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你们都来康复中心多少次了 How many times have y'all been to rehab?
我只是担心来这里可能没用 I'm just worried maybe it doesn't work.
你考虑过用美沙酮吗 值得一试 Have you thought about methadone? It's worth a shot.
翻 译 AliciaLee1990
但如果有人证明按处方服用奥施康定 The FDA would take action against OxyContin
也不安全 我们就会对其采取措施 if the drug was shown to be unsafe when used as prescribed.
死于服药过量的总人数 464 因吸食 咀嚼或注射药物致死的总人数 12 按指示口服奥施康定致死的总人数 452
校 对 草草 苏葵
我们会被上面摁住吗 You think we'll be shut down by the higher ups?
如果我们要起诉个人犯有重罪 We start charging individuals with felonies,
我们就得一击致命 we need the kill shot.
时间轴 Caroline
你们找过柯蒂斯吗 Have you spoken to Curtis?
他还是审核官吗 Is he still the review officer?
药品上市两年后 Two years after the drug hits the market,
后 期 MythCreator
柯蒂斯·莱特去了普渡制药 Curtis Wright ends up at Purdue Pharma.
开玩笑吧 You're kidding me.
《时代》杂志的年度人物 "Time Magazine's" Man of the Year,
鲁迪·朱利亚尼市长 Mayor Rudy Giuliani.
总 监 苏葵
我刚开了一家新的律所 我代理普渡制药 I just started a new firm and I represent Purdue Pharma.
我没有沉迷于工作 I'm not obsessed with work,
我只是想阻止 I'm just trying to prevent mass deaths
本地青少年被发现死于本地药房外
全国范围内的大规模死亡 from occurring across the country.
你有奥施康定吗 我糟透了 You got any Oxy? I'm in real bad shape.
我有海洛因 I got some H.
便宜得多 爽得多 It's way cheaper and it's way better.
亚瑟·赛克勒 你能庄严宣誓 Do you, Arthur Sackler, solemnly swear
你给出的有关芬尼克斯委员会的证词 the testimony you give for this Finnix Committee
全为事实 绝无虚言 愿上帝保佑你 will be the whole truth and nothing but the truth, so help you God?
我宣誓 I do.
赛克勒商业帝国的产业链非常完善 The Sackler empire is completely integrated.
可以在研发公司进行新药品研发 It can devise a new drug in its development enterprise,
进行药品的临床实验 have the drug clinically tested,
然后从多家与他们有联系的医院获得 then secure favorable reports on it from various hospitals
对临床实验结果有利的报告 where they have connections.
你的公司引用一些医生的评价 Your company makes false and grandiose claims
对打广告的产品进行夸大不实的宣传 about products you advertise using quotes from doctors
而这些医生实际上受雇于 that are, in actuality, on your own payroll,
你或你的家庭成员 hidden through a series of shell companies
秘密掌控的一系列空壳公司 you or your family members secretly control.
议员 我的公司是 Senator, my company is
一家有道义的处方医药广告公司 an ethical pharmaceutical advertising organization
致力于推广处方药 working in prescription drugs
主要为医生而制造的医疗物资 and materials produced primarily for physicians.
我们的经营理念一直是 We continue to operate on the basis
优秀 合乎道义的处方医药广告 that good, ethical pharmaceutical advertising
有利于提升社区健康 plays a positive role in advancing the health of the community.
多德议员
我非常尊重普渡制药 I have a very, very high regard for Purdue Pharma
和来自我选区的贵司员工 and its employees from my district
他们都在非常努力地制造高品质的药品 who work very, very hard to produce quality products.
如今这款叫作奥施康定的药品对于 Now, the drug OxyContin has become vital
患有慢性病和因疼痛 to people suffering with chronic
而日渐衰弱的人来说必不可少 and debilitating pain.
让我来问问范西医生 这里我引用 Now, let me ask Dr. Van Zee, and I quote here,
"传统观念认为如果一项药品得到广泛普及 "Conventional wisdom says that if a drug is widely available,
它将被广泛地滥用" it will become widely abused."
这说法有什么支持论据吗 Is there any more to this than that?
多德议员 那是个老的医学谚语 Senator Dodd, that is an old medical adage.
阿帕拉契亚地区的谚语吗 One of those Appalachian things?
不 是全国通用的谚语 No, it's a national adage.
引申来说 如果让一款能被滥用的药品 I would say by extension, if you have an abuseable drug
广泛普及 那它一定会被广泛滥用 that is widely available, it will be widely abused.
我在阿帕拉契亚小镇 In the 25 years I have practiced medicine
从医的25年内 in my small Appalachian town,
从没出现过像奥施康定这样 there has never been anything to compare
如此泛滥的药物滥用和上瘾现象 to the epidemic of drug abuse and addiction like OxyContin.
成瘾剂量
第一季 第七集
你要是见到这个女孩 If you see this girl,
请打下面的这个电话 just give a call at that number below.
会有奖励 There's a reward.
打扰了 Excuse me.
我在找我的女儿 贝琪·马勒穆 I'm trying to find my daughter, Betsy Mallum.
你见到过她吗 Have you seen her?
拜托告诉她我们不生她的气 我们真的很担心 Please, tell her we're not mad, we're just real worried.
我知道她在哪 I know where she is.
贝琪 Betsy.
贝琪 贝琪 是妈妈 Betsy, Betsy. It's Mama.
-宝贝 -妈妈 - Hon. - Mom.
我来了 我来了 贝琪 I'm here, I'm here. Betsy?
-我想回家 -好 - I want to go home. - Okay.
我最恨自己的时刻 I never hated myself more
莫过于当我同意取得逮捕报告时 than when I agreed to get arrest reports.
一些我以前的病患 Some of my former patients.
其中一些我曾经接生过他们 Some of them I had delivered as babies.
我所感到的羞愧和罪恶感... The shame and the guilt I felt--
好了 我得在此打断你 塞缪尔 Okay, you know what, I'm gonna stop you right there, Sam.
塞缪尔 你能告诉我你这些年接生过多少婴儿吗 Sam, can you tell me how many babies you delivered over the years?
214个 214.
-214个 -是的 214个 - 214, wow. - Yep, 214.
那时候 你知道的 什么都得干 In those days, you know, you had to do it all.
那肯定是很棒的体验 Well, that must've been wonderful.
-是啊 -对吗 - Yeah. - Right?
帮助那些父母 缓解他们的痛苦和焦虑 Helping all those parents? All the pain and anxiety?
是啊 Yeah.
接生他们的孩子 Delivering their children.
不像大多数城里的医生 And unlike most city doctors,
你得以见证他们成长 you get to watch them grow up.
-是的 -是啊 - Yep. -Yep.
你犯了些错 You've made some mistakes.
但你也做了一些很伟大的事情 But you've done some wonderful things, too.
下次疗程 我希望你写篇 Next session, I want you to journal about,
接生婴儿是什么样感受的文章 uh, what it feels like to deliver a baby.
好吗 Yeah?
还有我希望你关注你所做过的好事 And I want you to focus on the positive things that you did.
我们已经知道了你的所有悔恨 We already know about all your regrets.
我想听听这些新生命的故事 I want to hear about these births.
塞缪尔 Samuel?
好的 Yeah.
赛克勒艺术教育中心 The Sackler Center for Arts Education
摩迪莫·D·赛克勒基金会
赛克勒艺术教育中心
一百万美元
是我们家族参与过 is one of the most satisfying things
最得意的事情之一 that our family has been part of.
我想感谢我弟弟 雷蒙德 I want to thank my brother, Raymond,
今晚来此庆祝这一伟大项目 for being here tonight to celebrate the great work
以及下一代的艺术家们 and the next generation of artists.
儿童服用的奥施康定现在处于什么阶段了 What's the status with the children's OxyContin?
还在研发中 但进展良好 Still in development, but coming along nicely.
堂哥 Hey, cuz.
恭喜又是丰收的一年 Hey, congratulations on another great year.
销量节节攀升 Sales keep going up.
是啊 大卫 一切都很顺利 Yes, David, it's going well.
我们有些人在考虑买一家滑雪度假村的公司 So a few of us were thinking of buying a ski resort company.
他们在全国各地都有很棒的雪山 They've got amazing slopes all over the country.
我也知道你有多喜欢滑雪 所以... And I know how much you love to ski, so--
抱歉 Excuse me.
我...我得接个电话 但没错 我很感兴趣 I--I--I have to take this, but yes, yes, I'm very interested.
柯蒂斯 你说吧 Curtis? Tell me.
坏消息 理查德博士 It's bad, Dr. Richards.
我的线人来自药监局内部 My intel is from inside the FDA
他们准备审核 and they plan on reviewing
奥施康定标签的措辞 the wording of the OxyContin label.
而且很可能他们会换掉它 And it's very likely they're gonna change it.
-该死 -天呐 - Fuck. - Oh, my God.
但为什么药监局会突然换掉我们的警示标签 But why would the FDA change our warning label out of the blue?
-拜托 -够了 - Oh, please. - That's enough.
你儿子是唯一一个没意识到 Your son is the only one unaware
他卖的药品是全民抵制的对象 that his drug is a national punching bag.
该死 柯蒂斯 我们把你从药监局挖来 God damn it, Curtis, we brought you in from the FDA
就是确保不会出现这种情况 to make sure things like this didn't happen.
-没错 -听我说 理查 - That's right. - Look, look, Rich.
理查德博士 Dr. Richard.
缉毒署那位女士开始的舆论战造成了一些影响 The press war that woman at the DEA started has had some effect.
有太多关于这个药品的负面新闻 There's just too much bad publicity about the drug
所以药监局必须采取行动 and the FDA needs to take action.
柯蒂斯 我们能做出什么让步 Curtis, are there any concessions we can offer
来避免他们换掉标签 that will prevent them from changing the label?
我有个想法 Here's an idea.
如果我们说下架160毫克药片呢 What if we tell them we'll pull the 160?
-我们已经投入了... -我们可以试试 - We have invested-- - We can try.
但我认为我们最好的选择是 But I think our best bet is to see
看看能否想出什么新的标签措辞 if we can work out new language with them.
就像第一次 L-like the first time.
措辞也许没有之前那么有利 The wording may not be as beneficial,
不过但愿能最小化我们的损失 but hopefully will minimize the damage.
如果我们必须去掉"不易上瘾" If we have to give up "addiction is rare,"
销量会骤降 sales will plummet.
我们派一个代表团去见见药监局的人 Let's send a delegation to meet with the FDA.
我相信我们有办法帮他们 I'm sure there are ways we can aid them
重新拟定新标签 in rewriting this new label.
通话记录 每个州关于滥用的通报情况
好消息是违法贴假标签的罪名已经坐实 The good news is the misbranding case is open and shut.
我们收集的所有证据表明 Everything we've compiled shows
普渡系统性地夸大奥施康定的效果 that Purdue systemically oversold the benefits
却对其危害轻描淡写 and trivialized the risks of OxyContin.
但这没法让我们获得最终胜利 But it doesn't put us over the finish line
因为我们还没以个人名义对高层提起诉讼 'cause we still haven't charged individuals at the top,
并让高管去坐牢 and putting executives into jail
这才是震慑企业 is truly the most effective way
乔纳森·赛克勒 理查德·赛克勒 凯茜·赛克勒
避免他们做出类似行为最切实有效的方法 of deterring companies from this type of behavior.
你可以对公司罚款 但不能把它送进监狱 You can fine a company, but you can't put it in jail.
因为公司感受不到痛苦 Because a company feels no pain.
我想让普渡制药感受到痛苦 I want Purdue to feel some pain,
所以我们再最后加把劲 so let's make a final push.
我们去刨根究底 Let's shake every tree.
财务记录 推销记录 Financial records, call notes,
申请单 营销材料 applications, marketing materials.
看看我们能否找到对那些高管 See if we can find some hard evidence
不利的切实证据 against top executives.
大家都去吧 Let's go out there and do it. All right.
柯蒂斯·莱特
《我重拾生活》
早上好 摩尔斯女士 Morning, Ms. Moles.
我是兰迪·拉姆塞尔 美国阿宾顿检察官 It's Randy Ramseyer, U.S. Attorney's Office Abingdon.
我们四年前谈过话 We talked about four years ago.
抱歉 我上班迟到了 Sorry, I'm late for work.
那我们不如去药监局谈 Oh, should we talk at the FDA instead?
我有几个关于柯蒂斯·莱特的问题要问你 I had a couple questions about Curtis Wright,
尤其是关于他通过的奥施康定标签 specifically the OxyContin label that he approved.
你知道吗 事实上 You know, actually,
我们有一堆未解之谜 we got a bunch of unanswered questions
我们不怕对柯蒂斯·莱特以外的个人 and we're not afraid to open up our investigation
展开调查 to individuals beyond Curtis Wright.
你是指我吗 You're referring to me?
我是指在药监局 I'm referring to anybody at the FDA
任何参与了审核通过流程的人 女士 who played a part in that approval process, ma'am.
我们发现普渡的药代表用那个警示标签 We got Purdue sales reps using that warning label
将奥施康定作为基本不上瘾的药物销售 to sell OxyContin as basically nonaddictive.
而通过这个警示标签的人从药监局 And the guy that approved it went from working at the FDA
以每年37万9千美金的高薪跳槽到普渡制药 to working for Purdue Pharma for $379,000 a year.
在我看来 I mean, it looks to me like
他出卖了整个国家的健康 he sold out the health of the nation.
而我只想知道 And I just need to know
他是否被承诺了这个职位 以换取通过标签审核 if he was promised a job for that approval.
我不知道 我不负责那个标签 I have no idea. I wasn't part of that process.
现在我得去上班了 Now, I have to go to work.
几年前 我患了癌症 A few years ago, I had cancer.
我现在没事了 但在当时 And I'm fine now, but at the time,
我住院的时候 when I was in the hospital,
我很可能会对奥施康定上瘾 well, I very easily could've become addicted to Oxy.
那害死我的就不是疾病 And it wouldn't have been the disease that killed me,
而是我的药物 it would've been my medication.
我很幸运 I got lucky.
但我希望你想一想那些 I just want you to think of all the kids
没那么幸运的孩子们 that are not getting lucky.
我邻居的小孩上瘾了 My, uh, neighbor's kid got hooked.
拜托告诉我关于那个警示标签 你所知道的一切 Please just tell me what you know about that warning label.
我们俩都知道这里头存在腐败 We both know there's something rotten going on here.
我听说 I heard that
在这个药品通过审批的一年前 about a year before the drug was approved,
普渡制药在洛克威尔 药监局的对面 Purdue rented out a hotel suite in Rockville
租了一间酒店套房 down the road from the FDA,
他们在那里私下会见了柯蒂斯·莱特 where they meet with Curtis Wright in private.
据说 柯蒂斯和普渡制药的高层 Supposedly, Curtis and the Purdue executives
一起呆了三天的时间 spent three days together,
斟酌医疗审核的措辞 working out the wording of the medical review,
一起写了关于安全性和疗效的概述 co-writing the summary of safety and efficacy.
一名药监局的员工甚至 An FDA employee literally
帮普渡制药写了他们自己的审核 helped Purdue write their own review.
柯蒂斯·莱特 Did Curtis Wright
为普渡制药写了奥施康定的警示标签吗 pen the OxyContin warning label for Purdue? Did--
真的是他写的吗 did he actually write it?
不止一个人怀疑是他写的 There is more than one person that believes that he did.
你知道普渡在酒店和柯蒂斯·莱特 Do you know who from Purdue was in that hotel room
碰面的有谁吗 是... with Curtis Wright? Was it--
是高层管理人员吗 was it senior-level executives?
抱歉 我真的不知道 I'm sorry, I honestly don't know.
我知道的话 一定会告诉你 Because if I did, I would tell you.
我得去上班了 Got to go to work.
你之前和任何人说起过这事吗 Have you told any of this to anybody else before?
没有 No.
为什么 Why not?
因为就算我说了也没用 'Cause it wouldn't matter if I did.
在劳伦斯县滥用奥施康定的现象
全镇都是这种传单 There's these flyers all over town.
明晚有个大会 A big meeting tomorrow night.
关于奥施康定 我想我们应该去参加 About OxyContin, hmm? I think we should go.
我不希望人们在那里看到我 I don't want people to see me there.
这样他们就会知道的 妈妈 不要 Then they'll know, Mom. No.
我不在乎他们知道什么 I don't care what they know.
或许会有些有用的信息 There might be some helpful information.
我们得想办法让你好起来 宝贝 We got to find a way to get you better, honey.
真正的你还在 我知道 The real you is still in there. I just know it.
我不知道她去了哪里 I don't know where she's gone.
那我们就得去找到她 Well, we got to find her again, then.
好吗 Well?
-好的 妈妈 -好的 - Okay, Mama. - Okay.
你在看什么 What you got there?
是关于这个药的大会 It's for a meeting about all these drugs.
我知道你要说什么 I know what you're gonna say,
但我不在乎别人知道我们的事 but I don't care if people know our business.
你说什么也不能阻止我去 There's nothing that you can say to keep me from going.
我不想阻止你做任何事 黛安 I--I don't want to stop you from doing anything, Diane.
你做你该做的事吧 You do whatever you need to do.
我是贝丝·戴维斯修女 My name is Sister Beth Davies.
我想感谢你们所有人来此 I want to thank you all for coming down here.
这并不容易 因为你们中有许多人 It's not easy, as so many of you
带着沉重的负担 自己所爱的人 are carrying the heavy burden of a loved one
承受着药物上瘾的漫长折磨 suffering from this chronic disease of addiction.
说到这个 我想向你们介绍 With that said, I want to introduce you
阿帕拉契亚最出色的康复医生 to the most dedicated recovery doctor in Appalachia,
阿尔特·范西医生 Dr. Art Van Zee.
谢谢 贝丝修女 Thank you, Sister Beth.
我知道你们今晚来到这里不容易 I know it wasn't easy for you all to come tonight,
因为这个药瘾随之带来的是羞耻感 as this addiction has shame attached to it,
但我希望看到今晚的出席人数后你们能明白 but I hope you all see by this turnout
自己不是孤军奋战 that you're not alone.
这个药品不管你富有或贫穷 This drug doesn't care if you're rich or poor,
男人或女人 白人 黑人或棕色皮肤 man or woman, white, Black, or brown.
一旦你服用过量 它就会改变你的脑化学 Once you've taken too much, it changes your brain chemistry
以至于你不服用就会感到极度痛苦 so you're in so much pain without it,
感觉自己快死了 you think you're going to die.
我今晚让你们来此签下一则请愿 I brought you here tonight to sign a petition
要求药监局让奥施康定从市面下架 to ask the FDA to pull OxyContin from the market
直到它重制后 成为不易滥用的药品 till it can be reformulated to be resistant to abuse.
之前有过成功案例 It's been done before.
会后我们在那边放了桌子 So, after the meeting, we have tables set up over here
以便你们所有人签下请愿书 for you all to sign the petition
这样我们可以尝试结束这场噩梦 so we can try to bring an end to this nightmare.
贝琪·马勒穆
我第一次看到这些结果时 I couldn't believe these results
也不敢相信 长官 when I first saw them either, sir.
这就是铁证 I mean--and this is rock solid.
你看 尸检报告证明过量服用也会发生在 See, the autopsy report proves overdoses can occur in people
那些完全遵照医嘱的人身上 who are taking the drug exactly as prescribed.
死亡的不仅仅是瘾君子 It's not just drug abusers who are dying.
也有每日饱受病痛的患者 It's everyday pain patients, too.
你不能在和药监局的人商量之前 You can't just send out a press release
先把这个公布给媒体 without discussing this with the FDA first.
好的 但长官 正是我去年策划的舆论战 Okay, but, sir, the press war I orchestrated last year
才让药监局对普渡制药的警示标签采取行动的 is what got the FDA to take action against Purdue's warning label.
但你要是不和我们商量就行动的话... But if you act without discussing this with us--
长官 无意冒犯 Sir, with all due respect,
为了公众的个人安全 the public needs to have access to this data ASAP
他们需要尽快看到这些数据 for their own personal safety.
你打算什么时候把你的报告分享给药监局 When do you plan on sharing your report with the FDA?
我已经约好了下周会面 I've already set up a meeting next week
我还要求普渡制药的人出席 and I've requested Purdue to be there.
你在会议之前把报告给普渡制药了吗 Are you giving Purdue the report ahead of the meeting?
没有 No.
所以你要在他们没法提前审核报告的情况下 So you're jamming them into a fast rebuttal
打他们个措手不及 without being able to review the report first?
或许 Maybe.
你知道这么做会惹怒所有人 You know you're just going to piss everyone off.
我的目的是阻止一种危险药品 My goal is to stop a dangerous drug
被倒卖和滥用 from being diverted and abused.
我不是来交朋友的 I'm not looking to make friends.
打扰一下 Excuse me.
你不介意的话 If you don't mind.
如果你把它浸在泻盐里 If you soak that in some Epsom salts
然后直接剪掉指甲 and cut the nails straight across,
会好受些 that should help that.
谢谢 先生 我会照做的 Thank you, sir. I'll--I'll do that.
嗯 试一试 Sure. Give it a try.
当你抱着一个新生儿的时候 When you're holding a newborn
它发出人生中第一次哭喊 and it lets out the first cry of its life,
你的心跳无法抑制地加速 your heart can't help but jump a little.
那是亘古不变的语言 That's a language that's as old as those hills.
太棒了 Bravo.
我希望你下一篇文章写写 You know, I'd like to have you journal next about,
你所帮过的其他三个人 three other people that you have helped.
作为医生 三个你感到最骄傲的时刻 Your three proudest moments as a doctor.
好的 All right.
知道吗 这或许听起来很疯狂 You know, it sounds crazy, maybe,
但是... but, uh...
我一直在考虑重新成为医生的事 I think a lot about being a doctor again.
你从来没有不是医生过 塞缪 You've never not been a doctor, Sam,
这是你永远的职业 it's who you will always be.
你只是需要花些时间来治愈自己 It's just you need to take the time to heal yourself.
好吗 这是我需要做的事 Right? It's what I had to do.
我醉驾差点害死了一个女人和她的小儿子 I nearly killed a woman and her young son drunk driving.
塞缪 那些人从我制造的事故中走了出来 Sam, those people walked away from the wreck that I caused,
但我很长一段时间没能走出来 but I couldn't walk away for a long time.
我花了很长时间 才原谅自己 It took me a long time to forgive myself.
是啊 我感觉我所做的不可原谅 Yeah. I feel like what I did isn't even forgivable.
-我不... -不 听我说 - I don't-- - No. Look.
一种弥补 A way to make amends...
我们对别人所造成的伤害的方式是回馈 for the pain that we have caused others is to give back.
当你准备好时 And when you're ready,
你所能做的最好的事 就是治愈他人 the greatest thing you can do is heal others.
所以 没错 So, yes,
重新开始准备拿回你的医生执照 begin the process of getting your medical license back.
书面材料看上去没问题 Paperwork looks good.
只要你一完成你的缓刑条款 Soon as you've completed the term of your probation,
我们就可以开始推进了 we'll get the ball rolling.
很好 Good, good.
至少得要一年的时间 但值得等待 It's going to take at least a year, but it'll be worth it.
我认为只有一个问题 There is only one issue I see.
如果你在服用美沙酮的话 They won't reinstate your medical license
他们不会恢复你的医生执照 if you're on methadone.
美国没有哪个医委会会允许 There's no medical board in America that would allow it.
你有可能在一年内停用这个药物吗 Any chance that you'd be done in a year?
说实话 我不知道 或许可以 或许不行 I don't know, to be honest. Maybe, maybe not.
那么在你停药前 Well, then you shouldn't turn in this application
不能上交这份申请 till you're off it.
这是唯一能让我戒掉药瘾的方式 It's the only thing keeping me clean.
严格意义上来说 你没有戒掉 Well, technically, you're not.
这是一种麻醉剂 It's a narcotic.
它是保护性药品 It's protective.
它就像胰岛素保护糖尿病患一样 It protects the way insulin protects diabetics.
它是医委会医生计划里全面禁止的药品 It's banned by physician plans across the board.
这些维持药物 会影响人的精神状态 These maintenance medications, they affect cognition.
一派胡言 That's bullshit.
我的头脑已经多年没有这么清醒过了 My thinking hasn't been this clear in years.
先生 你可以对这个决定提起上诉 Sir, you can appeal the decision,
但我们从来没有通过像这样的上诉 but we've never had an appeal like this go through.
再见 Good day.
卡特勒医生 如果你的病人说有爆发性病痛 Dr. Cutler, if your patients report breakthrough pain,
你所做的就是加倍他们的剂量 all you have to do is double their dose
让他们整夜安睡 to get them a full night's sleep.
爆发性病痛这种说法 Isn't, um, breakthrough pain
难道不只是你销售更多奥施康定的方式吗 just a way for you to sell more Oxy?
不一定 Um, not necessarily.
-我听说... -你看看这个小册子 - I heard... - If you look in the pamphlet--
我听说你写的剂量越多 ...More milligrams you write,
你能得到的奖励就越多 bigger your bonus check.
所以这难道不是你为了能赚更多钱胡说的吗 So isn't all this just bullshit so you can make more money?
-这纸上半数的术语我都没听说过 -好了 - I haven't heard of half the terms in this paper. - Okay,
这样吧 我们短暂休息一下 tell you what, let's take a quick break,
喝点咖啡 十分钟后再回来 uh, grab some coffee, be back in ten.
跟我来 迈尔斯 Come on, Miles.
你有好一阵看起来不开心了 You've seemed unhappy for a while now.
是啊 我这段时间不太好过 Yeah, I've been going through a tough time, you know?
一些私人事情 Some--some personal stuff.
-和女孩有关吗 -嗯 是的 - Is it girl trouble? - Yeah, yeah.
我在和一个让我神魂颠倒的女孩约会 I'm seeing this chick who's driving my head in circles.
好吧 听着 All right. Look.
你得把注意力回到工作上 You have got to get your head back in the game.
你是我最出色的销售之一 伙计 You are one of my best sellers, man.
你是这里的一份子 You're family here.
无论你需要什么 尽管和我说 So whatever you need, you let me know.
谢谢 巴恩 很感谢你 Thanks, Barn. I appreciate that.
有件有意思的事 Something interesting came up.
我被派去路易斯安那州 I've been asked to be the regional manager
新奥尔良做区域经理 in Louisiana out of New Orleans.
天呐 这... Wow, holy shit. That's--
恭喜 这太棒了 Congratulations. That's great.
-新奥尔良是个很棒的城市 -多谢 - New Orleans is a great city. - Thanks.
我在想你或许能和我一起去 And I was thinking maybe you could come with me?
这样怎么做 How would that work?
作为什么呢 I mean, like, as what?
我的...我的员工 My--my employee.
还有... And, um,
还有作为我的男朋友 and my boyfriend.
你...你是在开玩笑吗 Are you--are you joking?
不是 No.
做女生真难 It's tough being a girl.
知道吗 你和一个男人上床久了 You know, you fuck a guy enough
然后你就会开始对他上心 and then you start to get attached.
这是最糟糕的情况 Ugh, it's the worst.
你...你是在说好听的话吗 Is that, um-- is that you being sweet?
好吧 Fine.
我喜欢你 I have feelings for you.
行了吗 这下你高兴了 Okay? You happy now?
我也喜欢你 I have feelings for you, too.
我一点也不知道 Wow, I had no idea.
去新奥尔良吧 Come to New Orleans.
我是区域经理 I'll be the regional manager,
而你会是我的明星职员 you'll be my star employee.
我们可以吃那里的面包圈 We can eat beignets,
然后你可以给我口 then you can eat my pussy.
听上去很棒 不是吗 Sounds kind of magical, doesn't it?
确实听上去很棒 Does sound kind of magical.
你看起来有些筋疲力尽 Well, you've seemed a little burned out.
你正需要些改变 Change is exactly what you need.
我们会在那里赚大钱的 We'll make a fortune there.
那是个蓬勃发展的市场 It's a booming market.
赚钱 赚钱 Money, money, money, money.
抱歉让你久等 我是这片区域 I'm sorry about the wait. I'm one of the only doctors
唯一一个诊治滥用阿片类药物的医生 that treats opioid use disorder in the region.
我很感谢你愿意见我 I'm just grateful you could see me.
贝丝修女对你评价很高 Sister Beth speaks real highly of you.
我对她的评价也很高 And I her.
我认为以心理治疗为主 药物为辅 I believe medication-assisted treatment combined with therapy
是让人康复的最好方式 is the best path to recovery.
没有她的帮助 我一个人无法做到 I couldn't do this without her.
这些药物太神奇了 It's extraordinary what this drug does.
我还是忘不掉这药 I still can't get it out of my mind.
这是因为你的大脑被重新布线了 That's because your brain has been rewired.
大脑额叶可能需要两年的时间才能完全康复 And it can take two years for the frontal lobe to fully heal.
据我所知 不需要这么长的时间 As I understood it, it wouldn't take that long.
两年 Two years?
恐怕这是最新的研究所显示的结果 I'm afraid that's what the most recent studies show.
并且还是在你停药后的两年 And that's after you stop.
有一种新药叫作苏博酮 There's a new drug called Suboxone
和美沙酮很像 但更容易服用 that's similar to methadone, but it's easier to take
因为你不需要每天去诊所 because you don't have to go to a clinic every day.
我能给你写个处方 I can write a prescription.
这个药被归类为麻醉剂吗 Is it classified as a narcotic?
是的 但你也许更容易戒掉它 It is, but you might be more successful in weaning off it.
它不能立马戒掉 而且老实说 It can't be done quickly and the truth is,
有些患者可能需要终身服用 some patients will need to take it the rest of their lives.
你也不知道我是否能彻底戒掉它 And you don't know that I'll ever really be off of it?
是的 I don't.
但我们可以试一试 But we can certainly try.
好的 Okay.
试试吧 Let's give it a shot.
纽特·金里奇已经表明有兴趣参选总统 Newt Gingrich has expressed interest in running for president.
他确实是个有趣的人 Certainly a very interesting guy.
鲁迪·朱利亚尼 事实上 Rudy Giuliani, in fact,
根据《今日美国》或CNN的民调 when we look at the "USA Today"/CNN poll
他排名领先 comes out actually first.
朱利亚尼会是对抗希拉里·克林顿 Giuliani would be the strongest candidate
最强有力的候选人 因为他能... against Hillary Clinton because he can--
该睡了 亲爱的 我希望你今晚能睡会觉 Bedtime, honey. I want you to get some sleep tonight.
好的 我大概半小时后上去 Yeah, I'll be up in about 30 minutes.
瞧瞧这群可爱的白人 Look at all these lovely white people.
这些就是赛克勒家族的人吗 These the Sacklers?
好吧 今晚你看够赛克勒家族的人了 Well, enough of the Sacklers for tonight.
上床睡觉吧 Come to bed.
过来 Come here.
抱歉 我在这个案子上花了这么多时间 I'm sorry this case has been so time-consuming.
不如你明晚回家吃晚餐 How about you come home for dinner tomorrow
然后陪孩子们玩 and play with the kids?
我明天不行 I can't tomorrow.
一位滥用阿片类药物的医生要做公开演讲 An opioid abuse doctor is giving a public presentation.
我得去参加 I need to go it.
好吧 Okay, well.
我...我能去吗 Can--can I go?
明天你想来参加吗 Tomorrow, you want to come?
是的 我想多了解一些 Yeah. I would like to understand a bit more.
这样结束后 你就能带我去烛光晚餐 Then you can take me to dinner afterwards for date night.
好的 成交 All right. You got a deal.
好吧 All right.
五年前 当我来到这间体育馆 Five years ago, when I came to this very gym,
我很单纯 I was naive.
我认为一旦普渡制药看到我们万人签名 I believed that once Purdue saw our 10,000 signatures,
他们就会重制这种药 they'd reformulate the drug.
但他们不仅拒绝了 But they not only refused,
还加大他们的宣传力度 they pushed even harder on their marketing.
当我在国会上做关于奥施康定的证词时 When I testified in front of Congress about OxyContin,
我太紧张了 I was so nervous,
但我认为我应该亲自警告我们的政府 but I felt I had to personally warn our government
正在发生的情况 about what was happening.
然而可悲的是 他们似乎也不在意 And, sadly, they didn't seem to care, either.
那些同样作证的普渡制药 Neither did the Purdue executives
高层们同样不在意 that were also testifying.
一些议员驳回了我的话 另一些毫不在意 Some senators pushed back against me, others were bored.
我得去打个电话 I have to make a quick phone call.
就在那时 我意识到这场危机 That's when I knew this crisis wasn't going
不会那么快结束 我们都... to end anytime soon. That we all--
喂 是我 我们最后一次 Hey, it's me. When did we last look
看普渡制药的国会证词是什么时候 at Purdue's congressional testimony?
那是我们四年前做的第一件事 That was one of the first things we did four years ago.
全是些官方辞令 It was all the usual talking points.
他们完全不知道滥用的情况 诸如此类的废话 They had no idea of abuse, all that BS.
现在我们花了几年的时间 Well, now that we spent years
翻看了所有他们的内部文件 going through their internal documents,
或许有可能证明他们对国会撒谎了 maybe it's possible to prove they were lying to Congress.
麦克洛斯基先生 Well, Mr. McClosky,
霍华德·尤德尔
普渡制药法务部长
当时是缅因州的检察官 who was the U.S. Attorney in Maine at the time,
跟我们说他发现问题的时候 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 Well, what is it?
叫作苏博酮 It's called Suboxone.
它类似美沙酮 这个也有用 It's like methadone, which also helped,
但这个药对我来说要好很多 but this, for me, is way, way better.
我听说过 它真的有用吗 I've heard about them. And they really work?
对我来说有用 只是... Well, it does for me. It's just, you know,
没有药物的帮忙 很难戒掉奥施康定 it's damn hard to get off this junk without medicine.
是啊 Yeah.
这简直不可能 It's been impossible.
我在很努力地戒掉 And I've been really trying.
我知道 贝琪 I know you have, Betsy.
听我说 And listen to this.
我想开车带你去这家诊所 I want to drive you to this clinic.
大概离你住的地方一小时的路程 It's about an hour from your place.
我每周开车接送你去那个诊所 I will drive you there and back every week.
你觉得呢 What do you think?
让我考虑一下 Let me think about it.
我真的非常抱歉 贝琪 I'm just so damn sorry, Betsy.
-喂 医生 -嗯 - Hey, Doc? - Yeah?
我爱你 I love you.
我也爱你 I love you, too.
它们是麻醉剂 They're narcotics.
你们只是在用一种药物换掉另一种 You're just trading in one drug for another one.
它们有各自的危险 也容易上瘾 They're dangerous and addictive in their own way.
没有什么能帮到我女儿 Nothing has worked for my girl.
我们把她带到这里 而有人在厕所里卖药给她 We brought her here and people sold her drugs in the bathroom.
这完全背叛了我们的信任 And that was a grotesque aberration of our trust.
但如果你服用这些所谓的药物 But if you take these so-called medications,
你就没有在把你的信任寄托在上帝 you're not placing your trust in a higher power.
而是寄托在更多的药物上 You're just putting it into more drugs.
所以药没有用吗 So they don't work?
没用 我很抱歉 No, they don't. I'm sorry.
妈妈 Mom.
我不信上帝 I don't believe in a higher power.
我只信赖海洛因 I only believe in heroin.
贝琪 别这么说 Bets, don't say that!
你听到他说的了 Now, you heard the man.
这些药物很可能和 These medications could be just as dangerous
最初让你上瘾的药同样危险 as the one that got you hooked in the first place.
我得去试试 I've got to try something.
我很想念过去的我 I miss who I was.
现在的这...这不是我 This is--it's not me.
好吗 All right?
从不是真正的自己 It never has been.
那天晚上我听见了 I heard you that night,
你跟我说你喜欢女生 when you told me you liked girls.
我自责了很多年我当时什么也没说 And I've been killing myself for years I didn't say nothing.
我觉得这一切 I feel like this all happened
都是因为那晚我的沉默导致的 because I stayed quiet that night.
不是的 It didn't.
我向你保证 I promise you.
我想或许是这样 I think maybe it did.
就算只是部分原因 Even just a little.
我想告诉你 等你好一些 And I want you to know that when you're better,
我希望你找个女朋友 I want you to have a girlfriend.
我会给你们俩做晚饭和早餐 And I'll cook you both dinner and breakfast
你们想吃什么都行 and anything you two want.
听起来很不错 That sounds real nice.
我得先好起来 I got to get better first.
我想试试 I want to do this.
好的 贝琪 我不... Okay, Betsy. I don't--
好的 我们送你去那个诊所试试 Okay, we'll take you to the clinic and give it a try.
他来了 Here he comes.
-先生 -谢谢 - Sir. - Thank you.
好的 谢谢 Okay. Thanks.
正如我们所料 As we suspected...
药监局要求更换标签 the FDA ordered a label change
新标签将会加上黑框警告 and that label will have a black box warning on it.
我们完蛋了 We're so fucked.
未必 Not necessarily.
有几个惊喜 There are a few surprises here.
在第三页上写了 It says on page three
他们同意标签上写 the label is approved to say,
"据悉药品不易上瘾" "addiction is reported to be rare."
真的吗 这对我们意义重大 Really? That's huge.
而且我们还能继续为中度疼痛患者销售该药品 And we're still allowed to keep selling for moderate pain.
谢天谢地 Thank God.
如果只能卖给重病痛患者 It would've ended us
那我们就真的完了 if we were restricted to severe pain.
百分百完了 Oh, 100%.
还有个大惊喜 There's one more big surprise.
药监局同意让我们写... The FDA has agreed to let us say...
该药品可以长期使用 the drug can be used for an extended period of time.
-你在开玩笑吧 -不 我没有 - You gotta be kidding. - No, I'm not.
什么 What?
我们现在可以和医生们说 We can now tell doctors
奥施康定可以安全地终身使用 OxyContin is safe to use indefinitely.
干得漂亮 儿子 干得漂亮 Well done, son. Well done.
我们是如何办到的 How the fuck did we pull this off?
是啊 我们和药监局商议时 Yeah, when we discussed it with the FDA,
他们似乎并不反对 they seemed open to it.
理查德博士说得对 I mean, Dr. Richard was right.
我认为他们并不完全理解 I don't think they fully understood
这种措辞 the true ramifications of,
带来的真正后果 you know, what this wording would do.
我的天 我简直不敢相信我们有多幸运 Oh, my God, I can't believe how lucky we got.
是幸运 和一点努力 It's luck with a little bit of a push.
市场部已经做了调查 Marketing has already run numbers
有了这个新标签 and with this new language,
他们认为我们可以在两年内将销量翻三倍 they think we can triple our sales in two years.
这种新措辞 Look, with this new language,
它甚至算不上黑框警告 it's not even really a black box warning,
更像是黑框警告精简版 it's more like black box lite,
而这正是你们需要告诉医生们的 and that is exactly what you need to be telling your doctors.
-我不理解 -什么 - I don't understand that. - What?
黑框警告标签说明药品比我们多年来 A black box label indicates the drug is much more dangerous
向医生们说明的要危险许多 than we've been telling doctors for years.
当然不是 Absolutely not.
新标签上写了它可以 The new label itself says that it can be used
长期服用 for extended periods of time.
能有多危险 How dangerous can it be?
至于黑框警告标签的问题 And as far as the black box itself goes,
如果提起来 你就和你的医生们说 if it comes up, you tell your doctors
这是"平面设计的练习" that it is an "exercise in graphic design."
请说 Yeah.
我可能错了 但这个新标签 I may be mistaken here, but this new label
给我们很大自由度 去运用更加激进的销售策略 gives us leeway to be even more aggressive now.
没错 就是这样 Fuck yeah it does!
老板们觉得用这个新措辞的标签 The bosses think that we can double,
我们可以将销量翻倍 甚至三倍 maybe triple sales with this new wording.
41号培训课程 处方药的误解
17号培训课程 教学资料
44号培训课程 小于1%的上瘾率
你在干什么 What are you doing?
我...我来找你 Hey, I, uh, came to find you.
我感觉不太好 I'm not feeling too good.
我想问问是否可以请假 I was going to ask you if I can take off.
关于我们早前谈到过的那件事吗 That thing we talked about earlier?
嗯 是的 Yeah, yeah.
-好吧 -谢谢 - Okay. - Thanks.
-比利 -嗯 - Billy? - Yeah.
别让一个女人搅黄了 Don't let a piece of ass fuck up a career
你就要飞黄腾达的事业 that's about to get a lot more lucrative.
谢谢 我不会的 Thank you. I won't.
好吧 Okay.
这是缉毒署全面的尸检报告 This is an exhaustive DEA autopsy study
显示奥施康定依照医嘱 that demonstrates the dangers of OxyContin
被服用的危险性 when taken as prescribed.
我已经请了黛博拉·莱德曼 I've asked Deborah Leiderman,
药监局的控制药品主管 the FDA's controlled substances director,
加入我们 因为我们没能提前拿到这份报告 to join us since we didn't get the report ahead of time.
我认为有必要借助她的专业知识 I thought her expertise would be necessary.
-当然 -谢谢 - Of course. - Thank you.
缉毒署药理学家大卫·戈文 DEA pharmacologist David Govin
会跟你们详述这些数据 will now take you through the data
数据来源于1304例尸检 which was derived from 1,304 autopsies.
首先 To start off,
我们发现98%确认因用过奥施康定的死者 we uncovered that 98% of our verified OxyContin user deaths
并非那些 were not drug abusers
碾碎该药 然后吸食或注射的瘾君子 who crushed and then snorted or injected the drug.
他们只是如药监局批准的方式吞服的 They had simply swallowed it, as approved by the FDA.
我们知道这是实情 因为我们有照片为证 We know this to be true because we had photographs of the pills
显示尸检时药片还安好无损在死者胃部 intact in their stomachs at the time of autopsy.
你们不可能确定他们是因服用奥施康定而死 It's not possible to determine OxyContin-verified deaths
因为毒理检验报告通常不会列出 since the toxicology reports usually do not list
死亡时其他药物的精确含量 exact levels of the other drugs at the time of death.
缉毒署标记的服用奥施康定死亡案例 The DEA marked a death as OxyContin-verified
是只有当血液中奥施康定的含量 only if the level of OxyContin in the bloodstream
本身足以致死的那些 was high enough to be deadly on its own.
假设检测结果是准确的 Assuming the measurements were accurate,
我们又怎么知道呢 how do we know that?
测量结果怎么会不准确呢 Why would they be inaccurate?
这些数据是直接从尸检报告产生的 The data came directly from the autopsy reports.
而且我们只算了和镇定剂 And we only counted drug combinations
和抗抑郁的药物组合 with tranquilizers and anti-depressants,
这些药通常会和奥施康定一起开 drugs commonly prescribed with OxyContin
来减轻患者疼痛时的焦虑 to reduce anxiety amongst pain patients.
很可能 In all likelihood,
出于对准确性的谨慎考虑 we undercounted the number of OxyContin overdoses
我们低估了奥施康定过量用药的案例数量 out of an abundance of caution for accuracy.
好了 好了 首先 Okay, okay. First of all,
普渡制药没有事先得到这些数据 Purdue had not been given access to this data in advance,
这就使我们无法发现 making it impossible for us to uncover errors
这些法医所犯的错误 made by these medical examiners.
而且粗略看了一下 在我看来报告的科学性 And at first glance, the science appears to me
很不成熟 而且过度简单 as rudimentary and overly simplistic.
如果我们有更多的时间作出回应 If we had more time to respond,
我们可以完全消除他们现有的顾虑 we could make crystal clear how far off they are.
没错 Absolutely.
这个报告非常全面 This study is exhaustive...
彻底 结果也很保守 thorough...conservative.
黛博拉 Deborah?
我更偏向普渡制药的观点 I tend to agree with Purdue on this.
光凭这些尸检报告目前还无法下定论 These autopsy reports are inconclusive at this point.
至少不像缉毒署所说的那样证据确凿 Or at least not as definitive as the DEA has presented them.
且我们自己的数据未显示出缉毒署指出的问题 And our own data does not underscore the DEA's analysis,
老实说 我也觉得模棱两可 which to be honest, I also find ambiguous.
仅基于这份报告 Based on this study alone,
我认为没必要造成恐慌 I don't find any cause for panic.
很好 很好 Great, great.
所以你们打算就这样忽略这些结果 So you're just going to ignore the results?
我没有在忽略它们 我只是不赞同 I'm not ignoring them. I'm disagreeing with them.
药监局在一年前就换掉了警示标签 The FDA changed the warning label a year ago
还给它加了黑框警告 and gave it a black box warning,
这是个严厉的处罚 也很合理 which was a harsh rebuke. And appropriate.
是的 Yes.
但在这个尸检报告的问题上 我站普渡制药这边 But on this autopsy issue, I side with Purdue.
我们也完全同意 感谢您 医生 And we completely agree. Thank you, Doctor.
-谢谢 -谢谢 辛西娅 - Thank you. - Thank you, Cynthia.
简直不敢相信 Can't fucking believe it.
我...我真的难以置信 Oh, I just--I can't believe it.
你觉得她是不是收了好处 Do you think that she was on the take?
她有意地破坏我们的调查 That she intentionally sabotaged our investigation?
或许她只是不喜欢你 Well, maybe she just doesn't like you.
-你在说笑吗 -不 不是 - Are you kidding? - No, I'm not.
你不该先去找媒体 You shouldn't have gone to the press first.
你本该在会议前把报告给他们 You should've given them all the report before the meeting.
是啊 然后他们就可以合谋一个对策 Yeah, and then they would've coordinated a response.
布丽姬特 布丽姬特 Bridget, Bridget.
莱德曼和麦克考米克用不着收好处 Leiderman and McCormick don't need to be on the take
去支持普渡制药 to side with Purdue.
你只需要看看柯蒂斯·莱特新工作的薪水 You don't have to look any further than Curtis Wright's new salary
就知道为什么药监局几乎永远站在他们那边 to know why the FDA almost always sides with them.
他们只是对未来可能的雇主示好 They're just being friendly to a potential future employer.
都是因为这个 对吧 That's all this is, isn't it?
我想着...我想着能庆祝一下 I thought-- I thought we'd celebrate.
我输了 I lost.
药监局支持了普渡制药 The FDA sided with Purdue.
你说真的吗 Are you serious?
他们说我们的数据无法下定论 但其实可以 They said our data wasn't conclusive, which it was.
药监局毁了能终结阿片类药物危机的机会 The FDA just blew their shot to end the opioid crisis.
天呐 天呐 天呐 天呐 Oh, my God, oh, my God, oh, my God, oh, my God,
我很抱歉 亲爱的 I'm so sorry. Oh, honey.
过来 快 我们先坐下 Come here. Come on, let's sit down.
我已经考虑很长一段时间了 Look, this has been on my mind for a long time.
而这正证实了我的想法 And this just confirms what I've been thinking.
你的工作在毁掉你的生活 Your job's destroying your life.
我甚至不认为他们会感激你 And I don't think that they even appreciate it.
我知道这很难 I know that this is hard,
但你考虑过从事其他工作吗 but have you thought maybe about doing something else?
完全不相干的领域 In an unrelated field.
远离这些人 Just get away from these people.
听我说 这没有在毁掉我的生活 Okay, uh, this isn't destroying my life.
这就是我的生活 我喜欢我的工作 It is my life. I love what I do.
我们不能继续这样生活在一起 We can't go on together living like this.
我人生的目标... My goal in life is...
不仅仅是作为你妻子 not just to be your wife.
我知道你的工作很重要 You know what, I know that your work is important.
我知道你在做的这件事很重要 I know that what you do is important.
我只是希望我对你来说也同样重要 I just want to be important to you as well.
我们结婚时已经不年轻 We got married kind of late in life.
婚姻本该让我们幸福 And it was supposed to make us happy.
但我不觉得我们任何一个人幸福 I don't think either of us is happy.
司法部
爱丽丝 Hi, Alice.
约翰 Hi, John.
这是里克·曼卡索和兰迪·拉姆塞尔 This is Rick Mountcastle and Randy Ramseyer.
他们在调查这个案子 They've been running point on this case.
这是爱丽丝·菲舍尔 刑事法庭庭长 This is Alice Fisher, head of the criminal division.
幸会 我听说你们在干很了不起的事 A pleasure. I hear you've been doing great work.
-很高兴认识你 -我很好奇 - Nice to meet you. - So, I'm curious.
要是有人雇了鲁迪·朱利亚尼 霍华德·夏皮罗 If anyone hires Rudy Giuliani, Howard Shapiro,
还有玛丽·乔·怀特 and Mary Jo White,
他们能受到司法部的特别接见 do they get a special audience with the DOJ
为自己的案子辩护吗 to plead their case
还是只有那些 or is that just billionaires
以自己名字命名博物馆的亿万富翁能这么干 with their names on museums?
真幽默 约翰 That's cute, John.
我们开这个会简直毫无意义 No, it is total bullshit that we're even taking this meeting.
我还听说朱利亚尼在游说这里的每个人 And I hear Giuliani is lobbying everyone in the building
不要以重罪起诉那些家伙 not to charge these guys with felonies.
听着 前任市长不能影响司法部 Okay, the former mayor does not influence the DOJ.
我们先听听他们有什么要说的 Let's just hear what they have to say
然后再做判断 and go from there.
我们可以提供上百封内部邮件 We can provide hundreds of internal emails
表明这些高层管理人员知晓了 to show how surprised these executives were
如果在2000年前就有药品滥用的情况有多惊讶 if there had been abuse prior to the year 2000.
没错 是有几起随机事件 Yes, there had been random incidences,
但所有的麻醉剂处方药都有一定程度的滥用情况 but all narcotic prescription drugs get abused to a certain extent.
而且没有任何异常情况表明 And there were no warning signs
奥施康定的滥用情况达到了空前的程度 that OxyContin had reached unusual levels.
而且因为几个胡来的药代表行为 And it would be highly inappropriate and overzealous
以重罪起诉个别高层 to charge individual executives with felonies
是极度不合理且小题大做的做法 for the actions of a few rogue sales reps.
已经讨论好几个小时了 Well, it's been about a few hours.
我讨厌太过小题大做 I'd hate to get too overzealous.
我们不如短暂休息片刻 Why don't we take a quick break?
来下我的办公室 Come to my office.
他们的辩护有道理 They have a legitimate defense.
不 并没有 No. No, they don't.
那只是他们的官方辞令 都是瞎说的 Those are just their standard talking points--it's bullshit.
这并不意味着他们不能说服评审团 That doesn't mean they won't sway a jury.
听我说 这些家伙在我的社区售卖这个药品 Look, these guys dropped this drug in my community,
他们让成千上万人染上药瘾 they addicted thousands of people,
然后他们赚得盆满钵满 and then they walked away with billions.
他们要么自己认罪 They will either plead guilty
要么也会被陪审团定罪 or they'll be convicted by a jury.
我的案子很有胜算 I've got a great case here.
这是个仍有风险的案子 It's a case that still has risks.
进来 Come in.
我不认为司法部会支持 I don't think you're gonna find main Justice
对这些高层的重罪起诉 will support felony charges against these executives.
这由不得你说了算 Well, it's not your call.
你不是我的上级 所以我自己拿主意 And I don't report to you, so I'll make my own decisions.
我知道这不是我说了算 I know it's not my call.
你也说得对 And you're correct.
我无权决定起诉对象 I have no decision-making power over charging.
不好意思 你是在说 Sorry, are you saying that
这个决定是来自司法部副部长吗 this is coming from the deputy attorney general?
我不认为你能得到司法部 I don't believe you will find support at main Justice
对这些人的重罪起诉的支持 for felony charges against these individuals.
抱歉 女士们 先生们 Excuse me, ladies and gentlemen,
能听我说句话吗 if I could have your attention.
非常感谢你们的长篇陈述 Thank you so much for your lengthy presentation.
经过认真考虑 After careful consideration,
我决定以重罪起诉迈克尔·弗里德曼 I have decided to indict Michael Friedman,
保罗·戈登海姆和霍华德·乌代尔 Paul Goldenheim, and Howard Udell on felony charges.
祝你们愉快 Have a great day.
如果他们不让我们起诉该怎么办 So how is this going to work if they won't let us indict?
我不知道 I have no idea.
喂 Hello?
喂 格蕾丝 我是贝琪 Hey, Grace, it's Betsy.
嗨 你好吗 Hey. How are you doing?
我...我很好 Oh, I'm--I'm good.
我想我终于开始控制住我的情况了 I think I'm finally getting a handle on all this mess.
太棒了 Well, that's great.
-尤里卡斯普林斯怎么样 -你肯定会喜欢的 - How's Eureka Springs? - Oh, you'd love it.
它... It's um--
就像是乡村酷儿的《绿野仙踪》 it's like Oz for country queers.
我...我想找个时间去看你 I'd--I'd love to come by sometime.
好啊 你该过来 Oh, yeah, you should.
能见到你我会很高兴的 Ah, it'd be great to see you.
那个... Hey, uh...
你觉得...等我好点的时候 do you think that-- maybe that when I'm better...
或许我们可以... we could, uh...
再试试 try again?
重新开始 Start over?
我想恐怕不行 I don't think that would work.
但...我希望我们是朋友 But, uh, I'd sure love to be friends.
好的 我... Yeah. I--
我能理解 I understand.
做朋友就很好了 Be real nice to be friends.
保重 格蕾丝 Take care, Grace.
你也是 贝琪 You too, Bets.
我有阵子没见到你了 It's been a while since I've seen you.
是啊 我明天开始服用苏博酮 Yeah, well, I'm starting Suboxone tomorrow.
那么...给我最后一剂作为告别 So...give me one hell of a sendoff.
没问题 You got it.
抱歉 黛安 我很遗憾 I'm so sorry, Diane. I'm so sorry.
喂 Hello?
喂 黛安 我是塞缪尔·芬尼克斯 Hey, Diane, it's Sam Finnix.
我一直在这儿等 I'm just waiting here.
你和贝琪会来的 是吧 You and Betsy are still coming, right?
抱歉 但贝琪现在在天堂 I'm sorry, but Betsy's in heaven now.
我女儿终于摆脱了痛苦 My girl is finally out of her pain.
这... That--
新药品正在改变世界 New medicines are changing the world.
它们能治愈曾被以为不可治愈的疾病 They can cure diseases once thought incurable.
它们可以将欢乐带去 They can bring joy...
曾经只有痛苦的地方 where there was once only pain.
我感到非常荣幸 能在委员会前 It has truly been an honor to testify before this committee
为这个对我和我家族来说意义非凡的项目作证 on a subject that means so much to me and my family.
我想告诉你们一个非常重要的观点 And I'd like to leave you with one very important thought.
没有任何法律或法规 No laws or regulations
能够阻挡现代医药的奇迹 will ever be able to stop the miracle that is modern pharmaceuticals.
谢谢 Thank you.
记录就是最好的证明 The record speaks for itself.