Addiction I Full Documentary I NOVA I PBS — Transcript

Full transcript

1. 0:01♪ ♪
2. 0:03NARRATOR: A devastating epidemic...
3. 0:05KEN: We just didn't know what to do.
4. 0:07We just felt powerless.
5. 0:09A parents' worst nightmare,
6. 0:12to find my kid not breathing.
7. 0:16JAMES WINNEFELD: He was always very good
8. 0:17at telling us, "Mom and Dad, everything's going to be fine,"
9. 0:20but it wasn't.
10. 0:23NARRATOR: Addiction is ruining lives
11. 0:25and ending them too soon.
12. 0:27(alarm blaring)
13. 0:28Overdose is the number one cause of death
14. 0:30for people under 50.
15. 0:32RAHUL GUPTA: We are racing against time.
16. 0:34We have the equivalent
17. 0:36of a Boeing 737 crashing every single day.
18. 0:39NARRATOR: But what causes addiction?
19. 0:42ROBERT MALENKA: Individuals struggling with addiction
20. 0:44are actually battling millions of years of evolution,
21. 0:48because our brains are exquisitely evolved,
22. 0:52to seek rewards.
23. 0:54It's those cravings, the inability to stop.
24. 0:59NARRATOR: A dangerous cocktail of biology and medicine
25. 1:03made deadlier by a drug 100 times more potent
26. 1:07than morphine.
27. 1:08DARWIN FISHER: Fentanyl is super toxic.
28. 1:10So you get a batch that comes on the street
29. 1:13that's a little bit hot,
30. 1:14and on those days, it's like,
31. 1:16bam, somebody's going down.
32. 1:18Bam, somebody's going down.
33. 1:20Bam!
34. 1:22NARRATOR: But can new treatments offer hope?
35. 1:25LAURA KEHOE: We have extremely effective medications
36. 1:28that are life-saving.
37. 1:30This is a very treatable illness.
38. 1:32ANNA LEMBKE: The solution to this
39. 1:34is for us to embrace addiction as a disease,
40. 1:38to bring it within the house of medicine.
41. 1:40FISHER: People recover from addiction.
42. 1:42Nobody is unreclaimable.
43. 1:46The only thing that you can't recover from
44. 1:49is death.
45. 1:50NARRATOR: "Addiction,"
46. 1:52on "NOVA."
47. 1:56♪ ♪
48. 2:08♪ ♪
49. 2:10NARRATOR: McDowell County, West Virginia,
50. 2:13feels like a place left behind.
51. 2:18Yet its miners helped power America
52. 2:21when coal was king.
53. 2:26Back then, the largest city, Welch,
54. 2:30was a thriving community.
55. 2:32But as coal jobs vanished by the 1990s,
56. 2:36the poverty rate in the county
57. 2:38climbed to 38%.
58. 2:43Then investigators found
59. 2:45that over a six-year period,
60. 2:47drug companies had flooded the state
61. 2:49with 780 million highly addictive pain pills.
62. 2:53(train horn blaring)
63. 2:58(rumbling)
64. 3:04JASEN EDWARDS: West Virginia was the perfect storm.
65. 3:07The whole state's dominated
66. 3:08by one of the hardest and most dangerous jobs
67. 3:10in the world.
68. 3:11Most of the old timers that work in the mines
69. 3:14work with pain.
70. 3:15And then pain pills started flooding the community,
71. 3:18and people that you used to know
72. 3:21weren't the same people that they used to be.
73. 3:24I mean, it, it just... it ruined everything.
74. 3:28♪ ♪
75. 3:30NARRATOR: Jasen Edwards and his two brothers Scott and Mark,
76. 3:33grew up in Sophia, West Virginia.
77. 3:38The town was near the Winding Gulf coal field.
78. 3:42Most of its residents were miners,
79. 3:46including the Edwards family.
80. 3:49All three sons would struggle with pain pills.
81. 3:55Jasen got his first prescription
82. 3:57after crushing his leg in a mining accident.
83. 4:02They cut my leg off the day after Christmas in 2008,
84. 4:07and I was back underground mid-to-late February.
85. 4:12First day I went back to work,
86. 4:15I had to crawl everywhere or ride everywhere I went,
87. 4:19because my stump was still too swollen
88. 4:22to put my prosthetic leg on.
89. 4:25A man hurts his back,
90. 4:27if he is not back to work, they will replace him.
91. 4:30And I could not have supported my family on the disability.
92. 4:34NARRATOR: Soon, a few pills a day
93. 4:37could no longer stop the pain.
94. 4:38(drill grinding)
95. 4:41But Jasen could easily buy more
96. 4:44by visiting doctors and showing his artificial leg.
97. 4:50JASEN: The first time I realized that I was in trouble
98. 4:53is when I couldn't go to work,
99. 4:54because I didn't have any pain pills.
100. 4:57And it wasn't because of how bad I was hurting,
101. 5:00it was because of the sickness due to detoxing.
102. 5:04♪ ♪
103. 5:06NARRATOR: Jasen was addicted to a powerful opioid painkiller
104. 5:09called OxyContin.
105. 5:13Opioids like OxyContin are chemically similar to morphine,
106. 5:17found in the opium of the poppy plant.
107. 5:20They mimic the body's natural pain relievers,
108. 5:25like endorphins,
109. 5:26which bind to proteins, called receptors,
110. 5:29calming pain and inducing euphoria.
111. 5:33Prolonged opioid use can alter the brain
112. 5:37and lead to addiction,
113. 5:38manifested by cravings and compulsive drug use
114. 5:42despite negative consequences.
115. 5:45♪ ♪
116. 5:49As opioids were aggressively marketed,
117. 5:51West Virginia soon had the highest rate of overdose deaths
118. 5:54in the U.S.,
119. 5:55alarming health commissioner Dr. Rahul Gupta.
120. 5:59GUPTA: We were amongst the top states
121. 6:02prescribing pain pills in the nation.
122. 6:05At the same time,
123. 6:07people were losing their employment,
124. 6:08they were also losing a way of life.
125. 6:11It spelled the perfect conditions under which
126. 6:15addiction began to creep in.
127. 6:18(indistinct talking)
128. 6:21♪ ♪
129. 6:26NARRATOR: At Stanford University,
130. 6:28psychiatrist Anna Lembke
131. 6:30also feared Big Pharma's pressure on doctors
132. 6:32was creating an epidemic.
133. 6:35When she got access to patients' prescriptions records,
134. 6:39her suspicions were confirmed.
135. 6:44Many people abusing pain pills
136. 6:46were getting them from doctors-- not drug dealers.
137. 6:50♪ ♪
138. 6:53I'll never forget when I first looked at the drug database
139. 6:56for a patient of mine.
140. 6:57I mean, it was just glaringly obvious
141. 7:00she'd been doctor shopping,
142. 7:01you know, 1,600 pills, I think, in the span of a month.
143. 7:04And I think it's important to know
144. 7:06that doctors were being sued
145. 7:08if they did not do everything within their power
146. 7:11to address a patient's pain.
147. 7:13So there was a serious problem going on here.
148. 7:16NARRATOR: Lembke was also seeing a new type of patient--
149. 7:21an "opioid refugee."
150. 7:24(dog barking)
151. 7:26KEN: How's your chemistry class coming?
152. 7:27CASEY: It's fine.
153. 7:30What are you guys working on in there?
154. 7:31Compounds, chemical compounds,
155. 7:33like iron...
156. 7:34NARRATOR: Casey leads a protected life.
157. 7:36Her father Ken watched drugs destroy his brothers,
158. 7:41so he moved his daughters out of the city
159. 7:43and put them in private schools.
160. 7:49In her teens, Casey stayed busy with sports.
161. 7:54But she began having severe muscle cramps.
162. 7:58CASEY: I remember one game in particular,
163. 8:01all of sudden I just started feeling really shaky
164. 8:05and then everything just started hurting.
165. 8:07My legs and my arms just cramped up really tight.
166. 8:11She fell straight to the ground screaming in pain.
167. 8:15It took me and one of her coaches to pick her up,
168. 8:17put her in our car, rush her out to Children's.
169. 8:21They did a million and one tests,
170. 8:22and then they found, you know, an ovarian mass.
171. 8:25Well, an ovarian mass in a teen, that's scary.
172. 8:28So then that required more medical workup
173. 8:31in order to discover that the mass was, in fact, benign,
174. 8:34but by then, you know, she had a surgery,
175. 8:36it had been removed,
176. 8:37and through all of this,
177. 8:38she received copious opioids.
178. 8:41♪ ♪
179. 8:44CASEY: Once I left the hospital,
180. 8:45I noticed that I was still having a lot of pain,
181. 8:48but it was nowhere near the surgery sites
182. 8:51that they had operated on.
183. 8:52KEN: We couldn't even touch her,
184. 8:55she was in so much pain.
185. 8:57She described it as
186. 8:58it felt like her bones were being ripped out of her body.
187. 9:01Now, the pain she was experiencing
188. 9:04was opioid withdrawal pain, but they didn't know.
189. 9:06So they whisk her back to the emergency room.
190. 9:09"What could this possibly be?
191. 9:10She's got terrible pain."
192. 9:12And, essentially, every single time
193. 9:14the solution was, "Prescribe more opioids."
194. 9:17But after a while
195. 9:18they didn't help as much anymore,
196. 9:20so I started taking way too many.
197. 9:24LEMBKE: Until at one point
198. 9:25an emergency room doctor realized she's addicted,
199. 9:29and what was his reaction?
200. 9:30He basically went out and he shamed them.
201. 9:32And he's like, "Your daughter's addicted.
202. 9:34We never want to see her here again."
203. 9:35NARRATOR: Stunned, Ken drove home,
204. 9:39with no idea of how to help his daughter.
205. 9:43Casey was now an opioid refugee,
206. 9:46battling cravings and withdrawal on her own.
207. 9:50We just felt powerless.
208. 9:53And as a dad, I'm supposed to be her protector,
209. 9:56and I just felt like I had, I had completely let her down,
210. 10:00that...
211. 10:06I just didn't,
212. 10:07I mean, I just didn't know what, what to do anymore.
213. 10:11♪ ♪
214. 10:15LEMBKE: There was implicit trust.
215. 10:17"If this medication were dangerous,
216. 10:18"they would tell me.
217. 10:20"As long as we take it just as prescribed,
218. 10:23everything is going to be okay."
219. 10:24And that is totally untrue.
220. 10:26Casey's a great example.
221. 10:29Now, given her family history of addiction,
222. 10:31she probably had an underlying vulnerability, right?
223. 10:33But what made her addicted
224. 10:36was the opioids that she received from her doctors.
225. 10:42NARRATOR: Addiction runs in families,
226. 10:44and studies suggest
227. 10:45that genes play a role in determining one's risk.
228. 10:52Addiction is a complex disorder,
229. 10:54and as a complex disorder, there's not one addiction gene.
230. 10:58It's multiple genes
231. 10:59and multiple other factors that interact with your genetics
232. 11:03that increases risk.
233. 11:06NARRATOR: Over 90% of addiction cases start before age 21,
234. 11:11when the brain is still forming.
235. 11:15For Jasen's brother Mark,
236. 11:16it was a time of impulsive decisions.
237. 11:20MARK EDWARDS: I had no idea how dangerous pain medication would be.
238. 11:26I never woke up any day and said,
239. 11:30"Man, I want to be an addict today."
240. 11:33And I asked myself, "How did you end up here?"
241. 11:38And I look back on my surroundings
242. 11:40and everything that was around me.
243. 11:42People everywhere was, was doing this.
244. 11:47It was almost like there was nothing else in life.
245. 11:51♪ ♪
246. 11:53NARRATOR: As doctors prescribed fewer pain pills,
247. 11:55drug cartels filled the void by selling heroin,
248. 11:59an illegal opioid cheaper than OxyContin.
249. 12:05Overdose deaths climbed
250. 12:07as heroin, long available in inner cities,
251. 12:09turned up in rural communities.
252. 12:12♪ ♪
253. 12:16In a single year,
254. 12:17more than 70,000 Americans died of an overdose.
255. 12:25Addiction is America's number one domestic issue today.
256. 12:28We have hospitals
257. 12:30that are overwhelmed with people who need help.
258. 12:34We have a prison system that is filled
259. 12:36with people who actually need treatment.
260. 12:39We have judges
261. 12:41that are often seeing more people with mental diseases
262. 12:45than a psychiatrist-- or a primary care physician like me--
263. 12:47sees in a day.
264. 12:49The entire fabric of our society is being destroyed,
265. 12:53as a result of addiction.
266. 12:55♪ ♪
267. 12:58NARRATOR: Addiction is often viewed as a moral failing--
268. 13:02stigmatized by words like "clean," "dirty,"
269. 13:06"abuser," "addict."
270. 13:09But scientists now know it's a disorder
271. 13:12that occurs as the brain changes in response to drugs.
272. 13:17MALENKA: Individuals struggling with addiction
273. 13:21are actually battling millions of years of evolution,
274. 13:24because our brains are exquisitely evolved
275. 13:28to seek rewards,
276. 13:30to seek reinforcement wherever and whenever we can.
277. 13:33♪ ♪
278. 13:37NARRATOR: To understand how reward shapes behavior,
279. 13:39Robert Malenka simulates a famous experiment.
280. 13:44A mouse is attached to a fiber optic cable
281. 13:47and placed in a cage with two holes.
282. 13:50♪ ♪
283. 13:53When the mouse explores the hole on the right,
284. 13:55a flash of light sparks a feeling of pleasure
285. 13:58in its brain.
286. 14:01At the other hole, nothing happens.
287. 14:07Yep, there he goes again, right now.
288. 14:08(voiceover): We are learning machines.
289. 14:12Our brains have evolved to be exquisite reward seekers,
290. 14:16and that was important for evolutionary survival.
291. 14:19But that came with a price--
292. 14:22our susceptibility to developing addictions.
293. 14:25NARRATOR: Obsessed with that burst of pleasure,
294. 14:30the mouse will probe the hole several thousand times
295. 14:33over the next hour.
296. 14:35MALENKA: I mean look at this,
297. 14:36he's just doing nothing else.
298. 14:39NARRATOR: This experiment revealed the reward pathway in the brain,
299. 14:44primarily controlled by a chemical messenger
300. 14:47called dopamine.
301. 14:50Dopamine tells your brain to pay attention,
302. 14:53that whatever it just experienced
303. 14:55is worth getting more of.
304. 14:59It's released by endorphins
305. 15:01or when we encounter anything pleasurable or exciting--
306. 15:07especially drugs that can push dopamine levels
307. 15:10ten times higher than normal.
308. 15:13MALENKA: All drugs of abuse cause this unnatural rise of dopamine.
309. 15:19And because of that,
310. 15:21they're among the most powerful experiences
311. 15:24our brains can have.
312. 15:25♪ ♪
313. 15:27NARRATOR: As drugs raise dopamine levels,
314. 15:29they also alter the connections between brain cells,
315. 15:33creating memoires of euphoria that trigger fierce cravings.
316. 15:40But it's not just about seeking pleasure.
317. 15:43People struggling with addiction
318. 15:44soon use drugs to avoid the pain of withdrawal.
319. 15:50JASEN: Withdrawals will make your bones ache.
320. 15:54I couldn't leave the house because I couldn't take a step
321. 15:58without soiling myself from the withdrawals.
322. 16:02(shattering)
323. 16:04You couldn't talk to me,
324. 16:06I'd throw something at you or bite your head off.
325. 16:10NARRATOR: When opioids are abruptly stopped,
326. 16:13stress hormones are released at catastrophic levels.
327. 16:18This imbalance triggers the opposite symptoms of opioid use,
328. 16:23including shaking, anxiety, pain, and intense dysphoria.
329. 16:29Many times I would lay my head on a pillow
330. 16:33and think, "I'm done.
331. 16:34I can't live like this, I don't want to be this person."
332. 16:38And I would wake up the very next day,
333. 16:41and I would just do more drugs.
334. 16:43I was powerless over my addiction.
335. 16:46It consumed me, it owned me,
336. 16:49I was a slave to it.
337. 16:54♪ ♪
338. 16:59NARRATOR: This cycle of addiction, says Dr. Corey Waller,
339. 17:03starts as the brain struggles to rebalance
340. 17:06as drugs overwhelm it with dopamine.
341. 17:09WALLER: When that happens,
342. 17:10the body decreases the production of dopamine,
343. 17:14and eventually you can't even get enough dopamine produced
344. 17:16to get out of bed,
345. 17:17let alone produce good relationships
346. 17:19and good decision-making.
347. 17:21♪ ♪
348. 17:23NARRATOR: To understand what happens to dopamine,
349. 17:26Dr. Nora Volkow has been imaging the brains
350. 17:31of people with and without addiction
351. 17:32to search for changes that occur with drug use.
352. 17:36♪ ♪
353. 17:40VOLKOW: We systematically were investigating
354. 17:41individuals addicted to different classes of drugs,
355. 17:44and we found that a common change
356. 17:46across all of the different types of drug addictions
357. 17:49was a reduction in the levels of dopamine D2 receptors.
358. 17:54NARRATOR: The number of receptor proteins,
359. 17:58seen here as red in the brains of control subjects,
360. 18:01are reduced in brains exposed to drugs.
361. 18:05Fewer receptors means the brain is starving for dopamine.
362. 18:09VOLKOW: Drugs interfere with your motivational drive.
363. 18:15So imagine what it means
364. 18:16to lose the motivation to do things,
365. 18:19to just not have it.
366. 18:21WALLER: And so anytime someone hears the term motivation,
367. 18:23they should really supplant that with dopamine.
368. 18:26Because without dopamine, you don't have motivation.
369. 18:29And so, when we look at a person
370. 18:30who is in the throes of an addictive disorder,
371. 18:33and say, "They just need to motivate!"
372. 18:34We're telling them to somehow magically make dopamine.
373. 18:38(tumblers spinning)
374. 18:40NARRATOR: And it's not just drugs--
375. 18:41gambling or eating can also spike dopamine levels
376. 18:46and become addictive.
377. 18:49Volkow found that people with morbid obesity
378. 18:52also have fewer dopamine receptors.
379. 18:57VOLKOW: Once those receptors are going down,
380. 18:59you are going to have a great difficulty
381. 19:04in self-regulating the desire not to eat,
382. 19:06because cognitively, your brain is fighting.
383. 19:09On the one hand you say, "I, I'm obese,
384. 19:11I don't want to eat anymore."
385. 19:12And at the same time, there is intense craving.
386. 19:15And if your brain is not functioning properly,
387. 19:19you cannot win the game.
388. 19:22You are going to give in
389. 19:24and impulsively and compulsively eat that food.
390. 19:28NARRATOR: And drugs can unleash even stronger cravings.
391. 19:34JASEN: My wife at the time
392. 19:35went and seen her sister for nine days,
393. 19:39and I spent $21,000 while she was gone...
394. 19:41(chuckles sardonically)
395. 19:44on pain medicine.
396. 19:46I did lose my job, I didn't care.
397. 19:50Only thing I cared about
398. 19:53was that magical date on the calendar
399. 19:54when I went back to the doctor.
400. 19:55WALLER: The body has a drive for dopamine,
401. 19:59and that craving flips them into survival mode.
402. 20:03If you understand that this is about survival for them,
403. 20:05you can understand why they steal $20 out of your wallet,
404. 20:10why they hock jewelry from the house.
405. 20:13JASEN: My habits was putting my wife and my daughter in danger.
406. 20:18Finally, she just done what any mother would do,
407. 20:21and they left.
408. 20:24♪ ♪
409. 20:27NARRATOR: Jasen attempted suicide
410. 20:29after his brother Scott died of an overdose
411. 20:31on the outskirts of town.
412. 20:35For Mark Edwards,
413. 20:36it was a moment of reckoning with his own addiction.
414. 20:40MARK: I did not want to be that person that was broken.
415. 20:44And I wanted to get help,
416. 20:47but every place that I called didn't have beds available.
417. 20:51I felt like that
418. 20:52if I didn't do something,
419. 20:54that I would end up dead.
420. 20:58♪ ♪
421. 21:01NARRATOR: Another drug is making the epidemic even deadlier,
422. 21:06especially in Vancouver, Canada.
423. 21:11The city has become a gateway for illegal fentanyl,
424. 21:14made in China.
425. 21:17Normally used for anesthesia, fentanyl is so potent,
426. 21:21it's often shipped a few ounces at a time
427. 21:24and later mixed with other drugs.
428. 21:28Hidden in innocuous-looking packages,
429. 21:31much of China's fentanyl is headed for U.S. markets.
430. 21:36But it's also devastating Vancouver.
431. 21:42FISHER: Fentanyl is a synthetic opiate created in a lab.
432. 21:45It is super toxic.
433. 21:46So you'll get a batch that comes on the street
434. 21:48that's a little bit hot.
435. 21:50And on those days, it's like,
436. 21:51bam, somebody's going down, bam, somebody's going down,
437. 21:53bam!
438. 21:57NARRATOR: Up to 50 times stronger than heroin,
439. 21:59an amount of fentanyl equal in size
440. 22:01to two grains of salt
441. 22:03will kill you.
442. 22:05(siren blaring)
443. 22:09Fentanyl's path of destruction
444. 22:11is closely monitored in West Virginia
445. 22:14by Dr. Rahul Gupta.
446. 22:16Using a digital map,
447. 22:20Gupta follows overdoses as they occur.
448. 22:23Circles stand for non-lethal incidents.
449. 22:28Squares indicate fatal ones.
450. 22:31And a spike of deaths in nearby states
451. 22:35means fentanyl-tainted drugs may soon show up
452. 22:38in West Virginia.
453. 22:39♪ ♪
454. 22:42GUPTA: On one day, we had 26 overdoses reported to us.
455. 22:47It was almost like a communicable disease outbreak.
456. 22:50And here's the scariest part.
457. 22:51We found that of all of those people who overdosed,
458. 22:55none-- no one--
459. 22:57was ever admitted into a treatment facility.
460. 23:01(radios squawking)
461. 23:03NARRATOR: But many people don't survive at all
462. 23:06because opioids, if taken in excess,
463. 23:08can quickly shut down breathing.
464. 23:11Hello?
465. 23:12NARRATOR: And because of the potency of fentanyl,
466. 23:15the risk of a fatal overdose is high,
467. 23:19no matter who you are or where you live.
468. 23:23♪ ♪
469. 23:31MARY WINNEFELD: Jonathan was a wonderful young man.
470. 23:33From a very early age, compassionate, smart, loving.
471. 23:39Our family did go through many moves.
472. 23:42We lived all over this country, overseas.
473. 23:45So that was, I think, tough for Jonathan.
474. 23:49NARRATOR: Jonathan Winnefeld was born into an accomplished family.
475. 23:57His father James rose through the naval ranks
476. 24:00to become the Vice Chairman of the Joint Chiefs of Staff
477. 24:03in 2011.
478. 24:07By that time, Jonathan was struggling.
479. 24:10JAMES: At one point, he was in five different school districts
480. 24:14in six years, which is tough for a kid.
481. 24:16And so what became apparent to us over time
482. 24:19was that Jonathan, as great a kid as he was,
483. 24:22was suffering from some form of anxiety and depression.
484. 24:27NARRATOR: Unfortunately, Jonathan was misdiagnosed
485. 24:29with attention deficit disorder,
486. 24:32and prescribed Adderall, a powerful stimulant.
487. 24:37Soon, to unwind at night, he began to drink.
488. 24:43To calm his anxiety,
489. 24:45he used Xanax, a mild tranquilizer,
490. 24:48and smoked pot.
491. 24:50Then, he experimented with heroin.
492. 24:55MARY: So we got him into counseling,
493. 24:57and I did what a normal parent would do.
494. 25:01I took away the Xbox,
495. 25:02I took away his phone, I monitored all of his moves.
496. 25:06In retrospect,
497. 25:08it was probably the worst thing I could have done for him,
498. 25:10because it isolated him even more.
499. 25:13(sirens blaring)
500. 25:14JAMES: And, ultimately, he tried to take his own life.
501. 25:17He ended up wrapping his car around a telephone pole.
502. 25:22It was at that point when we realized
503. 25:23that we needed to get Jonathan into inpatient treatment
504. 25:25or we were going to lose him.
505. 25:27(typing on keyboard)
506. 25:29MARY: I went on the internet and searched,
507. 25:31and it's overwhelming.
508. 25:33There are so many different places out there.
509. 25:35You don't know who's good, who's bad,
510. 25:37who's just trying to make money.
511. 25:39Financially, our insurance covered nothing.
512. 25:42We really tried to find the best treatment possible out there.
513. 25:45But, in America, there's not a lot of support
514. 25:48in the mental health
515. 25:50and especially in substance abuse.
516. 25:55NARRATOR: The Winnefelds found a center in Connecticut
517. 25:57to treat Jonathan's addiction and anxiety.
518. 26:02Like some 80% of programs,
519. 26:03it followed the 12-step model of Alcoholics Anonymous,
520. 26:07where patients admit they are powerless over drugs,
521. 26:10need help from a higher power, and commit to abstinence.
522. 26:16WALLER: If we look at the legacy treatments
523. 26:19that've been around for 70 years,
524. 26:21they revolve around going to meetings
525. 26:22and working through the 12 steps,
526. 26:25generally doing that a lot
527. 26:27with self-help and group-based therapy,
528. 26:29and then maintaining that abstinence
529. 26:32by using that alone.
530. 26:33NARRATOR: Jonathan's treatment for 15 months
531. 26:37cost the Winnefelds hundreds of thousands of dollars,
532. 26:41but it seemed worth it.
533. 26:46JAMES: Our son came back to us.
534. 26:49We were able to have a real conversation with him.
535. 26:51We saw, about a year into his treatment,
536. 26:53that he regained his ambition.
537. 26:56♪ ♪
538. 26:58NARRATOR: Seeming confident of his recovery,
539. 27:00Jonathan enrolled as a freshman at the University of Denver.
540. 27:05JAMES: That day we dropped him off at his dorm,
541. 27:07he was excited, looking good, fired up,
542. 27:11and it was one of the best moments of my life,
543. 27:13seeing him doing so well.
544. 27:16(phone vibrating)
545. 27:20NARRATOR: Three days later,
546. 27:22their hopes were shattered.
547. 27:25MARY: I was not prepared to get a phone call
548. 27:29saying that my son had passed away
549. 27:31in his bed, in his dorm room, from heroin and fentanyl.
550. 27:36Never, never, never would have guessed that
551. 27:39in a million years.
552. 27:43♪ ♪
553. 27:45NARRATOR: With failure rates nearing 80% to 90%,
554. 27:48is the abstinence-based approach to opioid addiction
555. 27:52scientifically flawed?
556. 27:55Abstinence-based programs really, for opioid use disorder,
557. 28:00are setting people up to fail and to relapse.
558. 28:02And in the face of this crisis,
559. 28:05where we know that every single time
560. 28:07that somebody uses an opioid,
561. 28:09they are at real risk of overdosing and dying,
562. 28:12this should never be recommended as a primary intervention.
563. 28:20NARRATOR: In Morgantown, West Virginia,
564. 28:22Dr. James Berry also believed abstinence-based treatment
565. 28:26was failing his patients with opioid addiction.
566. 28:30(nurse talking indistinctly)
567. 28:31BERRY: We would get them successfully detoxed,
568. 28:34get them exposed to family therapy,
569. 28:36group therapy, individual therapy,
570. 28:39and we'd find that they would invariably relapse,
571. 28:42and they'd just be out there on the streets using again.
572. 28:45♪ ♪
573. 28:47NARRATOR: Frustrated, Berry considered using methadone,
574. 28:49a long-lasting opioid
575. 28:51that curbs cravings from heroin and pain pills
576. 28:55without causing euphoria.
577. 28:57Methadone binds to opioid receptors
578. 29:01and normalizes brain functions altered by addiction,
579. 29:05including dopamine levels.
580. 29:08Here is your medication, sir.
581. 29:10NARRATOR: Under current laws,
582. 29:11most patients must take it at clinics.
583. 29:13Here is your medication, sir.
584. 29:15NARRATOR: In 2003, the opioid buprenorphine
585. 29:19became available under the brand name Suboxone,
586. 29:23which could be taken at home.
587. 29:27Less potent than methadone,
588. 29:30Suboxone only partially activates opioid receptors
589. 29:33to reduce cravings.
590. 29:36If taken as prescribed and not misused,
591. 29:39both drugs cut mortality by about half.
592. 29:43After a year,
593. 29:4640% to 90% of patients are in recovery.
594. 29:49You feeling better?
595. 29:51NARRATOR: Berry began giving patients Suboxone.
596. 29:54Oh, yeah, 100%.
597. 29:55They started doing well,
598. 29:56they started getting their lives back,
599. 29:58they started getting to work again.
600. 30:00Uh, Lawrence, how are you?
601. 30:01Good.
602. 30:02And how much time do you got today?
603. 30:04I got like 260 or...
604. 30:06BERRY: 245 days!
605. 30:08245, okay, yeah.
606. 30:10Tell us what you have been doing the last two weeks.
607. 30:11Work has picked up.
608. 30:13I'm about to buy into my boss's business,
609. 30:14yeah 35%.
610. 30:16He's gonna let me buy in.
611. 30:16No kidding!
612. 30:17So that will be awesome for me.
613. 30:19So you've really showed him what you've been able to do.
614. 30:20Yeah, yeah.
615. 30:22The main thing that makes Suboxone so effective
616. 30:24is it's helping with these cravings
617. 30:27that people are experiencing.
618. 30:29But it's so hard to break that chain.
619. 30:31BERRY: Patient after patient after patient
620. 30:34will tell me the same story.
621. 30:35"Listen, Doc,
622. 30:36"I am not using to get high anymore.
623. 30:39I am just using not to be sick anymore."
624. 30:41What Suboxone does is
625. 30:44it satisfies those cravings
626. 30:46in a way that they're under control.
627. 30:49It works so much better
628. 30:52on calming that demon inside you.
629. 30:53If I went home,
630. 30:56started doing opiates again,
631. 30:58I was going to kill myself.
632. 30:59(indistinct talking)
633. 31:01NARRATOR: With cravings under control,
634. 31:03patients can take advantage of a range of therapies
635. 31:06to help them cope and rebuild their lives.
636. 31:12LEMBKE: There are fantastic psychosocial interventions
637. 31:16like retraining your brain, being mindful,
638. 31:19learning more adaptive coping strategies.
639. 31:21The night before, I was saying...
640. 31:23CARRIE WILKINS: Because it's not just one epiphany moment.
641. 31:26It's a learning process.
642. 31:27You have to learn to be sober.
643. 31:29And it takes practice, it takes trial and error.
644. 31:31And you've got to be ready for the ups and downs.
645. 31:35♪ ♪
646. 31:38NARRATOR: One challenge, according to psychologist Rita Goldstein,
647. 31:42are the changes that occur with addiction
648. 31:44in the brain's executive control center,
649. 31:46the prefrontal cortex.
650. 31:49This is the prefrontal cortex, in the front of the brain.
651. 31:54And we're looking at gray matter,
652. 31:55separating it from the white matter.
653. 31:58So you can see,
654. 31:59it's actually tinted gray in this scan.
655. 32:01♪ ♪
656. 32:03NARRATOR: Scans reveal that chronic drug use
657. 32:06is associated with reduced grey matter,
658. 32:09especially in the prefrontal cortex.
659. 32:14GOLDSTEIN: Those regions are essential to make advantageous choices--
660. 32:18to make the right decision at the right time.
661. 32:21So, the lower the gray matter,
662. 32:23the more the decision-making is impaired.
663. 32:25You have a decrease
664. 32:27in the ability to control your behavior.
665. 32:31NARRATOR: Neuroscientist Yasmin Hurd
666. 32:34has found another way
667. 32:35that chronic drug use impacts the brain.
668. 32:39By analyzing the brains of overdose victims,
669. 32:43she's discovered that heroin changes the activity
670. 32:46of key genes.
671. 32:50Heroin changes the way our DNA functions.
672. 32:52It turns on genes that should not be on.
673. 32:56And turns off genes that should be on.
674. 32:58And so that imbalance changes the brain function.
675. 33:02♪ ♪
676. 33:05NARRATOR: The genes most affected
677. 33:06regulate the brain's key chemical messenger,
678. 33:08called glutamate,
679. 33:11which is essential for sending signals between neurons,
680. 33:13making thinking, memory, and learning possible.
681. 33:20HURD: It's not that addiction completely takes away
682. 33:22every aspect of your cognitive function.
683. 33:25In fact, you have to work even harder.
684. 33:27So I think people need to understand
685. 33:29that people with these disorders
686. 33:30are actually fighting a very strong battle.
687. 33:35NARRATOR: But is this a battle that can be fought and won?
688. 33:40Opioids are still being studied,
689. 33:42but scans reveal
690. 33:44that dopamine receptors reduced by other addictive drugs
691. 33:48can come back with recovery.
692. 33:52Rita Goldstein has seen evidence that grey matter can increase.
693. 33:58The ability of the brain to heal and to recover is amazing.
694. 34:01So definitely there is a lot of hope.
695. 34:04HURD: The question is,
696. 34:06"How long does it take?"
697. 34:07And everyone's brain is different.
698. 34:10(siren blaring)
699. 34:14NARRATOR: Yet most people don't have access
700. 34:16to effective treatment,
701. 34:18especially medications for opioid addiction.
702. 34:21♪ ♪
703. 34:23For Dr. Corey Waller,
704. 34:25the problem is that addiction is not handled
705. 34:27like other diseases.
706. 34:29WALLER: If a patient comes into an emergency department
707. 34:32with chest pain,
708. 34:33we have a pretty standard set of approaches.
709. 34:35We evaluate whether or not the heart's being injured.
710. 34:38We look at an E.K.G. that tells me,
711. 34:40"Do they need to get something done quickly?"
712. 34:43And no matter what the answer is,
713. 34:44we actually have a place for them to go.
714. 34:48NARRATOR: For overdose victims, the focus is mainly on revival.
715. 34:55These are patients who are basically dead.
716. 34:57They're not breathing.
717. 34:58They are this close to being dead forever.
718. 35:01WALLER: Let's give the Narcan real quick.
719. 35:02NARRATOR: The drug naloxone,
720. 35:04sold under the brand name Narcan,
721. 35:06can reverse an overdose
722. 35:08by pulling opioids off receptors in the brain.
723. 35:11You all right?
724. 35:12Good.
725. 35:15WALLER (voiceover): And in most emergency departments around the country,
726. 35:16that's the extent of the intervention.
727. 35:19Check the box, sign the chart, discharge the patient.
728. 35:22Unfortunately, we discharge them back out into the wilderness,
729. 35:25where there is no consolidated, appropriate care for them.
730. 35:29Big, deep breaths.
731. 35:30NARRATOR: Although Narcan saves lives,
732. 35:33it can also put patients into acute withdrawal.
733. 35:37Without medications to control cravings,
734. 35:41many will overdose again.
735. 35:45WOMAN: Oh, my God.
736. 35:48(child crying)
737. 35:52KEHOE: This human tragedy really is a human rights issue.
738. 35:58The last thing we should be doing
739. 35:59is kicking people out of care.
740. 36:00That's when they're in crisis.
741. 36:01♪ ♪
742. 36:04NARRATOR: Massachusetts General Hospital
743. 36:06runs one of the few programs in the U.S.
744. 36:09that immediately offers overdose patients medications
745. 36:12to control cravings.
746. 36:16KEHOE: This is a treatable illness.
747. 36:19We have to have people in that moment
748. 36:21who can say, "Hey, I'm here to help you.
749. 36:24"Are you interested in engaging in care?
750. 36:26We have Suboxone we can start you on right away."
751. 36:31We're seeing people come that day
752. 36:32and engage in care,
753. 36:33and the vast majority of them, 75% to 80%,
754. 36:37are returning.
755. 36:38♪ ♪
756. 36:40What's going on here? Did we tolerate it?
757. 36:42NARRATOR: Since effective treatment is hard to find,
758. 36:44the costs of the epidemic continue to rise.
759. 36:49In Charleston, West Virginia,
760. 36:52Dr. Stefan Maxwell cares for babies born dependent on drugs.
761. 36:56(baby wailing)
762. 36:58MAXWELL: It's a withdrawal syndrome.
763. 37:01They have vomiting, diarrhea.
764. 37:04Frantic behavior, they may scratch themselves.
765. 37:06These babies may go for many days without sleeping
766. 37:11or eating.
767. 37:12And symptoms may last up to three months.
768. 37:16NURSE: I know, baby, I know.
769. 37:17NARRATOR: Babies in acute withdrawal are weaned off opioids
770. 37:21by giving them smaller and smaller doses.
771. 37:25I just gave her a methadone about five minutes ago.
772. 37:30NARRATOR: Every 25 minutes,
773. 37:32somewhere in the U.S.,
774. 37:34a baby is born dependent on opioids.
775. 37:38Many will become wards of the state.
776. 37:44We have amongst the highest number of foster children
777. 37:47in the nation per capita.
778. 37:48We're having difficulty finding parents
779. 37:51and providing services.
780. 37:53In fact, we believe it cost
781. 37:55over a million dollars per child additionally
782. 37:58if they're born dependent on drugs.
783. 38:02♪ ♪
784. 38:04NARRATOR: Many parents with addiction are also facing challenges
785. 38:08like poverty and trauma.
786. 38:12BESSEL VAN DER KOLK: Trauma is an experience that overwhelms you,
787. 38:16that leaves you bereft, paralyzed,
788. 38:19and with no way out.
789. 38:21And it can come in many different contexts.
790. 38:24It can be physical, verbal, sexual abuse,
791. 38:28childhood neglect.
792. 38:29And these problems early in life
793. 38:32put you at risk later in life.
794. 38:35NARRATOR: Studies show experiencing a combination
795. 38:38of five adverse events
796. 38:40can increase the risk of addiction tenfold.
797. 38:45Trauma can cause long-lasting changes in the brain,
798. 38:49leaving sufferers like Marie
799. 38:50also vulnerable to depression and anxiety.
800. 38:56We had somewhat of a decent family life, you know,
801. 38:59but I watched my dad beat my mom my whole life, you know.
802. 39:02My dad was an alcoholic.
803. 39:04They finally divorced,
804. 39:06and me and my mom moved out here.
805. 39:07And my mom kind of lost it.
806. 39:11That's when I started
807. 39:12really, just, you know, going wild.
808. 39:14VAN DER KOLK: What you're left with as a kid,
809. 39:17is these heartbreaking feelings
810. 39:19of "I'm no good" and "The world is a terrible place."
811. 39:23Somebody says to you,
812. 39:25"Here is something that will make these feelings go away."
813. 39:29And so, people take drugs
814. 39:30because they can't stand the way they feel.
815. 39:33NARRATOR: After Marie had her first child,
816. 39:37she became addicted to OxyContin.
817. 39:41Child Protective Services took custody of her son
818. 39:44until she could pass her drug tests.
819. 39:48For a while, things went well.
820. 39:53But Marie began struggling
821. 39:55after giving birth to her second child.
822. 39:59MARIE: I went home to see my first son,
823. 40:01you know, because I hadn't been spending time with him.
824. 40:04And then I got a phone call,
825. 40:05and CPS said, "Get ready,
826. 40:07"'cause we got to meet you in Charleston
827. 40:08to take your kids."
828. 40:12NARRATOR: During her pregnancy,
829. 40:14Marie had been given methadone for free.
830. 40:17But after her delivery,
831. 40:19she had to pay for her treatment.
832. 40:24With no money or insurance, she relapsed.
833. 40:28It's a reality faced by countless people
834. 40:31without resources.
835. 40:33MARIE: By that time
836. 40:35I owed the methadone clinic over $600 and some, you know.
837. 40:39And, of course, when you go back, you know,
838. 40:40they wouldn't see you no more
839. 40:41because I owed them too much money.
840. 40:43So I couldn't, I couldn't dose no more,
841. 40:45so here I am back at it again, you know.
842. 40:48(sniffles)
843. 40:50MARY PRICE: She needed services that were lacking
844. 40:53here in rural West Virginia.
845. 40:56She needed those to be available for her,
846. 40:58and they're not.
847. 41:00And that saddens me, because...
848. 41:04because I know...
849. 41:07that the mom's hearts break.
850. 41:12(radio squawking)
851. 41:13MARIE: I'll never forget that whole scene in my life.
852. 41:18they surrounded us with cops,
853. 41:19and that was not needed, you know.
854. 41:21And my three-year-old said, "Mommy,
855. 41:23hold my hat while I'm gone."
856. 41:26(voice breaking): And...
857. 41:27they took him away.
858. 41:34WALLER: People always want to talk about,
859. 41:36"How do we stop the cycle?"
860. 41:39That's how we stop the cycle.
861. 41:40You don't stop the cycle by pulling the baby
862. 41:42because mom took drugs.
863. 41:45We just need to see it and treat it
864. 41:46like it's any other disease.
865. 41:48You get the mom stable, you get baby stable,
866. 41:51and you go home with a family.
867. 41:53♪ ♪
868. 41:57NARRATOR: Back in Vancouver,
869. 41:59the opioid epidemic spurred the city to take bold steps,
870. 42:03even before fentanyl tainted the drug supply.
871. 42:08In 2003 it sanctioned the first legal site in North America
872. 42:13where people could inject illegal drugs
873. 42:16under medical supervision.
874. 42:19Called Insite,
875. 42:21the program provides clean needles
876. 42:23to prevent the spread of infectious diseases,
877. 42:25drugs to reverse overdoses,
878. 42:28and help accessing services,
879. 42:29like medically assisted treatment.
880. 42:34FISHER: When people come to Insite,
881. 42:36often the first thing that they're thinking is,
882. 42:38"I need a safer place to use.
883. 42:40"I don't want to die in the alley.
884. 42:42"I'm tired of living in, essentially,
885. 42:43what are Third World conditions."
886. 42:45So what we're doing is we're saying,
887. 42:47"Come on in to First World health care."
888. 42:49And in the years since Insite's opened,
889. 42:52overdoses in the area have gone down,
890. 42:54and our H.I.V. rate in Vancouver has plummeted dramatically.
891. 42:57NARRATOR: Insite's success bolstered other efforts.
892. 43:02At the Overdose Prevention Society,
893. 43:06Sarah Blythe helps people test their drugs for fentanyl.
894. 43:11But that's not the only contaminant
895. 43:13she's worried about.
896. 43:16BLYTHE: Because we've seen everything
897. 43:17from cement filler to Comet to pig de-wormer,
898. 43:22like, you name it,
899. 43:23anything that they can put in there,
900. 43:25they do, and it's dangerous.
901. 43:27NARRATOR: A pink stripe indicates the presence of fentanyl.
902. 43:31It's now found in 88% of illegal opioids here.
903. 43:38Like many longtime users,
904. 43:40Daniel knows he's injecting fentanyl,
905. 43:45but the fear of dying
906. 43:46isn't as powerful as his cravings.
907. 43:52He first took opioids in prison to calm his anxiety.
908. 43:58There's always a fear
909. 44:00of something horrible about to happen.
910. 44:02There's going to be somebody getting stabbed,
911. 44:04a fight's going to break out.
912. 44:05And so when I did that first hit,
913. 44:08it was the first time I felt like I could relax
914. 44:12and not have to worry.
915. 44:13♪ ♪
916. 44:17FISHER: To my mind,
917. 44:18obviously the most important thing
918. 44:20about supervised injection sites
919. 44:22is that it implicitly says that,
920. 44:24"These lives are worth saving,
921. 44:26these people are valuable to us."
922. 44:28What's really important about it as well
923. 44:29is that it's a space of connection.
924. 44:31That's the space that people are going to ask for help from.
925. 44:37NARRATOR: Supervised injection sites are illegal in the U.S.,
926. 44:42but in Canada, the controversy is waning.
927. 44:46For 22 years, Bill Spearn has walked the streets
928. 44:51of the downtown east side.
929. 44:54Although drugs are still here,
930. 44:56overdose deaths decreased 35%
931. 44:59after Insite opened.
932. 45:04Once a skeptic of supervised injection sites,
933. 45:07today he's not.
934. 45:10SPEARN: Does it increase crime?
935. 45:12Does it encourage drug use?
936. 45:14Is Insite a big magnet that attracts drug users
937. 45:17from all over the world?
938. 45:18And the answer is no, it doesn't.
939. 45:21And I think that harm reduction
940. 45:23is something that every city should consider,
941. 45:26because it keeps people alive.
942. 45:29FISHER: It actually saves taxpayers dollars.
943. 45:31The most expensive housing that we have in this society?
944. 45:37Emergency rooms and jail cells.
945. 45:40We need to quit putting people in those
946. 45:42and start putting people in more compassionate spaces
947. 45:45like supervised injection sites.
948. 45:46♪ ♪
949. 45:51NARRATOR: Meanwhile in West Virginia,
950. 45:53heath commissioner Dr. Rahul Gupta,
951. 45:56is also trying to reverse
952. 45:58the soaring number of overdose deaths.
953. 46:02Today he's traveling with a volunteer medical team
954. 46:05to bring free health care to McDowell County
955. 46:08and take steps to stop preventable deaths.
956. 46:16GUPTA: This is naloxone.
957. 46:18NARRATOR: Because overdose fatalities here
958. 46:21are seven times the national average,
959. 46:23Gupta and his colleagues are trying to get naloxone,
960. 46:26the overdose reversal drug,
961. 46:28to as many people as possible.
962. 46:30That's how this drug works to save your life,
963. 46:33okay?
964. 46:34But after that you've got to get help as well.
965. 46:37I don't look at this as a single epidemic.
966. 46:39I look at this as multiple epidemics
967. 46:41coming together and evolving in real time.
968. 46:44NARRATOR: Gupta is worried
969. 46:47about the huge spike in hepatitis
970. 46:49and the rising number of H.I.V. cases.
971. 46:52Patients are offered free testing
972. 46:56to see if they need treatment.
973. 46:58VOLUNTEER: It just takes 20 minutes.
974. 47:01Now, I also want to talk to you about a needle exchange,
975. 47:03are you okay with that? Okay.
976. 47:05NARRATOR: McDowell is one of the few counties
977. 47:09that allows needles to be handed out to prevent infections.
978. 47:12Okay?
979. 47:13The idea here is to have your own set.
980. 47:16NARRATOR: According to Gupta's analysis,
981. 47:19every dollar spent on harm reduction
982. 47:21saves up to seven dollars in medical costs
983. 47:24and steers people towards treatment.
984. 47:27...when you do want to get help,
985. 47:29whether it's counseling or any other aspect,
986. 47:31we're here to help you.
987. 47:32♪ ♪
988. 47:34The cost are really unsustainable
989. 47:36if we continue this path,
990. 47:38losing over half a trillion dollars a year
991. 47:40for multiple years in our economy.
992. 47:43We've got to be smart about addressing addiction.
993. 47:47We have to find ways
994. 47:49to prevent it from happening in the first place.
995. 47:51VOLKOW: As a country,
996. 47:53we have neglected it,
997. 47:55and we have stigmatized it, and we have criminalized it,
998. 47:58and that has not solved the problem.
999. 48:00In fact, it has made it worse.
1000. 48:02NARRATOR: But America's addiction crisis is not just limited to opioids.
1001. 48:09Each year over 80,000 people die from excessive drinking.
1002. 48:15Smoking is responsible for over 400,000 deaths.
1003. 48:23And so if we don't build a stabilized, appropriate,
1004. 48:27evidenced-based treatment system for addiction,
1005. 48:29then the reason that medicine gets so costly every year
1006. 48:34is because what we're trying to do
1007. 48:36is not intervene on the front end,
1008. 48:39we're trying to fix everything that's broken on the back end.
1009. 48:41The solution to this
1010. 48:43is for us to embrace addiction as a disease,
1011. 48:47to bring it within the house of medicine,
1012. 48:48so that anybody struggling with addiction
1013. 48:51can walk into an emergency room,
1014. 48:53or a pediatrician's office,
1015. 48:55say, "I'm having a problem with drugs or alcohol,
1016. 48:58will you help me?"
1017. 49:00And that the answer is an enthusiastic "Yes!"
1018. 49:03(turn signal ticking)
1019. 49:06NARRATOR: Today most people struggling with opioid addictions
1020. 49:08cannot access medications
1021. 49:10or treatments proven to be effective.
1022. 49:17Some people recover on their own,
1023. 49:19but it's rare.
1024. 49:23Jasen is one who beat the odds.
1025. 49:26He is remarried
1026. 49:28and delivers cars for his brother Mark's business.
1027. 49:32♪ ♪
1028. 49:33JASEN: I am not the man that I want to be,
1029. 49:37but I'm not the man I used to be, thank God.
1030. 49:39I try to become better every day.
1031. 49:43Sometimes I fail, sometimes I succeed.
1032. 49:46But I keep trying.
1033. 49:47(cooing)
1034. 49:49NARRATOR: Mark recovered after five years of methadone treatment,
1035. 49:53followed by a faith-based program.
1036. 49:56MARK: And that love began to change me
1037. 50:00in a way that I didn't think would ever be possible.
1038. 50:03Shoot!
1039. 50:05Oh, good shot!
1040. 50:09NARRATOR: Casey is now on Suboxone
1041. 50:11and studying to become a doctor.
1042. 50:15Her muscle cramps have been diagnosed
1043. 50:17as fibromyalgia
1044. 50:19and rheumatoid arthritis.
1045. 50:23To control her symptoms,
1046. 50:25she takes 11 other medications,
1047. 50:28but none are opioids.
1048. 50:31Happy...
1049. 50:33(voiceover): Recovery is definitely possible.
1050. 50:35It might take years or months or however long,
1051. 50:39but it is possible.
1052. 50:40♪ ♪
1053. 50:44NARRATOR: Marie is on Suboxone and getting group therapy,
1054. 50:48paid for by Medicaid.
1055. 50:51Today, she is going to see her youngest son,
1056. 50:54who lives with a foster family.
1057. 50:59Bubby, come here.
1058. 51:02What are you doing?
1059. 51:05Get me in!
1060. 51:06Come here and give me a hug, Booga!
1061. 51:09Mmm, I love you.
1062. 51:12(voiceover): That baby means so much to me.
1063. 51:15Now that I'm getting it together,
1064. 51:17I hope that as time goes by,
1065. 51:19they'll see a difference in me, you know.
1066. 51:21NARRATOR: As long as Marie is in recovery,
1067. 51:24she can visit her children.
1068. 51:25Ready?
1069. 51:26I want to go with you.
1070. 51:28I wish you could go with me, Bubby.
1071. 51:30I want you to go with me, if you only knew.
1072. 51:34If you only knew.
1073. 51:36FISHER: People recover from addiction.
1074. 51:38They need basic stability, stability of relationships,
1075. 51:43they need housing,
1076. 51:44they need that sense of a future that they can look forward to.
1077. 51:49When we offer people things like that,
1078. 51:51they get better.
1079. 51:52They are better.
1080. 51:54Nobody is unreclaimable.
1081. 52:01♪ ♪
1082. 52:17♪ ♪
1083. 52:32To order this "NOVA" program on DVD,
1084. 52:35visit ShopPBS or call 1-800-PLAY-PBS.
1085. 52:40This program is also available on Amazon Prime Video.
1086. 52:45♪ ♪