Off Label -- Film Review

Off Label

Directed by Michael Palmieri and Donal Mosher


This film is a good idea on an important topic that doesn't quite come off.  I am very sympathetic to the objectives of these filmmakers.  I've been a long time opponent of the "chemicalization" of psychiatry.  Pharmaceutical companies are pushing psychotropic drugs on the American people in staggering numbers through psychiatrists and general medical practitioners where they are unnecessary, ineffective, and very often harmful.  But mental illness is fertile ground for making money.  However, the money is not in taking care of people and providing them with love and support, which is what they really need.  The money is made by selling them pills that numb and neutralize them as human beings.  The marketing of these many drugs is aggressive, corrupt, and deceptive.  The clinical research that is part of the approval process for these drugs is highly corrupt, and that is one of the primary interests of this film: the abuse of human guinea pigs who are either paid or coerced to participate in clinical trials by agreeing to take the drugs for a price.  The film features several of these luckless participants:  marginal people, barely functioning, selling their bodies to the drug companies in a last ditch defense against homelessness.  Their plights evoke sympathy, but these few people, miserable as they are, do not make the big case that the filmmakers want to make.  They definitely illustrate what is going on, but they are much too small fragments to understand this big iceberg.  My favorite interviewee in the film was the former drug rep, Michael Oldani, who had made the rounds to doctors' offices selling and promoting pharmaceuticals to doctors.  His comments were insightful and informative and did provide an outline of the big picture.  It is unfortunate that the film did not develop the information he presented.  A good documentary could have been built around his testimony, but these filmmakers seem to be lazy about doing research and they do not seem to be interested in creating the big picture with clarity and definition.  They take pictures of a few trees and say, "you get the idea of the forest from these."  But you only get a vague idea, and each of these small fragments is problematic in its own way, so the case is not made decisively in a well substantiated presentation.  Sergeant Andrew Duffy's case was another missed opportunity to show the collusion between the VA and pharmaceutical companies to chemically quell the effects of PTSD in returning veterans.  Sergeant Duffy's case was very interesting, touching, and had far reaching implications that unfortunately were not pursued.  It was just one more piece of this loosely stuck together collage.  The film wanders back and forth between these different sympathetic protagonists.  One gets to know them by the end of the film; one is touched by their struggles, and some of their flaws and inadequacies start to become apparent as well.  The film is too long and probably could have been cut by about a third without losing very much.  It was inspired by a series of articles that appeared in the September-October 2010 issue of Mother Jones by Carl Elliott.  If you are interested in this topic, I suggest you read his articles.  They are much more informative and much better constructed than this film.   He also has a 2010 book White Coat, Black Hat: Adventures on the Dark Side of Medicine that carries forward with this topic. Elliott seems to be a capable researcher, who presents knowledgeable, well-reasoned arguments.  But you have to go to the trouble to read something, as opposed to sitting back and letting it pour into your head off a film screen.  I wish I could recommend this film, but it is not up to its aspirations and it is not up to what is needed.  I do recommend the topic, and I hope that a better film treatment of it will come along.