It’s been more than five years since documentary filmmaker Sean Dunne of Peekskill, NY, released Oxyana. The IMDb description reads, “The ‘Hillbilly Heroin’ epidemic that’s slowly rotting the soul of rural America.”

As the film begins, a harrowing mist rolls over the hillsides and wooded ridges of Oceana, WV , while a lo-fi guitar score hums. When describing the small, rural town and recent events, a local dentist shares, “It’s incredible and amazing and awful, all at the same time,” as he slouches on an examining table. He laments that it became difficult to appreciate the beauty of the natural landscape as complex social and material problems emerged in his community. He felt haunted by its new reality.

He’s right — Oceana’s beauty is complex. Oxyana’s B reels hardly neglect that. At first, the filmmaker nails a distinct “West Virginianness” — the moodiness of low, ambient dream-haze lighting at roadside service shops at midnight, the lull and familiarity of winding back roads and passing by locals sitting on porches at dusk. The grit of the atmosphere and the grit under your fingernails. Coal lurches up impossibly long conveyor belts to be processed, ethereal fog obscures a full moon, and dew coats the windows of broken down 1970s Winnebagos parked between lush pine trees. West Virginia, like most places, is complex, and Oxyana pays careful attention to intimate glimpses of beauty in contraction, albeit peripherally.

Since the film’s release and subsequent acceptance into the documentary film milieu, the concept of the “opioid crisis” as a long-form documentary genre has emerged. Several independent films have joined Oxyana in undertaking the daunting task of documenting events leading up to and as a result of a public health crisis. Many weigh in on factors leading to the emergence of the American opioid crisis, making the normative claim that the monumental rise in licit and illicit opioid use and trafficking in rural American communities is wrought by irresponsible and unethical decisions made by doctors and pharmaceutical companies.

It’s worth noting, however, that not all documentary films are directed by filmmakers who are intimately familiar with the communities they profile, and Appalachian people have long been exploited by visiting photographers and documentarians.

In 1964, and in the wake of President Johnson’s ongoing war on poverty, photojournalist John Dominis captured images of residents of eastern Kentucky communities as a part of a photo series, titled “The Valley of Poverty,” for the contemporaneously popular LIFE magazine. Therein exists an even more uncomfortable reality that poverty tourism was once a common practice in eastern Kentucky.

The “Valley of Poverty” dispatch aimed to illuminate ongoing Depression Era wealth inequality, which was palpably evident in Appalachian Kentucky, but the photos, in many ways, reduced their subjects to nameless stand-ins for the socioeconomic challenges they themselves and their region faced. To Dominis, their valley appeared “lonely,” their homes “ruins,” and their children “urchins.”

OXYANA TRAILER from Sean Dunne on Vimeo.

Indie film buffs will recognize Oxyana’s Dunne as the creator of a breakout short film, American Juggalo, released in September 2011, which debuted at the 2013 Tribeca Film Festival. Juggalo functions as a sardonic, searingly funny biopic of the lives of a fiercely devoted subculture of followers of the Insane Clown Posse. A once-underground cohort of hip-hop artists hailing from Detroit’s working-class neighborhoods, I.C.P. boats an extensive discography and a loyal following of fans who immerse themselves in the music’s carnival themed lore and macabre motifs.

The laughs are cheap, however. A few views of the 24-minute long film and it’s nearly blatant that the director doesn’t seem to be laughing with the Dark Carnival. In reality, the film is laughing at a quirky fandom of individuals who are merely observing the working class tradition of finding relief, comradery and joy despite everyday pains and monotony through exploring music and culture.

The Juggalos and Juggalettes show the filmmakers how they cut loose and share with Dunne and his crew that the Gathering is the best weekend of their year. The Gathering of the Juggalos seems … eclectic — for lack of a kinder word — to outsiders. It’s no secret that I.C.P. and their fans have found little else but ridicule from onlookers since the Carnival’s inception. But to the Juggalo “family,” as they lovingly refer to one another, it’s meaningful. And to some, the Gathering is the only place where they truly feel accepted and embraced by a community who chooses to love them unconditionally, despite their status in “the real world.”

Juggalo’s dialogue reveals that, most of all, these people are genuinely happy, belting out the ubiquitous “whoop whoop” refrain each chance they get, and maybe — as bystanders — we shouldn’t knock it until we’ve tried it.

Watch the short and you’ll notice that Oxyana begins with Dunne’s newfound curiosity of Juggalo culture. Oxyana‘s opening scene is a short dialogue between the film crew and a man living in Wyoming County, WV, who had just lost a loved one. The man’s account becomes the focal point of the film, sharing intimate truths about the many ways opioid use has shaped his recent life. While holding an autographed shirt with I.C.P.’s hatchet man logo, he shares that it was his loved one’s “pride and joy.” He reveals that he recently lost him to an overdose and was struggling with his loss, holding on to a memento that was special to him in life.

I.C.P. has thousands of loyal followers across the U.S. It seems fairly innocuous that a 30-something man would be a member of the “Juggalo family.” I wondered if the filmmaker found the dialogue to be meaningful enough to be an introductory scene because it was such a palpably relatable depiction of loss. It calls the viewer to remember the longing and heartbreak associated with holding onto the last remnants you have to hold after losing a loved one. On the other hand, Dunne has made a career of mocking I.C.P.’s fans and their subculture, directing a narrative that their beloved cultural markers are garish, obnoxious, and honestly, trashy.

Juggalos gather at the National Mall for the Juggalo March in 2017. Photo by Blink O’fanaye on Flickr.

He chose to begin a long-form documentary that investigates the social and cultural conditions of a southern West Virginia community experiencing unforseen hardships with an “easter egg” Juggalo reference, and honestly, it’s difficult to ignore. Could it be that the scene reveals that Dunne was unintentionally othering his Appalachian film subjects in the same vein that he mocked the Gathering? The subject revealed a special vulnerability that comes with grieving. And I couldn’t ignore the place the scene had in context with Dunne’s earlier work.

The pain of Oceana’s residents is real. Dunne and producers show bleary-eyed, unfiltered accounts of the way opioid addiction has moved through their lives. However, the scene was an uncomfortable reminder that Oxyana’s narrative was never in the hands of those living in Oceana, West Virginia, no matter how well-intentioned its filmmakers were.

Over the past ten years, a documentarian has visited my own hometown to create a similar project.

The documentary trailer features B reel footage—supplemental footage used as “filler” between the main shots—of people intravenously using heroin as often as landscapes. The documentarian periodically visits East Liverpool, OH, to collect material for a documentary and photo-series “project.”

A voiceover explains that there’s nothing worthwhile here. People come here to die.

It’s clear that the filmmaker joins Dunne in conveying a similar message communicated by Oxyana: East Liverpool, too, is hardly more than a community in crisis.

The project offers “industrial de-evolution” as a wholesale diagnosis of our community’s problems without historical context of which of East Liverpool’s native industries no longer function or what led production to a halt. Glum, dreary footage and stills of buildings, neighborhoods and landscapes barely look like the same places I grew up.

My classmates, neighbors and people my mother taught as a high school teacher are depicted wearing outdated, tattered clothing, posed lifelessly in cluttered rooms of working-class homes. Images of the community are devoid of joy. Stereotypical misrepresentations of what people and cultural landmarks in our region look like abound. The systemic issues that these communities face are specters that render the community entirely dysfunctional.

Although I’m not an expert on the function of the “gaze” in art and film, it’s clear to me that the documentary filmmakers and photojournalists that visit Appalachia from elsewhere enter our communities with preconceived notions about who lives here and what struggles we face, effectively leading to inaccurate reporting and their own unconscious social distancing from their subjects.

In spite of everything, I don’t find it difficult to find beauty in places like Oceana or East Liverpool. Like other Appalachian communities, our relationship to more than a century of the presence of extractive industries in our region has compounded complex social problems, which over time have led to the public health crisis symptomatic of the emergence of a new extractive industry: pharmaceutical companies.

But our communities are not defined by the social problems we have no fault in generating, just as individuals and lives are not defined by their struggles with addiction and recovery. Most of all, Appalachian people should have the agency to direct new and extant narratives about their communities and those that do create seminal, revelatory works that uncover truths that would have been otherwise slighted by others.

As a long-form documentary genre focused on the opioid crisis and its cultural reverberations emerges, it becomes evidently clear that those that irresponsibly visit the region, who mistakenly engage in inaccurate reporting and misrepresentation of subjects, contribute to longstanding stereotypes about people in the region, leave and profit from their findings just might have more in common with exemplars of extractive industries that have shaped the Appalachia we know.

Holler-casting blackened bluegrass to you from the Ohio Valley, Liz Price studies Appalachian regional policy by day and spins mountain-metal by night.