Watch ‘The Oxy Kingpins’ Review: How the Opioid Crisis Really Worked

“The Oxy Kingpins” is a documentary that feels like it could be a Martin Scorsese movie. It’s “The Wolf of Wall Street” meets “The Insider” — the story of a scurrilous illegal business, and one of the hotshot thrill junkies who rode it to riches, and how that business connects up to a much larger corporate racket. The big players, in this case, are the pharmaceutical distribution companies that dumped opioids onto the market, addicting countless people to OxyContin, a narcotic painkiller that’s really heroin with a “medical” image brand. The thrill junkie is Alex Dimattio, a drug dealer who grew up in New York City, where he dealt weed in Washington Square Park and heroin on the Lower East Side, only to discover that he could make a killing (with a lot less risk) by selling OxyContin pills.

You may think that you already know the ins and outs of the opioid crisis. A whole lot of Americans in the heartland, many of them out of work and sunk into despair, taking refuge in drug use and becoming OxyContin addicts, because the market was suddenly flooded with the stuff. The opioid epidemic has killed more than 700,000 Americans. But how, from the ground up (and from the top down), did the disaster unfold? Brendan Fitzgerald, the director of “The Oxy Kingpins,” fills in the nuts and bolts of how the racket actually operated the way Scorsese did in “The Wolf of Wall Street” and “Casino,” giving the audience a wide-eyed, engrossing, information-packed street-smart tutorial.

He starts with Alex, a former dealer who served eight years in federal prison (he’s now the owner of a motorcycle company). Lean and charming and tattooed, Alex is a captivating straight shooter who suggests a Tim Roth character from the ’90s, and he’s the film’s off-ramp tour guide. He explains how he moved to Miami, a city long bound up in the drug trade, and launched his business, which hinged on tapping civilians to go to doctors’ officers and get prescriptions for pain medication. “Everybody in Miami is educated on the drug trade,” says Alex. “Including the little old lady at Walgreens.”

Once the business got rolling, Alex delivered 1,500 to 2,000 OxyContin pills a week to his connection in Boston, at a price of $31 a pill. (He paid only $7 apiece for them.) This meant that he was clearing $35,000 to $40,000 a week. What did he do with the money? “What every drug dealer does with their money,” he says with a barely repentant grin. “Cars, strip clubs, boats, houses, gold chains, and all the dumb shit you could buy.” Alex had a five-bedroom house in South Miami that become a party nexus, filled with associates like Doug, a lug who is interviewed (in a hood, with his voice distorted) about the ride they all took, and how guilty he feels about it. He and Alex would drive from Miami to Boston, which became a drag to do every week, and then they took the train, which made them nervous, until Alex started shipping the pills through FedEx (easy to get away with, bit still: a big mistake).

Okay, that may sound more like an episode of “Miami Vice 2000” than a Scorsese movie. But the horrible fascination of “The Oxy Kingpins” is that it fills in the links between the street-level black market for OxyContin and what was unfolding in the corporate sector. In Miami, a businessman would open a “clinic,” where a doctor was hired to do nothing but write OxyContin prescriptions all day long, and the storefronts had signs that read “Professional Pain Management” or “Pain Relief Center.” (In other words: “Heroin in Pill Form Sold Here.”)

Miami is a hub for drugs, and the pills sold by dealers like Alex were vacuumed up by monied customers in other cities. But OxyContin famously became the small-town scourge of post-industrial Middle America. And that’s because the distribution companies, led by giants like the McKesson Corporation, would pump staggering amounts of pills — literally millions of them — into a town with less than a thousand people in it. How was that possible? The pill delivery was predicated on the addiction it created. And that, according to Mike Papantonio, a veteran attorney who becomes the documentary’s dry-witted legal-crusader hero, was all part of the corporate business plan.

We see Papantonio in his offices in Pensacola, Fla., as he builds a case for the idea that the distributors of OxyContin were drug dealers, too. Papantonio interviews Alex, but he’s really interested in the bigger picture: the larger pattern of distribution, which went on unchecked for years, even though the companies actually had a legal obligation to investigate suspicious activity like local pharmacies asking to increase their opioids quota.

“The Oxy Kingpins” is a piece of documentary advocacy that makes the case — a bit too didactically at times — that executives like John Hammergren, the CEO of McKesson from 2000 to 2018 (he made an annual salary of $700 million), should be held legally responsible for the opioids epidemic. A closing title tells us that thousands of streets criminals, 500 doctors, and dozens of pharmacists went to jail in the wake of the crisis, while not one executive from a pharmaceutical distribution company has been charged with a crime.

That’s a crucial moral and legal point, and “The Oxy Kingpins” is muckraking food for thought. Yet it’s interesting that the film spends almost no time dealing with the river source of the epidemic: the pharmaceutical companies themselves, like Purdue, owned by the Sackler family (whose fortune dates back to Arthur Sackler, the psychiatrist who kicked off the new age of pharmaceutical mood enhancers with the marketing of Valium in 1961). That, I guess, is another film together — an even more scandalous and top-down one. And Purdue is, of course, fighting its opioid court battles as we speak. Yet even as the legal system dogs the company to pay damages (the question being how much), the people who were truly responsible for creating and selling OxyContin remain wolves behind closed doors.