‘The Crime of the Century’ Review: Alex Gibney Shows How Big Pharma Created the Opioid Epidemic

Tyler Hersko
·7 min read

Over 500,000 Americans have died from opioid overdoses since 2000. This tragedy is often referred to as a crisis, which is a term that Alex Gibney dismisses early in “The Crime of the Century,” his latest HBO documentary. A crisis is typically something that happens unexpectedly and can’t be prepared for — and there is nothing random about the surge of opioids in the United States over the last two decades. It was a deliberate tactic designed by pharmaceutical companies to boost their profit margins, and the situation spiraled out of control when the doctors and politicians that could’ve pushed back chose to aid and abet Big Pharma.

Time and time again, “The Crime of the Century” lays bare how the United States’ opioid epidemic was anything but accidental. The four-hour documentary, which is split into two parts and will air over two nights, makes ample use of its runtime to hone in on how pharmaceutical companies such as Purdue Pharma and Insys Therapeutics campaigned to make opiates widely accessible. It offers multiple deep-dives into how the opioid epidemic has impacted American citizens — individuals who have lost loved ones to opiate addiction are interviewed, as are the law enforcement and EMT workers who have responded to overdose cases. The result is a damning portrait of some of the pharmaceutical industry’s most sociopathic executives and the political forces that have enabled them, as well as a heartfelt cry for help from the comparably “ordinary” American who have lost friends and loved ones to the nation’s opioid epidemic.

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“The Crime of the Century” does not boast any revelatory information. By now, it’s common knowledge that pharmaceutical companies have knowingly lied to the public by promoting opioids as a “safe and non-addictive” solution to pain relief and there’s also a consensus that many of America’s politicians are bought and owned by the very corporations that they are supposed to regulate.

What the documentary lacks for fresh insights into the opioid epidemic it more than makes up for in its attention to detail. If you or someone you’ve loved has ever struggled with drug addiction, many of the facts and anecdotes in “The Crime of the Century” will be painfully familiar, but that doesn’t mean they aren’t presented well: The first half of the documentary is focused on the history of opioids and how American businesses, especially the Sackler family-led Purdue, conned their way into becoming the United States’ most well-known hawkers of addictive pharmaceuticals. “The Crime of the Century” shows how corporations such as Purdue became the United States’ largest suppliers of opioids, and no expense is spared on deconstructing the unscrupulous advertising tactics that such companies used to market their products, as well as how the widespread availability of opioids have impacted various families and communities.

Gibney’s documentary is a searing indictment of pharmaceutical businesses and the documentary is also critical of the industry’s chief enablers, including American politicians. As the documentary notes, Rudy Giuliani was a mouthpiece for Purdue’s deadly opioid marketing long before he became a #MAGA deplorable, while the dealings of Jamie Gorelick, the deputy attorney general of the United States under Bill Clinton’s administration who became a lawyer for opioid distributor Cardinal Health, are examined in enraging detail.

There’s already a public consensus that being bought and owned by big business is a time-honored bipartisan tradition — hello, climate change denying politicians who just so happened to be bankrolled by fossil fuel companies, and hello to everything the NRA does — but “The Crime of the Century” showcases just how insidious political lobbying can be: U.S. representatives such as Rep. Tom Marino (R-PA) and Sen. Marsha Blackburn (R-TN) are featured spouting the pharmaceutical companies’ talking points while their campaign contributions from said businesses are flashed onscreen. It’s equal parts informative and hopelessly maddening — the documentary doesn’t have the magic answer to how the pharmaceutical industry’s wrongdoings can be stopped when the people in charge of regulating it are so clearly being paid off, but damn, you can’t say Gibney doesn’t accurately describe the situation as it is.

Though “The Crime of the Century” is focused on relentlessly dark subject matter, there are “heroes” to root for in the documentary. While Gibney’s crosshairs air primarily trained on the epidemic’s chief proliferators, appropriate time is dedicated to the families of those who have lost loved ones to the scourge of opiate addiction, as well as the law enforcement and medical professionals who deal with overdose calls and drug dealers on a regular basis. Former DEA official Joe Rannazzisi, who was ousted after leading investigations into the pharmaceutical industry’s opioid networks, is one of the driving forces in the documentary’s latter half, while anecdotes from individuals ranging from EMTs to family members of those who have lost loved ones to opioid addiction are peppered throughout the documentary. Gibney does an exceptional job of critiquing the powerful forces that have enabled the nation’s opioid epidemic without losing sight of how the epidemic has impacted all facets of American life.

Although many viewers will be familiar with the key points in “The Crime of the Century,” the documentary’s exclusive footage will unsettle even those who consider themselves well-versed in the nation’s opioid epidemic. Gibney acquired an array of shocking footage for the documentary, including several exclusive interviews with former Purdue and Insys employees. Examples of bribery, illegal marketing tactics, and wanton corporate excess — the Insys marketing video that features a dancing bottle of fentanyl is utterly beyond the pale (and parody) — permeate the documentary. There is an ethical rot at the heart of America’s opioid epidemic, and Gibney makes devastatingly clear who is responsible for the human cost throughout the documentary. The documentary explains in lurid detail how the nation’s biggest pharmaceutical companies are essentially white collar drug cartels, while the politicians who enable their practices and the doctors who recklessly prescribe their wares are little more than enforcers and dealers, respectively.

The first half of “The Crime of the Century” is primarily focused on the history of opioids and how the Sackler family and Perdue laid the groundwork for the opioid crisis in the United States, while the second half of the documentary shifts gears to Insys and the proliferation of fentanyl. There’s an undeniable sense of déjà vu in the documentary’s latter half, which reiterates how drug companies were let off the hook with financial slap on the wrists while their wares continued to harm the Americans they were intended to help. Though some of the key points in the documentary’s latter half repeat the same talking points, such as political corruption, corporate greed, and the human cost of opioid addiction, there’s a point to the repetition: As Gibney notes, the United States government has only slapped companies such as Purdue and Insys with financial fines that pale in comparison their profits, essentially giving the nation’s opioid manufacturers a greenlight to perpetuate the status quo they created.

But then again, isn’t that part of the problem? A weak-willed United States government has essentially allowed pharmaceutical companies to do as they please, regardless of the human cost. As the documentary suggests, profit margins are all that matter to the business executives and the politicians that they bankroll. Perhaps the biggest criticism that can be levied against “The Crime of the Century” is that the documentary does not boast a call to action or a magical solution to the nation’s opioid epidemic beyond presenting the facts as they are. There’s no silver lining about solving the opioid epidemic in the documentary, which ends with a harrowing recording of a woman screaming on an emergency phone line about an individual she is close to who is dying of an overdose. “The Crime of the Century” is not a pleasant viewing experience, but it’s one of the most pressing and deeply-reported features on one of the United States’ most dire public issues in recent history.

Grade: A-

The first half of “The Crime of the Century” premieres on HBO on May 10 at 9 p.m. ET; the second part airs on May 11.

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