The Fix Q&A with Oscar winner Steven Okazaki about his documentary Heroin: Cape Cod, USA which debuts tonight on HBO.

Amid Cape Cod’s coastal lighthouses, quaint hamlets and seafood shacks, lives a lost generation. Be it lack of opportunity or simple boredom, white and mostly middle-class twentysomethings—locals of so-called Cape Nod—are blotting out their conscious life with constant shots of heroin. But if you follow the headlines, this phenomenon is happening in towns all over the country. Heroin, it seems, is now as ordinary and American as apple pie.

I carried Narcan in my camera bag and we gave it to some of the addicts.

Which is why I felt a sense of urgency watching Oscar winner Steven Okazaki’s latest documentary, Heroin: Cape Cod, USA. It is totally wracking, but necessary. At times it felt like watching gruesome surgery through a two-way mirror, or helplessly stumbling upon a brutal car accident. I simultaneously feared and desired to watch the eight millennial participants barbarically wrap white iPhone wires around their wrists, dig for veins, only to nod their supposed best days away in their childhood bedrooms.

This isn’t Okazaki’s first foray into filming heroin users. His 1999 documentary for HBO, Black Tar Heroin: The Dark End of the Street, followed destitute drug users in San Francisco’s Tenderloin neighborhood. They were mostly off the street, scrounging for money just to be well, not high. Okazaki’s newest work eerily coincides with the shifting demographics. The data suggest the fastest growing group of heroin users is mostly middle-class white kids, 18 to 25 years old.

Perhaps these descriptions sound like mere addict porn or an HBO rendition of A&E’sIntervention. Duping people into being themselves on camera, only to double-cross them by shipping them off to a bogus $30,000 a month rehab, all in the name of “tough love.” But Okazaki does nothing exploitive. Behind the lens is a crew who cares about the participants, their families, and their existential situation. It’s real love. Without judgment or agenda, Okazaki unceasingly documents their lives and the result is at once beautiful and dreadful.

The Fix caught up with Okazaki after watching the film, and below he discusses what it’s like to see a deadly project through to its bitter end.

In a lot of ways, you film people self-destructing. Is it hard to stand behind the camera and watch it all go down? At any point, did you ever want to intervene?

The addicts in the film are going to use whether we’re there or not. If we intervened they’d stop participating in the film. There’d be no film and their stories wouldn’t get out. I tell the crew to be prepared for anything. I carried Narcan in my camera bag and we gave it to some of the addicts.

I’ve seen people overdose. You put the camera down, call 911, and do everything you can to revive them. They’re safer if we’re there, rather than shooting up alone. I always ask them what’s up, what they’ve been thinking. If they’re thinking about detox, we take them, cameras rolling or not.

Aside from your participants using iPhone wires to tie off, in what ways do you see them as the modern-day heroin user? Are the eight participants you documented on the Cape generalizable to other young people across towns in America? If so, how?

The iPhone is also good for texting your dealer and getting the drugs delivered to you. You don’t have to go to the sketchy part of town.

I think the kids in Cape Cod are pretty much the same as kids elsewhere. They do the same hustle for money—steal their mother’s jewelry, tell their father they need new tires for their car, steal stuff from Home Depot and return it for cash, work at strip clubs, go into prostitution, deal, whatever they have to do. The desperation is the same.

The Dark Side of the Beach—HBO Spotlights Cape Cod's Heroin Epidemic - capecodposter

Parents who’ve lost a child to overdose have some of the loudest and strongest voices in drug policy activism today. Did the parents on the Cape band together on their own volition or did you ask them to group up for the film? How important was it to you to get their perspective?

The parents’ group meets every Monday somewhere on the Cape. We were there on Columbus Day and there was no meeting scheduled so I asked them if they would have a meeting in front of the cameras. I figured four or five people might show up and that would be great, but more than 20 people came, eager to talk.

Most of the kids in the film are still very connected to their parents, several still live at home, and many of them talk to their parents everyday. So it was really important to include them. They are part of the story. Some of them enabled their kids, some of them have spent their life savings trying to help their kid get clean. Their lives have been completely re-directed because of their child’s addiction.

Quite a few of the participants mention feelings of hopelessness, boredom, isolation, and having no “real friends.” Do you think this alienation preceded the heroin use, or is this an outcome of their use? Do you see addressing these existential frustrations important to kicking the habit?

Wow, that’s a hard question. All of the kids in the film became addicted between 14 and 20 years of age. That’s a really vulnerable age, when a lot of kids feel bored, isolated and hopeless, when you have so much shit to go through on your way to becoming a human being. Then along comes this drug that makes you feel good, blocks out the pain, makes you feel like a rebel. They’re not 30 years old, they don’t really know what they’re taking on. A lot of kids feel lost and destructive at that age.

Two out of eight of the documentary participants overdosed and died. That must have been difficult, as you spend time shooting and then countless hours editing. You must become very close. Is it hard to cope?

We spend a lot of time with them. I bring them back and I have transcripts of all their interviews and I’m reading them over and I look at them every single day. Eight to 10 hours I’m looking at their faces, so I develop really close feelings toward them. I also have to like the people I’m filming. It just seems like way too much work and is way too hard to be staying up and hanging out when you don’t like the people.

Sometimes you cut right on a little blink or facial tic, and sometimes I cry. They were around me for five days total, sometimes a couple of weeks, but I’ve been around them everyday. It’s really painful. They were once alive and smiling and laughing. It’s heartbreaking. The two young women who overdosed and died were smart, caring, lovely young people. You never know who’s going to survive and get clean, or go on forever using or die.

Did you show their families the footage?

One of the families put up a wall, didn’t want to know, wouldn’t answer our calls. That’s their right. We showed it to another [participant’s] mother just yesterday and eight cars showed up. She brought all of her sisters and brothers and other people for support. She wept. But she was really brave, and wants the film to get out. She was proud of her daughter for participating in the film, for trying to help other addicts.

So much sadness, regret and pain. It’s devastating. It’s a powerful drug. It shouldn’t be so easy to get.

Heroin: Cape Cod, USA debuts at 9pm tonight, Monday, December 28th, on HBO.

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