What HBO’s “Crime of the Century” Doesn’t Tell You

This article, in a slightly edited form, first appeared on Pain News Network on May 11, 2021.


About 30 years ago, when I opened a pain clinic, I met a patient who made a lasting impression on me. She was a middle-aged woman who sat on my examining table with an unsmiling expression, her shoulders hunched. While maintaining eye contact, she began to tell me about her experiences: living with severe, chronic pain; being passed around by hard-hearted doctors; and being ignored or misunderstood by her family members and friends.

Her words saddened me. My patient was telling me she lived in pain, but she also bore a stigma that complicated her pain management. While I was treating patients with chronic pain over the next decades, I would learn that her experience was not uncommon, but this was the first time I’d heard about it. Therefore, it was memorable to me. It reinforced my commitment to advocate for people with chronic pain who were unfairly marginalized, ignored, and dismissed.

A Narrow Perspective of Opioids

I thought about this particular patient after seeing the HBO documentary’s narrow perspective of opioids. It occurred to me that the visceral reaction from nearly any casual viewer would be, “Why are opioids even being sold?” That was unexpected and deeply disappointing to me.

In part, I agreed to be interviewed by Alex Gibney, the director of the documentary, to explain why opioids are still prescribed, despite their risks. I saw this as an opportunity to help educate the public about opioids. After months of exchanging emails and having conversations with a producer, I decided that speaking on the record would be a calculated risk. As a doctor who had prescribed opioids, and who had lost patients because of their pain, I had been confronted by tough interviewers in the past.

I believed this HBO documentary couldn’t be any worse than the other hostile interviews I’d done. I was wrong.

The interview reopened a painful episode when a patient under the care of my pain clinic died — despite the treatment we provided, not because of it. The interviewer asked me about my patient’s death. I chose not to address it during the interview out of respect for those involved, and I will refrain from doing so in the future. It seemed unnecessary to defend myself. The death was a tragedy. It has been adjudicated, and there is nothing that I can say about it at this point that would benefit anyone.

A claim that I must address, however, is this. The documentary says that I was paid hundreds of thousands of dollars in speaking fees which supposedly influenced my prescribing practices. The fact is that I was paid a relatively small amount in speaking fees. The purpose of those speaking engagements was to educate clinicians about the safest ways to treat people in pain, not to encourage them to use opioids.

Fundamental Problem With the Documentary

Beyond the erroneous claims about me, my fundamental problem with the documentary is its potential reach and influence. It is likely that, going forward, all instances of people taking any opioids for debilitating pain will be perceived through the lens of the documentary’s narrative. This, in addition to the 2016 Centers for Disease Control (CDC) opioid prescribing guideline, could have a further chilling effect on opioid prescribing — despite the fact that lowering the number of opioid prescriptions does nothing to reduce the number of opioid-related overdose deaths.

The documentary appropriately highlights how opioids can, and do, lead to addiction and deaths. But the fact is that not everyone who takes opioids gets addicted or dies; comparatively few do.

The benefits of using opioids outweigh the risks for many people with severe chronic pain. For a certain patient category, opioids can be the difference between life and death, and happiness and misery.

Having studied addiction for my entire career, I am deeply sensitive to the propensity of some people to be harmed by opioids.

I also am deeply sensitive to intractable pain for which there are no treatment options today other than the use – as judiciously as possible – of opioids. My experience with patients confirms two things: opioids kill, but so does pain.

We must resist the temptation to further restrict or ban opioids for people who desperately need them. Instead, physicians must be allowed to fulfill their professional responsibilities and uphold their oaths, evaluate patients with complicated needs, apply proper discernment, and treat their patients in accordance with the best available scientific evidence.

A CDC disease expert, DEA officer, member of Congress, activist, or documentarian should not ever attempt to practice medicine.

The Real Crime Is Letting People Suffer Needlessly

Today, one in three Americans (not including children or those with cancer) suffers from chronic pain, or pain lasting longer than 12 weeks. Chronic pain is a full-blown crisis, not unlike the opioid crisis. Yet we hear precious little about the chronic pain crisis. Most people with pain silently, if unwillingly, endure their conditions. Few of us would listen to them, even if we had the opportunity.

Thirty years ago, I waited until the patient had finished telling me about her experiences. Then I simply said: “I believe you.” Hearing those three words, she burst into tears of relief because so few people had been willing to take her at her word when she told them her life had been derailed by unremitting pain. Hers was among the millions of voices that were, and remain, unheard in this climate of opioid rage.

The documentary’s central claim about the opioid crisis is that marketing opioids is a crime and was understood as such at the time when they began to be used to treat non-cancer pain. The use of opioids was not a crime then, nor is it today. However, the failure to appropriately treat chronic pain when it is possible to do so should be a criminal offense.

Lynn R. Webster, MD consults with the pharmaceutical industry. He is author of the award-winning book, The Painful Truth,” and co-producer of the documentary,It Hurts Until You Die.”

You can find him on Twitter: @LynnRWebsterMD.



  1. Martin on May 15, 2021 at 11:32 pm

    Thank you so much for posting this! I have suffered for many years with chronic pain and found the only way to get relief, after trying exercise, yoga, acupuncture, non-opiod medications, and even surgery, was via opioids. I spent years in misery trying to find a doctor who would treat my chronic pain. I finally did and got my life back. I was able to play with my children again, do yardwork, exercise, and so much more. It was like someone had breathed new life into me. I was absolutely dependant on those medications but never addicted. After about 18 years of use, I decided to try life without the medications and had to use buprenorphine to prevent withdrawals from the high dose of oxymorphone I had been taking. Today I still have intermittent pain but it is manageable without the opioids. My ordeal was unnecessary at the time if I had been believed and not treated like an outcast for trying to find treatment for the pain that was robbing me of my life. And that was during the time of the patient’s bill of rights and a relatively positive attitude towards treating pain. I can’t imagine how difficult it would be today if I had to travel the same path or if I fall back into the intensity of constant pain I was in.
    I hate how the current narrative is robbing so many people of the ability to find a new lease on life like I did over 20 years ago. People are being driven to street drugs laced with fentanyl and dying because they cannot get the relief they need from their doctors. I find it utterly disgusting.
    Thank you again, Doctor! Please keep speaking out for those suffering in silence.

  2. Stuart on May 16, 2021 at 3:04 am

    This isn’t difficult to comprehend. “The Real Crime Is Letting People Suffer Needlessly.

    “Dr. Webster: Upon reading your comments regarding the stereotypical treatment you received from Hollywood (where I’d wager that most Hollywood residents likely still receive all the pain medications they deem necessary, one way or another) it struck me that perhaps approaching this catastrophe from a legislative angle may, at least help turn the tide.

    Since the majority of pain physicians today are extremely reluctant to prescribe any type of pain medication due to the (illegal/unconstitutional) actions being INTENTIONALLY MANUFACTURED by the corrupt government (DEA & DOJ).

    While, as you specified, “The use of opioids was not a crime then, nor is it today. However, the failure to appropriately treat chronic pain when it is possible to do so should be a criminal offense.” while it is indeed already a serious criminal offense, it’s called TORTURE! And, it’s already extremely illegal to knowingly and willingly torture any American citizen.

    Regardless if it’s a corrupt government agency, or not.

  3. Jacqueline Ribich on May 16, 2021 at 5:25 am

    Thank you Dr. Webster for continuing to battle for those of us in intractable severe chronic pain. I’ve learned so much from you, your books, and your tireless advocacy. I am humbled by your strength and perseverance. I will enjoy the little quality of life I have from treatment by a wonderful pain management doctor as long as the misguided government and society will allow. I so wish I could join you in your advocacy, but I haven’t the strength. All I can give is my deep gratitude, and a recognition of the work you do in the face of daunting adversity.

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