The Accuracy of Representing Addiction in Hollywood

Representations of alcohol and drug addiction in movies and television shows are primary methods of disseminating addiction-related information to populations unaffected by substance use disorder (SUD). While some filmmakers endeavor to exploit addiction, utilizing the condition as a means to increase drama or progress a plot, others choose to depict alcohol or drug abuse with truth, showing SUD as a multi-dimensional condition that ravages the minds and bodies of users and their loved ones.

Three feature films, Trainspotting, Everything Must Go, and Requiem for a Dream, address addiction from multiple perspectives and represent the disease in its fullness, earning them the praise of movie critics and viewers coping with addiction themselves.

Trainspotting (1996)

What it is: The film, based on a novel of the same name, follows Mark Renton, played by Ewan McGregor, and his peers as they navigate the underground drug scene in Scotland. Trainspotting offers a harrowing depiction of heroin addiction, featuring vivid portrayals of ritual use, withdrawal, and relapse. Poverty and addiction, inescapable cultural institutions perpetuated by a society that either does not know about the problem or will not recognize it, are the main themes of the film.

What it does: Trainspotting contextualizes heroin addiction within urban, lower-class society, showing compulsory drug-use as a form of social ostracization. Rather than critique the group that abuses and sells heroin, the film challenges the unspoken social code that prevents individuals entrenched in drug culture from returning to widespread acceptance. Renton and his peers have families, forge relationships, and make jokes, as both critics and viewers alike celebrate the film’s use of humor.

Among the film’s accomplishments is its ability to advocate for the addict but not the drug. The characters display recognizably human traits, but their vivacity is snubbed by the crippling effects of long-term drug use. Renton narrates that feelings elicited by heroin-use are euphoric and worth more than personal and familial safety, revealing his steady submission to the substance. When a court sends him to a rehabilitation facility, subpar services cannot prevent relapse.

In his critique of the film, “Trainspotting and the depiction of addiction,” Peter Byrne writes that “Degradation has also been a key feature of filmic representation of addiction and Trainspotting is no different: none of the film’s addicts can trust any of the others, all continue their moral decline, with one ending up quite literally in the gutter.” By the close of the film, Renton and his compatriots each struggle alone in the microcosm that is the Edinburgh drug world.

Everything Must Go (2010)

What it is: Comedian Will Ferrell plays unemployed businessman and alcoholic Rick Halsey in the film based on the short story “Why Don’t You Dance?” by Raymond Carver. Halsey, bereft after he is unexpectedly fired, returns home, case of beer in hand, to find his belongings scattered on the front lawn.

His wife, unable to cope with his addiction, moved his possessions out of the house in a clear sign to reassess his life trajectory. Like Trainspotting, the film engages heart and humor to humanize the main character. However, unlike the characters of the Scottish drama, Halsey forms a ragtag support group that guides him out of addiction.

What it does: Because the substance is legal for purchase, alcohol is rarely considered as dangerous as illegal drugs like heroin or cocaine. Alcoholism is extremely dangerous and its effects can strip an individual of their family and home, as represented in the film, or, in serious situations, their life.

Everything Must Go elucidates the dangers of alcoholism and emphasizes the necessity of a support group for recovery. When Halsey finds comfort and motivation from his neighbors, a pregnant woman and a young teenager, he addresses his addiction and limits his use.

The film presents an idealistic portrayal of recovery, but the honest confessions of the main character and his friends make this a valuable addition to the canon of addiction-related movies.

Requiem for a Dream (2000)

What is is: The College of Psychiatric and Neurologic Pharmacists (CPNP) succinctly summarizes the film: “Requiem for a Dream depicts four different kinds of drug addiction each leading different outcomes for the characters. Sara Goldfarb (Ellen Burstyn) is addicted to amphetamines, Marion Silver (Jennifer Connelly), Tyrone Love (Marlone Wayans), and Harry Goldfarb (Jared Leto) are all addicted to heroin.”

The CPNP continues, arguing that the film is not about recovery from addiction, but surrender to it. Incarceration, professional losses, and relationship damage all feature prominently in the film What it does: Requiem for a Dream shows two types of addiction, injecting diversity into the genre.

Critics applaud the film for its representation of the addiction in the elderly community, a population that is witnessing rapid growth in rates of SUD within the last decade. The National Institute on Abuse and Alcohol estimates that 17% of adults over the age of 60 combat SUDs.

Powerful images of withdrawal, including sweating and shaking, also provide access to the difficult lifestyle of an individual suffering from substance abuse. Unlike the protagonist in Everything Must Go who sees himself move toward recovery, the four main characters in Requiem for a Dream are fated to suffer continued abuse or forced, unassisted withdrawal.

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