No joke—heroin is mainstream. In American culture, few things gauge the public consciousness quite like Saturday Night Live, which makes a business of satirically highlighting what's on our minds. Sometimes in ways that make us laugh. Sometimes in ways that make us cringe. Often in ways that make us laugh and cringe. That was certainly the case this weekend, when SNL aired a fake commercial for "medicine" called Heroin AM, a combination of heroin, caffeine and cocaine—designed to help parents get high and, at the same time, stay productive. Heroin, of course, produces a rush that is typically followed by drowsiness. Caffeine and cocaine, on the other hand, are stimulants. And the dangerous combination of heroin and cocaine is sometimes called a "speedball." I watched the spoof live as it aired. And, to be honest, I did laugh. I also had a knot in my stomach—my body's way of questioning whether I ought to be laughing. Sadly, heroin has been on our minds a lot lately. Eighty-one Americans die every day from heroin and prescription opioids, the result of an alarming 17-year rise in use. Fueled by this rise, drug overdoses have now claimed almost a half million Americans since 2000. Yes, a half million. My wonderful mother is one of those people, lost to this epidemic only a year ago, after accidentally taking a lethal dose of heroin's legal cousin—prescription opioids—which she had been taking post-knee surgery and for years prior, due to chronic pain. It's an incredible American tragedy that only in the last couple of years has come to light, largely due to the gallant advocacy of loved ones who have decided that keeping this a secret is self-defeating and no longer acceptable. We have raised our voices and gotten the attention of community leaders, health care providers, governors, state lawmakers and even Congress and the President. Given the shroud of secrecy enveloping addiction for so many years, it has been an impressive display of grassroots activism. So, in the hours and days following SNL's mock commercial, I was not surprised to get several emails from people wondering what I thought, wondering what Hazelden Betty Ford thought. I was not surprised to see social media flooded with emotional responses from this now consequential constituency of Americans committed to reducing the impact of addiction across our country. Most reacted like my colleague William Moyers, one of the nation's leading voices on these issues, who said: "I found it appalling. With nothing redeeming about it, especially when you consider that young people don't always grasp or appreciate the nuances. I don't think viewers will go out and experiment with heroin or think it is okay to use. But that's not the point; when an influential media outlet jokes about a drug that is killing people in unprecedented numbers, it does nothing to help prevent such deaths." Or like this Hazelden Betty Ford follower on Facebook, who wants corrective action: "So disappointed in Saturday Night Live. Did anyone just see that skit? We all need to complain about this!!! Heroin is nothing to joke about!! I'm done with Saturday Night Live. They owe us a public apology!!" Another colleague, Marty Harding, who helps Hazelden Betty Ford mobilize communities around confronting the opioid crisis, had a more mixed reaction: "My husband and I saw this SNL skit and had an immediate gut reaction to the glorification of heroin being labeled as something you do to "have fun" and "let loose" and addiction as something that is both hilarious and survivable. But I have mixed feelings about it. The overall tenor of the piece is light-hearted and funny, but the horrifying darkness also presents the truth about heroin and cocaine in typical SNL satire. It implicates the pharmaceutical industry (with a ludicrous Heroin AM and Cocaine PM product) and shows the stark reality of what can happen to anyone, anywhere: addiction, death, impact on daily function, ones' family appearing as monsters. It ends with a mom, high on heroin and cocaine, driving off with a school bus of children. So what begins with humor ends with both explicit and implicit tragedy." Major media picked up on the story right away, from the Washington Post to the Boston Globe and Chicago Tribune. My own reaction, like Marty's, was mixed, and quite frankly, I'm still reflecting.