Requeim for a Dream: Methamphetamine Abuse

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This paper will explore the movie “Requiem for a Dream,” and an addiction to methamphetamines. It will identify the substance and give a brief description of its effects and danger to society. Classification of the drug will be discussed, and general concerns about withdraw symptoms. Also, the frequency of drug use will be discussed. Vulnerability factors, precipitating events, and the chain of behavior will be included in the assessment; this will provide the client insight into her cycle of addiction. The goal of my assessment is to determine what level her addiction is at, and assist her in receiving the most accurate treatment available.

Submitted: September 25, 2014

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Submitted: September 25, 2014



Requiem for a Dream was produced in the year 2000, and received great reviews. The focus of the movie was on, drug-induced utopias of four Coney Island individuals that have become shattered as their addiction (s) become stronger. This paper will focus on one individual, Ellen Burstyn, who played Sara Goldfarb in the movie. Sara Goldfarb played the mother of Harry Goldfarb (Jared Leto); Harry was addicted to various drugs that led to disruption within the household. Their relationship began to fall apart as both their addictions became more consuming. Sara became addicted to methamphetamines when a doctor prescribed diet pills with an amphetamine ingredient to help lose weight. First, the paper is going to give an overview of what Methamphetamines are, and the affects they had on Sara biologically, socially, and psychologically.

According to the National Institute on Drug Abuse, “Methamphetamine is a central nervous stimulant drug that is similar in structure to amphetamine” (2010). There are various levels of substances determined by severity of addiction level. Methamphetamine is a level two category because of its high addictive qualities. Acute effects of methamphetamine are, increased heart rate, blood pressure, body temperature, metabolism; feelings of exhilaration; increased energy, mental alertness, tremors; reduced appetite; increased irritability, anxiety, panic, paranoia, violent behavior, and psychosis. The health risks are weight loss, insomnia, cardiac or cardiovascular complications, strokes, seizures, and addiction. Also, for methamphetamine, dental problems can occur. Methamphetamine, can be swallowed, snorted, smoked, or injected (Darryl Inaba, & Cohen, 2007). The most commonly affected population are individual who struggle with depression, college students, and one’s who want to lose weight.



In the beginning of the movie, Sara watches television obsessively; resulting in weight gain, and an increase in isolation. One day, Sara received a phone call stating she has been selected to participate on a talk show; the talk show she obsessively watches. She began scrambling through her closet to find the perfect dress to wear for the occasion. She found a red dress, and could not get it to zip up all the way. She attempted a few diets and was unsuccessful. Finally, she confided in her friend; in which she received the name and number of a doctor who prescribes this diet pill that gives dramatic results. She went to the doctor and he prescribed the pill-with amphetamine ingredients. Little was described to her of the drug, only that it would help her lose weight.

Vulnerability factors, also known as risk factors, are important when assessing a client to identify underlying issues that increase their susceptibility to relapse; this includes past and present thoughts, feelings, or behaviors. It will provide the client insight about themselves, especially their triggers of the problem behavior. Sara faced vulnerability factors in her daily life she was unaware of. Examples of her vulnerability factors are, unresolved grief and loss issues from her husband, having a son who is addicted to substances, and a lack of social support. Sara did not have proper coping methods to function as a part of society. Sara isolated herself from everything and everyone. She thought since she was selected to be on her favorite talk show, her life would be perfect; but her appearance needed to be perfect first.

Precipitating events are what trigger the problem behavior; including drug abuse and relapse. Precipitating events assist a client to change their thoughts and feelings before the behavior occurs. These events can trigger vulnerability factors of a person to repeat their problem behavior. Sara’s precipitating event was receiving the phone call that she could participate on her favorite talk show. The chain of events began right at that moment. She was feeling anxious and inadequate; low self-esteem was the current vulnerability factor. She wanted to wear the red dress that was too small, and began using the diet pills that were prescribed by a doctor. The amphetamine ingredient in the diet pills began to destroy her system physically and emotionally, and she was unaware of it.


Biophysical, psychological, and social dimensions are essential when assessing a client. Amphetamines and methamphetamines affect the biophysical dimension by altering the brain’s chemistry and how it functions. Depletion of epinephrine, norepinephrine, serotonin, and dopamine are a common effect of methamphetamines or amphetamines. This happens because they borrow energy from these biochemical processes; when there is no more energy to be borrowed, burn out occurs (Darryl Inaba & Cohen, 2007). Sara reached this point when catatonia and depression were present by the diet pills. The amphetamine ingredient in the diet pills depleted all necessary chemicals to create natural energy, happiness, and confidence. Without the amphetamine, the brain could no longer create these chemicals on its own.

The psychological dimension involves perception, personality, memory, and other key mental functions. It also plays a critical role in helping to avoid danger and in organizing and motivating human thought, emotion, and behavior (Jose Ashford & Lecroy, 2010). In the movie Sara began to have severe symptoms of psychosis, including, hallucinations, and delusions. She was admitted into a mental hospital where she rejected treatment and refused to eat. Sara’s two friends went to visit her, and were shocked by how much she decompensated. All three sobbed into each other’s arms because now they realized the extent of her methamphetamine abuse. Everyone thought the diet pills were okay to take because a doctor prescribed them. Unfortunately, that is how most addictions start.

As Sara’s addiction grew, so did the tolerance to the drug. The first time she went to the doctor, he told her to take one pill in the morning, one in the afternoon, and one before bedtime. After four months she told him, it is not working the way it was; she did not have as much energy, her appetite was increasing, and she was feeling depressed. The doctor increased the dosage, and the same thing occurred; tolerance increased. She was unable to get the previous and desired effects she had when first taking the diet pills. After four months of taking the diet pills as prescribed, she began taking them whenever she thought about food.  According to the National Institute on Drug Abuse, “The sustained or repeated use of amphetamines can lead to physical and psychological dependence that will also result in withdrawal when the drugs are no longer being used” (2010).

Symptoms of withdrawal from amphetamines or methamphetamines need to be carefully observed. Some physical symptoms of withdrawal are, increased appetite, oversleeping, a potential for seizures, dehydration, and cardiac issues. The psychological symptoms include, irritability, hypersensitivity to light and sound, drug cravings, extreme mood swings similar to bi-polar disorder, suicidal ideation, and psychosis similar to schizophrenia, depression, hallucinations, and sensory misperceptions. If a doctor or provider observe these symptoms before acknowledging they are withdrawal symptoms; it is possible the client will get treatment focused on mental health; and no drug and alcohol treatment. When Sara is placed in the mental hospital, the doctor’s decided to take a different course of treatment; electroconvulsive therapy. Unknowingly, Sara gives the doctor’s permission to perform this treatment.


According to the Diagnostic Statistical Manual V, there are eleven criteria to diagnose Substance Use Disorders. The four subsets that the eleven criteria fall under are, impaired control, social impairment, risky use despite being physically hazardous, and pharmacological tolerance. Sara would fall under all four subsets, therefore, she would benefit from a Substance Use Disorder program. This program would teach positive coping skills, and provide a healthy dietary plan. The treatment facility in which Sara should be referred to will focus on the biophysical, psychological, and social dynamics of her life.

Sara has a low to moderate risk of relapse on methamphetamines. She has a moderate to high risk of self-medicating with another substance, due to depletion of brain chemicals resulting from amphetamine abuse. She would benefit from nutritional counseling along with an antidepressant in the selective serotonin reuptake inhibitor category, such as Prozac. Sara values herself as a mother and this will provide her with motivation during her treatment.



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