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Glitter and other Substances: Substance Use in ‘Euphoria’

Disclaimer: The article considers the events from Season 1 of Euphoria TV Series (2019)

Trigger warning: mention of substance use, mental health disorders


I first watched the TV series ‘Euphoria’ when it was initially released in 2019. I was immediately overwhelmed and a little repulsed. At the time, I did not know much about substance use, the stigma that people with substance use struggle with, the many debates, and the latest research. I did not know about the personal history of the show’s creator, Sam Levinson, who had also once struggled with substance use disorder. I was lacking context, like many of us usually do. I now realise that what I had experienced was discomfort. The show was never meant to be comforting. It was supposed to be stirring. And so, it was. I am glad that these words I type here are for a blog because I wish to reiterate here- all these opinions about the show and the themes it deals with are personal and therefore, are subject to improvement with more information and perspectives from people who have more knowledge through research or lived experiences.


Euphoria (2019-) is a US TV series unfolding the events in the life of high school students dealing with issues such as substance use, domestic violence, sexual assault and violence, discrimination, mental health struggles, body shaming, teenage pregnancy, peer pressure among others. We are acquainted with the personal histories of students across the span of the eight episodes in the first season through the main character of the show, Rue Bennett. Rue is a 17-year-old high schooler who struggles with addiction, i.e. substance use disorder, in its most extreme form. While watching Rue’s careless and aggressive demeanour towards her mother and sister, it is easy to blame her for ruining their lives as well. It may make one wonder, “Why can’t she just stop taking drugs for her family?”. Rue may then be just a selfish teenager who is incapable of getting a hold of her life.


But, let’s broaden our perspective and open our minds to some additional details: that is, the context. As a child, Rue was diagnosed with a bunch of psychological disorders like generalized anxiety disorder, obsessive compulsive disorder, attention deficit disorder, and possibly bipolar disorder; and as a result, was prescribed a cocktail of medications, none of which come without any harmful side effects. This is Rue’s first exposure to several drugs that are very much intended to alter her brain functioning. After some years, Rue lost her father to cancer after a long and painful battle with the terminal disease at home. The connection? Rue’s further exposure and opportunity to easily access the available addictive painkillers at home, particularly, oxycontin. Oxycontin is the drug that was promoted by the now-dissolved company called Purdue Pharmaceuticals as a non-addictive opioid painkiller that had, through fraud, managed to obtain FDA approvals in the United States and was widely sold for minor to major pain. Oxycontin was basically the root origin of the opioid crisis in the United States. Now, apart from this, having lost her father at an early age, it is understandable for Rue to have suffered psychological trauma further accentuating the mental health issues with which she struggled. It has been proven that initiation of substance use at an early age makes a person more vulnerable to substance misuse and SUD (Newton-Howes et. al., 2019).


I know it sounds like I am defending Rue. I am not. I am just stating the information and what it means for Rue. It is easy to miss the connections that ultimately form the socio-economic, historical, and political web that shapes a person. Rue’s biology may lay the foundation but the environmental factors further shape the development. Throughout the course of the show, Rue exposes the various disturbing realities of a teenager’s life. Peer pressure, sexual violence, assaults, physical and emotional violence, body shaming, bullying, all lead to the experience of stress chronically. This is now emphasised under the biopsychosocial model of diseases, in contrast to the medical model. The biopsychosocial model in psychology considers not just the biological factors but also the psychological and social factors which determine people’s health. This also helps us understand why a combination of medicine and psychotherapy works better. This implies that social support received from family, friends, and neighbourhood can be immensely helpful for one’s recovery from substance use disorder and in reducing the number of stressors.



But all of these things just described do not mean that Rue cannot stop taking drugs. The journey to recovery is a long and painful one, often riddled with hopelessness as relapse becomes a common occurrence. SUD can cause emotional and psychological, and often physical, distress to people close to the person suffering from SUD. The aggression, characteristic of withdrawal, causes significant stress for Rue’s mother and sister as well. While Rue stops her sister from experimenting with drugs at a carnival, research has found that people who have family members struggling with SUD may be more vulnerable to using substances. With the support from her family and friends, combined with medical treatment and group therapy sessions, Rue is on her way to recovery, but a recovery that is characterised by relapses.




Besides Rue, we also witness other characters engaging in casual substance use. We see them drinking, smoking, and snorting substances at parties and carnivals. What differentiates their use of substances from Rue’s? Given the addictive effect of substances and their variable impact on an individual’s life, the use, misuse and disordered use of substances can be imagined as a continuum with no clear distinctions between them.

Euphoria also manages to inform its audience, in an almost R-rated infomercial style, of the many realities surrounding the theme of substance use. The pharmaceutical companies push more and more drugs our way. The socio-economic conditions push some people to participate in drug peddling which gradually begins to shadow certain communities and areas with a rampant prevalence of drugs. Trauma and other mental health issues may put one at risk of developing SUD, which further adds to the health risks and exposure to greater violence, thereby worsening mental health struggles. The rehabilitation centres and support groups are, for many people, places of sexual assault (Bogart & Pearce, 2003; Cunha, 2015).


Media becomes the vehicle to condition us to use substances. In one scene, Rue impersonates Morgan Freeman’s character smoking a cigarette in a detective sequence (movies were often used as advertising platforms for persuading people to purchase and smoke cigarettes). On watching that, I was reminded of the depiction of casual consumption of cannabis (weed) in media nowadays. In a detail-oriented scene, Rue describes the many ways one can falsify the results of a drug test. The show also visually depicts the struggles with withdrawal, overdose, and relapse. Through both the detailed and subtle mentions,


Euphoria ultimately makes one more aware of substance use, an issue that is still associated with stigma in society and therefore, hinders the process of spreading important information that can aid in harm reduction following substance misuse. Euphoria deals with this issue carefully. By focusing on harm reduction, it acknowledges the experimenting climate that may benefit more from suggestions for harm reduction and prevention. In one scene, we can hear Fez, a drug dealer, demanding ‘Narcan’, that is, Naloxone after Rue consumes fentanyl. Naloxone is a highly advised medication for reversing the impact of an opioid overdose. By showing Fez demanding Naloxone, the show cognizes people of its emergency functions and necessity in harm reduction. In addition, the importance of medical history is reiterated for its role in harm reduction as Rue’s doctor refuses to prescribe her strong painkillers. While this North American TV series is the depiction of only (one) Western context, some parallels can be realised as suitable to the many contexts in India. Many medical institutions in India still lack a proper management system for keeping records of the medical history of patients.




Broadly, the show also highlights the importance of social support and the presence of caring adult relationships as major protective and resilience-promoting factors. In the initial episodes, the ignorance, stigma, and unawareness are evident when her peers confess that they assumed Rue had died several months ago, without showing any remorse over the assumption. Gradually, we notice the transition in Rue’s interaction with her peers as they ask questions and interact with her due to concern and curiosity. This can help a person feel included and accepted thereby reducing stress, providing support and motivating them psychologically to overcome an issue that wreaks havoc over their biological and nervous systems. The description of biological processes underlying SUD in simply phrased sentences helps take away the blame from the individual along with the narration of the psychosocial context.




If you or anyone you know is struggling with substance misuse or SUD, reach out for support:

  • National drug de-addiction helpline number (India): 1800-11-0031

  • Sangath's toll-free tele-counselling helpline: 011-41198666 (anywhere in India), 10am – 6pm on Monday-Sunday


Resources


About Substances

Reducing Stigma

Resources in India (Central Sector Scheme of Assistance for Prevention of Alcoholism and Substance [Drugs] Abuse for Social Defence Services)



References

  1. Bogart, C. J., & Pearce, C. E. (2003). “13th-Stepping:” Why Alcoholics Anonymous Is Not Always a Safe Place for Women. Journal of Addictions Nursing, 14(1), 43–47. https://doi.org/10.1080/10884600305373

  2. Cunha, D. (2015, September 22). “I was fresh meat”: How AA meetings push some women into harmful dating. The Guardian. https://www.theguardian.com/society/2015/sep/22/alcoholics-anonymous-aa-women-dating-addition-rehab

  3. Levinson S., Drake, Kreiss, H., Yardeni, T., Leshem, R., and Turen, K. (Executive Producers). (2019). Euphoria [TV series]. The Reasonable Bunch, A24, Little Lamb; DreamCrew, HBO Entertainment.

  4. Newton-Howes, G., Cook, S., Martin, G., Fould, J. and Boden, J. (2019). Comparison of age of first drink and age of first intoxication as predictors of substance use and mental health problems in adulthood. Drug and Alcohol Dependence, 194, 238–243. https://doi.org/10.1016/j.drugalcdep.2018.10.012

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