Health

What ‘13 Reasons Why’ Gets Right About Heroin Addiction

This post contains spoilers, obviously.

The second season of 13 Reasons Why, the vivid teenage drama that prompted a national dialogue last year over what TV critics, schools, parents, psychologists, and even teenagers, argued was a graphic, “glamorizing,” and “unhelpful” depiction of suicide, is now streaming on Netflix.

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Season 2 doubles down on tackling the visceral themes for which the series was originally criticized and a frenzy of think pieces about whether young people should watch season 2 are sure to come. Already, schools are taking preemptive action to warn students and parents about the new season, urging teens to either watch it with a trusted adult, or not at all.

The series addressed last year’s controversy with a thorough trigger warning before each episode, where the actors say exactly that: If you’re struggling with sexual assault, suicidal thoughts, or other issues, the show may not be for you. A disclaimer follows each episode directing anyone struggling to visit 13ReasonsWhy.info for a list of resources. Oddly listed is the widely discredited D.A.R.E. Program championed during the height of the War on Drugs, when cops went to schools and told students to “Just Say No!” (DARE was recently tweaked to be more evidence-based).

Which brings up a timely new theme that the series wrestles with in season 2, one that I happen to know intimately: heroin addiction.

During my senior year of high school, in 2007, I was addicted to OxyContin and eventually transitioned to using heroin. The opioid overdose rate for teenagers aged 15 to 19 tripled from 1999 to 2007, according to the Centers for Disease Control and Prevention’s Center for National Health Statistics. Though fewer teenagers are actually using heroin and other opioids than in 1999, the overdose rate is increasing, suggesting that America’s heroin supply is becoming more dangerous.

While the rate of teenage opioid use is in flux, my own experience is hardly anomalous and maps neatly onto the story of Justin Foley, a character in 13 Reasons Why, played by a rail-thin Brandon Flynn.

In true 13 Reasons Why fashion, Justin’s addiction is depicted in painful detail. Content that adults and parents say is graphic and explicit, young viewers see as real and authentic. After all, the show’s realism is why so many of us are talking about it, and why it became a runaway hit. At least that’s what the findings from a Netflix-commissioned study out of Northwestern University suggest. And, based on my experience as a former heroin user, and as a journalist covering addiction, the show’s depiction is refreshingly authentic.

Justin’s season 1 backstory

Before diving into the tragic story of Justin’s heroin addiction, here’s a quick recap of what happened to him in season 1. The implausibly deep and articulate Hannah Baker died by suicide, and she made 13 cassette tapes that painstakingly detail who is to blame. “Justin, honey, stick around. You’re not going to believe where your name crops up next,” Hannah says coyly in one of her tapes, which get passed around among students.

Hannah was alluding to a rape. In season 1, Justin, depicted as a jock with a conscience, was dating cheerleader Jessica Davis. The couple was drunk and hooking up at a party when Jessica passes out. Justin backs off and leaves the room, and in enters Bryce Walker—leader of the jocks, and Justin’s best friend since third grade—who rapes a barely conscious Jessica. Justin tried to intervene, but Bryce pushed back and had his way with her. Meanwhile, Hannah was hiding in the same room, complicit with Justin in Jessica’s rape. “We both let her down,” Hannah says in a cold voiceover.

The evolution of Justin’s addiction

Season 2 opens with the trial of Andrew and Olivia Baker v. Evergreen County School District. Hannah’s parents, the Baker’s, are suing the school for neglecting to intervene in Hannah’s suicide, despite her having reached out to the school’s impotent guidance counselor the day she died. Different students take the stand each episode, taking turns getting grilled by the school’s ruthless defense attorney. We see our first glimpse of Justin in episode 3, wearing a tattered sweater, living out of his sky blue Liberty High School gym bag, panhandling on the streets of Oakland, California.

One of the show’s protagonists, a righteous and outraged Clay Jensen, is out for justice in Hanna’s name and Justin’s an integral witness to a rape that could help take down Bryce Walker, who in a flashback we also see brutally raped Hannah in a hot tub. To convince Justin to come back to Liberty and testify at the trial, for which he was subpoenaed, Clay lies, telling him that Jessica (now his ex-girlfriend) wants him back (she doesn’t, sort of). Clay stashes Justin at his parent’s house, while, unbeknownst to Clay, Justin brought with him a stash of black tar heroin and tin foil, which he smokes next to the window as the episode fades out to the typically dramatic pop music that pervades the show. (Justin, like many users, starts out by snorting or smoking, rather than injecting.)

The guilt bearing down on Justin over letting his girlfriend be raped is part of the galaxy of reasons why Justin turned to using heroin in the first place. Unlike Justin’s convertible-driving, All Saints cardigan-wearing peers, he is poor. In season 2, we see more of Justin’s broken home. His mom is a drug user who dates a dealer—Justin nicknames him “Meth Seth”—who physically assaults him and his mom. Justin ran away after stealing Seth’s money, which is how he wound up on the street.

Addiction is often called a disease that doesn’t discriminate, meaning it can happen to anyone. That may be a sympathetic soundbite, but there are indeed internal and external factors that make some people more vulnerable to addiction, factors which Justin has in spades—genetics, lower income, and a dysfunctional home that leaves him feeling like no one loves him.

“I have come to look at addiction as a perfect storm of all these things that come together to make someone an addict,” Nic Sheff, a writer on the show, tells me. “Justin’s addiction felt like a natural evolution.” Like me, Sheff also happens to know addiction personally. In his 2007 New York Times-bestselling memoir Tweak, Sheff chronicles his dark plunge into heroin and meth addiction.

While in the throes of my own heroin addiction, I consumed tons of drug media. I stopped by my friend’s house to buy some weed and happened to see Tweak on his coffee table. My friend-slash-dealer called the book crazy and said I should read it.

There’s a saying in 12-Step groups that “half measures availed us nothing,” meaning, you have to go all the way. The saying aptly describes 13 Reasons Why as well as Sheff’s writing: brutal and forthright, holding back nothing. Sparing no detail creates a nervous empathy for a character on a bender, who steals money, lies, and hurts those around him. It’s hard to watch someone trapped in an infinite loop of self-sabotage. But through fierce honesty, and without being preachy, Sheff creates that same hesitant empathy for Justin as he did for himself in Tweak.

Empathy is the best antidote to stigma, and is tragically needed en masse to address why so many of us are dying from overdoses in real life.

Withdrawal and relapse

Justin’s jig is up shortly after moving in with Clay, who, while doing Justin’s laundry, finds the heroin and foil, and flushes it. A DIY detox begins with Justin vomiting between pulls from bottles of Pepto-Bismol and Immodium.

Withdrawal scenes in TV and movies are notoriously overdone. The affected intensity in Darren Aronofsky’s Requiem for a Dream comes to mind, as does a sweaty young Leonardo DiCaprio in The Basketball Diaries. But Flynn strikes the right balance in Justin’s physical torment: curled up in a blanket, gripping his stomach, agitated and restless. Before any of the heroin scenes were shot, Flynn flew to Los Angeles to meet with Sheff, and together they attended a Narcotics Anonymous meeting and went to a methadone clinic.

“There’s such a stigma around methadone in particular,” Sheff says. “I am such a strong believer in methadone and buprenorphine—we don’t die while using it.” Sheff says that Flynn was surprised by what he saw at the clinic. Instead of shaming and punishing, the doctor at the clinic welcomed everyone with a smile, which Sheff says helped Flynn understand that patients were doing good for themselves, that they were actually getting better. Flynn asked the doctor at the clinic about all the different physical withdrawal symptoms, which helped him make Justin’s pain believable. “Working with Brandon was amazing,” Sheff tells me. “He was so committed to wanting to understand and get it right.”

Justin eventually gets through his withdrawal, and starts going back to school, thanks to support from Clay and his family. Clay’s mom is an attorney who had to recuse herself from the school’s defense team, because Clay (who loved Hannah) created a conflict of interest. Upon learning that Justin is back, Clay’s mom is forced to alert the court since he was subpoenaed. Before testifying, we see Justin become particularly cozy with Clay’s parents. For a minute, Justin feels what’s like to be part of a loving family. Clay’s parents make him breakfast, send him off to school, and at night they watch TV on the couch, eating popcorn—Justin’s dream of an ideal family.

But for anyone who knows what heroin’s grip feels like, withdrawal is only the beginning. What follows upon facing raw reality sans analgesia is a cascade of depression and stress.


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Days before he’s due to testify, Justin scores some heroin at school. (This high school has some serious issues.) At first he’s looking for OxyContin, but the school’s dealer said it’s scarce and expensive. “I need to get really fucking high, and I’ve got 20 bucks,” Justin says. That’s pretty much how it goes. The summer before I went to college, prescriptions became both too expensive and hard to find, which is when I switched to snorting heroin. This same story has played out nationally. As fewer and fewer people can find a steady supply of black-market painkillers, they’ve turned to heroin, which is increasingly tainted with super-potent illicit fentanyl.

Overdose

Later, Justin is found pale and lifeless with a needle still in his vein on Clay’s bed by their friend, Alex. (In season 1, Alex tried to kill himself but survived, and now walks with a cane.) Justin’s flat on his back, struggling to breathe. Alex lost some mobility from the suicide attempt, and struggles to turn Justin over, to open his airway. Alex screams, and Justin’s barely breathing. Alex tries harder to muster his strength. Finally, he rolls Justin over and, as he does, Justin vomits and starts breathing again. “It’s a tolerance, thing,” Justin says afterwards. “I’ve only ever shot up a couple times.” Since Justin’s using had been on and off since he started living with Clay, his tolerance would have diminished, increasing the chance of an overdose.

Much like affected withdrawal scenes, overdoses in film and TV tend to be unrealistic. The most infamous overdose is from Pulp Fiction, when a zonked John Travolta stabs an overdosed Uma Thurman in the heart with a gigantic syringe of adrenaline. To this day, harm reduction activists view that scene as a gigantic missed opportunity to teach the public about naloxone, an opioid antagonist that reverses overdoses, which is either injected intramuscularly (thigh or arm) or via nasal spray. I brought this up with Sheff, who agreed naloxone education is important, but that it’d be difficult to believe that suburban teenagers who know nothing about drugs would carry around naloxone kits. You’d hope a team of writers could come up with a creative solution to make naloxone appear organically.

After the overdose, Justin sees his mom one last time, and steals more of Meth Seth’s money. As he’s about to head out on another bender, Clay texts him asking for help. Justin still needs to testify, and he’s critical to Clay’s plot to take down the jocks. The magic words that make Justin stick around are: “I need you.” All Justin has are his friends, and in the end he’s left to choose between the rapist-jocks or the crew that’s set on holding them accountable, to bring justice for Hannah and the other young women they raped.

When Clay picks up Justin from the bus stop, he asks Justin if he went home, and Justin says, “No, I just saw my mom,” implying that it’s no longer his home. Having no home and no family to care for him is the heartbeat of Justin’s addiction. An opiate high feels like a warm hug, the perfect antidote to Justin’s deep-seated loneliness and longing for love. Justin can synthetically produce that warm feeling with heroin, or maybe he find it naturally, from Clay and his family.

Ultimately, Justin chooses to testify against Bryce, even though that means incriminating himself for his role in witnessing a rape. The merciless defense attorney outs Justin’s heroin addiction in court, and to remain credible to the jury, Justin says that he’s “in recovery,” which, he technically was at the time—at least he was trying.

Recovery

But recovery can be short-lived. Justin was sentenced to juvenile detention for being an accessory to Bryce’s sexual assault. Bryce’s rich parents instantly posted his bail. But Justin was stuck in the system for a month because he was a minor and no home or guardian to be released to. Clay’s parents fix that by formally adopting him.

Despite finally having a family, Justin finds little relief from his addiction. Instead of shooting up in his arm, he goes in between his toes to hide the tracks. In the end, Clay doesn’t know that Justin, now basically his brother, is back on heroin.

“If the series goes forward, we’ll be able to examine what recovery looks like for a young person—how difficult it is, all the ups and downs,” Sheff tells me about plans for the future. “It is such a big issue right now, and something teens need to be aware of.”

It took me a few tries to finally kick for good. And Justin’s only 17, he started young but that means he still has a lot of life ahead of him. I started using around the same age and I turned 23 during my last round of rehab, when things finally clicked for me. Like me, Justin may need formal treatment, and maybe even medications like buprenorphine or methadone, for recovery to stick. It makes sense that heroin’s still an attractive option for Justin—he still has a lot to figure out.

Sheff tells me that of all the storylines in the show, Justin’s is the one that he most believes in as it goes out into the world. Yes, we see Justin inject heroin, we see him in withdrawal, and we see him overdose. But it didn’t feel voyeuristic, like watching someone take the plunge on the show Intervention. Opioids are driving a national crisis, and the series didn’t use Justin as prop to address it. Addiction is complex, and the series created an empathetic character, one that probably hits a little too close to home to a suburban teenager somewhere.

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