Richard Sackler begins to launch a powerful new painkiller, a rural doctor is introduced to the drug, a coal miner plans her future, a DEA Agent learns of blackmarket pills, and federal prosecutors decide to open a case into OxyContin.

Doctor Finnix begins to taper Betsy off OxyContin, Bridget sees the toll the drug is taking on communities, Rick and Randy investigate the world of "pain societies", and with sales climbing, Richard Sackler makes bigger plans for his new drug.