Dopesick episode 7 recap – “Black Box Warning”

By Daniel Hart
Published: November 10, 2021 (Last updated: November 10, 2023)
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Hulu series Dopesick episode 7 - Black Box Warning


Dopesick turns the screw even more to bring a horrifying 60 minutes of the preventable tragedy of the opioid epidemic.

This recap of Hulu series Dopesick episode 7, “Black Box Warning,” does not contain spoilers.

Read the review of the miniseries.

The more I watch Dopesick, the more I believe it is a horror than a drama. The horror of capitalistic evil within the hands of a few who flex any rule possible at the expense of thousands of deaths. That is horrifying, and it’s even worse that this story is based on true events.

Dopesick episode 7 recap

Episode 7 opens in 1972. The Sackler family attend a congressional hearing. Senator Dodd questions the ethics of their company. The Sackler family argues that their advertising is ethical. In 2002, in another congressional hearing, Senator Dodd pressed the issue of a widely available drug, which increases the likelihood of abuse. An expert states he has never seen an epidemic of drug abuse that is as bad as OxyContin.

Back to the core story, and Betsy is found by her mother among the homeless tents. Her mother is determined to find a way to get her better and wants Betsy to attend a town meeting regarding OxyContin. The meeting has a massive turnout, demonstrating how many people have been impacted by the drug. They agree to sign a petition to attempt to end this epidemic. This whole scenes feels sad — there’s so much hope and collectiveness, but as the viewer you can sense the end of the nightmare is nowhere near.

Samuel is in therapy; his therapist wants him to focus on the positive things that he did, rather than the regrets. Specifically, she wants him to focus on all the babies he has delivered. Samuel is making emotional progress, however his reinstatement to be a licensed doctor is under jeopardy — they want him off methadone first. Samuel tries arguing that methadone is helping his addiction, but his argument does not take him anywhere. He looks into another medication that may help him rid his addiction to opioids.

Richard Sackler learns that the FDA wants to change its warning label on OxyContin. He is surprised because he has brought someone in from the FDA (Curtis Wright) to work for them. Their ex-FDA colleague states they need to work on the wording. Randy speaks to an FDA colleague and learns that Purdue Pharma worked with Curtis Wright before he joined them — it’s suspected that Curtis Wright wrote the warning labels for the pharmaceutical company. The lengths they have gone to keep this drug in the system is alarming.

Billy is irritated at work, so his manager checks on him and tells him he is his best saleman. Afterward, Amber tells Billy that she’s being given the role of regional sales manager in New Orleans and wants Billy to join as her employee and boyfriend. Amber admits she has got attached and has feelings for him. But still, the money side of selling OxyContin has festered her mind, and you can tell Billy is irked by it.

Rick and Randy have made headways in their investigation showing that Purdue Pharma has lied to congress and committed fraud. They make the decision to finally indict them. In 2006, the FDA meet Purdue Pharma regarding changing the warning label. The FDA is considering adding the “Black Box Warning” to their label. Richard Sackler can see the end of the line on this drug and he wants to make a strong response. Richard holds a meeting regarding the label to discuss wording. He’s still persistent in fighting this, knowing the commercials at stake.

Samuel rings Betsy and tells her he is still fighting addiction from opioids. He apologizes for prescribing that drug to her and recommends a medicine to help reduce the addiction. He offers to drive her to a clinic every week to get this medicine to help her combat the addiction. Betsy gets advice from the church, and they do not advise this medication, stating that it is a narcotic, and they feel it is merely a replacement. Betsy tells her mother she doesn’t believe in a “higher power” and she wants to try something new so she can return to who she was. Her mother tells her that when she is better, she wants to cook for her girlfriend — it’s an emotional breakthrough in the mother/daughter relationship.

It’s confirmed; OxyContin is labelled with the “Black Box Warning” but, surprisingly, it states that “addiction is reported to be rare”, and can still be used for moderate pain. There’s also another concession; the FDA has agreed on the wording of “the drug can be used for an extended period of time.” The board is gleeful, knowing that they can market the drug indefinitely. It’s all about money, money, money. It’s sickening to watch Richard and the board to be happy about this.

In a sales meeting, Billy is confused about the “Black Box Warning.” He doesn’t understand how they can triple sales with this new wording, and he’s clearly conflicted by it. Feeling desperate, Billy steals some training tapes as evidence of fraudulent behavior in their sales and marketing techniques.

Bridget meets the FDA and Purdue Pharma again with their findings and research. The data is presented. They prove overdoses are mostly from OxyContin users when reviewing autopsy reports. Purdue Pharma wants to review the data, but Bridget tells them that the study is comprehensive, thorough, and conservative. The FDA expert agrees that the data needs to be reviewed, and raises how the label was given as a “Black Box Warning,” to undermine the research. Bridget is told she should have provided the report before the meeting. Afterward, it’s raised how the FDA and Purdue Pharma do not like her. Her husband raises concerns about her well-being and their relationship due to her work.

Bridget continues to struggle internally and externally with her fight against Purdue Pharma.

The ending

The ending of episode 7 brings tragedy, and one that’s difficult to swallow.

Betsy rings Grace and asks if they can try again (to be a couple) once she is better. Grace says no but that she would love to be friends. Betsy hears a baby in the background (and connects the dots that Grace has moved on) and gets off the phone as quickly as possible. She’s heartbroken, and once again, she finds herself with the same drug dealer; she injects opioids again. She thinks it’s a send-off until she goes on to preventative drugs. The next morning, the sheriff visits her home and delivers the news to her mother — it’s obvious what the news is before he says it. Betsy is dead, and the mother screams in emotional pain.

As for Samuel, well, he’s waiting for Betsy. He rings the mother and she drops the news that she’s dead. Samuel is in shock. The weight of the news will be crushing. He will feel responsible, but, we know it’s not his fault — this is a pharmaceutical horror show.

What did you think of Hulu’s Dopesick episode 7? Comment below.

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