By Off Label is not for the faint of heart. There’s nothing about the use of prescription drugs for off-label purposes that strikes me as particularly disturbing to watch, and there isn’t. It’s the cursory things that the film decides to show and tell. It’s the pictures of blown off faces as a result from the Iraq war and the story about the son who slit himself open with a box cutter as a result of a pharmaceutical study. These things are not necessary, but they do exist.
As interesting as the topic at hand is, the way it’s presented is occasionally distressing and frequently depressing. Consider yourself warned.
[This review was originally published as part of our 2012 Tribeca Film Festival coverage. It has been reposted to coincide with the limited theatrical release of the film.]
Off Label
Directors: Donal Mosher and Michael Palmieri
Rating: NR
Release Date: August 9th, 2013 (limited)
The more I think about Off Label, the less I like what it did. Visually, it’s a very nice documentary. The cinematographer may have gone a bit overboard with the shallow depth of field, but it’s nice to look at. The music is also pretty nice, if a bit repetitive. The editing is complementary and never seemed particularly obnoxious or unnecessary. All in all, it’s well made.
The problem is with the content. Off Label uses a number of different people from all walks of life to make a case against the use of prescription drugs, especially for off-label purposes. The film focuses on seven stories and eight main characters from all over America. There’s the youngish guy who makes all of his money from clinical trials, the bipolar woman who takes well over a dozen pills every single day, a medical anthropologist who once worked as a drug rep for Pfizer, the mother of a boy who brutally killed himself when he was put on the wrong medication, and a young veteran from Iraq with PTSD who is not getting the treatment he needs, among others.
This is all well and good, and some of the stories are hugely compelling (specifically those last three), but there’s a shocking amount of fluff and useless information given that the film only runs 80 minutes. At least two of the story lines are pretty much completely irrelevant:
- There’s a couple in Texas who funded their wedding through money made from drug trails. Aside from that, they have nothing of substance to add to the debate. The only reason they seem to be in the film is so all of their friends can talk about the huge number of drugs they’ve been prescribed.
- There’s also an African-American Muslim man who had been incarcerated years ago for marijuana possession and then put in a clinical trial which caused irreversible side effects. His story is horrifying and certainly relevant, but most of his time is spent preaching about the healing power of Allah and Islam. What he says is compelling enough, but it has no place in a documentary about the role of pharmaceuticals in American culture.
And it’s not like I feel that the stories that were really interesting were cut off at the knees or anything, but they definitely could have been expanded upon. The mother of the boy who killed himself has been fighting to have laws passed in order to make sure what happened to him could never happen again, but that’s relegated to some text before the credits. It’s the kind of thing they could have (and should have) talked to her about. But they didn’t. The smaller side-stories should have been excised entirely and the important ones expanded.
Perhaps the bigger issue is the fact that Off Label never acknowledges the benefits of off-label uses for drugs. There are good things that come from off-label uses. I know a number of girls, for example, who take birth control pills for hormone management. It helps them, but the film ignores that. The stories it shows definitely make a case against off-label drug use, but it’s entirely one-sided. That’s really not okay. It hurts the overall impact of the film, undermining the good things it does say, and it does say good things. It highlights very real problems with the way this country’s pharmaceutical industry is misused and taken advantage of.
Perhaps the filmmakers decided against it because it would have been too happy. Off Label is immensely pessimistic, and the few optimistic things that do happen all have pretty much nothing to do with drugs at all. The couple gets married, the man prays, and they’re happy. But that has nothing to do with the drugs; they’re just nice things that happen.
The final appearance of the youngish man who lives off of clinical trial money comes with an almost Michael Moore-esque level of emotional manipulation. He spends most of his story in Las Vegas, gambling away his money, and he talks about the very real possibility that he will be homeless when he goes back to wherever he’s from. As he says this on the voiceover, he walks by a giant billboard that announces a casino still has 19 years on its lease.
As he walked away, I was sad, but I felt cheated. It was like a joke. A piece of cute juxtaposition that will do nothing but depress the audience even further. I don’t need or want my emotions to be manipulated by a documentary. Of course the truth will have to be bent or stretched in order to fit so much into so little time, but Off Label‘s tricks are too obvious and too petty.
I’d love to see another documentary about this subject, because it’s definitely an important and interesting one. Off Label doesn’t do it justice. When I left the theater, I found that I had enjoyed it as a piece of entertainment but not as a legitimate look at a significant issue. As a documentary, Off Label is a failure.