Just when you thought Hollywood had told most of the stories about the opioid crisis, Netflix has released a new film, Pain Hustlers. Directed by David Yates and starring Emily Blunt and Chris Evans, the film follows the meteoric rise of Zana Therapeutics, a fictional company that has taken over the cancer pain drug market with its fentanyl spray, Lonafen. Zana Therapeutics is initially a minor player, but that all changes when unlucky single mother Liza Drake (Blunt) is recruited by sales representative Pete Brenner (Evans). Liza quickly made her first successful sale, and in a few months, Zanna grew from a nondescript, sparsely populated office to a public company that throws parties where Brenner, in a Lonafen-shaped foam suit reminiscent of "Painkiller," performs raps.

The film focuses on Liza and her efforts to increase commissions, and follows a scheme that has now become all too common for rogue pharmaceutical companies: a "by-the-book" procedure until the drug occupies an approved market (cancer patients who already have some opioid resistance) to start with, and then branch out to other, more routine pain needs (defined in the film as "off-label"). The result is an unethical and lucrative scheme that leaves both Liza and the audience shocked at how greedy humans can be (though the film could have spent more time on the victims of this scheme, rather than its machinations). Still, after watching this wild tale, it is reasonable to wonder how much of the film was inspired by real-life events and whether Liza Drake and Jack Neal (Andy Garcia) were really there. Let's read first what we know about the actual events that inspired "Payne Hustler.

As seen in the ending of the film, a fentanyl-based drug similar to the one depicted in the film existed in real life. Pain Hustlers was inspired by journalist Evan Hughes' 2018 New York Times Magazine report (and subsequent nonfiction book) on the Arizona-based pharmaceutical company Insys Therapeutics. Subsys, a highly addictive sublingual spray, was developed and marketed by Insys to manage breakthrough pain in cancer patients who are resistant to 24-hour opioid therapy. Hughes' report details the various techniques Insys used to push its painkiller to market. It hired an attractive staff of motivated salespeople and recruited physicians to recommend the drug to other prescribers through a "speaker program." As mentioned in the film, Insys' speaker program was actually a front for bribing physicians to prescribe this highly addictive drug to patients who did not need it.

In an interview with Tudum, Wells Tower, the film's screenwriter, explained why he wanted to turn a pharmaceutical scandal into fiction. He said, "I was struck by the fact that these people, who in most cases have no medical training, have a lot of influence over the drugs we are prescribed. I thought I had a story that could provide some truly shocking insight into how American health care works."

The real-life story of Insys Therapeutics had a similar ending to the film. Founder Dr. John Kapoor (the film's stand-in was named Jack Neal) was convicted of racketeering conspiracy by a federal jury in May 2019, along with other Insys executives, including sales manager Alec Barlakoff. Speakers Xiulu Ruan and John Patrick Couch were also indicted on charges of operating a "pill mill." That same year, Insys agreed to pay $225 million to settle a federal criminal and civil investigation, but the company subsequently went bankrupt; in January 2020, Kapoor was sentenced to 66 months in prison and ultimately served two years (released last June). (According to Reuters, Kapur is "the highest-level corporate executive ever convicted in court on charges related to the opioid epidemic."

As in the case of "Painkiller," some of the details of Insys' real-life debacle were too good to be left uncut. Yes, Alec Barlakoff, former vice president of sales at Insys, really did a parody rap about the company, along with an employee dressed in a suit shaped like a Subsys spray bottle. (As noted above, Barlakoff was one of the convicted executives, and Brenner in the film appears to be modeled after him and the company's former CEO, Michael Babich.

The film's portrayal of Zanna's "speaker program" was also quite on target. According to The Guardian, prosecutors argued that the real-life Insis "educational seminars" were little more than social gatherings at restaurants, bars, and strip clubs. They also noted that Insys paid about $260,000 to two New York doctors who wrote more than $6 million in subsis prescriptions in 2014.

In another wild detail, Liza Drake's mother, played by Catherine O'Hara, also appears to be based on a real employee of the company. A former New Jersey sales rep for Insys named Susan Beisler really did send Kapoor overly friendly emails about bribes given to doctors in the speaker program, and those emails became an important part of the lawsuit against him.

In the film's press notes, director David Yates explains that each of the characters in the film is a mixture of real details and fiction. With the exception of Liza, they are all loosely based on existing characters in the pharmaceutical industry." Wells was given permission to create his own unique characters. Liza is a single mother with a daughter suffering from health problems, a dreamer, and an underrated but incredibly capable person."

Liza plays a sympathetic guide to the rise of Zanna, Insys' fictional pronoun. While some of Insys' salespeople would have had similar rags-to-riches stories (Hughes' article even mentions that the company hired a former dancer), the single mother is entirely the creation of the film's creative team. Yates explained in his press notes that "[Emily Blunt and I] were drawn to a human being who was undervalued, underappreciated, missed all her opportunities, didn't do particularly well in school, but was nonetheless incredibly capable, very empathetic, and very much in tune with other people.

Hughes also told Time magazine that Liza's character epitomizes the type of people who became part of Insys' sales force. Hughes said that "Liza's character symbolizes the type of people who got assigned to the Insys sales force. 'Even if the details come from all over the place, they are real,' he said."