Alex Gibney doesn't do "light." If you've seen Going Clear or The Inventor, you know he prefers to take a massive, systemic disaster and peel it back until the rot is visible to everyone. But with the Crime of the Century movie—his two-part HBO documentary—he went after something that felt personal to almost every American household. It isn't just a film about drugs. It's a forensic look at a heist where the loot was human lives and the getaway drivers were wearing white coats and expensive suits.
Most people think they know the opioid crisis. They think of Purdue Pharma and the Sacklers. They think of OxyContin. While the movie covers that, it goes way deeper into the "how." It explores how a company basically rewrote the rules of science to claim that a highly addictive substance was somehow safe. It's infuriating. Honestly, watching it feels like witnessing a slow-motion car crash that lasted twenty-five years.
How the Crime of the Century Movie Rewrites the Narrative
We usually talk about addiction as a failure of the individual. The Crime of the Century movie flips that script entirely. It frames the entire epidemic as a manufactured event. It wasn't an accident. It was a business plan. Gibney uses leaked documents and internal whistleblower testimony to show that the "crime" wasn't happening in back alleys, but in boardrooms and through the US mail.
The film spends a lot of time on the concept of "pseudo-addiction." This was a term pushed by pharmaceutical reps to convince doctors that if a patient showed signs of addiction, they actually just needed more drugs. Think about that for a second. It’s a circular logic that is as brilliant as it is demonic. If the medicine makes you sick, take more medicine.
One of the most jarring parts of the documentary involves the "revolving door" between the government and big pharma. We see high-ranking DEA officials who were supposed to be the "cops" on the beat eventually leaving their government jobs to work for the very companies they were investigating. It makes you wonder who was actually looking out for the public. When the people writing the laws are the same people getting paid by the companies breaking them, the system isn't broken—it's working exactly as intended for the people at the top.
The Rise of Insys and the Fentanyl Nightmare
While the first half of the Crime of the Century movie focuses on the foundation laid by Purdue, the second half is where things get truly dark. It shifts focus to Insys Therapeutics and their drug Subsys. This was a sublingual fentanyl spray intended solely for breakthrough cancer pain. But that’s not how it was sold.
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- Sales reps were hired based on their looks and their ability to "connect" with doctors, not their medical knowledge.
- The company used "speaker programs" which were basically just bribes disguised as educational seminars.
- They set up a "reimbursement center" that essentially committed insurance fraud on a massive scale to get the drug approved for patients who didn't even have cancer.
The footage of the Insys sales meetings is stomach-turning. You see employees rapping and dancing around a giant bottle of fentanyl. It’s surreal. It feels like a parody, except people were dying in the thousands while these guys were popping champagne.
Why This Isn't Just "Another Documentary"
The Crime of the Century movie stands out because it doesn't rely on cheap emotional beats. It doesn't have to. The facts are loud enough. Gibney treats the viewer like an adult, laying out complex legal maneuvers and regulatory failures without oversimplifying them.
You've probably heard the name Richard Sackler. The film treats him as a central figure, but it also highlights the "enablers" in the FDA. For example, the way the original OxyContin label was approved—including a specific claim that delayed absorption reduced abuse liability—is scrutinized as a turning point in medical history. That one sentence on a label changed everything. It gave doctors the "permission" they needed to prescribe opioids for back pain, toothaches, and minor surgeries.
It’s easy to blame the addicts. It’s much harder to look at a system that was incentivized to create them. The documentary shows that for every "pill mill" doctor in a strip mall, there was a multi-billion dollar distribution company like Cardinal Health or McKesson shipping millions of pills to towns with populations in the hundreds. They knew. They had the data. They just didn't stop.
The Impact of Whistleblowers
The film gives a lot of screen time to people like Joe Rannazzisi, a former DEA whistleblower who tried to sound the alarm. Watching him talk is heartbreaking because you can see the frustration of a man who did his job and was punished for it. He explains how the "Marino Act" basically stripped the DEA of its power to freeze suspicious drug shipments.
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This is the "century" part of the title. It’s a crime that spans decades and involves every level of society. From the lobbyists in D.C. to the reps in the field, everyone had a role. The Crime of the Century movie makes it clear that while some people went to jail—like the executives at Insys—the structural issues that allowed this to happen are largely still there.
What Most People Get Wrong About the Movie
A common misconception is that the film is just anti-medicine. That's not it at all. It’s anti-fraud. There are plenty of people who genuinely need pain management, and the tragedy is that the actions of these corporations have made it harder for legitimate patients to get help. The "crime" didn't just kill people; it stigmatized a whole class of medication and ruined the relationship between doctors and patients.
Another thing: people think the story is over because the lawsuits are happening. The Crime of the Century movie argues that the settlements are just "the cost of doing business." If a company makes $10 billion and pays a $2 billion fine, they still made $8 billion. In the world of corporate finance, that’s a win.
Critical Insights and Real-World Evidence
The documentary points to specific data points that are hard to ignore.
- The sheer volume of pills: In one Mingo County, West Virginia pharmacy, millions of doses were delivered to a tiny population.
- The marketing shift: The transition from treating terminal pain to treating "chronic non-cancer pain" was the most profitable pivot in pharmaceutical history.
- The lack of criminal prosecution: While Purdue filed for bankruptcy, the individuals who profited the most have largely kept their personal fortunes.
How to Watch and Process This Information
If you’re going to sit down with the Crime of the Century movie, prepare to be stressed. It’s four hours long (split into two parts). It’s a lot to take in. But it’s necessary viewing if you want to understand why the legal landscape looks the way it does in 2026.
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The film serves as a reminder that "legal" does not always mean "moral." It challenges the viewer to look past the marketing and the corporate jargon to see the human cost of greed. It’s a masterclass in investigative journalism.
Actionable Steps for the Informed Viewer
Watching a documentary like this can leave you feeling powerless, but there are ways to engage with the reality of the situation.
- Support Harm Reduction: Organizations like Harm Reduction Coalition work on the ground to provide naloxone and support for those struggling with use disorders.
- Check the Data: You can actually look up how much money your own doctor receives from pharmaceutical companies through the Open Payments database. Transparency is a powerful tool.
- Advocate for Policy Change: Keep an eye on legislation regarding pharmaceutical marketing and the "revolving door" between regulatory agencies and the private sector.
- Educate Others: The biggest weapon these companies had was the lack of public awareness. Sharing the facts about how these drugs were marketed helps prevent the same tactics from being used with the "next big thing" in medicine.
The Crime of the Century movie is more than just an HBO special. It’s a document of a period in history where the pursuit of profit overrode the basic duty of care. By understanding how it happened, we might—just maybe—prevent it from happening again.
Next Steps for Deep Research:
- Read "Empire of Pain" by Patrick Radden Keefe: This book provides the definitive history of the Sackler family and complements the first half of the movie perfectly.
- Verify Local Resources: Familiarize yourself with local needle exchange programs or Narcan distribution centers. Knowing where these are can literally save a life in your community.
- Research the "Marino Act": Look into the specific legislators who backed the 2016 law that hampered the DEA's ability to fight the crisis; it’s a direct case study in how lobbying affects public health.