You run a pharmacy with a very loose interpretation of "doctor's orders". Buy pills wholesale from the MARKET, then fill scripts for your patients at a healthy markup. Cash only. No receipts. No questions.
Patients arrive with prescriptions written by "doctors" you've never met. In the fill screen you decide: which drug, how many days of supply (3-day taster, 1/2/4 week supplies), how many pills per day, and what to charge (60-160% of street price). The label on the bottle is always accurate. The business model is not.
Compare the dose risk to the patient's tolerance. Under-dose them and they'll badmouth you (Rep -). Over-dose them and... well, the ER, rehab, and the county morgue all send thank-you notes (Heat +). Extra pills "for the weekend" are on you, champ.
Reputation (50-100) brings more patients and better pay. Heat is how interested the police are in your "philanthropy". Hit 100 and the DEA repossesses your inventory. Permanently. Heat fades a little each week. Bodies don't.
When the waiting room is empty, fast-forward a week to see how your "treatment plans" worked out. Patients come back with reviews of their last high - or don't come back at all. Rehab takes 3 weeks, jail 2, hospital 1. Death is forever, and so is the paperwork.
Hire the Nurse (fewer deaths and ER trips), the Bouncer (fewer robberies and sting operations), the Cop (less heat, cheaper bribes) and the DEA agent (raid warnings and better escape odds). Everyone costs a weekly wage. Miss a payroll and they quit - and the DEA agent definitely talks.
Big Pharma Benny and The Candy Store want your patients. Each week they may poach one of your customers. Fight back with a PRICE WAR (costs heat, blocks them), a BRIBE (buy peace), or SABOTAGE (expensive, effective, 25% illegal-er).
At 100 heat the DEA kicks in the door. FLUSH IT ALL to destroy most of your inventory and cut heat hard - you might still get caught. Hide the stash or talk your way out instead, if you're feeling lucky. Random paperwork audits can be paid off, shredded, or forged. Your call.
Buy from Rexall Wholesale or The Import Connection - loyalty earns up to 15% off. In the INVENTORY tab, buy powder and run the pill press to manufacture pills at a fraction of wholesale. Low-quality batches are cheaper... and more lethal.
Buy The Riverview Annex (THE EMPIRE tab) for a second pharmacy across town. It holds its own stock - move pills in the INVENTORY tab, and every fill pulls from both stores. The DEA only raids one location at a time. Open a front business (smoothie stand or car wash) to launder cash: sitting on more than $25,000 of dirty money draws heat each week, but cash you put 'in the wash' comes back clean next week for a 15% fee. The blenders never ask questions.
Loan sharks lend fast and collect faster - weekly interest, and three missed payments brings the repo men. Donate to the community to rebuild goodwill after... incidents. High goodwill means a fuller waiting room.
SAVE stores your empire in your browser (localStorage). The game also auto-saves every week. The DEA doesn't honor save files. The button is right there in the top bar, next to the escape hatch.