Dying In Vein: An Inside Look at the Opioid Crisis

By John Lavitt 10/11/17

“I want people to understand the raw and real suffering experienced by both the addicts and their families."

poster for Dying in Vein documentary
This harrowing new documentary sheds light on the dark nature of opioid addiction by exploring its impact on users and their families. Image via Jenny Mackenzie

In a new documentary called Dying In Vein: The Opiate Generation, director Jenny Mackenzie illuminates the dark prison of having an addiction in the age of heroin and prescription painkillers. The California premiere of this intense look at the opioid epidemic will be on Monday, October 23rd at 1 p.m. at the Laemmle’s NoHo 7 as part of the Reel Recovery Film Festival. The film will be followed by a question and answer session with the filmmaker.

Given the raw power of the film, the recovery-oriented audience is sure to have many questions about how Mackenzie managed to capture such a visceral account. While descending with the viewer into the ugly daily reality of addiction, she also reveals the devastation felt by the families and friends of people struggling with substance use disorders. Beyond showing the intimately interconnected suffering of the addicted person and their families, Mackenzie gives voice to the doctors and therapists on the front lines. She allows the recovery professionals to detail how the national opioid epidemic began and their tragically frustrating attempts to stem the tide.

Indeed, the wheel of addiction continues to spin from the beginning to the end of this harrowing documentary. The drug highs achieved by injecting heroin seem insignificant when placed next to the pain of the family members and friends. Feeling helpless and overwhelmed, these witnesses often watched as the dark descent happened. Unfortunately, their words and actions, even threats and locked doors, often failed to have the intended effect. In too many cases, nothing can be done but bury the shadowy remains of their loved ones.

What does Jenny Mackenzie hope this film will accomplish?

Image via Jenny Mackenzie

“I want the film to be used as a catalyst to create conversations about addiction. Heroin addiction has been deeply closeted for many years because we don’t want to believe that it’s happening to our kids, our friends, and our neighbors. Community conversations across the country will help to remove the stigma and the shame. Hopefully, the film will help people address this problem by having a window into the experience of heroin addiction and what happens behind closed doors. Anyone with first-hand experience dealing with this epidemic understands that addiction needs to be treated as a chronic disease, not as a moral failure.”

When drug misuse descends into addiction--a chronic disease that often proves to be fatal--the outcome can be heartbreaking. Early in the film we are witness to the funeral of Chase Alexander Saxton. Old pictures and home movies show a handsome young man with a vibrant future cut short by heroin addiction. After his death, Chase’s family reads his personal journals, and they are horrified to read, page after page, the same dark refrain: “I am addicted to heroin. I can’t stop. I need help. I can’t do this on my own.”

At the funeral, Chase’s sister expresses the conflicting emotions familiar to anyone close to someone who has an addiction: “There’s nothing I can say to express the poignancy of this moment…. Words feel especially useless when I can feel hate for someone and love them with the same ferocity.”

Enmeshed in the noxious warm bubble of addiction, the opiate generation is insulated from genuine human contact and feelings. The poignancy is a dagger piercing the souls of those left behind in the wake of the ruins. Amid the coffins, there is silence.

Jenny Mackenzie explores why people who are addicted to opioids won’t access help even when it is offered. Why are they so willing to take the ultimate risk day in and day out?

Maddy Cardon’s struggles and toxic relationship are viscerally displayed in the cinema vérité narrative of the story, and we feel her desperation. She explains the awful paradox: “The addiction is stronger than a mother’s love for her child.”

Image via Jenny Mackenzie

When we meet Maddy, she is so sick that we wonder whether she will live long enough to make it to her next birthday. The intimacy of the camera makes us doubt that any future awaits any of the young people deeply enmeshed in the web of addiction. Although they want to get clean, they are so scared of going through withdrawal and leaving behind the comfort zone of their misery.

The power of Jenny Mackenzie’s film is intensified by the soundtrack. The music drives the scenes of grief and the hard reality of moving forward from tragedy. The immediacy of the cinematography does not allow the viewer to escape what is happening by watching from a voyeuristic distance. Rather, it drops us directly into the challenges of someone in recovery, the loving chaos of a codependent couple trying to get clean, and the unforgiving reality of a family grieving the loss of their son. Moreover, we watch as an emergency room physician does his best to save one patient at a time in the face of an epidemic with no end in sight.

Frustration is the common denominator among the physicians interviewed by Mackenzie. Dr. Todd Allen, the Director of Emergency Medicine at Intermountain Healthcare, explains the root of the problem. In the 1990’s, the measurement of pain became what doctors refer to as “the fifth vital sign.” Suddenly, every patient had to be asked what their pain level was, and the pain had to be treated. Doctors were evaluated based on the quality of the treatment. This requirement for positive reviews and feedback led directly to the prescription opioid crisis. If patients signaled any amount of pain, they were prescribed opioid painkillers. The doctors fell in line with the pharmaceutical companies’ expectation that life should be experienced without an ounce of pain. If there is any pain, prescribe a pill to treat it, and profits will continue to climb.

Image via Author

Dr. Allen rues how doctors became willing accomplices to this pharmaceutical lie. He explains the quandary: “If we were rated highly by our patients for addressing their pain, there was a positive feedback cycle. It’s a system with perverse incentives… When we have more prescriptions, we have more addictions. When we have more addictions, we have more overdoses. When we have more overdoses, we have more deaths. That’s the way it’s going to go.”

Another Utah doctor explains how he feels caught between a rock and a hard place: “I want to be able to tell people that taking these drugs is dangerous. Anyone who takes opiates for more than six weeks, all of their health outcomes are worse… It’s amazing, but you can’t have that conversation without risking your satisfaction scores and patient relationships.”

Ultimately, the myth of living pain-free gave rise to a generation of people dependent on opioids. These people were reluctant to ask for help because of the shame and blame that exists around addiction. Combined with an overwhelmed treatment system, the epidemic of opioid addiction and fatal overdoses comes across as a fait accompli.

How do so many people become chained to the wheel of addiction, an unforgiving and vicious cycle that leads to such devastation? Almost every young opioid user thinks they are the exception to the rule. “I have it under control. I can handle it. I’m not going to make the same mistake as they did. Trust me! I am fine, but do you happen to have any extra money I could borrow for a little while?”

Once the addiction sets in, however, it’s too late to make another choice. If heroin is the chain, then being dope sick is the lock that keeps the chain in place. As an addict in recovery named Matt explains in the film, “Being dope sick is like this primal distress of the soul… You use the drugs to cover up what’s going on beneath the emotional stuff. But even when you’re not high, you are so distressed that you don’t have to think about the emotional stuff because everything is focused around getting your drug.”

Trauma and shame are the psychological drivers of addiction. Guilt can lead to accountability while shame feels like an inescapable state of being. Unlike shame, guilt is about taking responsibility. In contrast, shame is a state of soul deprivation where the toxic pain resides. If you are feeling shame, you don’t believe you can get better. There is no escape.

As therapist Sarah Finney, one of the front-line heroes in the documentary, says, “The shame and the self-hatred dance together, and they keep dancing until the addiction is treated… All addiction is life-threatening, but for the heroin addict, it’s just going to get you faster.”

Jenny Mackenzie hopes Dying in Vein will help people understand the extent of the challenge posed by the opioid epidemic. She says, and her film expresses this sentiment so well:

“I want people to understand the raw and real suffering experienced by both the addicts and their families. I want to foster compassion for that suffering. If we can begin to decrease the judgment and expand the conversation in our communities, we can begin to change and give recovery a chance to work. We need policy changes, medical regulatory changes, and a better healthcare system that offers coverage for a medical disease that is chronic and relapsing and needs a combination of sustained interventions and long-term treatment options. I hope we can help make actual progress that fosters sustainable recovery and saves lives.”

If you miss the L.A. screening, you can catch Dying in Vein on Hulu, Amazon, or iTunes. Learn more at Jenny Mackenzie Films

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Growing up in Manhattan as a stutterer, John Lavitt discovered that writing was the best way to express himself when the words would not come. After graduating with honors from Brown University, he lived on the Greek island of Patmos, studying with his mentor, the late American poet Robert Lax. As a writer, John’s published work includes three articles in Chicken Soup For The Soul volumes and poems in multiple poetry journals and compilations. Active in recovery, John has been the Treatment Professional News Editor for The Fix. Since 2015, he has published over 500 articles on the addiction and recovery news website. Today, he lives in Los Angeles, trying his best to be happy and creative. Find John on Facebook, Twitter, and LinkedIn.