One year and one-half ago, Sheila Nevins (President of HBO Documentary Films), asked a vital question of friend Perri Peltz. “Why are so many young people overdosing. Is this drug abuse or something else?” At the time the numbers were around 72 people-a-day passing out on the streets, in buildings, in their homes, going into comas, and dying from a self-poisoning drug overdose.
For an investigative reporter like Perri Peltz, the question had tremendous import. It seemed that she and others she spoke to knew of someone’s relative or child or neighbor or friend or friend of a friend’s family member who had overdosed. So she decided to investigate and what she discovered was profound. It upended any preconceptions of the demographic of individuals who were overdosing and the families who were living with the trauma and torment of wondering what they might have done to save the lives of loved ones who had died.
The film journey took Perri Peltz and her team into the homes of middle class Americans. They were the antithesis of former stereotypes of drug users, abusers and/or dealers. Interestingly, there was one factor in common. Their addiction to opioids and “upgrade” into heroin began with a hospital or doctor’s visit prompted by a car accident, a physical fall, a back injury, or other pain related trauma. Their drug dealer was not a scruffy, surreptitious, back alley miscreant. It was their medical school educated doctor/general practioner who believed Purdue Pharmaceuticals’ aggressive promotional campaign that narcotic painkiller OxyContin because of its time release design was not addictive, but in its new form could be used to safely eradicate pain and allow individuals to function in their complete capacity of wellness.
Nothing was or is farther from the truth. In a 2007 settlement Purdue Pharma executives admitted culpability and pleaded guilty to “misbranding” or not appropriately warning users of the deleterious addictive properties of OxyContin: made of the pure narcotic oxycodone, that contains a large amount of the opiate in each tablet because of the time-release design. Did sales representatives and executives gauge the risk-reward ratio? Did they consider that by the time doctors and families of patients realized the unrelenting addictive properties of OxyContin and sued, the company could still be ahead of the game, reaping tremendous profits after any monetary settlements? Perhaps not, though this has indeed been the case. The product was heavily marketed for six years. In 1996 alone, annual sales reached $ 1 billion.
Perhaps profit wasn’t a motive after all, and the promotion that led to the incredible drug sales was not an intentional move by the company to addict and endanger users. However, with the over-prescription of opioids by doctors and the increase of opioid overdose deaths to epidemic proportions, that is a moot point. People are dying of self-poisoning. And this very important film that aired on HBO Monday evening, 1 May, may give those who see it pause, if/when their doctor attempts to over-prescribe an opiate like Oxycodone (such as OxyContin®) or Hydrocodone (such as Vicodin®).
Peltz removes any notion that opioid addiction that morphs to heroin addiction happens to “the other guy or gal.” With a clear, cogent, and unremitting perspective, she identifies four families who were tragically and fatefully seduced by events that appeared to be benign. A daughter (who was a wife and mother), had kidney stones and was in terrific pain. She gave her medications to her sister who became addicted as she herself became addicted. A beautiful wife and mother in her forties was prescribed opioids after an initial hospital visit; she became addicted. A son was prescribed opioids after surgery to remove a cyst; he became addicted. A daughter was prescribed opioids after she fell and had hip and back pain; she became addicted.
In each instance, Peltz follows family members as they discuss the growing arc from doctor to over-prescription to ending prescription to “graduation” into seeking more and more pills. In four instances out of the five patients, individuals moved into heroin addiction when the prescriptions stopped. Heroin delivers the same effects and it is cheaper. In the instance of the beautiful wife and mother (the husband eventually had to divorce her), her addiction prompted her to physically injure herself to obtain opioid prescriptions from various doctors who complied with her persuasive pleas for narcotic painkillers.
With heartfelt empathy Peltz examines each of the stories using family and medical testimony, interviews, family photographs and videos, and poignant discussions. She shows how the families were sideswiped into awareness that a nefarious drug was in their midst and it had taken over the soul, body, and mind of their loved ones. Though in each instance there was rehabilitation numerous times, there was also relapse. Only in one instance that Peltz illuminates, is the individual now on the road to recovery and there is light at the end of the long tunnel of addiction. However, the other four patients who began on prescriptions of opiates never were released from the narcotic’s hold over them. They poisoned themselves as they attempted to satisfy the great hunger that the opiate increasingly inured them to. They died and are mourned. And this film tells their story in the hope of preventing one more death from opiate overdose.
In a Q and A after the film screening, Dr. Andrew Kolodny (Co-Director of Opioid Policy Research Collaborative Brandeis University), Gail Cole (film subject and co-founder, Hope and Healing After an Addiction Death) and others discussed that because of its incredibly addictive side-effects, OxyCotin and other opioids must be prescribed circumspectly. Their most effective use is at end-of-life or other long-term pain conditions. Such examples they gave are unlike the prescription examples for the patients identified in the film who became addicted, then overdosed and died.
Peltz reveals in the title and throughout the film that doctors’ inappropriate over-prescription is a hazard. The probability of over-prescription leading to possible self-poisoning by patients along a journey of addiction should not be risked or even entertained. This was further given credence to the announcement Peltz made after the World Premiere that the epidemic numbers of opioid overdose are now higher than 91 deaths-a-day.
This is a must see monumental film that touches all of our lives whether we recognize it or not. With knowledge comes power and the ability for patients and families to question their doctors about over-prescription of opiates, if the occasion arises. Doctors are also becoming aware of the epidemic and are over-prescribing much less. Advocacy and support of families who are struggling up the long hill of a family member’s opiate addiction is an imperative.
Warning: This Drug May Kill You airs on HBO2 on Wednesday. Check this website for times.
For clips of brief interviews with Dr. Andrew Kolodny, Gail Cole, Perri Peltz and Sascha Weiss, check Youtube and Warning: This Drug May Kill You.