The LIAAC Blog

News and thoughts from the Long Island Association for AIDS Care

Witnessing a Crisis: A Review of HBO Documentary “Warning: This Drug May Kill You”

By Sara Guando

As children we would defend ourselves with the old saying “stick and stones…” As adults we know that, yes, sticks and stones might break your bones but words can also hurt you. In this day and age, we also know that words are not always dependable. People are relying on mainstream news less than ever and that can be very dangerous. So, what can we rely on? What can we trust? Well, what about images? We don’t always talk about the effect of things we see, but images can be incredibly powerful. Images make us react – they can make us laugh, bring us to tears, or allow us to witness something about the world that we have never seen, or know nothing about. When we see something, it becomes more than just words on a page. So, let’s talk images.

We all have preconceived ideas about certain things. If I said “describe the best thing about summer” you may picture your favorite beach, your backyard pool, your family and friends at a barbeque. If I said “what’s the best thing about the morning?” you may think of a steaming cup of coffee in your favorite mug. But, if I said “tell me what a heroin user looks like” what would you picture? How does it make you feel? Can your idea of “a drug addict” ever be changed?The HBO Documentary “Warning: This Drug May Kill You” is series of images that can open up people’s eyes to the opioid epidemic that is often hidden and not fully understood. From the beginning, the documentary is an unflinching look at opioid use. It begins with a series of cell phone videos of people in the midst of an overdose. Facts about opioid use in America as it currently stands are shown on screen. The combination of these two images are concerning and provide no sugar coating to the crisis. The cell phone videos are then layered with audio from pharmaceutical marketing videos from the 90s. The marketing campaign, from Purdue Pharma (maker of OxyContin) promoted more generous use of opioids to treat pain and downsized the risk of addiction. The words spoken are in clear contrast with the images on screen. The drugs are being called safer and less addictive “than previously believed,” meanwhile, on screen, people on opioids are seen doubled over on sidewalks and buses, unable to keep their eyes open. As the pharmaceutical campaign is stating “less than one percent of patients taking opioids become addicted” cell phone videos of opioid overdoses appear, and the images of people doing CPR, yelling, and slapping those overdosing become overwhelming. Then, another fact: “deaths from prescription opioids have quadrupled since 1999.”

Throughout the documentary compelling stories are paired with powerful facts about the epidemic. The film predominantly follows the life of a young woman named Stephany, and her struggles with heroin – an addiction that, for her, began with being prescribed opioids for kidney stones at the age of 16. Stephany describes the progressive take-over of her addiction. She illustrates how she and her sister, Ashley, went from faking pain for prescriptions, to getting pills from friends, and then from snorting pills, to snorting heroin, to injecting the drugs. Stephany goes on to tell about the loss of her sister to a heroin overdose and the impact that has had on her life. We learn that 80% of heroin users start with prescription drugs.Perhaps more than the facts, a powerful feature of this documentary is that Stephany is the only heroin or prescription drug user that we meet throughout the film. None of the others are alive to tell their story. The rest of the stories we hear are from the loved ones of people that ultimately died of opioid overdoses. We hear about how loved they were, and how ordinary their lives were when they began. When clean, Wynn Doyle was a wonderful mother with a passion for a happy life and for her children. We learn that she quickly became reliant on prescription pills after her third C-section. Wynn tried to prevail. She went to rehab at least eleven times trying to conquer her addiction. Her children would search her home regularly for drugs, but through purposeful self-harm and “doctor jumping” Wynn continued to feed her addiction until her death. Through his parents, we meet Brendan Cole, the oldest brother of three boys, who died of a drug overdose in his parents’ home, within 24 hours of returning from rehab. Brendan’s struggles began at a young age, after a cyst removal. How could he or his family have known that a prescription to ease the pain of that procedure would ultimately take his life?

In a way, Stephany becomes more purposeful in understanding the “normalcy” of someone who becomes addicted to opioids, and then heroin. Not only is she telling her story first-hand but when we first see Stephany she’s clean. She is young, coherent, well-dressed. The viewer is sympathetic, if not relatable, to her emotions regarding her struggles, and the loss of her sister. However, when we return to Stephany’s story later, we see the addiction more than the girl. Stephany has relapsed and the viewer responds to this with steadfast emotion – anger, frustration, sadness. We watch as her daughter describes what steps she would take if she sees her mother overdosing. Stephany is unkempt, and distant, no longer communicating her feelings or telling her story. And this image is what many people see when asked “tell me what a heroin user looks like.” Many most likely no longer see someone who is relatable, who is “normal,” who you may love or who is in many ways just like you – a mother, a daughter, a brother, an only child, someone who was at a simple doctor’s visit one day, or had surgery, or had a baby. Yet it is in these small acts that so many people’s lives have changed forever.

The facts throughout this film are strong, but the images are what dominate in the viewer’s mind. However, for all of this unwavering, unforgiving effort to show the opioid crisis throughout the country, there are big pieces of the puzzle missing. In this man-made epidemic there are risks beyond addiction. The spread of HIV and hepatitis has been affected greatly by heroin and injection drugs. How did we get here? What can we do? The documentary is missing a lot of this vital and potentially life-saving information.

Join us on Part Two of this opioid blog series, where we will pick up the parts of this discussion that fell short, and how the epidemic is hitting home here on Long Island.

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