If you looked across the epidemic, you would see junkies, smugglers, cops, ruined veins and broken mothers, all connected in a vicious puzzle stretching from the poppy fields of Mexico to the cracked streets of Georgia and, finally, into scattered graveyards, where prayers and hymns echo over coffins of the fallen.

America’s heroin and opioid scourge is intimate and distant, resounding and silent. It is a haunted landscape of slack-faces, failed recoveries and holding cells. More than 64,000 people died last year of drug overdoses, a cataclysm affecting our politics, healthcare and courts, as well as how we hold accountable, or not, the pharmaceutical industry, drug cartels and small-time dealers with pockets full of fentanyl.

A surge in documentaries in recent years, including HBO’s “Warning: This Drug May Kill You” and “Dr. Feelgood” by Eve Marson, has examined the consequences, statistics and lies behind an affliction that kills at least 175 Americans a day. The films have focused on drug marketing, prescribing doctors, border patrol agents, drug rehab centers, wrecked families, traffickers and soaring addiction rates in small towns from Vermont to Kentucky.

The stories have turned troubled lives into metaphors and morality tales for a country many feel has gone astray at a time when political discourse often reduces complex problems to simplistic sound bites. The documentaries offer a glimpse into the breadth of the drug trade across the economic spectrum and into the criminal and commercial sides of addiction.They show shattered lives playing out in a society that, as it has with gun deaths, has become at once shocked and inured to tragedy.


In an era of shrinking news budgets, alternative-truths and fervor over fake news, the films, part of a documentary renaissance, are vital journalism in a multiplatform, streaming world.

The Showtime documentary series “The Trade” explores the connection between Mexican drug cartels and heroin addicts in the U.S. (Our Time Projects / Showtime )

Films by Elaine McMillion Sheldon and Matthew Heineman are among the most unflinching and disturbing portraits of a numbing and perilous terrain. In “Heroin(e)” and “Recovery Boys,” Sheldon shows the toll of addiction in the isolated hollows and coal towns of her native West Virginia, which in 2016 had the highest drug overdose death rate in the U.S. Heineman has connected Mexican cartels to heroin addicts in America in his five-part Showtime series, “The Trade.”

“It was fascinating to me that all these people, whether poppy growers in Guerrero, Mexico, or the addicts in Atlanta or law enforcement in Columbus, Ohio — everyone is trapped in this perpetual cycle of the drug war and with that, comes violence and heartbreak,” said Heineman. “Building walls and treating it as a war, this historical way of tackling the issue, has not helped and I think that we as a nation, communities and individuals, need to start thinking about this as a healthcare issue.”


Heineman and Sheldon’s work has the immediacy of an Instagram and the depth that comes from long hours spent burrowing into battered lives. Their documentaries are a telling mix of insightful reporting and narrative arcs that have resonance in an era of streaming (Netflix, Vice Media and other companies have increasing appetites for documentaries), social media, questions over crime and compassion and steep cutbacks in the news business.

“There’s less money in long-form investigative journalism. Foreign news bureaus are shutting down all over the world,” said Heineman, whose earlier films include “City of Ghosts,” which followed citizen journalists recording atrocities by Islamic State in Syria. “Documentary film is filling that void. It’s both a luxury and a huge responsibility to be able to stay with a story for so long, to be able to follow characters for a year, to be able to shoot over 1,000 hours of footage. We’re in a golden age of television and documentary.”

Today’s drug crisis is the latest iteration in America’s legacy with narcotics. It is reminiscent of the morphine epidemic of the late 1800s and the crack-cocaine trade that gripped inner cities in the 1980s. The extent of the emergency struck Sheldon when she read “American Pain,” a book by John Temple about Florida pill mills supplying OxyContin to addicts in Appalachia, and watched a commercial during the 2016 Super Bowl that advertised a drug to limit the constipation side effect for people on pain medications.

“It literally said, ‘Are your opioids making you constipated?’” said Sheldon. “My mind was blown. I had seen opioids as a problem in my backyard. But when I saw that on the Super Bowl, knowing the Super Bowl audience was the entire country, and this ad would be running because that many people are on opioids and suffering from constipation. I felt a real urgency.”


“Heroin(e)” follows three women — a fire chief, judge and community activist — trying to stop the rising tide of overdoses in Huntington, W.Va. The film was nominated this year for an Academy Award. She followed it with “Recovery Boys,” which debuted last month on Netflix, a story of the victories and transgressions of four addicts in a rehabilitation program run by Jacob’s Ladder in Aurora, W.Va.

“I don’t want to die,” said one addict.

“I didn’t know people lived sober,” said another.

“I felt a real urgency,” filmmaker Elaine McMillion Sheldon says about her reaction to seeing an ad related to opioids during the 2016 Super Bowl. (Rebecca Kiger / Netflix )


Their stories, filmed over 18 months, tell of crime, histories of addiction, joblessness and the struggle for recovery in a part of the country that is as stunning in its beauty as is in its despair. Sheldon’s camera is ever present, hovering, never intruding, but capturing the misery of detox, the fleeting joy of a birthday and the tears in a mother’s eyes as a son relapses. An addict’s regrets are seldom as strong as his cravings, and the film is a compassionate, apolitical glimpse into the chasm between the two.

“I don’t believe we’re having the conversation beyond keeping people alive. Most recoveries are a lifelong process,” she said. “The messy sides of addiction have yet to be fully pulled apart. It’s almost become so known that people simplify it too much. But it goes beyond opioids to mental health, trauma, poverty, economic opportunities. Yes, the pharmaceutical companies flooded the state with pills. But we need to talk about roots of addiction and recovery.”

Raised in West Virginia, Sheldon was tentative about documenting addiction in a coal region that is more stereotyped than understood. Hollows run narrow, family ties deep, and shame leaves indelible marks. But year by year, she watched the pain and loss as jobs dried up, towns turned cruel and glassy-eyed, and opioids, heroin and, later, fentanyl became plentiful.

“So many of my classmates from middle school and high school have overdosed, some are in active addiction, some in recovery,” said Sheldon. “I was always a little wary of approaching the topic because of I didn’t want to romanticize drug use or the potential exploitation of someone at their worst moment. Those two things kept me out of the topic for a while.”


Like Sheldon’s films, Heineman’s “The Trade,” which Showtime released for free to nonsubscribers on YouTube, is intimate and, at times, devastating. But his panorama is sweeping, veering from poppy fields, beheadings and the reach of cartels — one drug lord fashioned himself as Santa Claus handing out gifts to village children — to junkies in Atlanta to a detective in Ohio, who says of heroin: “It tears people apart, eats them away.”

A scene from the Showtime original documentary series “The Trade” (Season 1, Episode 03). (Our Time Projects / Showtime )

Heineman’s style is bracing. His camera stays on the brink of conflict — emotional, psychological, physical — similar to his approach in “Cartel Land,” an Academy Award-nominated and Emmy Award-winning documentary about vigilantes who fight to stop drug smuggling on the U.S. and Mexican sides of the border. The characters in “The Trade” are inured to him, and even in these days, when people play on Facebook and Snapchat, there are only a few scenes that have the artifice of a reality TV show. You feel as if dropped in on men and women caught in large and small unravelings.

“The way we consume media is changing and it’s changing the way that we as filmmakers interact with our subjects,” he said. “People are much more savvy with having cameras around. They know how those images can be used. You’ve got to break through that and get an honest portrayal of who that person is. The goal is to become part of the daily fabric of their lives.”


That is apparent in scenes of heroin being scooped into bags by masked men and driven toward the U.S. border, and when an addict in Atlanta, who lives in a trailer and roams like a bent silhouette on the outskirts, can’t find a vein. Thousands of miles apart, these lives are connected, even that of a Latina trafficker in Ohio, who hands her newborn child to her sister when agents put her in handcuffs. Their messy, unpredictable lives give the film the pulse of discovery.

“If you ended up with the story you started out with,” said Heineman, “you weren’t listening along the way.”

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Twitter: @JeffreyLAT


jeffrey.fleishman@latimes.com

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