How do you make a movie about the opioid crisis fun? Can you? Should you? The answer to these questions — as proposed by director David Yates (emerging from Harry Potter jail, where he’s been since the mid-2000s), screenwriter Wells Tower, star Emily Blunt, and Netflix — is Pain Hustlers, a fast-moving pharma drama that attempts to blend an earnest, relatable issue movie with the seductive excess of a Scorsese-lite true-crime roller coaster. It works, up to a point. Carried by a typically strong Blunt performance, Pain Hustlers is both watchable and eye-opening, even though its dramatic impulses do kind of cancel each other out.
Tower based his screenplay on Evan Hughes’ 2018 New York Times article and subsequent book about how, in the 2010s, a small pharmaceutical company played its way into the big leagues — and then into racketeering charges and bankruptcy — on the back of powerful, fentanyl-based opioid painkiller Subsys, which it effectively bribed doctors into prescribing. But Pain Hustlers is heavily fictionalized. Tower changes all the names and moves the action from Arizona to Florida, enabling Yates to summon scenes of trailer-park desolation and fluorescent sleaze. He also invents the character of Liza Drake (Blunt), a hard-up single mom. For Liza, a sales gig hawking a Subsys-like drug is a way out of her desperate economic situation, and straight into a moral quagmire.
Liza is brassy, passionate, street-smart, and empathetic, and she seems quite clearly inspired by real-life crusader Erin Brockovich, as played by Julia Roberts in Steven Soderbergh’s 2000 legal drama about a working-class woman battling a corporation that’s poisoning people at the bottom of the food chain. But Liza also serves as a Jordan Belfort type — Leonardo DiCaprio’s character in Martin Scorsese’s The Wolf of Wall Street, perhaps the definitive movie about sales culture. Like Belfort, she’s designed to give us a vicariously thrilling insider glimpse at how this murky world works.
Working a shift at a strip club, Liza bumps into Pete Brenner (Chris Evans), a sales rep for Zanna, a pharma startup that’s failing to claw its way into the market with its fast-acting fentanyl formulation that users spray under their tongues (called Lonafen in the film). He spots her intuitive talent for giving people just what they want, and he offers her a job.
When she accepts, partly out of worry about paying the medical bills for her daughter, who has epilepsy, Pete juices up her CV with fake medical qualifications and presents it to Zanna’s eccentric founder, Jack Neel (Andy García). But first, he scrawls the letters “PHD” in the corner. Liza protests that she didn’t even finish high school, but it turns out this is code for exactly how Zanna likes its salespeople: “poor, hungry, and dumb.”
Pete is right on two counts, but Liza is anything but dumb. Her ingenuity and charm interlock perfectly with Pete’s ruthlessness. She swiftly climbs the ladder, saving the company by persuading Pete to let her create a low-rent version of the “speaker programs” other pharma companies use to recruit doctors to prescribe their products. At these boozy, sponsored away-days, key doctors are paid to deliver a speech to their peers — and to fellow clients. They’re a disguised form of kickback that operates in a legal gray area; Pete describes the programs as “doing 67 in a 65 zone,” and says the perpetrating companies will only earn a slapped-wrist fine if they’re found out.
Wholesale bribery isn’t the end of it, though. During the time frame when Pain Hustlers is set, fentanyl-based drugs are only legal as pain relief for late-stage cancer patients, since the drugs’ dangerously addictive qualities aren’t a primary concern in those cases. But Neel wants to keep his company growing. That means new markets, which means talking doctors into pushing these potent opiates at patients who don’t need them. Overdoses start to rack up, and Liza, now a wealthy marketing exec, faces a crisis of conscience.
Pain Hustlers requires a series of pretty ungainly gear-shifts from Blunt, and it’s a testament to her magnetism and brilliant command of tone that she manages them so smoothly. It’s as much of a pleasure to watch her trade barbs with her mom (Catherine O’Hara) in a seedy motel room as it is to observe her slick wheeling and dealing in a series of eye-popping power suits, or to go from there to tearful moral awakening.
Evans flounders in her wake, miscast. That’s not because this shameless, amoral role asks him to subvert his heroic Captain America persona. His part in Knives Out did the same thing, and that was a delightfully flippant heel turn. But Pain Hustlers is too loud for this secretly subtle actor. His best scenes with Blunt are a couple of deliciously underplayed occasions when Pete fumblingly tries to pivot their partnership in a romantic direction, and Liza offhandedly rejects his pitch, undoing this inveterate salesman completely.
Oddly for a movie about salespeople, where the filmmakers have clearly worked so hard on finessing their own pitch, Pain Hustlers ends up underselling the human cost of the opioid crisis. A few peripheral characters overdosing can’t begin to describe the way this corporately engineered epidemic of drug addiction laid waste to entire communities, even (and especially) after the crackdown on prescription opioids drove then hopelessly dependent populations toward heroin use. (If you can stomach it, check out “Heroin Town,” the first episode of Louis Theroux’s documentary series Dark States, which explores the impact of the crisis on one West Virginia city. It’s an hour of television you will never forget.)
But the movie does succeed in unpacking the raw grift and exploitation of the pharma sales business, and the wider dysfunction of the American health care and legal systems that allows it to go unchecked. (Insys, the company that inspired the film, perhaps pushed things too far and paid the price, but the practice of “speaker programs” is apparently still widespread.) Tower’s script has so much empathy for its characters — including the hustling sales reps and even a corrupt pain doctor played by Brian d’Arcy James — that it naturally turns the spotlight on the morally bankrupt capitalist ecosystem that exploits them all.
Yates, clearly enjoying leaving the Wizarding World behind after no less than seven consecutive Harry Potter and Fantastic Beasts films, keeps the movie pacy and purposeful. The director seems to be exercising muscles he hasn’t used since directing the classic 2003 British miniseries State of Play, a similarly sinuous thriller with a conscience.
None of this would work as well if Pain Hustlers didn’t bring its perspective inside the seedy pharma sales machine that powered a human catastrophe. But in Liza’s final-act awakening, the filmmakers try to have their cake and eat it too, and in the process, they scrub away most of the story’s complexity and resonance. They commit neither to a Scorsesean ride into the heart of darkness, nor to Erin Brockovich’s clear-sighted crusade. Blending those conflicting ideas turns this copycat into a movie with half the impact and a fraction of the moral weight of either of those movies. But still, Pain Hustlers is a fun watch that also elucidates one of the darkest spasms of modern American capitalism, and that’s something. It makes the sale.
Pain Hustlers is streaming on Netflix now.