The latest from American Academy Award-winning documentary director Laura Poitras (Citizenfour, My Country My Country) is a poignant documentary that masterfully delves into the dark and personal reality of addiction and the ongoing opioid crisis in America. In doing so against the backdrop of the prolific photographic career of Nan Goldin, All The Beauty and the Bloodshed (2022) provides a far-reaching understanding of the epidemic’s multifaceted causes and effects, deftly illustrating the complex and destructive nature of addiction and the systemic failures that have contributed to its accumulation of over 100,000 annual deaths in the country. The film has been a staple of the festival circuit since its 2022 Venice Golden Lion win. Most recently, it has been presented as the opening film of the 2023 One World Romania festival.

Direct action

Goldin’s struggle with addiction and subsequent advocacy work is portrayed throughout All the Beauty and the Bloodshed. In doing so, it becomes a powerful tool for raising awareness and (in terms of recovery, most notably) relatability, inspiring empathy and education among viewers. Hers is a life story wrought with the personal toll of addiction and the necessary resilience and determination (and stature) to affect change.

Through Poitras’ skillful interweaving of interviews with those personally affected, activists, and community members, the film contextualizes Goldin’s biography within the larger picture of the opioid epidemic, revealing its widespread devastation and lack of adequate response from the powers that be. Hers is a life of many incarnations, from suburban childhood to No Wave staple, from dive bartender to globally recognized artist. This story sees her travel to the halls of power and creativity in a selfless act of ongoing direct action, demanding accountability from the corporate oligarchs of big pharma and its institutional cronies along the way.

Purdue Pharma

Of those powers-that-be, the film’s primary antagonist is OxyContin developer Purdue Pharma. Poitras sheds light on the role of Purdue Pharma, its multi-billionaire family owners, The Sacklers, and powerful government friends. It is the trifecta of profits over people. OxyContin, the highly addictive synthetic opioid and Purdue Pharma’s golden product was introduced to the public as a one-stop shop for moderate to severe pain relief. Eventually dubbed “Hillbilly Heroin,” the drug would be developed in the wealthy suburbs of New York City (to be precise, its corporate headquarters located in my own hometown of Stamford, Connecticut. Can I just take the moment to mention that if you’ve never met a Purdue Pharma sales rep in your life, congratulations on the maintenance of your soul) before being shipped and widely prescribed to rust and coal belt workers across the American South and Mid West.

From its late 90s introduction to its 2010s heyday, OxyContin fuelled an exponential rise in addiction and death, touching virtually every family and person in the country along its relentless path of devastation. Eventually, OxyContin would give way in popularity to the largely Chinese-produced synthetic opioid Fentanyl, itself some hundred times more potent than street-level heroin. Now, with some 110,000 annual opioid-related deaths, the crisis has become the number one cause of death among adults aged 18-45.

But, aside from being the kind of late capitalist villains our modern era seems to proliferate en masse, The Sacklers have also been some of the world’s most prolific supporters of the arts. Virtually every artistic institution of note has donned its name prominently. The Metropolitan Museum of Art, Tate Modern, Guggenheim, Serpentine Gallery, National Portrait Gallery and more have counted decades worth of Sackler donations to their vast purses and collections. Although, as the film shows, any government-level accountability is virtually impossible to come by – often actually enriching The Sacklers in the process – Goldin and her harm awareness advocacy group P.A.I.N (Prescription Addiction Intervention Now) target these art institutions as the harbingers of accountability – and to significant effect. Goldin and P.A.I.N directly influenced virtually all to remove The Sackler’s name from their collections by organizing direct actions of all sizes, from simple demonstrations to large-scale die-ins. Perhaps a largely symbolic win, but in the ever-frustrating fight against all things profit, important nonetheless.

The scope of the crises

By juxtaposing Goldin’s linear life story with the recent history of action against Purdue Pharma, All the Beauty and the Bloodshed is comprehensive in its scope of the crises. It never strays into preachy territory or even offers the kind of universal solutions past films on the subject, like Eugene Jarecki’s The House I Live In (2012), have. Instead, it is an intimate, personal story through the nightmare of addiction and those who profit from it. As a companion, 2021’s Amazon Prime limited series Dopesick would be a worthy piece of supplemental viewing. That show, a Michael Keaton lead narrative, goes into the nitty gritty of the crises on the ground with the doctors, patients, and Sacklers (including a horror film villain-worthy performance from Michael Stulberg as stunted Sackler child and OxyContin brains Richard Sackler). Though All the Beauty and the Bloodshed focuses directly on activism, it nonetheless can provide the macro context necessary to understand crises that have not yet hit European shores.

But within its vast scope, All the Beauty and the Bloodshed only sheds light on what has fuelled Goldin’s addiction, occasionally touching on the ease of prescription. Goldin’s is a story similar to many a suburban upbringing – one of suppressed, generational trauma and the constant impetus of the unvarnished American image. Those who have had a direct experience with addiction, particularly the cold grasp of opioids, know that addiction is not a universally treated affliction. In fact, it is one of the few, if only, modern social dynamics that affect irrespective of class. I have known some of the wealthiest people to suffer in the throws of prescription pain addiction and some of society’s most impoverished. Across all classes, races, religions, backgrounds, and sexualities, American addiction is as ubiquitous as “apple pie”. It doesn’t take a lot to find a pill, suck off its time-release coating, and find relief from all your pains, mental and physical, even if just for a number of minutes.

And here it is where Goldin’s activism is most effective. Its authenticity. The kind only someone with direct knowledge of the experience of addiction can have. The type of empathy to understand that the journey to recovery depends on many factors, from policy level to corporate prudence to, yes, even personal responsibility. But, for all the personal responsibility in the world, society has to be one where its conditions are complicated toward hope, not despair. As All the Beauty and the Bloodshed moves along, conversations around rehabilitation and harm reduction increase in frequency, which is fresh air against the (necessary) corporate annihilations. It is the grassroots level of recovery. Where those suffering are looked at as human, and rehabilitation trumps incarceration. Where the people are looked at as people, not profits, even if done so indirectly. All the Beauty and the Bloodshed does this all and creates one of the most personal and well-rounded looks at modern addiction as can be.

Steve Rickinson

"Came to Bucharest after living in Amsterdam & Brooklyn, among others, Steve is the industry editor for Modern Times Review documentary magazine.