| 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]
Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brown powders sold illegally around the world as heroin are routinely diluted with cutting agents. Black tar heroin is a variable admixture of morphine derivatives—predominantly 6-MAM (6-monoacetylmorphine), which is the result of crude acetylation during clandestine production of street heroin. Heroin is used medically in several countries to relieve pain, such as during childbirth or a heart attack, as well as in opioid replacement therapy.
Harm reduction, or harm minimization, refers to a range of public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviors, both legal and illegal. Harm reduction is used to decrease negative consequences of recreational drug use and sexual activity without requiring abstinence, recognizing that those unable or unwilling to stop can still make positive change to protect themselves and others.
Naloxone, sold under the brand name Narcan among others, is a medication used to reverse or reduce the effects of opioids. It is commonly used to counter decreased breathing in opioid overdose. Effects begin within two minutes when given intravenously, and within five minutes when injected into a muscle. The medicine can also be administered by spraying it into a person's nose. Naloxone commonly blocks the effects of opioids for 30 to 90 minutes. Multiple doses may be required, as the duration of action of some opioids is greater than that of naloxone. Emergency medical services data from Massachusetts found that 93.5% of people given naloxone survived their overdose.
Nancy Goldin is an American photographer and activist. Her work often explores LGBT subcultures, moments of intimacy, the HIV/AIDS crisis, and the opioid epidemic. Her most notable work is The Ballad of Sexual Dependency (1986). The monograph documents the post-Stonewall, gay subculture and includes Goldin's family and friends. She is a founding member of the advocacy group P.A.I.N.. She lives and works in New York City.
Supervised injection sites (SIS) are medically supervised facilities designed to provide a hygienic environment in which people are able to consume illicit recreational drugs intravenously and prevent deaths due to drug overdoses. The legality of such a facility is dependent by location and political jurisdiction. Supervised injection sites are part of a harm reduction approach towards drug problems. The facilities provide sterile injection equipment, information about drugs and basic health care, treatment referrals, access to medical staff, and, at some facilities, counseling. Most programs prohibit the sale or purchase of recreational drugs at the facility.
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 OUD.
Purdue Pharma L.P., formerly the Purdue Frederick Company, is an American privately held pharmaceutical company founded by John Purdue Gray. It was owned principally by members of the Sackler family as descendants of Mortimer and Raymond Sackler. In 2007, it paid out one of the largest fines ever levied against a pharmaceutical firm for misleading the public about how addictive the drug OxyContin was compared to other pain medications. Although the company shifted its focus to abuse-deterrent formulations, Purdue continued to market and sell opioids as late as 2019 and continued to be involved in lawsuits around the opioid epidemic in the United States. Purdue filed for Chapter 11 bankruptcy protection on September 15, 2019, in New York City.
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.
Substance use disorder (SUD) is the persistent use of drugs despite substantial harm and adverse consequences as a result of their use. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as chronic guilt; an inability to reduce or stop consuming the substance(s) despite repeated attempts; operating vehicles while intoxicated; and physiological withdrawal symptoms. Drug classes that are commonly involved in SUD include: alcohol (alcoholism); cannabis; opioids; stimulants such as nicotine, cocaine and amphetamines; benzodiazepines; barbiturates; and other or unknown substances.
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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.
In the United States, the opioid epidemic is an extensive ongoing overuse of opioid medications, both from medical prescriptions and illegal sources. The epidemic began in the United States 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 great majority of Americans who use prescription opioids do not believe that they are misusing them.
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.
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The New York mandatory opioid antagonist prescription bill is legislation sponsored in the New York State Senate and Assembly. The Senate bill, numbered NY S. 5150-B, sponsored by state Senator Pete Harckham, will require prescribers to co-prescribe an opioid antagonist with the first opioid prescription of the year for certain high-risk patients to combat accidental overdoses.
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