| Heroin(e) | |
|---|---|
 Film poster | |
| Directed by | Elaine McMillion Sheldon |
| Produced by | Elaine McMillion Sheldon Kerrin Sheldon |
| Music by | Daniel Hart |
| Distributed by | Netflix |
Release date |
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Running time | 39 minutes |
| Country | United States |
| Language | English |
Heroin(e) is a 2017 American short documentary film directed by Elaine McMillion Sheldon and produced by Elaine McMillion Sheldon and Kerrin Sheldon. It was nominated for the Academy Award for Best Documentary Short Subject at the 90th Academy Awards. [1]
The documentary centers on the opioid epidemic, specifically its effect on Huntington, West Virginia, where the overdose rate is 10 times the US average. [2] It follows police, judges, and local nonprofits attempting to help people who struggle with opioid addiction and bring them to recovery as the city grips with a growing number of heroin and prescription painkiller overdoses, and eventually, the much more potent fentanyl. Among them are three women alluded to in the film's name: Huntington Fire Chief Jan Rader who, with other emergency responders, treats overdose victims; Cabell County Judge Patricia Keller, who heads the drug court; and Necia Freeman of Brown Bag Ministry, who delivers food to women who resort to prostitution to support their addictions. [2]
The documentary explains the use of naloxone to treat overdose victims, and explores the psychological toll on the county's first responders who see dozens of overdoses a month. It follows first responders to calls as people overdose, including one instance where a woman is revived at the counter of a convenience store while customers continue checking out nearby. There are several dozen interviews with people who have been addicted and are in recovery who discuss the effects of the drug on their lives and their efforts to recover from it.
Sheldon, who grew up in Logan and Elkview, West Virginia, said the opioid epidemic was personal and that she had friends and classmates impacted by addiction. The documentary was produced as a collaboration with the Center for Investigative Reporting, with a hopeful tone that focuses less on history, statistics and politics, and more on the daily routines of people impacted daily by opioids. [3] Media covering the issue focused heavily on victims and she later said she wanted to create a documentary that focused more on the people helping them. In the process, she said she hoped the documentary would bring attention to addiction as something that impacts people of all demographics. [4]
In making the documentary, she said she sought to change the perception of opioid addiction from a "moral failure" to one of a "medical issue" where recovery is possible. Appalachia has seen problems with opioid addiction for some time before it gained a wider public understanding in the United States. She told Vanity Fair that she felt that while government, health care and pharmaceutical companies weren't paying attention to the plight in West Virginia, that the solutions to the opioid epidemic would ultimately come from there, because of how people like the subjects in her film have worked to help one another. Conversely, she said West Virginians have ignored the problem for too long and it needs to be addressed, regardless of the documentary's impact on how others view the state. [5]
The documentary was shot between February 2016 and May 2017, off and on. Sheldon and her husband were the only two involved in filming on the ground, which they did off-and-on for a total of 38 days. The Center for Investigative Reporting funded the film through its Glassbreaker initiative. [4]
Sheldon reached out to the city mayor's office about the documentary, and was introduced to Rader, Keller and others. She and her husband subsequently rode along with the Fire Department for about 20 days over a period of six months. Rader later told Roll Call she was concerned with members of her department suffering from post traumatic stress disorder as its members see 40 or more dead bodies a year, including friends and classmates. She also said she wanted to highlight the estimated $100 million impact opioids had on Cabell County's economy, [6] as her department responds to five to seven overdoses a day. [7] Though Rader, Sheldon was introduced to a number of people who experience the opioid epidemic every day, and settled on the three women featured in the documentary because they often work with the same people at different parts of their lives. [4]
After filming, the couple approached Netflix which helped them craft the story in editing and post-production. The film's short length helps it as an educational tool, Sheldon said, because community screenings can dedicate an hour to the film — 39 minutes watching it and 20 minutes having a discussion about its contents. The creators built a field guide for screenings so it could be viewed in prisons, rehabilitation centers, and medical schools. [4]
The film debuted at the August 2017 Telluride Film Festival. Netflix released it for streaming the next month. Screenings of the film have followed around the country, particularly in communities impacted by opioid addition. [4]
Heroin(e) has an approval rating of 100% on review aggregator website Rotten Tomatoes, based on 10 reviews, and an average rating of 8.25/10. [8]
The film was praised for its tone. Forbes called it an "optimistic counter-narrative" that focuses on an alternative to harsh or judgmental approaches to understanding the impacts of opioids. Forbes said it makes "a powerful case for compassion and for second, third, fourth and 10th chances," though not exploring their causes as deeply as other works such as J. D. Vance's Hillbilly Elegy . [7] The Clarion-Ledger wrote that its "gritty" approach allowed the viewer to understand the daily lives of people trying to help those affected by addiction. [2] The New York Times considered it a front-runner for an Oscar because it "addresses an issue in the news — the opioid epidemic — with present-tense reportage and an eye toward putting human faces on the crisis." [9]
Huntington residents interviewed about the film were generally supportive of its contents, noting that it highlights the compassion of people in the community helping others. [10]
Rader attended the 2018 State of the Union Address as a guest of Senator Joe Manchin and during the trip spoke to lawmakers about the opioid epidemic, which has had a substantial impact on Huntington's economy. [6]
Fentanyl is a highly potent synthetic piperidine opioid primarily used as an analgesic. It is 30 to 50 times more potent than heroin and 100 times more potent than morphine; its primary clinical utility is in pain management for cancer patients and those recovering from painful surgeries. Fentanyl is also used as a sedative. Depending on the method of delivery, fentanyl can be very fast acting and ingesting a relatively small quantity can cause overdose. Fentanyl works by activating μ-opioid receptors. Fentanyl is sold under the brand names Actiq, Duragesic, and Sublimaze, among others.
Naloxone, sold under the brand name Narcan among others, is an opioid antagonist, a medication used to reverse or reduce the effects of opioids. For example, it is used to restore breathing after an opioid overdose. Effects begin within two minutes when given intravenously, five minutes when injected into a muscle, and ten minutes as a nasal spray. Naloxone blocks the effects of opioids for 30 to 90 minutes.
Supervised injection sites (SIS) or drug consumption rooms (DCRs) are a health and social response to drug-related problems. They are fixed or mobile spaces where people who use drugs are provided with sterile drug use equipment and can use illicit drugs under the supervision of trained staff. They are usually located in areas where there is an open drug scene and where injecting in public places is common. The primary target group for DCR services are people who engage in risky drug use.
Speedball, powerball, or over and under is the polydrug mixture of a stimulant with a depressant, usually an opioid. The most well-known mixture used for recreational drug use is that of cocaine and heroin; however, amphetamines can also be mixed with morphine and/or fentanyl. A speedball may be taken intravenously or by nasal insufflation.
Opioid use disorder (OUD) is a substance use disorder characterized by cravings for opioids, continued use despite physical and/or psychological deterioration, increased tolerance with use, and withdrawal symptoms after discontinuing opioids. Opioid withdrawal symptoms include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood. Addiction and dependence are important components of opioid use disorder.
Purdue Pharma L.P., formerly the Purdue Frederick Company (1892–2019), was an American privately held pharmaceutical company founded by John Purdue Gray. It was sold to Arthur, Mortimer, and Raymond Sackler in 1952, and then owned principally by the Sackler family and their descendants.
An opioid overdose is toxicity due to excessive consumption of opioids, such as morphine, codeine, heroin, fentanyl, tramadol, and methadone. This preventable pathology can be fatal if it leads to respiratory depression, a lethal condition that can cause hypoxia from slow and shallow breathing. Other symptoms include small pupils and unconsciousness; however, its onset can depend on the method of ingestion, the dosage and individual risk factors. Although there were over 110,000 deaths in 2017 due to opioids, individuals who survived also faced adverse complications, including permanent brain damage.
A pill mill is an illegal facility that resembles a regular pain clinic, but regularly prescribes painkillers (narcotics) without sufficient medical history, physical examination, diagnosis, medical monitoring, or documentation. Clients of these facilities usually receive prescriptions only against cash. Pill mills contribute to the opioid epidemic in the United States and are the subject of a number of legislative initiatives at the state level.
The Pennsylvania Department of Drug and Alcohol Programs is a cabinet-level agency in the Government of Pennsylvania. The objective of this department is to manage and distribute state and federal funds used to oversee alcohol and drug prevention, intervention and treatment services.
Paul Thomas Farrell Jr. is an American attorney from Huntington, West Virginia who ran for President of the United States in the 2016 West Virginia Democratic primary.
There is an ongoing opioid epidemic in the United States, originating out of both medical prescriptions and illegal sources. It has been called "one of the most devastating public health catastrophes of our time". The opioid epidemic unfolded in three waves. The first wave of the epidemic in the United States began in the late 1990s, according to the Centers for Disease Control and Prevention (CDC), when opioids were increasingly prescribed for pain management, resulting in a rise in overall opioid use throughout subsequent years. The second wave was from an expansion in the heroin market to supply already addicted people. The third wave, starting in 2013, was marked by a steep tenfold increase in the synthetic opioid-involved death rate as synthetic opioids flooded the US market.
In the United States, a quick response team (QRT), also known as a drug abuse response team (DART), is an integrated, first responder and community paramedicine unit comprising law enforcement officers, rescue personnel, health care professionals and / or substance abuse counselors.
Tim Ryan is an American activist, drug abuse interventionist, author and speaker. He is the Founder and Executive director of “A Man in Recovery” foundation. According to the National Safety Council, Ryan is notable for his position in favor of Drug policy reform and as a proponent of legislative change in American drug policy. His work was the subject of the A&E series “Dope Man” in July 2017. Ryan is also the author of the 2017 memoir From Dope to Hope: A Man in Recovery.
A take-home naloxone program is a governmental program that provides naloxone drug kits to those that are at risk of an opioid overdose. Naloxone is a medication that was created to reverse opioid overdoses. As an opioid antagonist, it binds to the μ-opioid receptors blocking the opioid's effects. Naloxone quickly restores normal respiration. The ongoing opioid epidemic has caused many public health authorities to expand access to naloxone.
The opioid epidemic, also referred to as the opioid crisis, is the rapid increase in the overuse, misuse/abuse, and overdose deaths attributed either in part or in whole to the class of drugs called opiates/opioids since the 1990s. It includes the significant medical, social, psychological, demographic and economic consequences of the medical, non-medical, and recreational abuse of these medications.
Chinazo D. Opia Cunningham is a physician, researcher, and Professor of Medicine at Albert Einstein College of Medicine in New York City. She is also the Director of Diversity Affairs for the Department of Medicine. She worked on the frontlines during the HIV/AIDS crisis in San Francisco and in 2020 began working on the frontlines of the Coronavirus disease 2019 (COVID-19) pandemic in New York City. She also specializes in treating patients with addiction, overseeing a network using buprenorphine to treat people with opioid addiction.
Rahul Gupta is an American physician from the state of West Virginia. In 2021, he was appointed to serve as director of the Office of National Drug Control Policy by President Joe Biden. He formerly served at the helm of the West Virginia Bureau for Public Health.
New Jersey's most recent revised policy was issued September 7, 2022 pursuant to P.L.2021, c.152 which authorized opioid antidotes to be dispensed without a prescription or fee. Its goal is to make opioid antidotes widely available, reducing mortality from overdose while decreasing morbidity in conjunction with sterile needle access, fentanyl test strips, and substance use treatment programs. A $67 million grant provided by the Department of Health and Human Services provides funding for naloxone as well as recovery services. This policy enables any person to distribute an opioid antidote to someone they deem at risk of an opioid overdose, alongside information regarding: opioid overdose prevention and recognition, the administration of naloxone, circumstances that warrant calling 911 for assistance with an opioid overdose, and contraindications of naloxone. Instructions on how to perform resuscitation and the appropriate care of an overdose victim after the administration of an opioid antidote should also be included. Community first aid squads, professional organizations, police departments, and emergency departments are required to "leave-behind" naloxone and information with every person who overdosed or is at risk of overdosing.
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