Which came first — the physical pain crisis or the opioid crisis? A film that corrected a misconception about conflicting causes showed at San Quentin Rehabilitation Center May 17.

About 40 residents saw the documentary Tipping the Pain Scale, directed by Jeff Reilly in 2021, which drew attention to America’s addiction epidemic. Dr. E. Hollander sponsored the event. The Senior Psychologist Specialist and director of mental health programs at SQRC dedicated her entire health care career to working with persons impacted by the justice system.

“There is a strong correlation between the two that helps persons in their recovery,” Dr. Hollander said about which came first. “I believe that people are most vulnerable to be dependent on substances when they are not feeling okay with themselves and are not dealing with the world in a healthy way.”

Tipping the Pain Scale highlighted emotional pain and absence of hope, the main causes of mental health crises and addiction. According to Dr. Nzinga Harrison, a physician featured in the film, the story followed the logic that the physical pain crisis led to the opioid crises. The real narrative, Harrison said, pointed to the emotional pain crisis as having led to a drug crisis.

Hollander said that whenever she worked directly with patients, she would ask them to identify and chart significant moments in their lives — and then she would ask them to track their substance use.

The documentary followed activist Roz Pichardo as she took care of persons struggling with addiction in Philadelphia. She came into this work as part of her healing after having survived the traumatic experience of an attempted homicide on her that instead had killed her boyfriend.

The film followed Boston Police officer Josh de la Rosa as he made his rounds to support the local community. It showed de la Rosa giving free haircuts while in uniform. He had learned barbering as a careerfallback in his teenage years — growing up surrounded by addiction, drug dealing, and crime, he had fully expected to spend his adult life in prison.

The film documented the recoveries of Boston mayor Marty Walsh and former Raider tight end Darren Waller. The film also covered Washington state representative Lauren Davis’s advocacy for persons suffering from addiction. Inspirational spoken word by poet Joseph Green, interspersed throughout the film, encouraged youths to believe in themselves.

In discussing the potential impact of the film on incarcerated persons, Hollander said, “When watching this film, individuals are shown that no matter what they’ve done and no matter what has been done to them, there’s a woman in Philadelphia who will give them a hug and call them her ‘sunshine.’ There’s a nationally renowned politician who will give them his personal phone number in order to support them in their recovery. There’s a famous NFL player who will share his story with them and listen to theirs. The feedback I’ve gotten from this and other screenings is that seeing these examples, creates new hope in people that they, too, can have acceptance, love, community, and sobriety.”

Marqus Tobin, 40, incarcerated for 10 years, said his emotional pain resulted from the death of his 2-year-old son, which caused a deep depression for which he received mental health services.

“I already had a wall up from losing my mother at 5 years old. Then, my son died suddenly while I was locked up,” Tobin said. He said participating in Humans of San Quentin, a social media platform featuring incarcerated persons, uplifted him by giving him the opportunity to write about his addiction and his life of crime. Tobin said he first saw Tipping the Pain Scale on PBS several years ago and the film inspired him to want a better life.

After having watched the film, Tobin said he took a deep look into his life. “I thought about what my grandma said, ‘When is enough, enough?’” Tobin said he had converted to Islam and the spiritual transformation “was like a breath of fresh air and things improved in my life. I saw people doing positive things, giving back to the community.”

After the viewing, Dr. Hollander read a message from poet Green, followed by a conversation with 14 residents about the way the film affected their lives.