Michael Keaton stars as a small-town doctor in US opioid crisis drama Dopesick

In 1996 a new drug began circulating in the United States that would directly lead to the loss of hundreds of thousands lives and the collapse of entire communities. Yet despite being in the midst of a national crisis, the DEA took an unusually laissez-faire approach to this relentless narcotics operation. After all, it’s hard to carry out raids or sting operations when the dealers of this particular cartel are doctors, the pushers are sales representatives and the kingpins are members of “the most philanthropic family in America”.

Dopesick, a slow-burning new mini-series of burning importance, is a dramatised account of how the Sackler dynasty, and their company Purdue Pharma, caused an uncontrollable epidemic of opioid abuse throughout the US with their insidious campaign to make their “miracle drug” OxyContin the most prevalent analgesic in the country.

Undoubtedly due to the ongoing developments in litigation and multibillion-dollar settlement agreements involving Purdue and the Sacklers, the show marks the second major TV release this year to focus on this subject, following an acclaimed HBO documentary, titled rather more damningly The Crime of the Century.

But Dopesick doesn’t seek to be brazenly incendiary or forensically investigative (though it is adapted from an eponymous book by the journalist Beth Macy). While shocking statistics and sums are occasionally quoted by the attorneys building a case against Purdue, the show’s power stems from the fact that it never forgets that this isn’t simply an abstract battle between Justice and faceless Big Pharma. It is first and foremost a human story: of loss and greed, hubris and vulnerability, compassion and detachment. In faithfully fictionalising real people, in imagining the circumstances by which this lethal product came about, the series perhaps comes closer to a sense of the real toll of the epidemic than a fact-laden article or documentary.

At the core of the show’s pursuit of authenticity are the outstanding performances of its ensemble cast, each of whom represents a different part of the causal chain that leads from the inception of a new drug in 1986 to a grand jury investigation in the early 2000s.

We begin with the fountainhead of all this misery: Richard Sackler (Michael Stuhlbarg). A wilting branch in a distinguished family tree, he putatively works to cure pain, but will subvert and invent scientific evidence to ensure that his highly addictive OxyContin pills eclipse his uncle Arthur’s success developing Valium. While the Sacklers make Succession’s Roy family seem comparatively affable, Dopesick is perhaps at its most chilling in the scenes involving the Purdue sales team, who at one nauseatingly cynical point, applaud the launch of a new dosage that is tantamount to so-called “Oxycution”.

On the other end of the spectrum is Dr Finnix — a role lived, rather than played, by Michael Keaton. A conscientious small-town Virginia doctor, he’s spent 40 years caring for his neighbours, not least 20-something minor Betsy (Kaitlyn Dever) who goes to him for both treatment after an injury and advice with a sensitive personal matter. Devastatingly it’s Finnix who prescribes Betsy her first bottle of OxyContin, having been worn down by a Purdue rep (Will Poulter) into trying it on his patients. So Dopesick heartbreakingly suggests how the catastrophe began: a bitter pill swallowed by doctors became a deadly pill swallowed by the public.

★★★★☆

Available now in the US on Hulu; from November 12 on Disney Plus in the UK