为我后背受伤 for, uh, a back injury...
一开始药效很好 And it worked great at first, but...
但后来就失效了 Then it stopped working,
而且我需要更多的药 and I needed more.
给你 亲爱的 Here you are, sweetheart.
我猜 I guess--
一直以来我都是 I guess I always felt kinda tense
在人身边感觉紧张焦虑 and uncomfortable around people.
但吃了药之后 But taking the pills, it was...
我第一次感觉像个正常人 It was the first time I felt normal.
或许是这辈子第一次 In maybe my whole life.
但现在 And now...
现在的我感受不到 And now I don't feel
任何事 anything at all anymore.
我只想吃药 All I think about is getting more pills.
这令我害怕 And it can get scary.
一切都会好起来的 Aww, everything's gonna be just fine.
别担心 Don't you worry.
你多久没吃药了 How long has it been?
两天 我感觉我快死了 Two days. I feel like I'm gonna die.
亲爱的 这可真是难受 Oh, honey, it's the worst feeling in the world,
但我能帮你 but I can help with that.
你能吗 You can?
我有10 20 40毫克的 I got 10s, 20s, and 40s.
一毫克一美元 如果你有40块 It's a dollar a milligram, so if you've got $40,
我现在就能给你四颗10毫克 I can give you four 10s right now.
摆脱痛苦很舒服 对吧 I mean, wouldn't it be nice if all this pain just went away?
没错 Yeah.
给你 Here you go.
太谢谢你了 Thank you so much.
-会没事的 亲爱的 -谢谢 - It's gonna be all right, sugar. - Thank you.
我们下周见 好吗 I'll see you here next week, all right?
沃尔特 Hey, Walt.
医生 你怎么样 Doc, how you doing?
很好 很好 不好意思 现在很晚了 Ah, good, good. Hey, sorry, I know it's late--
没事 没什么 Hey, no, you're all good.
我要一些80毫克的药 Yeah, I'm gonna need some of that 80s
如果你有 或者40毫克的也行 什么都行 if you got 'em, or 40s. Whatever you got.
有 你走运了 我刚补过货 等下 Yeah, yeah, you're in luck. I'm newly replenished. One second.
收起来 收起来 Now, hey, put that away--put that away.
好的 好的 All right. Okay, okay.
医生 Doc?
-拿到了吗 -好了 给你的 - You got it? - All right, I got you.
好 这里是两个12包 All right, now, this is two 12 bags.
-好吗 -好的 - All right. - All right.
给你 Got you here.
不错吧 That's good, hey?
-谢谢 谢谢 -真好 - Thanks, thanks. - That's good.
你最近怎么样 你还好吗 All right, how're you doing? You all right? Good?
-我很好 伙计 -抱歉 抱歉 - I'm good, man. - Sorry, sorry.
抱歉这么晚把你叫起来 I woke you up so late there, man.
你也知道犯瘾多难受 You know--you know how it is.
-医生 -怎么了 - Say, doc? - Yeah?
你看上去不太好啊 You don't look good, man.
没有 我好着呢 No, I'm not. I'm not.
不 我知道 对自己好一点 好吗 No, I know, but do yourself a favor, all right?
用鼻子吸 先捣碎再吸 Snort those, crush them up. Snort 'em.
这要怎么吸 How do you do that?
把它们放进嘴里 Put them in your mouth, all right,
大概一分钟 for about a minute.
然后弄掉表面的缓释层 And then rub off that coating on the outside,
做个小标记 so make a little mark.
然后捣碎了再吸 All right, crush it up, snort it.
这样更爽 It's gonna hit you way better.
尽管本故事改编自真实事件 但角色 人物性格 事件 地点和对话都做出了戏剧化处理 为了尊重艺术化改动 角色名称 故事 产品或实体均为戏剧处理 无意影射现实