| 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]
Harm reduction, or harm minimization, refers to a range of intentional practices and 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 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.
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) 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.
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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.
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 1,040% 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.
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Anna Lembke is an American psychiatrist who is Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic at Stanford University. She is a specialist in the opioid epidemic in the United States, and the author of Drug Dealer, MD, How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop. Her latest book, a New York Times bestseller, Dopamine Nation: Finding Balance in the Age of Indulgence, was released in August 2021.
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