One of the somber notes on which 2015 concluded was the airing on HBO of the documentary “Heroin: Cape Cod, U.S.A.” The film ends on an upbeat: one of the local addicts we’ve come to know in the film has been clean for three months and is hopeful about the future. But we have learned to take this with irony. Others of the eight young addicts featured have been clean longer, have relapsed and are dead or MIA.
The documentary makes two important points: bucolic Cape Cod is not immune to the nationwide opioid epidemic; and, once hooked , an addict has an extremely hard time getting unhooked. Cape viewers who read this newspaper probably don’t need convincing on either count, given the coverage in the last year or two.
But to this viewer the main point made by the film is that we—our society and culture, including the experts– are still, after decades of heroin being the poster child for life-wrecking addiction, more or less clueless about its causes and cure.
It’s a point the film makes inadvertently, by illustrating it.
One of the young addicts asks (paraphrasing here): “I know not all kids get themselves hooked, why me?” Nice middle-class mothers in a support group: “Our kid was an athlete, popular, did well in school. We were a good family. Why us?”
The film itself seems equally confused. So being black, poor, living in an inner city are not necessary contributing factors. But are being white, middle-class, and living in a rural paradise causes, as this film might lead you to conclude?
If there is something about Cape Cod that is causing addiction, what is it? We are characterized in the film mainly by beautiful outdoor shots of Wellfleet and elsewhere, used as an ironic context for wrecked lives. But I don’t remember much, if any, emphasis on a tourist economy and the secondhome market, more likely contributing factors.
By focussing on kids of good, middle-class families, the film seems intent on making the point that this can happen to anyone. But other sources suggest that in fact half of addicts have a genetic predisposition.
One big emphasis of the documentary is that some of these kids got hooked on legitimately prescribed painkillers, then switched to heroin, which is readily available and cheaper. But as the addict referred to earlier acknowledges, not all young people get hooked, perhaps only a small percentage. It would have been helpful if the film had interviewed his peers who are not addicts for their perspective.
The movie suggests that being young is a contributing factor, since all the addicts featured are young. What it doesn’t do is suggest what it is about being young that makes youth especially vulnerable. Is it possible that part of what it takes to resist the euphoric experience of heroin is values which may not be well-established in the young? Or a purposeful life no longer available on Cape Cod?
Is it possible that a factor in the opioid epidemic is widespread, unquestioned use of such legit drug fixes as Viagara and SSRIs?
The disease model of addiction favored in recent decades removes the moral stigma. But the analogy introduces problems of its own. Disease (say, ebola or cancer) is a painful experience which we all naturally avoid if possible; the drug experience is a euphoria which makes it extremely attractive. If addiction is what you catch from contact with “germs” (that is, drugs)–and there is evidence that drugs actually impair the brain’s ability to resist–there would seem to be another disease that makes some more vulnerable than others to both trying a drug and continuing to use it. (We speak of an “addictive personality.”)
No doubt limiting over-prescription of painkillers is part of a solution. But a deeper, clearer understanding of the addiction phenomenon seems even more important.
This documentary seems more part of the problem than part of a solution.
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