HBO’s ‘Heroin’ Is a Harrowing, Necessary Documentary About Addicted Teens


“People come here to vacation thinking it’s a wonderful place, but it’s the worst place to be at now,” one addicted teen tells filmmakers at the outset of Steven Okazaki’s HBO documentary Heroin: Cape Cod, USA. “People are dying left to right.”

Those deaths now include several of the eight young people Okazaki focuses on in the hour-plus documentary: Ariana, Benjamin, Cassie, Colie, Daniel, Marissa, Ryan, and Jessica. By the end of the film, some have succumbed to overdoses, a very few are trying to stay clean, and most are still living the life of addicts, hustling money by day to get their fix by night. A few say they want out, or to change, but others, by their own admission, are not ready. Yet when we learn their respective fates through captions on the screen, it’s like a breath has been forcibly taken from us.

The film creates this effect by lingering with these kids and young adults, even watching them shoot up, and showing how they veer from braggadocio to confession to tears and back again. The audience gets a small but potent sampling of what it’s like to care for someone who keeps slipping back into the grasp of addiction. You want to scream, “Get yourself together!” But you also feel tremendous sympathy. We understand why, even though kicking them out of the house might be a smarter move, their parents simply can’t bring themselves to take the risk.

The filmmakers also spend significant time with the parents of addicts on the Cape, who often house and clothe these kids while their habits develop. At a parents’ support group, they talk with laughter and tears about struggling to keep from enabling their kids, and many lament the past: these teens had happy childhoods. They played sports (in fact, several addictions began with painkillers that were prescribed following sports injuries or car accidents). They had everything they wanted. Many of the kids also talk about their happy lives and families, but listening to their description of life now, there’s an almost universal flatness, an attempt to describe a void of existential emptiness. “There’s nothing to do,” says one. “You either work and you’re normal, or you do drugs.”

These aren’t addicts in grips of denial. They’re self-aware young people who have the vocabulary of millennials: they talk openly about their self-esteem, the hurt they’re causing, and above all the fact that they can’t seem to reconcile their desire to improve their lot with their desire for the next high. The film’s subjects describe shooting up as: “the love of my life,” or “like Christmas morning” or being at the top of a rollercoaster. They explain that an unquantifiable pain and boredom simply goes away when they’re high.

The stats that arise from this disease are grim and telling about this “new” phase of the epidemic. Eighty percent of heroin users start with prescription opiates, from which pharmaceutical companies make $15 billion a year. On the Cape, 85% of crimes are opiate-related. Many of the subjects of Heroin: Cape Cod, USA admit to committing petty crimes, whether drug dealing or theft, to support their habits. One, Marissa, strips and sell sex instead because she says she would rather hurt herself than others.

This isn’t the only shocking revelation the film contains. Daniel —who says he was bullied for being Jewish while growing up — is seen selling to, and shooting up, several of the girls in the film, including injecting veins on his or their necks. Benjamin bemoans how incredibly boring his life is when he’s clean: just work, home and video games. He keeps “disappearing.” Colie tries to score a final hit before going into rehab, explaining: “Everybody gets high before they go to detox. That’s like, what you do.”

Heroin; Cape Cod, USA ends with one bright note. One subject appears towards the end, looking healthy and smiling at a Chinese restaurant, and we learn that she’s been clean for a year. Her visible change in demeanor and appearance is remarkable, and we see through her what’s possible for the rest of her peers.

Throughout the film, we’re asked to treat Ariana, Benjamin, Cassie, Colie, Daniel, Marissa, Ryan, and Jessica as victims, as people who are sick, deserving of sympathy. And this is the absolute right way to understand addiction, a new approach that many politicians and law enforcement officials are adopting. But all the film’s images of blonde girls with needles — and its many, many shots of Dunkin’ Donuts, clearly situating us in New England — also remind us of the double standard in the way addiction, and drugs, were treated in other eras when the “face” of the scourge wasn’t white and rural.

Some experts and researchers see, in the different responses to these drug epidemics, further proof of America’s racial divide. Are policymakers going easier today on heroin users (white and often affluent) than their elected predecessors did a generation ago when confronted with crack addicts who were largely black, disenfranchised, and economically bereft? Can we explain the disparate response to the “black” heroin epidemic of the 1960s, in which its use and violent crime were commingled in the public consciousness, and the white heroin “epidemic” today, in which its use is considered a disease to be treated or cured, without using race as part of our explanation?

The answer, of course is that the newly compassionate approach to opiate addiction is due, at least in large part, to the race of the people suffering. These eight young people’s plight, to an extent, belies pernicious myths that could have been undercut years ago: that drugs are inevitably entangled with broken homes, “urban” pathologies, immorality.

Why does one person have the strength to recover, and others fall under? Daniel asks. There’s no answer, just as there’s no community that’s immune to addiction. One can only wish for similarly humane treatment of the struggles of addicts everywhere, not just in idyllic rural places.

Heroin: Cape Cod USA premieres on HBO on Monday, December 28, at 9 PM.