The most affecting and enraging moment in Warning: This Drug May Kill You, an documentary about the opioid crisis that airs on HBO Monday, is its opening montage, spliced together from camera-phone footage. Scene after scene shows addicts nodding off, collapsing onto the ground, or being revived by paramedics. In one case, the most heartbreaking, a woman lies motionless on the floor of the toy aisle in a grocery store while a toddler tugs at her arm and wails inconsolably.
The sequence is followed by clips from a 1990s marketing campaign for Purdue Pharma, the manufacturers of OxyContin, in which a doctor, Alan Spanos, professes that doctors were wrong in thinking opioids couldn’t be used long-term, or that they might lead to addiction or even inactivity. “We feel [opioids] should be used much more liberally for people with all sorts of chronic pain,” Spanos says, as the film cuts back to more cellphone clips of addicts zoning out.
The contrast between Spanos’s blithe assurance that opioids—a specific group of drugs used to relieve pain—are perfectly safe and the manifold examples of the destruction the prescription-painkiller epidemic has wreaked since 1999 is infuriating. And it suggests that This Drug May Kill You is going to recount the many ways in which the aggressive marketing of pain medication contributed to the deaths of nearly 183,000 Americans in 16 years. But Perri Peltz’s documentary, instead, focuses on the families living with the aftermath of opioid addiction, which primarily means living with grief. That the stories are all familiar by now—a routine injury or hospital visit leads to a mindbogglingly large prescription for pills, which leads in turn to addiction—doesn’t undermine their poignancy, or the sense of a national crisis that’s spiraled out of control. Still, it may leave you longing for a more muscular indictment of Big Pharma when it comes to what’s been reported as the worst drug crisis in American history.
The first subject interviewed is Stephany Gay, a former addict who was prescribed Vicodin and OxyContin at the age of 16 for kidney stones. Stephany explains how she went from taking an extra pill here and there to going through a month’s prescription in two days. After she went to the doctor for help, he simply wrote her another, stronger prescription. When buying 15 pills a day at $10 each got too expensive, she turned to heroin, as did her sister, Ashley, whom Stephany shared her earliest prescriptions with. Stephany recalls the events leading up to Ashley’s fatal overdose. She hugs her mother, who calls losing her other daughter “the worst nightmare anyone could live with.” At the end of the scene, a title card reveals that Stephany relapsed six weeks after filming.
Peltz interviews three other families: the husband and children of a wealthy mother who got addicted to the prescription drugs she received after a C-section, the parents of a New Jersey 23-year-old who had surgery to remove a cyst and also became addicted to the pain meds he was given. Peltz follows one mother to a grief group founded by parents who’ve lost children. All the parents appear entirely shell-shocked that a drug like heroin could permeate their otherwise ordinary existences, but This Drug May Kill You makes clear exactly how it happened. One father, recalling how his daughter was given “these monster painkillers” after a back injury, explains that “they gave her enough that by the time the prescription ran out, she needed more.”
As difficult as the stories are to hear about, they’re similar enough that they beg for deeper analysis. All the families Peltz focuses on are white, and she herself has mentioned in interviews that the epidemic has “disproportionately affected white America,” which may be conversely because of racial bias: Doctors are less generous with opioids when it comes to nonwhite patients. It’s hard not to consider, too, whether the fact that the current crisis predominantly involves white Americans affects how addicts are treated, being proffered rehab instead of facing incarceration.
Peltz returns to Stephany later in the film, as she asks for help at a police station. The officer who assists her is kind and empathetic, and Stephany is immediately escorted to a state-sponsored rehab. It’s a rare heartening moment, but it also seems to demand some additional context. How many states offer help in this way? How can treatment programs be expanded? What, if anything, is being done to hold pharmaceutical companies accountable? The film mentions the 2007 settlement Purdue reached after they pled guilty to misleading doctors, regulators, and the public about the addictive properties of OxyContin, but 10 years later, it’s apparent that the problem is worse than it’s ever been.
What This Drug May Kill You does do is put a human face on a full-blown disaster, which in turn helps to de-stigmatize addiction. There have been numerous accounts published recently that interrogate the many victims of opioid addiction: the addicts themselves, their children, and their parents, who find themselves taking care of grandchildren when they’d planned to enjoy retirement. Peltz’s documentary may not break new ground, but it’s a reminder that the reason the opioid epidemic became so entrenched is that it was enabled by some of the most trusted figures in society—the doctors like Spanos, who assured patients that pills would help more than they’d hurt.