Could dodging stereotypes on screen and, instead, telling real stories of addiction help people with drug and alcohol problems get help sooner?
Professor Dan Lubman, the Executive Clinical Director of Turning Point, a leading national addiction treatment and research centre, and Professor of Addiction Studies and Services at Monash University, thinks it could.
Many portrayals of addiction perpetuate stigma and discrimination and prevent people and their families reaching out for help when they need it most, he says.
“What we see in TV and film about addiction are stories that are written primarily to entertain, and as such, rarely reflects how people experience an alcohol, drug or gambling problem in real life,” Professor Lubman says.
The stereotypes often attached to drug use can be a big barrier to seeking help.
“One of the biggest barriers to treatment in Australia is the fear of social stigma,” says Dr Marianne Jauncey, Medical Director at the Uniting Medically Supervised Injecting Centre in Sydney’s King Cross, in the documentary Half a Million Steps. The film documents the journey 2018 of 100 walkers who formed a relay from Dubbo to Sydney – half a million steps – carrying a baton with a letter to the state government calling for drug law changes.
The documentary paints a clear picture of the lack of treatment options in some areas, and the stigma faced by those who have addictions.
A 2018 paper published by the National Drug and Alcohol Research Centre highlights numerous ways stigma can make people shy away from the help they need: expectations of rejection, fears that disclosing their drug use could cause employment and relationship problems, assumptions by friends or family that they were untrustworthy, violent or erratic.
“The most common issue participants identified when speaking about experiences of stigma and discrimination in the community at large was the pervasive impact of the stereotyped ‘junkie’ image,” the paper says.
One of the paper’s co-authors, Professor Alison Ritter, Social Policy Research Centre, UNSW Sydney, tells SBS: “Illicit drug use is actually quite common in Australia. Around half of adults have at some stage consumed an illicit drug. Only a small proportion of people who use illegal drugs become dependent. For cannabis this is about 10 per cent of all people who have used cannabis, for heroin it is around 23 per cent and for cocaine it is 17 per cent. This reminds us that using a drug does not inevitably lead to dependence.
“Yet this is a difficult message – because there is a desire to prevent people consuming any drugs at all, and that means that depictions of drug use in popular media tend to focus solely on dependent or problematic use.”
The ‘junkie’ stereotype is one of several that crops up a lot on screen. As a 2014 paper on stigma and discrimination put it: “The general public … has grown accustomed to seeing media portrayals of untreated individuals with mental illness or drug addiction as dishevelled, often homeless, and potentially dangerous.”
At the other end of the scale, comedy shows and films often make light of the realities of addiction.
A project that analysed more than 70,000 television scripts to see which shows glamorised or downplayed substance abuse, and which treated the issues more seriously found that: “When we examined drug mentions by TV genre, we found that comedies accounted for a whopping 41 per cent of the total drug-related mentions and that the category far surpassed drama and crime. … It seems that drug and alcohol plotlines are most often mined for humour and ignore or minimise the serious effects of substance use and abuse. Such light-hearted depictions can leave viewers with a skewed vision of the roles these substances play in reality,” was one of the conclusions of the script search, published by an American addiction treatment service.
Professor Lubman points out that on-screen depictions of drug and alcohol can affect not only the way drug users are viewed, but how people with problems think about treatment and recovery.
“In the fictional world, heavy drinking, gambling or drug use is typically portrayed as cool, funny or flawed. In action films and TV series, addiction is frequently glamorised, with the anti-hero, such as James Bond, Jessica Jones or Jack Sparrow, able to function at the limits, without any obvious impairment. In comedies like Will and Grace or The Hangover, heavy drinking or drug use is portrayed as humorous with any serious harms minimised or ignored. At the other end of the spectrum are TV shows and movies that depict the person with addiction as either flawed or weak, who has to hit rock bottom and is reluctant to accept any type of help,” he says.
“These extreme views of what addiction looks like means that most people who are struggling with alcohol, drugs or gambling do not identify with these characters, and as such, are confused about what is happening to them (‘I can’t have a serious health problem because I’m not like them’), and don’t realise that treatment is not only available but works.”
As Australia’s Alcohol and Drug Foundation points out in this article, a person who has a dependence on alcohol and other drugs may not only be reluctant to seek help due to the stigma attached to drug use. There are multiple ways stigma can impact a person’s life, including discrimination within the health care system itself.
So are there many realistic portrayals of problems with drug and alcohol use?
“Films like Trainspotting, Candy and Requiem for a Dream, while difficult to watch at times, try to portray addiction as realistically as possible, and highlight the considerable pain, isolation and damage that can occur,” says Professor Lubman. Movies such as A Star is Born and Leaving Las Vegas illustrate how destructive the shame and stigma of addiction can be, as well as highlighting that alcohol, drugs and gambling are major contributors to suicide. Other films such as 28 Days, When a Man Loves a Woman, Traffic and Rocketman provide glimpses of what treatment involves, explore the underlying drivers (such as trauma) that underlie addiction, and highlight the challenge of reaching out for help.”
TV shows that portray a more nuanced picture of drug and alcohol use include Nurse Jackie (about a nurse addicted to prescription drugs) and Shameless (an award-winning British comedy-drama series). And in November, SBS's groundbreaking documentary series, Addicted Australia, will be taking a very personal look at various types of addiction and what treatment can be like.
Professor Lubman hopes we’ll see more realistic portrayals on screen.
“What we need to see on screen is a change in the narrative to reflect what most people experience. There are parallels here with what we used to commonly see in storylines about mental illness – depictions of violence, madness or weakness. Fortunately, organisations like Beyond Blue have helped to change the narrative around mental health, where the community accepts it as a real health condition, supports and rallies round those affected, promotes help-seeking and celebrates recovery. In contrast, we rarely hear about where to get help for addiction or that change is possible. Instead, prevailing community beliefs are that treatment doesn’t work and the only option is rehab. What we need to see in TV and on film is that addiction can affect anyone, from any background, at any age … There needs to be more nuanced and humane portrayals of addiction that reflect the complexity of people’s journeys.
“If we start telling the real stories of addiction, it is likely that we will also see a change in how the community perceives addiction, which over time, will hopefully reduce stigma and promote earlier help-seeking.”
Need help? For crisis support: Lifeline 13 11 14 or lifeline.org.au; For alcohol and drug support: 1800 250 015 counsellingonline.org.au; For gambling support: 1800 858 858 or gamblinghelponline.org.au
SBS is putting the spotlight on Australia’s addiction crisis in a new landmark documentary series. Addicted Australia follows 10 Australians who join a unique six-month treatment program designed by Turning Point. New episodes of Addicted Australia premiere Tuesdays at 8.30pm on SBS and SBS On Demand. The four-part documentary will be available with simplified Chinese and Vietnamese subtitles.
Watch episode 1: