The artist Nan Goldin didn’t think she was worthy enough for the director Laura Poitras to make a documentary about her.

Poitras had won an Academy Award in 2015 for “Citizenfour,” about Edward Snowden, and had been placed on a federal watch list after her 2006 Iraq war film “My Country, My Country.” Goldin recalled thinking, “I don’t have any state secrets” and “I’m not fighting against the machine in the same way as everyone else that she’s worked on.”

Poitras was equally intimidated by Goldin. The photographer, who published her first radical collection, “The Ballad of Sexual Dependency,” in 1986, has been chronicling her own life for decades in daringly intimate portraits of her friends, her lovers and herself. “I was kind of like, I don’t know if I’m cut out,” Poitras said. “What can I contribute here?”

Together, however, they have emerged with “All the Beauty and the Bloodshed,” which won the prestigious Golden Lion at the Venice Film Festival in September. The top festival prize is a rarity for a documentary that itself exists outside the conventions of its genre.

At once a chronicle of Goldin’s activism in the face of the opioid crisis and a sweeping account of her artistic and political emergence, the film, in theaters Nov. 23, juxtaposes excerpts from her slide shows of taboo-busting images with footage of her protests with her group Prescription Addiction Intervention Now, or P.A.I.N. They were fighting the outsized influence that the Sackler family, which owned Purdue Pharma and was behind the proliferation of OxyContin, had on the fine-art world. “All the Beauty” reckons with profound loss — including the suicide of Goldin’s older sister — all the while showing the power of community action. The result is an experience that is both achingly sad and invigoratingly stirring.

Both Poitras and Goldin have made portraits throughout their careers, and, as Poitras pointed out, “All the Beauty” is part of a long tradition of artists representing other artists. “There is this kind of prism-type quality,” she said in a video interview.

Goldin fiercely guarded her own story but allowed Poitras in. “We’re two strong women who are not used to other people telling us,” Goldin said in a separate interview at her Brooklyn apartment. “We’re each the boss of ourselves; we’re each the final world of ourselves and our work.”

For Poitras, Goldin stood up against powerful forces in ways that made her a natural fit for the filmmaker’s oeuvre. For Goldin, who also served as a producer, her activism was a byproduct of how she lives. “I think the most important thing maybe about my life’s work, outside of artistically, is that the work helps to eradicate stigma, about all these issues like suicide and depression and drug use and sex work and different forms of sexual identity,” Goldin said, adding, “I never do the work to fight stigma. I do the work because it’s what I’m living and it’s what I care about. And then later I see the construction of it as something that can help fight stigma.”

The desire to document P.A.I.N.’s work originated before Poitras came on board. Goldin founded the organization just months after leaving a treatment program in 2017 for her addiction to OxyContin, which had developed three years earlier following wrist surgery. “The people that I’m very close to wanted to make sure that I got back to work,” she said. “That was one of the impetuses for starting this film.”

A camera was on hand to capture P.A.I.N.’s protests and die-ins at institutions like the Metropolitan Museum of Art and the Harvard Art Museums, demanding that they stop taking Sackler money and remove the name from their buildings. The goal of these public statements? As Goldin wrote in Artforum upon P.A.I.N.’s founding: “To get their ear we will target their philanthropy.”

(Last month, the Victoria and Albert Museum removed the Sackler name, leaving only one of the six museums at which P.A.I.N. demonstrated, the Arthur M. Sackler Museum at Harvard, with the moniker. In 2021, the Sacklers agreed to a settlement in a move that ended thousands of lawsuits and also protected the family from civil claims.)

Still, Goldin and her group needed producers. In 2019, she met one in Howard Gertler, whose credits included David France’s exploration of ACT UP, “How to Survive a Plague.” At the time, he was working on a documentary about the artist Peter Hujar, for which Goldin was interviewed. Coincidentally, just a short while later, Goldin and Poitras, who had met in 2014, had breakfast. Poitras said she encouraged both Goldin and Gertler, whom she had known for years, to follow up with each other.

But Poitras continued to think about the work P.A.I.N. was doing, challenging people in power and ultimately succeeding. “It just kept rattling around in my head,” she said. “I was kind of a little obsessed.” She asked Gertler, who became one of several producers on the project, if they were looking for a director and wound up signing on later in 2019.

While it was the immediacy of P.A.I.N.’s calls for accountability that made Poitras think she was the right person for the material, she began to see the film as an interplay between the past and the present when Goldin told her about the fiery show she had curated in 1989 during the AIDS crisis, “Witnesses: Against Our Vanishing.” Time spent with Goldin complicated the structure even more.

“Her photographs have a rawness to them and an emotional depth, and I felt the same way about her voice and the way that she spoke about her life,” Poitras said. “I was completely riveted by that.”

Goldin can pinpoint the moment she started to trust Poitras. She had allowed the documentarian to film her preparing “Memory Lost,” a slide show that wrestles with the experience of addiction, and “Sirens,” which combines movie stills and a Mica Levi score simulating highness. Poitras made some comments on the process.

“They were very intense pieces, very difficult,” Goldin said, explaining, “If I’m sitting and watching an artist make something, I have to give my opinion. She’s a bit the same, I guess. Her opinion was really good.”

That trust was vital to their work together, which deepened during the Covid lockdown of 2020, when Goldin sat for a series of audio interviews with Poitras. “After we did the first one, it went really to an intense emotional place pretty quickly, and then we stepped back,” Poitras said.

They laid out an agreement about how the process would unfold. Goldin could speak freely during their conversations, knowing she would be involved in what material would ultimately be used in the finished film. The interviews were so personal that Poitras treated them as she would the top secret documents she has handled in her career. “They were on encrypted drives,” she said. “They were incredibly sensitive and completely ‘need to know.’”

After Goldin saw a cut in May, she invoked that agreement to address issues she perceived. “It wasn’t the way I wanted to tell my story,” she said. They did more interviews. Her goal, Goldin said, was accuracy in her own narrative. “It’s my voice telling my story with my pictures, so it has to be true to me, and it has to be true to what I want to say,” she said.

It was “absolutely collaborative,” Poitras said. They were still making changes even after the Venice premiere.

In “All the Beauty,” Goldin speaks about her addiction, her experiences with sex work and her abusive relationship with a boyfriend documented in “The Ballad of Sexual Dependency.” The title of the film, conceived of by Poitras, comes from the hospital records of Goldin’s sister Barbara, who died by suicide at 18. The director found that the phrase, taken from a report about what Barbara interpreted on a Rorschach test, encompassed the tragedies on display onscreen but also the celebration of resistance.

“The story of Goldin’s activism would make a worthy film,” Sheri Linden of The Hollywood Reporter wrote in a review. “The story of her birth and blossoming as an artist would too. The story of her sister pulls all this into another dimension, and the way Poitras and Goldin have brought the threads together, into the light, is a distillation likely to shake you to the core. It’s art.” IndieWire called the movie “a towering and devastating work of shocking intelligence and still greater emotional power.”

Goldin, who said she thought the title was “brilliant,” used that word again to describe other decisions Poitras had made. “I would have never created a film like that,” Goldin said. “I have deep, deep respect for that. It’s only my film in that it’s driven by me.”

“All the Beauty and the Bloodshed” is the product of two “rigorous” artists colliding, in Gertler’s estimation, while another producer, John S. Lyons, described them as “yin and yang: Laura is cool and Nan is hot,” adding, “They just melded in a really interesting way.”

The “Empire of Pain” author Patrick Radden Keefe, whose reporting on the Sacklers drew Goldin’s attention and who appears in the film, sees the finished movie as a “mingling of these two different, formidable sensibilities.”

Since Venice, the Golden Lion has sat on the mantelpiece in Goldin’s apartment. Poitras wanted her to have it. “I’m very honored by that,” Goldin said. “She often says that, ‘You know, it’s both of our film.’ It’s not exactly. We both know the limitations of that. And I never wanted it to be my film rather than hers. I have total respect for her as a filmmaker.”

When asked why she gave the award to Goldin, Poitras said: “We got it on the day before her birthday. And it felt like a good birthday present.”