Pain Hustlers – A sharp and revealing look at what some people do out of desperation and others do out of greed

“I was just astounded by this incredible story,” says screenwriter Wells Tower after reading a New York Times article, “The Pain Hustlers,” by journalist Evan Hughes about the dubious practices of a pharmaceutical company and the doctors they had convinced to prescribe their new drug. Producer Lawrence Grey had also read the article and discovered Towers’ interest, inspired to make a film about the opioid crisis. “It was rapidly becoming one of the preeminent issues in our culture,” he says.

“I found it mind-blowing that these people, who for the most part have no medical training, have so much influence over the medications we’re prescribed,” says Tower.

“And they have this influence because they’re bribing doctors to prescribe medications, in this case fentanyl, even to patients who don’t need it. I knew we had a story on our hands that could offer some really shocking insights into how American
medicine works.”

Wells Tower
Evan Hughes

“There’s an incredibly human and juicy story here,” notes journalist Evan Hughes, who worked on his book, Pain Hustlers: Crime and Punishment at an Opioid Startup prior to and simultaneously with the film’s development. (Tower occasionally accompanied him to the trial of the central characters in the real-life tale.) “When you do what I do, you’re always looking for two things in an idea. The article has to be about some issue of wider cultural resonance, in this case, pharma’s role in the opioid crisis. But the other dimension you’re looking for is a human story.”

“Wells and I are fans of one another and had been looking for something to do,” notes producer Grey. “Wells and I immediately connected and had the same way into the story, which was through Liza. What would have been a fifteen- to twenty-minute audition call turned into three hours of us working out the three acts of the movie.’

“But this is also an industry where people who are often at the bottom of the economy can come in and make hundreds of thousands, if not millions, of dollars,” adds Tower. “We knew there was an incredible American dream story to be told here, too.”

After years of immersion in the wizarding world of Harry Potter, BAFTA-winning director David Yates was looking to tell a more grounded story in the real world, one that didn’t need any green screens or wands.

Over the course of the next several years, Tower and the team developed Pain Hustlers, based loosely around Hughes’ still-evolving book, combining it with Yates’ vision of a scrappy single mom fallen on hard times and various completely original characters.

“We all felt compelled to bring this story to the screen,” says Yates. “We agreed at the outset, we didn’t want to create an earnest drama,” says the director. “The note to Wells was where we can, let the script be funny as well as moving. Make it kaleidoscopic. Humor has always been a part of my storytelling as a filmmaker – it allows an audience in, and even with a subject as dark and as important as this, there is room for it .”

“This film blends a variety of different tones in a unique and special way,” says Grey. “First and foremost, it’s a story of three generations of smart women struggling to make a better life for themselves, and it’s a really funny, honest, emotional journey for them; this part of the movie is the most fictionalized. But there’s secondly the story about the pharmaceutical industry, and that’s just an outrageous, amazing, darkly comic, thrilling subculture which is impossible to invent. The true facts of that world are more debauched, outrageous, and affecting than anything a writer and a producer can come up with in a room.

Pain Hustlers – (L to R) Director/Producer David Yates and Producer Lawrence Grey on the set of Pain Hustlers. Cr. Brian Douglas/Netflix © 2023.

“Something we were really cognizant of from the very beginning of the process is that this also should be a story about the victims,” continues Grey. “No matter how comic we would let the story become, or how much we would fictionalize it, we made sure that we are always honoring the victims. It’s the story of the characters of Camille and Sidney and Matt, who represent the millions of people and their families who’ve been affected by this tragedy.”

Despite Liza’s role in this crisis, “I hope audiences come away with some empathy and understanding for her,” says Tower. “I hope they feel some universal resonance in how someone’s careerism and desire to provide for her family leads her to a complicated place.”

But as for the industry, “I hope people walk away with a new understanding of how the pharmaceutical industry works. I think people should be shocked. The thing that’s so astounding about this story is that, even after all these prosecutions – the real story hit the news in a pretty big way – nothing has changed about these speaker programs. This practice of pharmaceutical companies putting money into doctor’s pockets tacitly in exchange for prescriptions, it’s still going on. I think that’s astonishing, and I think people should know about it.”

The result is the gripping, wild ride of Liza Drake (executive producer and star Emily Blunt), who is recruited to the failing Zanna pharmaceutical company by charming-but-shady salesman Pete Brenner (Chris Evans). The pair work to convince physicians like Dr. Lydell (Brian d’Arcy James) to write prescriptions for their miracle, fentanyl-based drug Lonafen — who’s sublingual delivery method to provide fast pain relief to cancer patients was developed by Dr. Jack Neel (Andy Garcia) in the wake of his wife’s death. Liza, who takes the gig in part out of concern for paying for medical care for her daughter Phoebe (Chloe Coleman), also ropes her mom Jackie (Catherine O’Hara) into the scheme. As they succeed in their mission via dubious tactics, including a regulation-flouting “speaker program,” Zanna’s fortunes rise, lifting Liza and Pete with them. But the human costs are grave as their greed grows.

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A Conversation With Director David Yates

Pain Hustlers – Director/Producer David Yates and Co-Producer Cliff Lanning on the set of Pain Hustlers. Cr. Betina La Plante/Netflix © 2023.

How did you come to direct Pain Hustlers?
I’d spent a good deal of time on soundstages and with visual effects teams in the wizarding world, a giant train set of a place to be, and I’d been looking for awhile for a contemporary story that felt both immediate and immersive and would take me back to my roots of social issue drama. Lewis Taylor, who works with me, introduced me to Evan Hughes’s article “The Pain Hustlers” in the New York Times Magazine – and to Wells and to Lawrence, and we immediately hit it off.

So, Evan’s book and your development process were on parallel tracks?
Yes, he was developing a book based on the article as we were developing the script. We built the script from the ground up with Wells Tower and pivoted it mainly around the fictional character of Liza Drake.

Given your most recent work with huge IP, it sounds like this was a very personal project for you?
I was intrigued by the pharma world, particularly the low rent end of it, the workaday reps and sales teams striving to make a living in a hugely competitive business of dealing with people’s pain. Our own health care system in the UK isn’t as defined by the profit motive as the American one – and that aspect of the story also fascinated me. And mainly, I loved the characters Wells was creating on the page, and his writing.

And also, a fraught subject given the continued tragic nature of the epidemic. While some filmmakers have already covered some of that angle, you chose a different route. When did you realize the film would be such a tonal balancing act, contrasting a grave subject with very poignant moments with humor?
Right at the very beginning. There were some other stories in this space, and so from a very early point of development in the script we said, “How are we going to be different? What are we going to say or explore that feels special and unique to all the things that have come before us?” We arrived at this more subversive tone. We tried to navigate it at script stage first and foremost. It’s playful and one big party for the first half, and then it starts to mellow into something a little bit more somber and thoughtful in
the second half. And the movie pretty much follows that roadmap.
Practically everything throughout my career has always had some humor embedded in it, and humor to me is an absolute part of life. Even in the most traumatic situations, humor somehow finds a way through, and it’s this remarkable release valve for people in challenging situations, and for audiences as well.
For me, if you’re going to ask people to spend two or more hours watching what you’ve done, it’s imperative that you are able to entertain them. But in this case, we’re entertaining them, but we’re also, I hope, moving them, and we’re informing them.

Some of the other characters are based on real people, correct?
With the exception of Liza, they’re all kind of loosely based on existing characters from that pharma world. But we gave Wells license to create his own unique version of people. They’re inspired by, I would suggest, rather than biographical per se. And Liza was our invention, a single mum with a daughter struggling with health issues, a dreamer, undervalued but incredibly capable.

Pain Hustlers – (L to R) Director/Producer David Yates, Emily Blunt as Liza, Catherine O’Hara as Jackie and Director of Photography George Richmond on the set of Pain Hustlers. Cr. Brian Douglas/Netflix © 2023.

Since you didn’t base her on a specific individual, what were your conversations with Emily like about creating Liza?
We were both drawn to a human being who’d been undervalued, underestimated, who’d missed all those opportunities, hadn’t done particularly well at school, but who was nonetheless incredibly capable, very empathetic, very in tune with other people. Her superpower is that she understands people, and she’s a bit of a dreamer. She’s also hugely ambitious, and what she’s really looking for, ultimately, I think, is validation and acceptance. I always thought this movie was ultimately a kind of parable of the American dream and what happens when it goes badly wrong. Everyone who has ambition is told “go for it” and that success is wonderful.
But in the case of this story, unless the system is properly policed, and you’re playing by certain rules, you can hurt people. Emily was probably the most prepared actor I’ve ever worked with. She comes to set with a game plan every single day and knows exactly what she wants to explore in the architecture of the human being that she’s playing.

Pain Hustlers – Chris Evans as Brenner in Pain Hustlers. Cr. Betina La Plante/Netflix © 2023.

And Chris Evans as Pete?
Everything in Pete’s life is transactional. It’s all about the sale. He doesn’t really have any deep connections with anyone beyond that notion of hitting the right numbers. So there’s a superficiality to him, but equally there’s a vulnerability to him. He’s also very entertaining because he’s completely unfiltered— loud, brash, profane. Casting Chris Evans for that was a delight because his clean cut, alpha male, heroic demeanor is completely turned on its head when you cast him as a sleazebag pharma sales rep. I’d seen him do a couple of things that really surprised me previously. I love seeing an actor do
something surprising. And Chris is like an athlete. And I don’t just mean physically but in terms of his commitment to the role. He is on set first thing, and he’s very present, always driven, always wanting to do the best.

Andy Garcia goes to some new places in this film.
Yes. Andy wouldn’t leave the set. We would finish work with him, say at two in the afternoon, and normally an actor can’t wait to get away and prepare for the next day, but Andy would go get changed, and then come sit by the monitor, and we’d watch the scenes together of the other actors, and we’d chat about filmmaking and talk about life. He was lovely to have around.

The locations also help to tell the story here as she moves out of her sister’s garage to the motel to the fancy beachfront apartment. That and the changing offices feel integral to the evolution of the company and characters.
The arc of Liza’s journey is the classic rags to riches one, but because she succeeds by navigating a particularly tricky moral maze, her rise is ultimately bittersweet. The warmth and humanity she discovers at the extended stay motel where she begins, is left behind in the hustle of everything. Money doesn’t bring security or safety, or peace of mind. It yields the exact opposite by the end of her story, because of her actions.
It was enjoyable working with Molly Hughes our production designer, Colleen Atwood our costume designer, and our gifted hair and make-up team to chart the journey and deliver the key milestones for it.

What do you hope people are talking about when the film ends?
Would they do what Liza did? Could any of us be tempted to follow that path? And the notion of accountability. What I love about Liza is that she steps up, and does the right thing. She lost control, and through her greed and desire to be valued, she hurt people, but by the end of our story, she knows within herself, she needs to be held to account. To me that’s a simple but refreshingly important part of the story.