Despite regulatory, legislative and industry efforts, the opioid epidemic is the deadliest public health crisis America has ever faced. Opioids are now responsible for more deaths than heroin and cocaine combined.
According to the National Institute on Drug Abuse, roughly 54 million people have used prescription painkillers for non-medical reasons at least once.
Two recent Hollywood releases highlight just how far the addiction crisis has spilled onto the fabric of American society. Beautiful Boy chronicles the heartbreaking experience of meth addiction through an at times tense, at times touching father and son relationship over the years. Ben is Back sees Julia Roberts as a mother coping with the sudden return of her 19-year-old addict son on Christmas Eve.
But for those looking to get a more universal view of America's troubling relationship with opioids, Healthcare Dive reviewed about a dozen documentaries to bring you this curated list of the best five to watch.
5. Understanding the Opioid Epidemic
If you're an average layperson looking to get a comprehensive, well-researched intro to the opioid epidemic, this PBS documentary is a great place to start.
Produced and written by John Grant, the roughly hour-long film traces the overlapping causes that culminated in the exponential growth of opioid addiction and deaths nationwide from the late 20th century to the present.
Through interviews with experts including law enforcement and physicians, along with stirring addict and family testimonials, Understanding the Opioid Epidemic profiles the most deadly drug crisis in American history, along with potential solutions and treatment for those caught in the seductive grip of opioids.
The film, partially funded by BlueCross Blue Shield Association and the Brain Research Foundation, is available online for free.
4. One Nation, Overdosed
2017 saw a record number of drug overdoses, an increase driven at least partially by synthetic opioid use.
MSNBC's Jacob Soboroff investigates the role synthetics have played in the deadliest drug crisis in American history in this roughly 45-minute documentary, aired in 2017. One Nation, Overdosed profiles the rise of fentanyl, a potent synthetic heroin analog, in Dayton, Ohio, briefly touching on each of the major events that led to a recent rash of overdoses in the midwestern state.
Unlike many other investigations into the American opioid crisis, One Nation, Overdosed runs a bit like a Law and Order episode: Soboroff primarily interviews addicts and their families along with law enforcement and coroners. In one sequence, he rides along an undercover sting.
It's entertaining for sure — at one point, Soboroff even attempts to order fentanyl online from China. At another, he heads to the border and witnesses a border control agent seizing stacks of meth from a would-be smuggler.
It's a well-crafted (albeit occasionally disoriented) exposé of addiction in what some call the "crossroads of America," and one of the few that focuses on the role that Mexican cartels and drug trafficking have had in exacerbating the epidemic.
The full film is available online on MSNBC's website.
3. Dr. Feelgood
Coming in just shy of 90 minutes, Dr. Feelgood is a rich portrayal of William Eliot Hurwitz. Depending on whom you ask, Hurwitz is either a caring and innovative physician who, over the course of his decades-long career, helped the chronic pain of hundreds of patients countrywide. Or he's one of the most prolific drug distributors in America's history.
The documentary, directed by Eve Marson, seems comfortable with this duplicity. Hurwitz is a Janus: two-faced, purporting his own innocence even while undergoing two criminal trials for narcotics distribution and serving five years in prison.
The role of physicians in perpetuating the opioid crisis is inarguable — FDA Commissioner Scott Gottlieb has lambasted them as "cavalier" — but Hurwitz refuses to be a scapegoat. What law enforcement termed a "pill mill," he calls simply having 500 patients in 39 states. Accused of knowing his patients were selling the overflow from his monumental prescriptions to addicts, Hurwitz says he's just too trusting.
Such overprescription, which some pinpoint as the cause of the crisis, remains rampant. Surgical patients use only roughly 30% of their opioid prescriptions and many people aren't disposing of the extras.
And now physicians are terrified to prescribe opioids due to what Hurwitz characterizes as a haphazard and desperate response to a much more complicated problem.
There's some weight to this. The American Medical Association's 2018 Opioid Task Force progress report found that American doctors are prescribing fewer opioids, as well as increasing prescription drug monitoring program use. But it's unclear whether lower rates of prescribing translate to fewer drug deaths on the streets.
Whatever the truth, Marson's documentary highlights the vacuum of effective chronic pain management in the United States — a vacuum that can leave scores of patients in agonizing pain without a treatment for a problem they can often neither see nor prove to their doctors.
Netflix original documentary Heroin(e) is a stark portrayal of three women on the front lines of the opioid epidemic in Huntington, West Virginia, where there's an overdose rate of 10 times the national average. Created in association with the Center for Investigative Reporting and directed by Peabody Award-winning filmmaker Elaine McMillion Sheldon, the film is Oscar- and Emmy-nominated. If you watch it, you'll understand why.
Jan Rader, deputy chief of the Huntington Fire Department, fights for funds to buy naloxone, an opioid antagonist that helps overdose victims start breathing again. Briskly maternal Necia Freeman is a local realtor who moonlights as founder of the Brown Bag Ministry, giving free food and advice to prostitutes on the streets of Huntington. Judge Patricia Keller of the Cabell County Drug Court wields her gavel to keep recovering addicts on the path to sobriety.
West Virginia, a predominantly blue-collar state, exemplifies the cyclical nature of a drug crisis. A lot of people in these rural areas are employed in physical labor, get injured and receive pills through legitimate means. After they're hooked, they move onto heroin because they can't get access — or afford — pills anymore.
Over the 40-minute span of the documentary, the overdoses pile up — in the bathroom of a local pizza joint, Gino's; up against a counter in Sheetz; behind a locked door in a home. As Rader and her fire department run from one scene to the next, you're struck by the route mundanity, the well-oiled practice of their movements. It's clear they've done this dozens of times before. It "doesn't shock me anymore," shrugs one firefighter.
Two decades of overdoses in Huntington were few and far between, notes Rader: "Now we have five, six, seven a day."
When Rader is sworn in as chief of the department (the first female fire chief in West Virginia history) it's hard not to feel emotional. And it's hard not to let those emotions bubble up at the denouement of the film, when Rader's final interview is interrupted by an overdose report.
"I gotta go," she says. She grabs her walkie-talkie and runs out of the room, off to try to save another life.
1. Recovery Boys
The statistics around the opioid epidemic are terrifying, but Recovery Boys explores the crisis on the ground floor. The 90-minute documentary, also a Netflix original, is one of the few that doesn't dramatize or wallow in the cyclic tragedy of ecstatic heroin highs, the scratching withdrawal pangs. Instead, it honestly follows four young men struggling to recover from opioid addiction over a year and a half at Jacob's Ladder, a farming-based recovery center in Aurora, West Virginia.
Over the course of the documentary, you become strangely attached to the eponymous recovery boys: Jeff, an impish young husband and father struggling to stay sober for his two daughters; Rush, a redheaded Jesus lookalike in khaki, on his 10th recovery program; Adam, who has stolen from his grandmother so frequently to bankroll his addiction she's on the brink of homelessness; and Ryan, coming into Jacob's Ladder right off the street and detoxing hard.
Over the 18 months of the documentary, the atmosphere at Jacob's Ladder sharpens to a knifepoint as the boys struggle with the stigma of being an addict and their relationships: with their families, with each other and — most importantly — with their sobriety. Decisions that are everyday to the majority of Americans are tinged with anxiety: if the boys choose to attend a barn dance, there may be alcohol there, or other attendees may know they're addicts. If they don't go, they may miss out on people who like them, or on a fun night.
Or, just by leaving Jacob's Ladder, they may be coaxed into shooting up again.
Perhaps the most painful part of Recovery Boys is seeing the lack of effective care for recovering drug users. Jacob's Ladder is an outlier, opened by doctor Kevin Blankenship in response to the lack of rehab options in West Virginia and his own son’s opioid addiction.
And it can only keep the boys for a six-month term before sending them back out into a world ill-equipped to take them. Jeff "doesn't know a sober person back home." After he leaves Jacob's Ladder, he relapses.
Watching Recovery Boys, directed faultlessly by Heroin(e) filmmaker McMillion Sheldon, is like driving fast on a bumpy road: you're anxiously unsure which of the boys, if any, will slip back into drug use. But you root for them and cheer on their successes and get a glimpse behind the obfuscating veil of stereotype into a truth of the opioid crisis many prefer to ignore: addicts are people too.
Also worth a watch:
Runnin'. This 2017 STAT documentary, directed by Alex Hogan and Matthew Orr, explores the heroin crisis in the suburbs of Boston through Hogan's group of childhood friends.
Stigmatic: Our Opioid Crisis. 'Stigmatic' can mean relating to the top of the flower that dispenses pollen, relating to a stigma or an individual with sores who has borne great suffering. This hour-long documentary explores the chemistry of opioid drugs and their prevalence in Bay Bounty, Michigan, through the multifaceted lens of the word and the crisis.
Do No Harm: The Opioid Epidemic. Though less artistically polished than the other documentaries on this list, Do No Harm is perhaps the most detailed in tracing the historical causes leading up to the cusp of the opioid crisis in the 2010s: how Purdue Pharma's misleading marketing of OxyContin, rampant physician overprescribing and the easy availability of street heroin joined hands and resulted in the deaths of hundreds of thousands of Americans.