Is Painkiller based on a true story?

For showrunner Noah Harpster, the goal of the Painkiller is for “people to realise that there were moments when this could have been stopped; that it could have gone a different way”.

"We want the audience to be entertained, of course, but we also hope that, by the last episode, they're filled with fury," he added.

But how much of the drama is fact versus fiction? Read on for everything you need to know about the true story behind Painkiller.

Painkiller Netflix true story

Painkiller explores some of the origins and aftermath of Purdue Pharma's mass marketing campaign of controversial drug OxyContin.

The new drama is based on Barry Meier's book, Pain Killer: An Empire of Deceit and the Origin of America's Opioid Epidemic, as well as Patrick Radden Keefe's 2017 New Yorker Magazine article, The Family That Built an Empire of Pain.

While the drama certainly has a foundation of fact, Painkiller is a fictionalised retelling of events and so many of the specific characters we are introduced to in the series aren't real people. But, according to Painkiller executive producer Eric Newman, "some of our characters are clearly versions of real people".

He told Netflix ahead of the series release: "Other characters, like Edie Flowers, are composite characters — a fictional amalgamation of a few different people. But even the fictionalised elements of this show are grounded in the knowledge that the painful repercussions of opioid addiction are playing out across America every day.

"That’s what lies at the heart of Painkiller; trying to understand how this all started, so that we can maybe finally stop it."

The very real story of OxyContin, Purdue Pharma and the billionaire Sackler family have been explored in various mediums over the years, namely through the aforementioned investigative journalism and writing by Meier and Keefe, but also through Painkiller executive producer Alex Gibney's critically acclaimed two-part documentary film, The Crime of the Century.

As explored in the series, the Sackler family pushed research in the '90s to replace Purdue Pharma's innovative new drug MS Contin with OxyContin, a drug containing the sole active ingredient of oxycodone. Despite initially being a drug used for end-of-life palliative care for cancer patients and those in extreme pain, Purdue Pharma employed doctors and funded research to alleviate concerns that OxyContin was highly addictive.

In a plot point explored by Painkiller, Purdue Pharma trained their sales reps to sell to small-town doctors and convince them of the benefits of the opioid, infamously stating that the risk of addiction was less than one percent. Although Purdue Pharma cited a study from Hershel Jick and Jane Porter, who found only four cases of "reasonably well documented addiction" in "11,882 patients who received at least one narcotic preparation", the study has been continuously mis-cited over the years.

As explored in Painkiller, Jick and Porter sent this letter and their findings to the New England Journal of Medicine and soon, that letter became the touchstone of Purdue Pharma's OxyContin marketing campaign. But the major part missing from that letter was the fact that Jick and Porter had only looked at hospitalised patients in regimented settings, thus not including patients being prescribed opioids at home.

Jick has since told the AP: “I’m essentially mortified that that letter to the editor was used as an excuse to do what these drug companies did.”

Purdue Pharma managed to get OxyContin approved by the FDA in 1995, along with a claim that OxyContin was safer than other painkillers due to its patented delayed-absorption mechanism which was “believed to reduce the abuse liability”.

That plot is also explored in Painkiller, as the FDA's examiner, Dr Curtis Wright (played in the series by Noah Harpster, who is also Painkiller's series creator), oversaw this approval process and left the FDA soon after. Within two years of leaving the FDA, he had accepted a job at Purdue.

Even so, many doctors were very hesitant to onboard and prescribe OxyContin to their patients, having known the risks of opioid addiction for many years. In 1997, though, the American Academy of Pain Medicine and the American Pain Society published a statement about the use of opioids to treat chronic pain. Interestingly, the statement was written by a committee chaired by Dr J David Haddox, a speaker who was paid by Purdue.

Painkiller's opening credits include real-life testimony from those impacted by relative's opioid addictions and their subsequent deaths, underlining how addictive OxyContin is and how its impact can still be felt to this day.

With sales of OxyContin skyrocketing after a sustained marketing campaign, within the first five years of being launched, OxyContin had generated a billion dollars a year. Sales reps were earning hundreds of thousands of dollars for bonuses and being rewarded with holidays by Purdue, something that is also explored in Painkiller's character of Shannon Schaeffer (West Duchovny).

Richard Sackler, then the co-chairman of Purdue Pharma, altered the sales strategy for the company, stating that reps were to be measured on the success of their sales due to the strength of the OxyContin doses sold, rather than the number of doses. At this time, there were increasing signs of drug abuse in rural areas of America like Appalachia and Maine, as well as the increase in people selling their pills on the black market and crushing or snorting OxyContin.

Purdue Pharma's position on the matter was that the abuse of OxyContin was a case of personal responsibility, with Richard Sackler stating that “all health problems devolve upon the individual”.

Ultimately, the fact that Purdue Pharma misrepresented the risk of addiction proved costly for them as in 2015. Richard Sackler was deposed by four lawyers in Louisville, Kentucky, a deposition that was concerned with the development and marketing of OxyContin. But before the case had gone to trial, Purdue had settled the case for $24 million.

But the Sacklers do continue to be caught in multiple lawsuits, alleging that OxyContin helped start a crisis that caused more than 500,000 US overdose deaths over two decades. The series states that "Purdue Pharma filed for bankruptcy in 2019 as a direct result of the multi-state lawsuits". It also states that the Sacklers agreed to pay a settlement of $6 billion and have had to forfeit ownership of Purdue Pharma, which will become a new company known as Knoa.

At the time of the May 2023 ruling, the Sackler families of the now dead Purdue founders, Mortimer and Raymond Sackler, supported the court's decision, stating: “The Sackler families believe the long-awaited implementation of this resolution is critical to providing substantial resources for people and communities in need."

As of 2023, though, final approval for Purdue Pharma's bankruptcy is still pending, and no member of the Sackler family has ever been criminally charged in connection with the marketing of OxyContin or any overdose deaths involving the drug.

Painkiller is available to stream on Netflix now. Check out more of our Drama coverage or visit our TV guide and Streaming Guide to see what’s on tonight.

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