Editor’s note: In This State is a syndicated weekly column about Vermont’s innovators, people, ideas and places.
For years, Dr. Fred Holmes made house calls in and around St. Albans, caring for youngsters with ear aches, rashes and all sorts of other childhood ailments. For the past five months the retired pediatrician has been making calls farther and wider, throughout the state, to address another affliction increasingly suffered by the young: drug addiction.
He has visited some 45 groups since September, adding 8,500 miles to the odometer. He and a team of recovering addicts he’s helped have talked to as few as 32 people in one high school and to as many as 600 at Brattleboro’s Latchis Theatre and 1,200 at the Flynn in Burlington.
In a phone conversation from his home in Fairfax, when asked, he mentions upcoming visits to: Woodstock’s town hall; a Grand Isle school; correctional facilities in Rutland and Springfield; Dartmouth-Hitchcock Medical Center in Hanover, N.H., to talk to pediatricians; and a First Nation event in Canada (“I’m not sure where, but I hope in Quebec,” he says, with a laugh).
The list continues …
Holmes just arrived home after a snowy ride from Richford, where he spoke, as always, after a showing of “The Hungry Heart,” the documentary on drug abuse that has stirred many Vermonters. You want more numbers? He guesses he has appeared before a total of 10,500 people.
Holmes, 72, is a key figure in Bess O’Brien’s latest creation, a documentary about young prescription drug addicts in St. Albans and their attempts to overcome their disease with Holmes’ help.
O’Brien, Holmes and one of the recovering addicts received a standing ovation from the Legislature last month, when Gov. Peter Shumlin introduced them during his State of the State address. In the speech, the governor called for a boost in treatment measures, arguing the addiction should be treated as a disease, not a crime.
The result? Holmes and O’Brien have ridden news cycles, both local and national. The film, admits O’Brien, just gained immediacy with the recent death by heroin overdose of actor Philip Seymour Hoffman.
“We sort of rode the shirttails of the governor with two weeks of non-stop calls from the press,” says O’Brien, mentioning she has heard from ABC News, On-Point Radio, CNN, NPR, even a newspaper in Holland.
In the minutes before a showing of the film last week at Montpelier High School, Holmes sat down for an interview with a reporter from Al Jazeera America.
“I am not an expert on drug addiction; I am not a brilliant doctor,” said Holmes over the phone, but he was astute enough to follow up when eight years ago a young man, who as a child had been one of his patients, entered Holmes’ office to seek help with his drug addiction.
Kyle (surname withheld), described a life of desperation, giving Holmes a glimpse of St. Albans’ underbelly, its entrenched drug culture, about which the doctor confesses he had not a clue.
Curiosity piqued, Holmes learned more about drug addiction and the local problem and began treating other young addicts after he was licensed to prescribe suboxone — a drug that eases withdrawal from opiate addiction.
“It was insane. I started getting 1,000 calls a year from people of all ages asking for help,” Holmes says.
With help from a patient, he prepared a questionnaire circulated among young drug abusers in town to help him understand the problem, and eventually he invited addicts to reveal their stories in narrative form. The results were honest, graphic and shocking. Holmes shared the material with state agencies and Sen. Patrick Leahy’s office. And someone mentioned filmmaker Bess O’Brien.
A self-described “reporter-activist,” O’Brien (co-founder with her filmmaker husband Jay Craven of Kingdom County Productions of St. Johnsbury) has several documentaries to her credit: She has directed recent films on domestic violence, heroin abuse, teen angst and foster care. She saw potential.
The governor in his speech to the Legislature mentioned the social costs, the fact that since 2000 there has been a 770 percent increase in treatment for opiate abuse, that 80 percent of Vermont’s inmates are behind bars because of drugs, and that there’s now an epidemic in heroin use.
But “The Hungry Heart, like only a film can, delves deeply into the human tragedy, the price paid by family when there is a family, the struggle addicts face as they try to quit.
Why begin drugs? It’s answered in the film.
“It made me feel like somebody,” says Katie (surname withheld), who nearly died of an overdose. “I became more sociable; I became the girl I wanted to be.”
“I was 13, and my mother was doing it, so we begged her for a line, and she gave in,” says Penny.
“Young, dumb, curious, so I thought I would try it,” explains Dustin Machia, who sampled oxycontin with friends during a break between high school exams. He reports having stolen $20,000 in tools from his family’s farm to support the addiction, from which he is recovering.
Some report drugs fill an emotional void; others report being hooked from the get-go, probably the result of a genetic predisposition.
The film follows their encounters with Holmes as he prescribes suboxone, talks to patients about their problems, presses them to make their appointments at treatment centers, congratulates them on their success.
The concomitant dangers of suboxone are addressed in the film, but most of the addicts say that drug, responsibly administered, was crucial to recovery.
“I don’t know if I would be sitting here today without suboxone,” said Stephanie, microphone in hand, as she answered a question from one of 200 people on that recent night at Montpelier High School.
O’Brien’s shots of St. Albans in the winter of 2010 are gloomy and include railroad tracks and power lines running off in the distance, a cemetery scene and dilapidated housing. “The world has fallen in on (the young addicts), so I presented a bleak rather than a beautiful Vermont,” she explains.
O’Brien did little research before the project. She felt knowing too much might actually inhibit her efforts. She and her one-person camera crew crowded into Holmes’ office as doctor and patient conferred. She shot 150 hours over 25 days, over seven months.
“It was a bear editing,” O’Brien says. “So much ‘film’ had to be left on the floor.”
As a physician, Holmes is a gentle and concerned prober, asking his patients about their finances, whether they have a place to live, whether they have money, whether they are eating properly, in short, he asks about their whole economic and social milieu.
That was why in his practice he did house calls: to understand the full nature of a problem. “I have always felt they were the most important thing a physician could do.”
He would go to a home to understand if the parents or parent of a child could afford the co-pay, if they had transportation, if the adults in the household had a good relationship, if they could find their way to the hospital if needed.
Now, he’s back on the road, stretching the distances, helping communities understand the full nature of drug-abuse problems.
“We’re trying to continue the conversation,” he says.
Dirk Van Susteren is a Calais freelance writer and editor.