The truth of everyday drug addiction is rarely told accurately on screen. From the chaotic nihilism of Trainspotting, Requiem for a Dream and Fear and Loathing, to the sanctimonious priggishness with which every American coming-of-age film deals with recreational drug use in teens, the often more mundane, dark truth that sits somewhere in-between is seldom shown. Yet it’s a reality for so many and, with the escalating opioid addiction in America, it’s a story of increasing importance.
In new film Beautiful Boy, two real perspectives are weaved together from the individual memoirs of a father and son, the latter of whom struggles through meth addiction. With Americans making up less than 5% of the world’s population, but consuming 80% of the world’s opioid supply, and opioid overdoses now the leading cause of death among Americans under 50, it’s never been more important to understand the realities of drug addiction. Though high-profile figures like Kanye West and Nan Goldin are being more open about their own addictions and recoveries, it remains stigmatised — a further obstacle in someone’s path to recovery.
To mark our cover story with Timothée Chalamet, who stars as Nic — Beautiful Boy’s titular son — we spoke to mental health and addiction charity Addaction about what to do when you think you or someone close might be struggling with addiction.
What are the most obvious signs that someone has a problem with drugs?
Signs vary a lot depending on the substance and the person. Someone who’s taking more and more cocaine at the weekend will usually show up with different issues to the cannabis user. Common signs can include anxiety, mood swings, lack of interest in activities they usually enjoy, money issues, erratic behaviour, relationship problems, and difficulty showing up for things like work or family commitments. None of these signs are specific to drug use and might indicate any number of other things. That’s why it’s so important to talk to someone you’re worried about and let them know you’re there if they need to talk.
What advice would you give someone who thinks a friend or family member might have a drug addiction? What are the most practical things you can do?
Substance use can be really complex, not just for the individual but also for family and friends. The first and most important piece of advice is: don’t panic. It can be tough to change habits and behaviour. It takes time and lots of communication, and the person has to want to change. This can be particularly tough for parents who obviously want to do whatever it takes to keep their children safe.
As a starting point, the most valuable thing you can do for a person is to let them know you care and you’re willing to help. Remember that they may not want to talk about or even acknowledge a drug problem right away. Small regular chats are more effective than an interrogation or a high-anxiety intervention.
Our advice is to avoid talking to someone when they’re under the influence of a substance. Try to choose a low intensity moment, maybe when you’re walking side by side on a walk or in a car. Let them know you’re worried and you’re there to talk and help. Try not to make ultimatums and do your best to stay calm.
In terms of how to approach it, we’d advise doing a bit of research about the substance (you don’t have to be an expert) and maybe get a bit of advice and support yourself. You can do this through Addaction’s online Web Chat service. It’s also a good idea to know what help is available. There are drug services in every part of the UK. They’re free and confidential. Your GP can also be a fantastic source of support and is a good first port of call.
What advice do you give those who feel under pressure to take drugs because their friends do?
Peer groups are often very influential in shaping our behaviour, especially for young people. To a certain extent it’s worth remembering that teenagers are hardwired to experiment. It’s how they find their way in the world. For some, this will mean experimenting with alcohol or drugs. Most young people who use drugs in this way will grow out of it without any problems. Others might need help or support if they run into problems with drugs. No person should ever feel pressured to use substances. If you’re in a group where this sort of pressure is a factor our advice is to set your boundaries, make your own choices and be prepared to walk away.
The opiate addiction in America is widely reported as an increasingly urgent problem. What about in the UK?
Last year more than 50,000 Americans died as a consequence of the opioid crisis, more than all gun deaths and road traffic deaths combined. Americans make up less than five per cent of the world’s population but they consume 80% of the world’s opioid supply. Opioid overdoses are now the leading cause of death among Americans under 50. A coroner in a badly affected part of Ohio described the crisis as “a mass casualty event, played out in slow motion”.
The crisis is primarily due to over prescribing of highly addictive opioid painkillers. Sales of prescription opioids in the US quadrupled between 1999 and 2014. There was initially a low level of awareness about the addictive nature of opioids like OxyContin. As the number of overdoses increased, many doctors became more reluctant to prescribe opioid pain relief. By this stage though, millions were addicted. By 2015, two million people had a prescription opioid use disorder and 591,000 suffered from a heroin use disorder. As the number of prescriptions decreased, people sought out alternatives on the black market. Demand for illicit opioids increased to such an extent that the price increased hugely. Many turned to cheaper alternatives like heroin and the powerful synthetic opioid fentanyl.
The UK has seen nothing like the scale of the crisis in the United States, although there have been moves to restrict the supply of painkillers like pregabalin and gabapentin. The government has ordered an investigation into the prescription of painkillers after research found one in 11 patients are prescribed drugs that can cause dependency. In general the UK has tighter regulation on the prescribing of opioids, although the number of prescriptions reportedly doubled to 23.8 million in the last 10 years.
With increased conversation around mental health, do you think attitudes are changing towards the way we treat addiction?
There’s still quite a lot of shame out there, especially around drug use. We see people all the time who’ve waited too long to reach out for help. Often this is because the person is afraid of judgement and scared to say they need support for a drug or alcohol problem. It’s slow but these attitudes are changing. Almost everyone knows someone who’s had an issue with drugs or alcohol, so these aren’t niche problems: they’re everyday kitchen table topics. People who’ve been through treatment are often hugely helpful to others who might be at the start of a recovery journey. We all have a role to play to make it okay to ask for help.
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