OFF LABEL (Donal Mosher, Michael Palmieri 2013)

[Chris Knipp]

Donal Mosher, Michael Palmieri: OFF LABEL (2013)


ANDREW DUFFY IN HIS ARMY DAYS

Scattershot documentary never finds a focus

What is the documentary Off Label about? That's the trouble; Donal Mosher and Michael Palmieri, who made it, haven't quite decided. They seem to have wandered from one idea to another as they followed one person after another. Almost everybody seems damaged here, even the "authorities" consulted. These are primarily Michael Oldani, of Milwaukee, a self-defined "medical anthropologist" who began as the agent for a drug company marketing the antidepressant Zoloft in its early days; and Robert Helms, a spokesperson and databank for people used as "guinea Pigs" in drug testing. Helms has a book and a website both called Guinea Pig Zero. He chronicles and advocates for this group, but also remains a member of it, making a shaky living by entering drug tests -- besides which he's a heavy user of the amphetamine mixture Adderall. Helms is shown appearing on "To Tell the Truth," whose kitsch excitement the film returns to later. There is some discussion of the burgeoning drug industry and over-prescription, especially of antidepressants, by primary care physicians in recent decades. Obviously, the subject is prescription drugs in America. What about them, though? The filmmakers approach is too scattershot to mean anything.

Along comes Mary Weiss, whose psychotic son was chosen by his doctor to enter a clinical trial, which he chose as a lesser evil rather than going into a mental institution. His doctor was the one running the trial. Even when (she says) the drug was clearly making her son much worse, Mary Weiss couldn't get him taken off. He committed suicide, in a gruesome manner that she describes to us. Weiss, who has successfully advocated for a state law preventing the kind of insider setup her son was trapped in, is heard from repeatedly. But then there is Paula Yarr and her husband who work at the Bigfoot Museum in Santa Cruz, California. By her report "severely bipolar," she claims her current regime of taking twenty pills a day from a bucket full of pill bottles, is very working well, despite side effects.

And then there are the various and quite unrelated guinea pigs. An Asian man, Paul Clough, who was an orphan in a group home, lives on the edge of homelessness, his arms full of track marks from injections in drug tests. His regular trips to Vegas risk putting him back on the street. He is not at home with any other job or life. A couple with multiple piercings are near the Mayo Clinic and the man, Jordan, makes money from risky drug tests. The film shows their wedding an tearful declaration of love. They're offbeat, perhaps, but seem otherwise happy and normal. Still another case is that of Jusef Anthony, an older African American, who entered drug tests when in prison years ago for small marijuana change. He suffers lifelong symptoms, including itchy, disintegrating fingernails. He takes refuge in Islam. His case brings up other, unrelated issues.

Oldani has some interesting inside information. He says Big Pharma's sales reps who visit doctors think they're performing a useful service, but in fact are cheating to sell their particular product. He explains how as a promoter of Zoloft he helped get it prescribed "off label" -- for issues not legally specified -- by reporting uses and leaving hints around, never doing anything actually illegal, but twisting the clinical rules and contributing to their being twisted further, all for the expanded sale and use of his company's product. He says (and we probably know this) that in America today antipsychotics are heavily overprescribed and overused for every kind of psychological problem. He points out now a big and growing need is for doctors who can detox their patients from wrong cocktails of drugs they've become dependent on. But the theme of "off label" prescribing, though the film's title, is one that's only briefly touched on here.

Helms, on the other hand, asserts that psychotropic drugs work best in controlled environments, like on chimps in a zoo. He also suggests (and we can see this) that the guinea pig life is dangerous and unhealthy. But no alternative is offered. The filmmakers rely on their few, in some cases dubious, speakers, for information about what pharmaceutical companies are doing. What about the benefits of new drugs? What about the development of drugs other than psychotropic?

Another voice, this time against the use of psychotropic drugs, is that of young vet Andrew Duffy, a PTSD sufferer who joined the Army National Guard for Iraq duty and would up as a medic at Abu Gharaib prison asked to give punitive medical care to prisoners, including IVs applied with 14-gauge needles. Here the film stops to show someone -- we don't know who -- spattered with blood from injection by a big needle. By this point in this short but still meandering and too long film it's beginning to seem Mosher and Palmieri are into sensationalism as much as they're into any argument. This is like a Mondo Cane of pills. Despite severe psychological issues he speaks of having had, for which he was prescribed a raft of antidepressants that he says did him no good, Duffy is articulate and humane in his advocacy of support groups like Veterans for Peace, which he says have helped him more than any therapists. He has become a veterans advocate himself. There's a good story here about veterans, drugs, and the system, but this film isn't it.

Ultimately the film pays more attention to the lady taking a bucket of pills and the loopy, if sweet, piercing couple and their irrelevant wedding, and the mother obsessed with her suicidal son than to Oldani. And Oldani comes off as an independent oddball like all the rest, even though he is, in fact, indeed an Associate Professor of Medical Anthropology at the University of Wisconsin, Whitewater. Off Label ends off topic -- except that it never found a topic -- visiting some of its sad victims to show how they take refuge in faith, be it Muslim or Christian. Could the filmmakers have botched their job any more than this? They show little sign of knowing how to locate their information or organize it. Strongly contraindicated.

Off Label, 80 mins., now distributed by Oscilloscope, debuted at the San Francisco International Film Festival April 30, 2013, was also shown at Tribeca, and opened theatrically in NYC and on VOD August 9, 2013.