Review: Heroin Town

Georgia Cerni
4 min readFeb 23, 2021


Louis Theroux’s latest documentary is a harrowing and fleetingly hopeful one. Heroin Town chronicles widespread opioid addiction in Huntington, West Virginia, a city of 49, 000. Heroin Town is one of a three-part series called Dark States, Theroux’s foray into the dark underbelly of the U.S. In addition to West Virginia’s opioid crisis, Louis explores sex trafficking in Houston and murder in Milwaukee in the upcoming BBC series.

At Carlton’s Cinema Nova, accompanying the screening of Heroin Town, which is only an hour in duration, is an exclusive interview with the documentarian himself. We take a look back on Louis’ lengthy career — his beginnings with filmmaker Michael Moore on cable television cast as self-described “beanpole British” observer of American life. There is an insight into Louis’ practise as a documentarian — he only meets documentary subjects upon the beginning of filming and is always committed to remaining as objective as possible. We are reminded that this objectivity was interrupted somewhat when Louis encountered neo — Nazi’s in Louis & The Nazi’s (2003). Memorable Louis moments also include his challenging of Megan Roper — Phelps of the Westboro Baptist Church in The Most Hated Family in America (2007).

Though iconic, Theroux is not beyond reproach — he has received criticism in the past for applying his awkward style to sensitive topics like autism in Extreme Love: Autism (2012). It is a valid concern — as Simon Usborne of The Independent noted, Louis career has largely focused on the “weird” — so to tackle more serious social issues takes a degree of caution. Indeed, in documentary, there is a fine line between exploitation and compassion but for the most part in Heroin Town, Theroux prioritises the people of Huntington. Even when people around him are using heroin, Theroux remains calm, non — judgemental (although concerned) and it is his approach to the interviewees that defines the tone and the audience’s response.

While observational style no doubt characterises Louis’ work, his documentaries are much more than passivity — Theroux is unfailing curious in his encounters. Heroin Town is no different, and Louis is compassionate in his encounters with those society often deems as beyond it. In Heroin Town, we meet three individuals who are engaged in active addiction to opioids, most notably Heroin or the even more lethal Fentanyl (typically laced with Heroin). One of the most captivating people we meet is Katillia, a young woman dependent upon heroin who uses 6–7 times per day. Up keeping the addiction costs her hundreds of dollars a day, alleviated by her boyfriend’s ability to supply her with drugs. The toxicity of the relationship is something Katillia is more than aware of, but she is willing to remain in a violent partnership not so much for love of heroin but for the need of it. It becomes clear that even with a Theroux film, opioid addiction is something one can never understand if they haven’t experienced it.

Heroin Town does well as conveying the dark reality that opioid addiction is to be understood as an epidemic with its origins in the manual labour legacy of West Virginia and the wider tri-state area. Many of the people in the film describe their addictions as beginning with prescription painkillers, many either stolen from relatives with workplace injuries or being prescribed to them for recovery from car accidents or the like. Indeed, fire chief Jan Rader (who is spotlighted in the Netflix documentary Heroin(e)) describes that while the pharmaceutical industry made billions off of painkiller prescriptions, they have remained largely unhelpful in cleaning up the situation they created. Heroin Town reserves it’s damning criticism for the pharmaceutical industry rather than those addicted to opioids.

Perhaps one of the most defining aspects of Heroin Town is our insight into Nate’s life. Nate is an active opioid user who lives on the bank of the Ohio River, where a number of folks in similar situations have begun to dwell. Unlike Mickey, one of the film’s few recovered opioids users who attributes his recovery largely to God — Nate discusses the benefits that heroin has — it keeps him high and in good spirits. Many of the other interviewees exhibit more awareness that their opioid use is detrimental to their lives, but Nate has no plans of quitting. Nate is despondent, Mickey is inspiring — but it is the latter who is the outlier in Huntington.

Of course, implicit in Heroin Town is hope — through real-life superhero Jan Rader, the drug Narcan which reverses an opioid overdose, new mother Alisha and her newborn son Archie, both on track to surviving opioids influence on their lives. The defining mood of the film, though? It’s bleak. Nate shouldn’t be viewed as a fool — instead, he knows that overcoming heroin would take a mammoth effort and a whole lot of pain — it took Mickey over one hundred overdoses to get to sobriety.

Heroin Town is in many respects a call to action, a cry for intervention for towns like Huntingtown which have been ravaged by opioid addiction. More than that though, it leaves you wishing that we could go back and time and stop these interviewees we grow to love from even being subjected to the horrible addictions that a billion dollar industry has profited from.

Rating: 9/10

This review was originally published for RMITV’s chief review publication In Review.