Four doomed characters illustrate the downward course of drug initiation and addiction. Aronofsky's innovative portrayal is arrestingly brutal and compelling; many viewers will be disturbed by penetrating and darkly lucid visual effects guiding the descending spiral--from spring to winter, from life and hope to destruction and death.

One character, Sara Goldfarb, played courageously and brilliantly by Ellen Burstyn, becomes addicted to diet pills prescribed by a despicably careless physician. The other characters--her son, Harry (Jared Leto) and his two friends (played by Marlon Wayon and Jennifer Connelly)--are heroin addicts and dealers. In separate ways all move toward the same abyss.

Although graphic and, at times, extremely difficult to watch, the frightening nightmare of addiction should be required viewing for those who might yet succumb and those who think that just saying "no" works. The grisly and unbearably sad storyline and its explicit horror recalls the 1989 film and novel on which it was based, Last Exit to Brooklyn, also written by Hubert Selby, Jr.


The film can be used with any number of novels and other films to generate discussion about a major social problem and the despair it engenders. The list might include Abraham Verghese's memoir, The Tennis Partner (see this database) and other films such as Drugstore Cowboy; I'm Dancing as Fast as I Can; Days of Wine and Roses; Bright Lights, Big City; Traffic; and When a Man Loves a Woman. Medical students, who have an addiction to the television program, ER, are familiar with Dr. Carter's drug dependence and its consequences.


Based on the novel of the same name, by Hubert Selby, Jr., who also wrote the screenplay. Ellen Burstyn was nominated for an Academy Award.

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