The film follows a simple structure, and shows the drug-related degradation of five youths (Jake, Tracey, Jessica, Alice, Oreo) during the course of three years. The film depicts drug-related crimes and diseases: prostitution, male prostitution, AIDS, and lethal overdoses.

Leni is young woman haunted by memories of her past - her parent's death, her abusive ex-boyfriend - and tormented by nightmares that add to her mounting anxiety. Is the monster that stalks her real, or just a manifestation of her mental pain? And how entwined in the truth behind her own madness is Leni?

In the late 1990s, some officers at Vancouver Police Department made a documentary film (THROUGH A BLUE LENS) about the everyday lives of six drug addicts in Vancouver's skid row, the Downtown Eastside. TEARS FOR APRIL reintroduces us to these six people; with footage shot over a period of nearly ten years, it continues their biography.