Behind the Scenes of HBO's "Warning: This Drug May Kill You"

By Dorri Olds 05/01/17

The documentary examines the opioid crisis through a personal lens, sharing the stories of four families who have been devastated by addiction. We interview director Perri Peltz as well as Gail Cole ahead of the premiere.

Drug Warning Document on Clipboard
The new documentary explores America's opioid addiction through four families' stories. via HBO

Journalist and documentarian Perri Peltz (Risky Drinking) takes a searing look at our nation’s opioid crisis and presents it from a personal angle. Heartbreaking stories are told through intimate portraits of four families that were shattered by addiction. The doc, Warning: This Drug May Kill You, premiered at the Tribeca Film Festival and airs on HBO May 1.

By now, anyone who keeps up with the news knows we are experiencing the worst drug epidemic in American history. More people are dying from opioid overdoses in the U.S. than from car accidents or gun homicides. Narcotics are killing nearly 100 Americans per day and the annual death toll has quadrupled since 1999. Now, imagine each of those numbers as a person you love.

The film quickly gets to the root cause of the drug crisis: pharmaceutical companies. In 1996, Purdue Pharma launched an aggressive campaign to promote widespread use of opioid pain medications. Peltz’s doc shows a 1999 Purdue promo video. A good-looking doctor with a sophisticated accent and reassuring tone says these drugs are safe. Interspersed with his voice is a montage of random people nodding out on buses, in stores, passed out on the street. The voice overlay soothingly recommends using these pain meds as a long-term answer to pain. Another voice chimes in to say, “Less than 1% of patients become addicted.”

One of the most chilling scenes shows a toddler sobbing in a store aisle. She’s standing beside her mother’s lifeless body which is sprawled out on the floor. The toddler frantically pulls on her mother’s hand, trying to make her get up, but the child cannot budge the dead weight.

In 2007, Purdue Pharma pleaded guilty to lying about the risk of addiction to OxyContin. They’d known it was highly addicting. Purdue paid one of the largest pharmaceutical settlements in U.S. history: 600 million dollars. More horrifying is how little that lawsuit curbed the sale of opioids, which remains a multi-billion-dollar industry. More than 250 million prescriptions are provided every year.

Medical professionals are under enormous pressure to keep doling out these dangerous narcotics, which include OxyContin, Vicodin, Percocet, Opana, Demerol, Dilaudid, Norco, Fentanyl, Codeine. All are chemical cousins to heroin and morphine. Through research, we’ve learned that prolonged use of these opioids actually increases pain. What better way to sell a product than to create a demand for it? For example, a patient seeks relief from an aching back, or busted knee. An MD prescribes an opioid painkiller. As the patient continues to take the medication, tolerance develops, so they take more. In cases where people become addicted, they may turn to street drugs like heroin if they can no longer obtain the prescription.

In the movie, one of the families decimated by addiction is Gail Cole’s story. Her son Brendan died at age 22 from a heroin overdose.

I felt sickened by the thought that Cole could’ve been my mother—or anybody’s mother. No parent should ever go through what these families have. Brendan Cole died in his parents’ home in Allendale, New Jersey. I was moved by her story. As a sober addict myself, I am painfully aware of the worry I caused my own parents. I wanted to reassure Cole that no amount of love and good parenting could’ve prevented what happened. She and I met in the HBO office on Thursday.

“Brendan was my oldest of three boys,” said Cole. “He was so full of energy; full of life.” She described him as kind and caring. “He liked to help people.” Like so many others, Brendan was prescribed opioid painkillers after a surgery, then again after a tonsillectomy. She is not sure exactly when Brendan’s addiction began. “It happened some time in college,” she said. “But we didn’t find out about it until he was starting his second semester in senior year when Brendan told us he had ‘a little pill problem.’”

Brendan had been in and out of rehabs but kept relapsing until the night his father found him passed out on the bed. The police and an ambulance came and he was revived with Narcan. “We went to the emergency room. He was there till about 1:30am,” Cole said. “Then the hospital let him go. They said they couldn’t force him to go to detox because he didn’t try to kill himself. But there was no plan.” Cole’s strength and grief led to a desire to talk to others who had lost a loved one to addiction.

In addition to meeting with Cole, I sat down with the filmmaker, Peltz.

Peltz's documentary was inspired by the burning question: How did we, as the United States, become enmeshed in the worst drug epidemic in the history of this country? “It was almost this feeling of friendly fire,” Peltz said, describing a haunting sensation she felt while making the film.

“Here we are in this epidemic,” Peltz said, “yet Purdue Pharma and several of its subsidiaries are still marketing these narcotics in Asia, South America, and Europe. Where have we learned the lessons? Isn’t the pharmaceutical industry going to accept responsibility and say, ‘Wait a second. We need to change the way that we market this’?”

Peltz clarified that prescription opioids are not inherently bad. “They’re good drugs, and they help pain in dramatic ways,” she said. “But they’re good for short-term, acute, severe pain—post-surgical pain, end-of-life pain, cancer pain. They should not be used in any cases for long-term chronic pain.”

Despite these positive uses, too many people end up becoming addicted to prescription painkillers. Addiction is not a moral failing. Dr. Nora Volkow, the director of the National Institute on Drug Abuse (NIDA), is leading the charge to spread the message that addiction is a brain disease. There are chemical changes that happen in the brain when somebody becomes addicted. Yet there is still a strong stigma.

Peltz said, “Good people become addicted. There are a lot of people out there who would like you to believe that it’s bad kids abusing good drugs. It’s just not true. I hope we drive that home in the documentary.”

Brendan’s mom said, “There are so many layers involved in an addiction death. The guilt, the shame, the self-doubt. ‘Did I do enough? What if I’d looked right instead of left?’ It’s very lonely.” Overwhelmed with grief, four weeks after Brendan’s death, Cole learned of another woman who had lost a child to an overdose. Cole reached out to the other mother and the two “talked each other off the ledge.” They were a great support system and held each other up that first devastating year. In the same way that AA works, where only an alcoholic really gets another alcoholic, the two moms started a grief group on March 4, 2015 called Hope and Healing After an Addiction Death

HBO’s website offers a list of resources for families devastated by addiction.

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Dorri Olds is an award-winning writer whose work has appeared in many publications including The New York Times, Marie Claire, Woman’s Day and several book anthologies. Find Dorri on Twitter, Facebook, and LinkedIn.