‘Like a hammer and a hug’: Netflix documentary shows the women trying to save a city from addiction

"It's a new way to treat this crisis that we're in with empathy."

Huntington Fire Chief Jan Rader in "Heroin(e)." CREDIT: Netflix
Huntington Fire Chief Jan Rader in "Heroin(e)." CREDIT: Netflix

Huntington Fire Chief Jan Rader is the first female fire chief in the state of West Virginia. Her city is best known as the site of the worst heroin epidemic in the United States. A new documentary, Heroin(e), currently streaming on Netflix, begins with Rader on her way to the site of an overdose. Sometimes — about half the time, by her estimate — there are children in the house when she goes in. She worries about her younger colleagues, new on the job, who “are seeing 30 to 40 dead bodies a year. And not just bodies. They’re young people.” It didn’t used to be like that, back when she started out.

Sometimes she can save people. She is never not trying to save people. And later on in Heroin(e), she will say, “I don’t care if I have to save somebody 50 times. That’s 50 chances.” For this call, though, there won’t be 50 chances. The call was for a 23-year-old woman, and she’s already dead.

If you are someone who feels a kind of daily rage at the volatile state of the union — if you inhale anger every time you get a news alert on your phone and spiral at all the apocalyptic updates — it might surprise you to find that Rader is not an angry person. She is a sly teller of dirty jokes (which, alas, were cut from the fleet, 39-minute film) with a matter-of-fact attitude about her responsibility to help other people. Also, as I learn within ten seconds of meeting her, she’s a hugger.

Rader shares the focus of Heroin(e) with Necia Freeman, who runs the Brown Bag Ministry, delivering food and support to sex workers, and Cabell County Judge Patricia Keller, who holds the volunteer position of drug court judge. Along with director Elaine Sheldon, these women spoke with ThinkProgress about making and appearing in this documentary, treating addiction with compassion, and what it’s like to have your hometown make headlines as America’s heroin capital.

Elaine, how did you decide to focus on these three women?

Elaine Sheldon: The Center for Investigative Reporting was funding women directors making films about women making change. And I had met Jan through a reporting trip to Huntington. She took me around for a week and introduced me to Patricia and Necia and the rest of the drug court treatment team, and homeless drop-in shelter — everywhere. I called her my fixer. We stayed about 5-7 days, kept that on a hard drive, and started working on a separate film about guys going through recovery from heroin addiction. And when CIR put out that callout for women making change, I had this week of footage. So we went back and shot about 20 more days — about 30 days over the course of a year filming them.

[…] They’re pretty obvious candidates to have a documentary made about them. They’re doing something that — I think they think what they’re doing is just normal and what they should be doing, and why wouldn’t they be doing it? But it’s new. It’s a new way to treat this crisis that we’re in with empathy, and I think they represent that really well. They’re on the front lines.

What was it like to shift your focus from people going through recovery to this apparatus? 

Elaine Sheldon: It was sort of simultaneous. I never really shifted. These women give me hope. Documenting people in recovery, it’s a daily grind they go through. Every day is a new challenge… These women are able to look ahead, in the future, and start thinking about how they can do more preventative things and help the guys we were documenting in the other film. That section of society that’s being left behind. There’s not a lot of recovery options. There’s only seven detox beds —

Jan Rader: Eight. There’s only eight detox beds in all of Cabell County. 96,000 people. We estimate 14 percent are suffering from substance use disorder. We’ve got people begging for detox. And we’ve got eight beds.

Elaine Sheldon: So when people argue, ‘Jan, why would you save someone two times, three times, from Narcan?’ There’s guys we’ve documented who were saved 14 times, and now they’ve been clean two years. I just can’t imagine — I’m glad I found people that care, that see them as human beings and not as junkies and addicts. That’s what the film is trying to do: humanize this issue that we feel so distanced from, that we see statistics that seem completely unfathomable.

Necia Freeman: I think the number that’s so important, that I don’t think the common public knows, is we have eight detox beds, but 95, if not 99 percent of the recovery places will not let you go until you’ve detoxed. So, why aren’t you going to recovery? You can’t get a detox bed.

Jan Rader: And you can’t even detox in jail.

Necia Freeman: So you have to be able to be clean to get into rehab. Now what do we do?

Cabell County Judge Patricia Keller in "Heroin(e)." CREDIT: Netflix
Cabell County Judge Patricia Keller in "Heroin(e)." CREDIT: Netflix

How did all of you feel about the prospect of being in a documentary like this?
 
Patricia Keller: Weird. We’re very shy. But we so believe in what we’re doing that it’s worth putting ourselves out there.

Jan Rader: It’s bigger than us feeling weird about putting this out there… We’re also very driven by helping our community and helping others. And I think all three of us probably grew up the same way: You help people in need. You don’t turn your back on somebody. And be kind.

Necia Freeman: I think a lot of this goes back to how you were raised. Which goes back to people who are doing drugs and have children in their home… Somebody has to go in and intervene when these children are young to show them the hope.

Jan Rader: How can we expect kids to move forward, or anyone to move forward, when — Maslow’s Heirarchy of Needs? We’re dealing with people who can’t meet their basic needs of security, clothing, food. How can you expect them to have self-actualization if you can’t even provide that as a community?

This is a community that you all live in, and you know that it is more than, and more complicated than, the worst of it — its biggest hardships. And yet, in part because of films like this, this is the first understanding that a lot of people will have of this place that you love. Is there any apprehension about that? Do you feel like people only get one small understanding of what Huntington is about, when they think of where you live as the site of a heroin epidemic?

Necia Freeman: Google Huntington, and what’s the first thing that pops up? [I asked someone] to do that two months after a couple major overdoses. And she said, “Oh dear God.” That’s what we’re up against… Economically, [the heroin epidemic] is hurting all parts of our lives.

“I realized that when I say to someone, ‘four of the girls who were on my middle school cheerleading squad are either dead or addicted,’ that is very odd to some Americans, to think that a middle class girl would know heroin addicts.”

Do you think the short-term stigma, then, is worth it if ultimately that attention brings the resources that you need?

Necia Freeman: The next time you type in Huntington, now we want you to see the Netflix film. You’re seeing that we are trying to make a difference. And it’s more than just us three.

Jan Rader: Mayor Steve Williams, he had a call to prayer for Huntington in 2014. He’s a positive person, and people kept asking him, “What’s next?” He started the Mayor’s Office of Drug Control Policy. And his philosophy is: We will not be defined by our problem. We’re going to be defined by how we deal with our problem. And we knew going in that being transparent about this problem was going to draw a lot of negative attention. But, you know what? We choose, as West Virginians, to focus on the positive. And so does our leader. I think that speaks volumes for him: As a mayor, he’s willing to go out on a limb and say, my town has this problem, and we’re going to fight it head-on. If we had more mayors, and governors, and senators, and representatives —

Necia Freeman: And Supreme Court justices!

Jan Rader: If we had more leaders that would do that, instead of turning their backs, what would happen? Negativity breeds negativity. Let’s let positivity breed positivity.

Talking about positivity makes me think about the part of the film that focuses on drug court. I’d never really thought about what went on there, and I don’t know if this is the takeaway you were all going for, but I thought, it seems really nice there! Not that anyone ever wants to be there. But the compassion is really striking.
 
Patricia Keller: Well, we try to be nice there. Because we’re dealing with a population that has been beaten down tremendously, and we want them to know they are supported, and they can change. We have to convince them that they can do this, too. That said, one of my fellow judges in West Virginia teased me and said, “You’re kind of like a hammer and a hug.” Because we try to be very positive, and we care deeply about the people that are in drug court.

Necia Freeman of Brown Bag Ministry in "Heroin(e)." CREDIT: Netflix
Necia Freeman of Brown Bag Ministry in "Heroin(e)." CREDIT: Netflix

Necia Freeman: I think one of the things I’ve noticed [as we’ve done press for the movie] is that everyone’s commented on [Patricia’s] demeanor. And I don’t want that to come across as — how she handles herself at the bench is what you see, on the documentary. But the part of it that I love — it’s one of my favorite parts with her — she got ready to say something to somebody, she took a breath, and she changed her words… She thinks before she speaks. She’s not judging. She’s taking it per person, per case. I run a prostitution ministry, and we’ve got people in drug court who, their moms are in prostitution ministry and now their kids are in drug court. It’s multi-generational. She’s been able to say, “We can no longer help you,” and it’s in the same tone as, “We are here to help you.” And I think the participants know that that’s genuine and it’s honest and it’s not degrading. There’s rarely someone that’s kicked out where you do not see tears among the court team. Because we want them to make it.

Jan Rader: You have people who have never had a positive experience, not only with law enforcement but with the medical community, and we have doctors stepping up and saying, “Yes, I will care for your drug court participants,” because they have exceptional problems because of IV drug use. So they’re having positive encounters, and it’s just amazing.

How much were you surprised by, Elaine? Given all the background research and reporting you’d done before you started filming, what was the most unexpected thing that you learned or saw?
 
Elaine Sheldon: I never feel like what we’re saying is radical. I feel like caring for people is a thing we should all share in common. But I realized that when I say to someone, “Four of the girls who were on my middle school cheerleading squad are either dead or addicted,” that is very odd to some Americans, to think that a middle class girl would know heroin addicts. There wouldn’t have been a lot to surprise me, because this is the community I’m from as well, and I knew a lot. But what surprised me was [Jan, Patricia, and Necia’s] resilience. They get up every morning and they do it, and they don’t show their doubts, if they have them, and they encourage other people to do the same. Some of the scenes that Jan goes into for these overdoses, and I didn’t even see half of them.

Necia Freeman: When she’s doing overdoses, there’s children in those houses sometimes.

Jan Rader: Thank God Elaine wasn’t there when those happened, because I don’t know if she could have handled that. But it’s not uncommon. There’s children involved probably 50 percent of the time, either sitting there watching us work on their parents, or at school, and then guess who deals with them, on a regular basis? Family court judge, or our teachers.

“I think they think what they’re doing is just normal and what they should be doing, and why wouldn’t they be doing it? But it’s new. It’s a new way to treat this crisis that we’re in with empathy.”

Elaine Sheldon: I think, for a lot of people, it’s a reeducation of values. Even people within my extended family don’t understand why I would spend two years of my life documenting heroin addicts. What redeemable factor is there to document within a heroin addict? is sort of the thought. So for me, that’s been shocking. To see people I know who have it within them to be compassionate, but have yet either not come face to face with it close enough that they’ve had to check themselves, or maybe it’s me, a family member, that can open their eyes to it, or with this film. That’s why these three women are so important: They, themselves, are someone you can grasp onto and go on this ride with, because you trust them. They show up for work everyday. They’re citizens that are upstanding in some way. They do the right things, and we don’t all do the right things.

Part of what structured this film was this grant to make a film about women. But a thought that I had while I was watching it was: Women have to clean up everything.
 
Patricia Keller: You said it, sister-friend.

That at the end of the day, women are doing the grunt work of making things better. And I wonder if that’s something you think about in your jobs. If you think there’s anything to my enraged thesis! And if so, why is it that this responsibility falls on women so often? Or why are women more willing to take up that responsibility?
 
Jan Rader: My guess would be that women in general will sit back and think things through, before acting, and men tend to react immediately… I think there need to be more women in pretty much everything we’re dealing with, because there’s some darn good ideas there.

Necia Freeman: I think men have the tendency to say — and this ticks me off so bad — “It is what it is. There’s nothing you can do about it. Move on.” And that’s not true. There’s something you can do about everything. If it’s not right, there’s something you can do.

Elaine Sheldon: I don’t know that I think there’s anything innately different within a man and women to make women more capable. I think it falls on us because of society’s expectations… In general, society expects women to do that work: to be the nurturers, to be the caretakers… Women have it particularly rough, though, when they are addicted. Because guys I’ve documented have lost their children. And they’re not expected to get their children back. Women often can’t go to a six-month rehab; who’s going to take care of that child? So they often find themselves trapped in situations. And there’s often less resources available for women.

Is there anything that, either due to time constraints or what you didn’t feel comfortable filming, that you wish you could have included? What’s on the cutting room floor?
 
Elaine Sheldon: There’s a lot! Because it’s 39 minutes. What you don’t see is how much they interact, and they interact a lot. They’re on the drug court treatment team, and they meet for three hours before the court proceedings to talk about each individual person, what they’re going to do with them that week, if they’re going to give them some reward, talk about their progress, before they actually go to the bench. It’s a whole part of drug court that’s missing. The only piece of information — even though I had to cut out all of Jan’s dirty jokes and her funny banter with the fire department, I miss all that stuff — but the biggest thing I would add is, no one knows [Patricia] is a volunteer. She’s a volunteer drug court judge. That’s not a paid position. She’s a paid family court judge. That’s a really important detail I’ve learned now, screening with audiences, [people don’t know], so I’m trying to tell people this. Drug courts will never take off the way we need them to if we don’t fund them. It’s $7,000 per participant to have someone in drug court. And how much is it to send them to prison?

Jan Rader: $24,000 a year to send them to prison. At minimum, and that’s without anything extra, like if they need dental work.

Elaine Sheldon: And if they graduate from drug court, only 8 percent go on to commit a crime in two years.

Jan Rader: Versus 80 percent if they don’t go to drug court. And we can’t get the Supreme Court to fund this?

If you had to pick just one thing, what do you think is the biggest misconception about heroin abuse and specifically how it’s affecting your community?
 
Jan Rader: These are not bad people. We’ve got to get rid of the stigma. The stigma is our number one barrier to moving forward.

Elaine Sheldon: Recovery isn’t one-size-fits-all. We need to give people time to get well. We need to give them options to get well. And we need to be more forgiving.

“This film is just an inkling of the conversation that needs to be had.”

Jan Rader: You know, we don’t cut off somebody’s insulin supply because they’re diabetic because they’re not being compliant, or they’re overweight, or they’re eating poorly. We don’t do that, now, do we? As a nurse, 80 percent of my patients were non-compliant. That’s why they ended up in the ER. So you want to make those suffering from substance abuse disorder compliant? Really? And it’s a brain disorder? Really? Our expectations are a little high there.

Elaine Sheldon: But it’s also a cultural shift. These are new thoughts around — and some would say, historically, communities of color have not been privy to these conversations. They haven’t been granted access to rehabilitation. So these women are leading a different form of how we treat it, how we look at it. And it’s going to take a while for people to catch up. This film is just an inkling of the conversation that needs to be had.

What has the response to the film been like? 
 
Patricia Keller: People have been reaching out to share their stories, and that just tells you how strong the stigma has been. You know, people will die and they won’t want to put in the obituary that they died of a drug overdose. So people sharing their stories, that’s been amazing to me. Overwhelming.

Elaine Sheldon: You’ve received handwritten letters, hundreds of emails. Jan’s received emails from first responders from all over the world, from female civil servants across the country.

Jan Rader: It’s been humbling. And it really shows that there are a lot of people out there that are just needing a cheerleader. I think this is a group of individuals, those struggling with substance abuse disorder, they need a cheerleader. They need somebody to stand up and say, “We’re people too.” I feel like a lot of them view this documentary that way.