A recent opioid-abuse awareness ad isn’t just targeted at teens; it’s also written and directed by one.
“Hey Charlie,” is a nearly 4-minute ad from The Christopher D. Smithers Foundation and Columbia University Medical Center, following a 17-year-old boy living in suburbia as he goes from a star athlete with good grades to abusing prescription pills and worse—almost in an instant.
A pointed narrative about the kind of rapid, surprising decline that’s becoming increasingly common in recent years, it’s the brainchild of Brinkley Smithers — the 18-year-old granddaughter of the philanthropic nonprofit’s founder and great-granddaughter of its namesake. It’s also the centerpiece of the group’s broader effort, titled “Stop the Spiral,” to promote pharmacology-based treatments for opioid addiction—in short, using anti-craving drugs like methadone to help keep users clean, rather than relying on 12-step or faith-based abstinence approaches.
Some 60,000 Americans die each year from drug overdoses, some 40,000 of them involving opioids. Prescription opioid overdose alone—not counting drugs like heroin—claimed some 22,000 lives last year.
A high school senior, Smithers zeroed in on the idea last summer while volunteering at the Long Island Council on Alcoholism and Drug Dependence (LICADD)—an organization also founded by Smithers’ grandfather, and that receives funding from the Smithers Foundation—where she says she learned about the way opioid addiction affects families, and about the prevalent stigma around the disorder.
“A lot of people think people who are addicted to pills, or anything really, are just lowlifes—so they don’t really care and don’t really pay attention to it,” she says. “I wanted to make it like it could be any other normal kid that you just would imagine, who’s doing well; he just fell into the wrong thing at the wrong time at a party—how it usually kind of happens.”
After writing the script, she—then still age 17, like the protagonist—shared it with Steve Chassman, executive director at LICADD. He connected her with Robert Smyth, a director at production company Heavy Pictures, who co-helmed the spot to help bring it to life.
It was essential to the team that the film steer clear of the preachy tone so many PSAs adopt—Smithers cites the infamous egg in a frying pan, while others try to lecture young people about avoiding bad choices. “Coming from a kid’s point of view it never really works,” she says. “You can tell kids to not do things all you want but it’s no sure thing that they’re going to listen. I wanted to tell a story and have people feel something and make a choice for themselves, because that’s what’s most effective, I think.”
So far, the clip has accumulated more than 3 million views, boosted by initial paid promotion on platforms like Facebook, Twitter, and Instagram.
Some viewers may note stylistic similarities to Darren Aronofsky’s “Requiem for a Dream,” especially in the editing, but Smithers says that while she understands the comparisons, she hadn’t seen the 2000 feature film—a brutally graphic generational cult classic about drug abuse—until after the PSA was finished (See also: Aronofsky’s 2011 anti-meth PSAs.). The goal of her piece, she says, is to get teenagers and adults talking more openly about opioid use and addiction “and to show you don’t have to be afraid to come forward, you don’t have to be afraid to get help. This could be you. This could be anyone, and (we want) to erase the stigma.”
A second PSA currently in the brainstorming phase, meanwhile, will focus more on showing how effective forms of treatment—evidence-based, medicine-assisted approaches—will play out. “People need to know it’s OK to get medication for this problem,” says Smithers, who’ll be attending NYU’s Tisch School of the Arts to study film starting in the fall, and included “Hey Charlie” in her application portfolio.
The Smithers Foundation, founded in 1952 to fight substance abuse, primarily involving alcohol, has over the past four years or so increased its commitment to battling opioid use disorder, says President Christopher Smithers, also Brinkley’s father.
“We’re losing a large portion of our youth to an epidemic,” he says. “It doesn’t have to be this way. But because we use archaic ways of looking at treating it and looking at it, our society has done this to ourselves, basically.”
The answer isn’t in the criminal justice system, he explains, or what he describes as the dogmatic thinking of abstinence and faith-based programs.
“We’ve known for a long time that medications and medical care are what should be on the front line to treat this, but these medications are out there but they’re not being used,” he explains. “Countries like Switzerland and other countries in Europe are very progressive in how they treat these things and their problems have gone away. ”
In the United States, the idea of “treating people that are very, very sick with an ideology and talking to them about getting a connection with a power, it’s got to change. A sick person wants to feel better—to get their body and their mind feeling good. You can’t put all those ideas… on top of their dire situation. It kills young people, they just want to go out and get higher.”
By contrast, a program that the foundation has created in partnership with the psychiatry department at Columbia University Medical Center, for example, recommends the use of one of three FDA-approved drugs—buprenorphine, methadone, and XR-naltrexone—for at least a year under medical supervision to diminish cravings and reduce the risk of overdose. The same program argues against the use of detoxification and 12-step programs unless combined with pharmacological treatment, and for the removal of financial and insurance based barriers to same-day treatment.
“If you see someone that wants to inject heroin in their veins and nothing is going to stop them because they feel so sick, are you going to take them to a church basement or are you going to take them to a doctor, where you can get medications to take away that desire to go and get heroin?” says Christopher Smithers. “It’s simple. It’s a common sense approach.”
One obstacle to the strategy has been public perception. Last year, then-Health and Human Services Secretary Tom Price drew the ire of addiction experts for dismissing medication-assisted treatments using methadone and buprenorphine—also technically opioids—as simply substituting one opioid for another, contrary to research showing their effectiveness.
“It’s disgraceful, that somebody that high up in our government would say something like that,” says Christopher Smithers. “It reinforces the stigma, and it’s this backward keeping- everybody-in-the-dark thinking. We’re just trying to break through that and shed light on a dark treatment industry a dark method—because nobody knows what happens most of the time when somebody goes into a treatment center. They close the doors behind them, and that’s it.”