The Cape looks quite spectacular in the new HBO documentary "Heroin: Cape Cod, USA." There are magnificent shots of the beaches, with their granular beige sand, their salt-washed wooden footpaths, and the kind of rigorous surf that promises to wash away your pain. There are heroic old houses with shingles that have endured decades of ocean gusts, and there are town centers that are quintessentially quaint. You can almost smell the fried clams.
But as the title of the film makes clear, all of the familiar beauty serves as a darkly ironic backdrop for an achingly sad story about the heroin epidemic. The truth is that, at some of the gorgeous Cape beaches in the film, there may well be a teenager shooting up in a rest room, her eyes dulling and her body exhaling as she sits back on a toilet.
Many of us have heard before the story in "Heroin: Cape Cod, USA," in countless news articles about the growing numbers of deaths and O.D.s from the drug, in headlines about celebrities who've lost the battle, on TV magazines showing how painkillers can lead to the cheaper and easier-to-find heroin, and in movies and TV shows willing to portray the unvarnished truth. Much attention has been paid of late to the way heroin has undone Vermont, another region known for natural beauty. But I'm not sure we've ever heard the story of this plague told with the kind of intimacy and narrative power of "Heroin: Cape Cod, USA," which airs Monday at 9 p.m.
Quite simply, the film, directed by Oscar-winning filmmaker Steven Okazaki, will break your heart. As it focuses on eight young people dealing with a heroin habit, as well as a group of parents of addicts, it will evoke your deepest sympathy. And it will open your eyes, as these kids talk remarkably freely about their love and hatred for the drug, about the way their bodies crave what their minds are trying to reject, about loneliness and how their "running partners" are more like allies born of convenience than true friends.
As he talks to the addicts, Okazaki puts the camera up in their faces. And they respond in kind, sharing details of how they score, and why they score. In one scene, we watch a woman named Colie desperately try to buy heroin and use it because, later that day, she is checking herself into rehab. We watch them shoot heroin into their necks, their bruised arms, and their battered hands.
The tale of Marissa is particularly poignant. She talks about how, while many of the addicts she knows will steal to get money for heroin — "Everything I'm wearing right now is stolen," says Shan, Colie's girlfriend — Marissa prefers to work at a strip club, where all she is putting at stake is her own self-respect.
Okazaki talks to an emergency room doctor and a pharmacist, and he peppers facts about heroin addiction throughout — for example, that some 80 percent of heroin addicts, including some in the film, started off with prescription painkillers after accidents. But the strengths of "Heroin: Cape Cod, USA" are the honesty of the portraits and the fact that Okazaki was in these people's lives long enough to capture their patterns and arcs, as some of them rise and some, tragically, fall.
There are far too many devastating lines in the movie to include here — lines such as when a freckled and clear-eyed young woman named Arianna says about the first time she used, "I found the love of my life." Or when another addict, Danielle, says about the collateral damage of her addiction, "Anyone with my last name I hurt the most."
But the line that stuck with me most of all comes from a parent, who is speaking at a support group about what our culture is just beginning to accept — that addiction is a disease.
"If my kid had some other disease that was as dangerous to him as his addiction," she says with both bitterness and humor, "people would be bringing casseroles. But I haven't gotten any casseroles."
HEROIN: CAPE COD, USA
On HBO. Monday, 9-10:15 p.m.
Matthew Gilbert can be reached at firstname.lastname@example.org. Follow him on Twitter @MatthewGilbert.