The episode's title refers to a major regulatory shift. After DEA Agent Bridget Meyer presents evidence that OxyContin causes death even when used as prescribed, the FDA requires Purdue Pharma to add a "black box warning"—the most serious type of label warning for prescription drugs.

In a heartbreaking conclusion to her story, Betsy reaches out to her ex-girlfriend, Grace, hoping for a reconciliation once she gets clean. Upon realizing Grace has moved on, a dejected Betsy turns to heroin for a "final send-off" before starting treatment. She suffers a fatal overdose and dies just hours before she was scheduled to begin Suboxone therapy.

Finnix continues his own recovery journey using Methadone and explores switching to Suboxone, which he finds more effective. He attempts to help Betsy by offering to drive her to her first treatment, only to be crushed by the news of her death.