The opioid epidemic — the headlines are everywhere. Every day, the urgency in fighting this very real public health crisis becomes greater, as news reports broadcast one staggering statistic after another. In the U.S., nearly 100 people die a day. It’s a frightening figure, but what’s even more startling is to peel away the numbers and realize there are very real faces and individuals behind the stats: children, parents, siblings, cousins, colleagues, spouses…

Perri Peltz’s latest documentary Warning: This Drug May Kill You (HBO) gives us an unfiltered look at the very human element of opioid addiction. She follows four struggling families who have lost someone to this tragedy. In one, 16-year-old Stephany is prescribed opioids for kidney stones. She begins sharing with her sister; both eventually turn to the cheaper alternative, heroin. The sister overdoses. “I couldn’t imagine putting you through losing another child,” Stephany, who vows to get clean, tells her mom. The story, however, doesn’t end there.

Here, we talk to Peltz about the film.

The origin of Warning: This Drug May Kill You…
This documentary began with a simple question from Sheila Nevins (president of HBO Documentary Films). It was almost two years ago, before President Obama had really put the issue of opioid addiction on the map. Sheila wanted to know why so many people were overdosing and dying — and why the prevailing narrative seemed to be that it was “bad kids abusing good drugs”. Producer Sascha Weiss and I started researching the topic and learned that this was not an epidemic of abuse but an epidemic of addiction and that too often these addictions had started with a prescription for an opioid pain medication from a doctor.

We chose to focus on the families and the aftermath of addiction because…
We wanted to show viewers what addiction looks like — and that the stereotypes are wrong. These aren’t people hiding in back alleys — they are people who had for the most part been prescribed opioid pain medications by their doctors. We wanted to show the human toll of the worst overdose epidemic in the history of the United States.

How we discovered the families in the film…
We worked with many outreach organizations including Shatterproof, a national organization based in Connecticut, Hope and Healing after an Addiction Death in New Jersey, and Live4Lali in Illinois. We also worked with The Fix, a daily website for alcohol and drug addiction. We owe a tremendous debt of gratitude to our very brave families who allowed us into their lives during their darkest moments with the hope that their stories would help other families.

And we gained their trust by…
The Caseys, Doyles, Gays and Coles are amazing — we can’t say enough about their generosity and willingness to share their stories. And often we are forcing them to relive the worst moments of their lives. With time they became more and more comfortable with us and the presence of the camera crews. But it’s hard and they are incredible.

One little-known thing we hope people realize about opioid addiction…
I am going to mention two little-known things because I think they are both so important. OxyContin, Fentanyl, Vicodin, Percocet etc. are all opioids — they are legal opioids. Heroin is also an opioid. They are chemical cousins and produce effects that are indistinguishable. Opioids are effective medicines for short term severe pain — they should be taken with great caution and consumers need to understand that they are very addictive and related to heroin.
The second lesson learned is that there are effective medications that are available that can really help people recover. Drugs like buprenorphine, naltrexone and methadone can make a real difference. Unfortunately, these medications are stigmatized and as a result they are under-utilized.

The difference between opioid addiction and other forms of addition…
Opioids are highly addictive drugs — much more so than alcohol. Physical dependence can develop quickly (within as little as one week) and produce painful withdrawal symptoms when people try to stop taking them.

The scene in the documentary that resonates the most for me…
That’s a tough one. Different scenes resonate with different people. For me the scene that gets me every time is when Kathy is holding her daughter Stephany who has recently relapsed. Kathy has already lost one daughter to an overdose and you can see the sheer terror in her eyes as she contemplates the real possibility that she might lose another child to this pernicious disease.

And scenes we cut that I loved…
I have learned that to be effective a documentary must remain very focused. Too many stories can confuse and dilute the message. I was sad to lose the story of an amazing man named Gary Mendel. Gary tragically lost his son to opioid addiction and decided to leave his company and start an organization called Shatterproof. Shatterproof is wonderful and helps families across the country fight addiction. If you or someone you know is struggling with opioid addiction, check out their website.

The hardest part about working on this film…
The hardest part is saying good-bye. We spent so much time with these wonderful families and then it is time to leave.

I hope audiences walk away from this film with…
We hope audiences walk away with an understanding that the title of the film is real. This documentary is meant to be a true warning — that opioid addiction can happen to anyone and that it often starts with a prescription from a well-intended doctor. We aren’t bashing doctors nor the medicines — we just want people to be aware!

The best thing you can do to help a friend or family member who may be addicted…
Let them know you can recover from an opioid addiction. It isn’t easy — but there is help and if they don’t know where to turn, they can call the SAMSHA national Helpline, 1-800-662-HELP (4357). It is open 24/7, 365 days a year.
And for everyone else — we all must do our best to remove the stigma surrounding addiction. These are good people struggling with the brain disease of addiction. This is an epidemic of addiction — not abuse.