Detoxification as Performance Art

This article, in a slightly edited form, first appeared on Pain News Network on May 31, 2019.


Treatment Box: Rebekkah’s Story” won an Emmy for Outstanding Special Class – Short Format Daytime Program at the 46th Annual Daytime Creative Arts Emmy Awards. The 6-minute video was produced by The Truth About Opioids, which is an opioid misuse and prevention educational campaign for youth and young adults.

According to a press release, the video “was designed to help young people understand the facts about opioids, the risk of addiction and the crucial role they can play in solving the crisis within their communities.” The documentary has also been broadcast on television and can be seen online:

Unfortunately, the producers failed to accurately convey the facts. The video actually shows us how the media and the Academy of Motion Picture Arts and Sciences (which produces the Emmys) perpetuates misinformation by conflating addiction with withdrawal.

Unhelpful Narratives About Addiction

This is not the first time we’ve seen movies about drug use and addiction that convey misinformation. I wrote a blog, not long ago, about the problems with two mainstream movies, “Ben Is Black” and “Beautiful Boy,” both of which reinforced the news media’s unhelpful narratives.

“Treatment Box: Rebekkah’s Story” continues in the same tradition. The producers apparently were pursuing a headlines-grabbing story, and they found one. Rebekkah, the focal point of the documentary, is a young woman whose exposure to painkillers turns into a heroin addiction.

The movie begins by stating the misleading statistic: “Eighty percent of heroin users started with a prescription painkiller.” That implies taking painkillers as prescribed for medical reasons leads to using heroin eighty percent of the time, but that would be an inaccurate conclusion.

How Heroin Use Actually Begins

It is true that, in 2005, a small sample of treatment-seeking heroin users had previously used prescription opioids. However, most of them were not prescribed an opioid for pain. Instead, they obtained opioids from family or friends for nonmedical use.

In fact, a vast majority of people who used heroin had abused other substances prior to abusing prescription opioids. Usually, their long history of substance abuse began in adolescence, and it did not begin with using opioids.

Moreover, by 2015, 1 in 3 heroin users initiated their opioid use with heroin. Rebekkah’s situation—progressing from oxycodone use to heroin—is unusual. The video holds up Rebbekah’s story as a cautionary tale of what can happen if you use prescription opioids, but her story is atypical.

“She had been an accomplished dancer and athlete, and that was lost when her addiction took over her life and self-image,” explains the video’s website. “Now Rebekkah is regaining control of both—courageously making her detox public in order to help other people while she works towards a new start.”

The producers of “Treatment Box: Rebekkah’s Story” present a difficult story, but they propose a thesis that withdrawal is synonymous with addiction. That is incorrect.

Withdrawal may be associated with addiction, but it does not necessarily follow from addiction. Not everyone who goes through withdrawal has the disease of addiction, and not everyone with addiction must go through the agonizing withdrawal that Rebekkah did.

Watching Someone in Misery Provides No Answers

A major problem that most people with addiction face is the stigma associated with their disease and their inability, or unwillingness, to obtain help. Fear of facing a legal penalty (such as incarceration) or a social consequence (estrangement from family members, job loss, and so forth) often prevent those who are using heroin from seeking treatment. People experience opioid withdrawal largely because of the healthcare and criminal justice systems that make access to appropriate and safe treatment illegal, unavailable, or unaffordable.

Perhaps the producers believed that watching someone in misery would be educational. It is not clear, though, how they thought it might be helpful to frighten viewers. Withdrawal is horrible to experience, and most people are already aware of that.

It’s also troubling how the producers went about creating their video and the story they told. Their set was a makeshift hospital room projected in a cubicle visible to pedestrians walking near Times Square in New York City. (To expand the viewing audience, the documentary has also been broadcast on television.)

The setting was essentially a stage for performance art. The producers seemed to focus on storytelling at Rebekkah’s expense. The scene and backdrop seem to represent Rebekkah’s purity and an innocence that was allegedly robbed by the evil doctors who prescribed her pain medication.

Rebekkah takes on the role of a gladiator engaging in combat against a metaphorical beast: the agony of opioid addiction. She is the heroine with whom we should empathize. We are supposed to share her anger toward the wicked doctors.

Viewers watch Rebekkah suffer from withdrawal without receiving the medical treatment that should be available to anyone in withdrawal. It was surprising that, in the documentary, an addiction physician was complicit in exploiting a person undergoing withdrawal.

No one should be forced to experience what Rebekkah went through.

There is more to the story than we are shown. As viewers, we are led to simply conclude that, if we are exposed to an opioid—even if it’s for a legitimate purpose—we will lose all self-control and become addicted to heroin. That can happen, but it is not common. Almost always, there are other factors that contribute to the transition from appropriate use to abuse and addiction. This is the truth not addressed in the film.

The film begs the question: why did Rebekkah really start to use heroin? What did heroin provide that she could not resist?

The ending of “Treatment Box: Rebekkah’s Story” differs from reality, too. Addiction is usually a life-long disease, and patients who recover frequently relapse. The video’s conveniently neat and tidy resolution does not accurately reflect what occurs in a real-life setting.

“Treatment Box: Rebekkah’s Story” claims to tell the truth about opioids. It does not. It shows Rebekkah’s decision to voluntarily experience a horrible withdrawal that was both unnecessary and avoidable. She should have been given appropriate medical care as she recovered from heroin abuse.

Unfortunately, withdrawal by compliant, non addicted patients who are being forced off opioids don’t have the same stage to tell their stories. Their voices often go unheard, and their agonies are invisible.



  1. Connie Martin on June 2, 2019 at 2:05 am

    OMG! While I’ve seen and read more stories that I can count that are so misleading about legitimate Opioid use, this ridiculous film has just put me over the edge! The film certainly accomplished what the filmmakers wanted to convey, and the hell with actual facts! Lord, a normal movie fact-checker should have removed this piece of fiction for even being considered for an award of all things. I found it absurd how it’s labeled and discussed as if this girl is going through horrible withdrawals from Opioid use, when in fact, she had become a heroin addict! Fun Fact: That is not the same thing! First it was the CDC and their horribly-misguided attempt to curb the overdose deaths from opioids, which have only continued to rise, when they had been told in advance, that these deaths were from street drugs and not from legitimate pain patients, and yet, they still issued the ‘Guidelines” that have dictated my quality of life and pain levels for the last three years. Then the CDC finally manages to come out with the infamous letter, trying to clean up a bit of their mess, now stating that they were offering merely ‘guidelines,’ not mandates, as most all pharmacies, insurance companies and doctors took as such, and that the 90 MME dose was meant for ‘new patients’ and wasn’t intended for chronic pain patients on much higher doses, for longer periods of time. Really? Duh! Would have been nice if you had freaking clarified that the first time – 3 years ago before so many people killed themselves! Are you happy yet? I just saw my father’s pain doctor last week when we went in to request an increase in his Oxycontin ER dose. The 40mg is not working and he is in horrible pain every day. Instead of treating his pain with knowledge and compassion, we were told that he was being tapered down and off all opioid pain medications. When I asked “Why?” I was told it was due to the “CDC Mandate.” I asked this lame doctor if they were even aware of the letter released not that long ago, by the CDC, which was only to try to do some damage control over the countless suicides that have now occurred with chronic pain patients thanks to the CDC? No, he hadn’t read it, nor was even aware of it! He’s a Pain Specialist for crying out loud! If it wasn’t for Dr. Lynn Webster and other intelligent doctors, who truly know what they’re talking about, we would all be in the dark, with even more morons believing this opioid BS the media is peddling, the CDC and the DEA is cramming down our throats, and all of the garbage that continues to flow. HOW LONG WILL THIS INSANITY GO ON? WHERE HAVE FACTS AND COMMON SENSE GONE? C’MON WE’RE DYING HERE!

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