Contemporary Drug Problems 32/Fall 2005 467
Script(ing) treatment:
representations of
recovery from addiction
in Hollywood film
BY CURT HERSEY
American films and television programs increasingly feature
characters recovering from addiction. These representations are
based on previous depictions and help create a cultural
understanding of addicts. This study analyzes the depiction of
addicts and addiction in three Hollywood films whose narratives
are largely situated within a treatment center: Clean and Sober
(1988),
When a Man Loves a Woman (1994), and 28 Days (2000).
It concludes that the films depict a stock experience of treatment
that is surprisingly univocal, as well as unrealistic when compared
with the availability and realities of real-life programs. In addition,
the films limit their representations of successful recovery to white,
upper-class individuals and offer only one conceptual framework
for addiction.
KEY WORDS: Addiction, film, recovery, treatment, representation.
AUTHOR'S NOTE: / would like to thank Dr. Ted Friedman, Dr. Robin
Room,
Karen Hersey, and the journal reviewers for their suggestions and
comments on this article.
©
2005
by
Federal Legal
Publications,
Inc.

468 SCRIPT(ING) TREATMENT
Addiction
and recovery have been topics of Hollywood films
and
movies of the week and are increasingly integrated into
mainstream
television shows through the inclusion of addicted
characters.
Now the producers of reality shows have entered
the
field with the new American television show Intervention,
on
the A&E channel. Intervention follows addicts (broadly
defined
to include substance abuse, as well as shopping and
other
addictive behaviors) through the progression of their
addiction,
and then confronts them with a choice between
treatment
or expulsion from the lives of their loved ones.
Although
there are myriad possible moral and clinical
objections
to such a show. Intervention seems to be the next
step
in a growing wave of media products using addiction and
recovery
as plot devices. Several recent American television
shows,

such as The Sopranos, Dawson's Creek, and Law and
Order, include central characters seeking recovery from
substance abuse through clinical treatment and support groups.
Although new to the small screen, such television story lines
tap into a narrative about institutional treatment that has been
developing in Hollywood for the past several decades.
Addiction has appeared on the movie screen since Edison's
earliest films (Starks, 1982); however, the now familiar
images of modem institutional treatment did not appear until
the late 1980s. After a decade of American cultural backlash
against addicts and drug treatment during the years of the
Reagan administration, public opinion seemed to shift
throughout the 1990s toward encouraging people with
substance-abuse problems to get help (White, 1998). Since
that time, Hollywood has released several works with
narratives focused on institutional treatment of addiction.
Through their representations of addicts, substance abuse,
treatment centers and the experience of recovery, these films
help construct for their audiences a common cultural
understanding of addiction. They can be viewed as a
discourse in a Foucaultian sense—creating meaning and
marking off the boundaries of how filmgoers should view and
understand treatment.
469
The representation of drug treatment in America can affect
society in several ways, including stigmatization. Elizabeth
Hirschman (1992), in her study of cocaine use in films, argues
that "motion pictures which focus upon addiction can serve as
instructive, semiotically-rich texts for communicating cultural
knowledge about addiction" (p. 428). This communication is

not simply one-way, though; it exists as a continual feedback
loop,
with movies "both reflect[ing] and shape[ing] individual
and societal values, attitudes, and behavior" (Wedding, 2000,
p.
3). Thus representations from cinema can become received
knowledge, which is incorporated into societal views. These
shifts may then be mirrored and reinforced in subsequent
movies. Obviously, films are no "magic bullet" with the power
to instantly change public perceptions and beliefs; however, as
a part of the culture industry, Hollywood does participate in
teaching us about ourselves.
Films can speak to society as a whole, but they can also be
instructive for individual groups. Previous research found that
movies featuring substance abuse provide a strong point of
identification for addicts (Hirschman &
McGriff,
1995;
Lalander, 2002). Films are part of a learning process about
addiction, and the movie screen might be one of the few
places where addicts can see their filmic counterparts
receiving help.
This study compares the depicted reality the films present to
audiences with previous addiction cinema and with real-world
economic and cultural conditions. Since films privilege certain
viewpoints through representational strategies and by leaving
out alternatives, I also examine the ideologies of the films and
issues of textual silence. The study offers a critique of these
issues in the spirit of other well-known ideological film
studies, such as Ryan and Kellner's (1988) Camera Politica.

In this article, I conduct a critical discourse/ideological
analysis of the three major Hollywood films released since
the 1980s that feature treatment as a major part of their
470 SCRIPT(ING) TREATMENT
narratives. After researching literature on addiction and film,
I chose the films for the study and viewed each one many
times,
specifically looking for socioeconomic representations
of characters, treatment of different races, sexes, and sexual
preferences, methods of production as they relate to addicted
characters and drug usage, and the depiction of treatment/
self-help groups. I then outlined the narrative of each film
and compared the uses and meanings brought to addicts,
addiction, and substances. I found that these movies construct
a fairly unified image of treatment. In the films, 12-step-
based substance abuse treatment is readily available to
middle-class, non-minority addicts. The economic realities of
treatment are ignored, as are alternative paths to recovery.
Minority addicts are similarly disregarded or stereotyped.
Previous treatment film research
During the late 1970s, some film scholars and researchers
involved in social, scientific and medical research of
alcoholism began studying the ideological implications of
alcohol and alcoholics in film. A 1978 conference sponsored
by the British Film Institute generated several papers about
the representation of movie alcoholics, including the only
study devoted to examining the depiction of treatment. In his
paper, Bruce Ritson (1979) writes: "If I were worried that I
was becoming an alcoholic and decided to seek help on the
basis of the films about alcoholism which I had seen, I would

know that I must avoid hospital[s] at all costs" (p. 51). He
discusses how most movies ignore treatment altogether, but
those that do, feature "a blur of needles, burly attendants,
locked doors and terrifying screams" (p. 51). No further
research on treatment depictions in film has been published
since that time.
When combined with the more general literature on addiction
in films, Ritson's analysis provides a good starting point to
question whether certain ideologies continue to appear in
471
substance-abuse cinema, and how recent treatment films
rework older concepts. Much of this previous research
specifically centered on alcoholism; however, modern
treatment facilities and psychiatric models tend to focus less
on particular substances and group them all under the heading
"addiction" (White, 1998). I adopt the same language and use
"addiction" in place of substance-specific terms.
Treatment films
Although many Hollywood films include depictions of addicts
and addiction, only three recent movies have devoted
considerable screen time to depicting substance-abuse
treatment: Clean and Sober (1989), When a Man Loves a
Woman (1994) and 28 Days (2000). The structure and plot of
these films share a common debt to earlier movies about
alcoholism. Denzin (1991) has labeled the mid-1940s to early
1960s the "classic" period of Hollywood alcoholism films.
Bracketed by The Lost Weekend (1945) and Days of Wine and
Roses (1962), this era also corresponds to the height of the
social-realism movement. Social-problem films fell out of favor
in Hollywood, but they found a home with the oft-maligned

"made for TV" movie during the 1970s and 1980s. Although
alcohol continued to appear in major film releases, "excessive
drinking was not automatically connected to the problems that
appeared in drinkers' lives" (p. 129). Addiction was no longer
the focus, merely a subplot. The only major American motion
pictures addressing substance abuse during the 1970s were
either comedies, such as Cheech and Chong vehicles, or
biographical stories like Lady Sings the Blues (1972).
The 1980s signaled a return to the representation of addiction
within a social-realist framework with Clean and Sober. The
film follows an addict from drug abuse to treatment and back
into society, with over half of the film occurring within a
treatment facility. Since the release of Clean and Sober, many
other movies have included characters entering treatment.
472 SCRIPT(ING) TREATMENT
trying to quit using, or seeking out self-help groups; however,
only two other films also include extended depictions of life
inside a treatment facility and the methods used to get addicts
clean: When a Man Loves a Woman (1994) and 28 Days
(2000).
These three movies present surprisingly similar
narratives about drug treatment. Taken together, the films
create a depicted reality of treatment for viewers who have
never struggled with substance abuse or known addicts
seeking help.
In Clean and Sober, Daryl (Michael Keaton) is a real-estate
broker who is unable to give up cocaine and alcohol. After
embezzling company money and becoming implicated in a
woman's overdose, Daryl checks into a treatment center to
hide.

While in treatment, he tries to get drugs and
romantically pursues another patient named Charlie (Kathy
Baker).
After they are released from treatment, Charlie dies in
a car wreck as she is trying to snort cocaine. The film ends
with Daryl speaking in front of an Alcoholics Anonymous
(AA) meeting.
When a Man Loves a Woman chronicles the destruction
addiction visits upon a family. Alice (Meg Ryan) and Michael
(Andy Garcia) seem to be the perfect upper-middle-class
couple, but Alice clearly drinks too much. While intoxicated,
Alice hits her oldest child, Jess (Tina Majorino). She agrees
to enter treatment and slowly begins to get her life back
together. Michael finds it difficult to accept his wife's new
friends and way of life, and he moves out. The film closes
with Alice speaking at an AA meeting; Michael emerges
from the crowd and they reconcile.
In 28 Days, Gwen (Sandra Bullock) is a party girl who is
unable to stop partying. She steals a limousine at her sister's
wedding and drives it into a house. Subsequently she is court-
ordered to enter a treatment program, where she rejects the feel-
good camaraderie of the facility. However, after some initial
escapes and drug episodes involving her boyfriend, Jasper
473
(Dominic West), Gwen begins to participate seriously in the
activities at the treatment center. Once she is released, Gwen
chooses to leave Jasper in order to pursue her new way of life.
Representations of addicts
I have divided my analysis into two main categories. First I
examine how these films represent addicts and addiction, and

what these representations suggest. I then discuss how treatment
is depicted in the films, and analyze and compare their
constructed reality with the real-world treatment field.
The question of how addicts are portrayed is central to
understanding the ideological positioning of addiction within
these films. It is also instructive to compare these
representations with earlier films to see how certain ideas
reappear or become reworked by newer filmmakers. The
familiar devices of the addict "hitting a bottom" and seeking
out help remain. Likewise, the addicts who seek treatment in
these newer movies continue to be upper-middle-class and
white, as in the classical films. As we shall see, one of the
major shifts between the classical Hollywood approach and
contemporary approaches is a lessening of the stigma of
using substances and being an addict.
Like all cultural products, films traffic in stereotypes.
Filmmakers develop and borrow easily recognizable
"shorthand" devices that stand in for complex cultures and
segments of society. Problems develop when these
representations are seen as absolute, already existing
boundaries that define a larger whole (Dyer, 1979). Such
stereotypes also work to mask the power struggles lying
behind all such naming and representational activities. Cape
(2003) identifies four stereotypes of addicts appearing in drug
cinema. All the main characters in these subject films fall
within his "tragic hero" mold: a flawed yet "likeable, readily
identifiable character" (p. 168). Many of the stereotypical
474 SCRIPT(ING) TREATMENT
qualities identified in other substance-abuse cinema research
also appear in treatment movies; however, representations

within these three films do show some signs of departure,
especially in their depiction of female addicts. I return to a
discussion of gender within these films later.
Films in the first half of the 20th century, as well as those in
the 1970s and 1980s, often associate alcoholism with so-
called creative professions, such as writing, acting, etc.
(Room, 1989; Denzin, 1991). By the late 1980s, substance
abuse on the screen diversified to include other walks of life,
including portrayals from inside the world of corporate
America and from the inner cities. The addicts in the films
included in this study, like those in earlier movies, begin their
stories firmly entrenched in an appealing, upper-middle-class
lifestyle. In Clean and Sober, Daryl is a real-estate broker
who works for a large company and makes very lucrative
deals.
In When a Man Loves a
Woman,
although Alice is a
teacher (a profession not commonly associated with a
glamorous life), she and Michael have a roomy, upscale
townhouse in San Francisco and go on vacation in Mexico.
28 Days, by contrast, never mentions whether Gwen has a
job.
Her apartment is not especially luxurious; however, the
film begins with her partying in a posh club. Although these
films may present a less glamorous lifestyle than 1980s
cocaine films such as Less Than Zero (1987), these addicts
are still financially well off and living attractive lives prior to
"hitting their bottom." They all have financial and social
resources that prevent too hard a fall from their normal life of

privilege. There are no scenes of living on the street or the
desperation associated with the continual hunt for substances.
These are most assuredly "upper-class addicts."
In her comparison of 1920s and 1960s alcoholism films. Herd
(1986) found that the movies shifted from portraying external
causes for alcoholism to the (now familiar) assumption that
internal factors cause alcoholism. Despite acceptance by the
medical community and much of the public that addiction
475
comes from within, recent filmmakers still find it necessary
to provide a necessitating external factor for a character's
substance abuse. As is discussed later, this may be attributable
to the AA concept of "hitting a bottom." Regardless, all three
treatment films do offer precipitating events based on anxiety,
stress,
or failure for each character's addiction.
Clean and Sober provides no pre-existing catise for Daryl's
addiction. Daryl seems to be quite content with his lifestyle,
until the police start pursuing him. He responds by increasing
his drug use and then checks into a treatment program. Unlike
Clean and Sober, both 28 Days and When a Man Loves a
Woman
link their characters' addiction to their family history.
During detox, Gwen flashes back to scenes of her childhood
with her sister and addicted mother. The sequences show how
their mother put them into danger and eventually died from
her using. Through the flashbacks and sequencing, Gwen's
addiction is directly linked to her mother's substance abuse.
The concept of addiction affecting entire families is endorsed
by many self-help groups, particularly Adult Children of

Alcoholics (ACOA), and it became incorporated into
addiction films during the 1980s (Lynch, 1999; Denzin,
1991).
This approach is even more evident in When a Man
Loves a
Woman.
The film suggests several factors for Alice's
addiction, including her father's drinking and Michael's
controlling nature. Although these family issues could be
seen as external factors, they are presented less as a cause of
substance abuse than as links to an addiction-prone
personality that, in turn, causes substance abuse.
Beginning in the 1980s, an increasing number of films began
to focus on addicts who use multiple substances. The classical
social-realist films were almost exclusively inhabited by
alcoholics; in current substance-abuse films alcoholics are
almost a quaint exception. While Daryl splits time between
alcohol and cocaine, Gwen is equally happy with pills or
alcohol. When a Man Loves a Woman offers the sole
476 SCRIPT(ING) TREATMENT
throwback to the classical alcoholism film in the character of
Alice; however, the people Alice befriends in recovery admit
to using a variety of substances. It almost seems that Alice's
roles as mother and wife preclude all but the most socially
acceptable substance abuse, feeding into ideologically
conservative notions about women and motherhood.
In her discussion of 1920s alcohol films, Denise Herd (1986)
notes:
"Romantic goals dominated the entire plot of the
melodramatic film, thus creating the primary situational

context of alcohol problems" (p. 216). This remains true for
the treatment films under discussion here. Their increased
focus on addiction therapy does nothing to diminish the
importance of romance within their narratives.
These relationships are easily explained away as a classical
feature of Hollywood scriptwriting, but they do hold a deeper
meaning within alcoholism films: "The resolution of his/her
drinking becomes a symbol for the resolution of the problems
of the relationship" (Denzin, 1991, p. 249). Thus the fate of the
couple is tied to whether the addict will choose a life of
sobriety or continue using. Since Gwen's fiance continues to
use in 28 Days, Gwen's decision to stay clean is reinforced
when she tells him, "Everything has to be different, and that
includes us." After a brief kiss she bids him goodbye. Daryl is
unwilling to let go of his girlfriend, even after he finds drugs in
her purse. Her death allows him to resolve the situation within
the classical alcoholism motif without having to actually
choose staying clean over remaining in the relationship. By
contrast, in When a Man Loves a Woman, Michael tries his best
to be supportive of Alice, but he has to learn his limitations
before they can reunite. These relationships are a central focus
of all three films, and their resolution implies a direct
correlation between the choices the characters have made about
their addiction and their recoveries.
There are other characteristics of addicts common to these
three films that researchers have not generally identified with
477
the larger group of addiction cinema. Each movie recognizes
that drug use was, at one time, fun for the addicted character.
Many of the earlier alcoholism movies focused almost

exclusively on the progressive decline of characters, rarely
acknowledging their pleasurable periods of using. "Demon
alcohol" was the villain of the classical social-problem film,
but recent movies suggest that the substance itself is not the
cause of the problem. Spouses, co-workers and friends drink
and use drugs in these films. For example, in When a Man
Loves a
Woman
Michael usually drinks with Alice, but there
is no suggestion he is an addict. Instead, the films imply that
the nature of addiction is found within the individual
character rather than in specific substances—an approach
familiar to treatment professionals.
The representations of addicts in treatment films do replicate
some of the conventions of earlier alcoholism movies.
Characters are upper-middle-class and employed, and they
encounter adversities that seem to precipitate an increase in
their consumption of substances. Recent films, however,
reflect subtle changes in stereotypes of addiction in society.
Substance abuse is viewed more as a disease than a moral
failing (at least among the economically well off), and most
of the characters consume multiple types of drugs. These
more obvious representational strategies combine with
connotations within the text to establish a fairly consistent
ideological stance.
Reading between the lines
The depictions of addicts within these treatment films raise
several ideological questions about their handling of issues
such as race, sexual orientation, class, and gender. I address
these categories in this section and show that these treatment

films present a consistent view of middle-class Caucasians'
addiction while ignoring or negatively stereotyping addicts
from different races and socioeconomic backgrounds.
478 SCRIPT(ING) TREATMENT
As mentioned previously, the main characters of all three
films could be described as middle-class to upper-middle-
class.
The only "poor" addict developed as a character is
Charlie in Clean and Sober. She is also one of only two
addicts (the other is Gwen's teenage roommate in 28 Days) to
die in these films. Unlike other characters, who have more
options because of their money, Charlie is locked in a dead-
end mill job with an abusive boyfriend. In these films staying
clean seems to be fairly easy if you have the financial
resources and a supportive environment.
Filmmakers might have chosen to focus on middle-class
characters in order to subvert cultural stereotypes about who
abuses drugs. Earlier films about alcoholics certainly pursued
this goal (Room, 1989). While this approach might be
understandable, addicts on the lower rungs of the social and
economic ladder end up being left out of these tales of
redemption. Instead, addicts on the fringes of society are
primarily featured in bleak, cautionary tales such as
Menace
II
Society (1993) or Requiem for a Dream (2000). Through
exclusion and negative portrayals, the subject films seem to limit
recovery through treatment as a possibility for the working class.
All three leading actors who portray addicts in these films are
white. These characters' middle-class lives before treatment

seem to be populated entirely by Caucasians (excepting Andy
Garcia, who portrays Michael in When a Man Loves a
Woman),
with minorities existing only in stereotyped servant
roles like "cleaning woman" and babysitter. Denzin (1991)
found the same problem with representation in his study,
saying that films "systematically excluded certain classes and
types of subjects," resulting in a "dominant middle-class
ideology about who had this problem" (p. 238). Hollywood
perpetuates racist stereotypes by excluding minorities from
these stories of redemption and then foregrounding them as
addicted criminals and similar negative portrayals in other
films.
The more socially acceptable "alcoholic" is white, and
less appealing stereotypes like "crackheads" are usually
479
minorities. Such an approach also seems to open up treatment
as an option only for the first group, while largely excluding
minorities from institutional help. Although most major
characters are white, these treatment movies do include some
diversity in their depictions of treatment.
All three films feature African-American actors playing
treatment professionals and patients, though few other racial
minorities are represented. The presentation of black addicts
inside the facilities in
When
a Man Loves a
Woman
and
Cleati

and
Sober
stands in stark contrast to the presentation of white
characters. When Daryl enters the detox ward in Clean and
Sober, he walks into the television room and sees Xavier
(Henry Judd Baker), a large African-American man, talking
to
himself.
Xavier then throws something through the
television, storms out of the room in a flurry of fists and
curses, and begins pacing the halls, physically lashing out at
the
staff.
Comparing this image of a deranged, hulking black
addict with the dazed, peaceful expressions of the white
patients as they detox, it becomes apparent that these images
play on cultural stereotypes about black drug addicts. The
angry, dangerous black man is a stereotype often evoked in
popular cinema (see Guerrero, 1993) and might be expected
to emotionally distance the audience from minority addicts in
the film. The African-American characters in Clean and
Sober receive barely any screen or speaking time, instead
existing primarily for laughs and plot mechanics.
In
When
a Man Loves a
Woman,
Michael comes to visit Alice
in the treatment facility, where he meets Malcolm (Bari K.
Willerford), a large African-American man who tells him,

"Your wife is amazing." Michael is visibly uncomfortable.
After Michael leaves the building, he sarcastically comments,
"I like your new friends." When Alice asks if he met
Malcolm, he replies, "Big black guy?" She smiles and tells
Michael, "He's a cokehead (pause), the girls are with him."
Michael reacts with a start, but Alice quickly adds, "He's not a
child molester, he's an armed robber." The scene is played for
480 SCRIPT(ING) TREATMENT
laughs, but it also illustrates that Alice has looked beyond the
exterior of her fellow patients and has recognized their
common "affliction." However, the "humor" of the exchange
comes from stereotyped images of the menacing black addict
who must be kept away from white women, especially little
girls.
The underlying message is "Malcolm can be trusted
because he is off the street and in this nice treatment center."
He becomes an "exception" to the stereotype rather than
transcending it. The audience can laugh because Malcolm is
not a "normal" black drug addict. Neither film favorably
portrays an addict who is a racial minority. So while the
audience is encouraged to identify with white substance
abusers, none of this empathy is shared with minorities.
Interestingly, each film does include African-American actors
portraying treatment professionals. They are more well-
rounded characters (especially Morgan Freeman's in Clean
and Sober) than the black addicts depicted; however, they
could be viewed as "exceptional cases" set apart from the
other stereotyped characters. In some ways, like many
representations of black judges or police officers, these
officials reinforce dominant ideological positions by

becoming the point of contrast with the dangerous "Other"
most minorities represent to mainstream audiences.
Although 28 Days does not include as troubling racial
representations as the other two films, its depiction of the sole
homosexual identified in any of the three movies is just as
problematic. Gerhardt (Alan Tudyk), speaks in a German
accent (further setting him apart from the other patients),
cries throughout the film, is unable to articulate himself
without becoming emotional, and is the subject of most of the
movie's jokes. There are no tragedies or life-and-death
considerations in his addiction and recovery. Inside the
facility he is forced to wear a sign saying "no male contact,"
and once he is released, his main concern is "I'm never going
to get laid." His substance abuse is secondary to his role of
buffoon in the film. The serious process of recovery in all
481
three films is associated only with white heterosexual
characters, usually females.
While largely ignoring or marginalizing racial minorities,
these films seem to overrepresent female addicts. Three out of
the four major addicted characters are women: Alice, Gwen,
and Charlie. During the early 1990s, women comprised 27%
of addicts in treatment facilities (NIDA & NIAAA, 1996),
rising only slightly, to 30%, in 2002 (SAMHSA, 2004). Do
female addicts take center stage because they are better able
to elicit the sympathy of the audience? In Clean and Sober,
Daryl tends to be a frustrating character who alternates
between deep depression and fits of rage. The movie itself
tends to be darker and less comical than the other two films.
Extreme emotional displays are commonly linked to women,

so perhaps filmmakers thought audiences would be more at
ease and willing to identify with addicts like Gwen and Alice.
Previous research has found that cinema usually equates
female alcoholics with promiscuity (Herd, 1986; Room,
1991),
yet none of these films reflects this cliche. By casting
mostly women in the lead roles of addicts and removing the
threat of out-of-control sexuality, filmmakers may have been
attempting to broaden the appeal of their stories.
Although the representations of some of the female addicts
may have improved, the films still feature several sexist
assumptions in their subtexts. In a study of female alcoholics
and teetotalers in popular media, Thelma McCormack (1986)
found that both images of women were devalued. The
characters in her study had no ability to act decisively and no
authority. Similarly, both Charlie in Clean and Sober and
Alice in When a Man Loves a Woman are never entirely free
to make their own decisions. Alice seems to turn to drinking
largely in response to the power her husband wields over her.
Charlie is manipulated either by Daryl or by the other men in
her life. She tells Daryl that she has security at the steel mill
where she works "as long as once a month I forget to wear a
bra and show them my high beams." In the end, she pays the
482 SCRIPT(ING) TREATMENT
ultimate
price for her indecisiveness and her inability to stay
clean.
Like the women in McCormack's study, Charlie not
only
lacks agency, she is bereft of any qualities that might

allow
her to assert control over her own
life.
Both
28 Days and When a Man Loves a Woman suggest that
Gwen's and Alice's addictions can be ascribed to family-
relationship problems. Daryl, by contrast, has no apparent cause
for his substance abuse. This stereotypical move of linking
female using to relationship problems has a long history in
addiction films (see Denzin, 1991; McCormack, 1986; Lynch,
1999).
Such a move results in a loss of agency for these
characters. Viewers are given the impression that these women
are truly victims, while Daryl is often incapable of inspiring the
same pity. Perhaps society is more comfortable with the figure
of a helpless woman driven to use than with one who has just
chosen to use substances but is unable to stop.
The depictions of addicted characters affect the way these films
construct addiction for their audiences. They also carry
ideological messages that teach society which addicts can be
helped and how. Female addicts require additional excuses for
their using and are burdened with emotional and familial issues
that males do not have to face. The overwhelming percentage of
white, upper-middle-class men and women in these films seem
to successfully choose a life of abstinence after treatment. The
poor and the minorities do not fare so well—they receive
relatively little screen time and mostly unflattering portrayals. The
absence of positive representations of minorities (along with the
scant attention paid to them) creates a limited picture of the
addicts society should help. If they are not members of society's

dominant caste, there seems to be little hope for them.
Representation of treatment
Having previously shown the limited representational
strategies used to depict addicts in these films, we should ask
how their images of treatment compare with the reality of
483
America's substance abuse field. I show that these treatment
films offer a consistent yet highly limited representation of
treatment that is unrealistic in light of the economic pressures
of the time.
The images of treatment in these three films stand in stark
contrast to the pre-1980s addiction movies. Lewington (1979)
wrote of "the image of the locked door or barred window"
and the "sadistic or pessimistic male nurse"(p. 28), but the
facilities in these three films become progressively warmer
and more lavish. In Clean and Sober, Daryl walks through
swinging doors into a swirl of activity and voices. With' the
sterile interior of a hospital, the place is more reminiscent of
the institution depicted in One Flew Over the Cuckoo's Nest
(1975) than the resort look of the other two treatment films.
Patients are afforded some freedoms, though: There are no
guards, no barred windows, and always-available television,
exercise classes, and field trips to AA meetings. Alice checks
into a roomy facility resembling a New England inn in When
a Man Loves a
Woman.
Patients are provided with gardens to
stroll in, a television room with a pool table, and a craft
room. With Serenity Glen in 28 Days, treatment makes the
transition to country club. The facility features a horse stable

and a lake where patients canoe. The bleak images of
institutional treatment wards transition to elaborate
rehabilitation/vacation spots for the financially well off.
In addition to drastically altering the previous image of
treatment centers in film, these movies also contradict the
economic facts of the treatment profession. In his chronicle
of the history of addiction treatment, William White (1998)
points out that an expansion of patients and posh facilities
during the 1980s met with resistance from insurance
companies. The maximum stay for patients slowly decreased
until, in the mid-1990s, insurance companies decided that
"future benefits for addiction treatment, where they existed,
would be offered almost exclusively for outpatient rather than
inpatient or residential treatment" (p. 285). These outpatient
484 SCRIPT(ING) TREATMENT
programs, though much more numerous in the real world,
have not captured the imagination of Hollywood as
residential facilities have. Thus moviegoers are shown an
experience that, except for those who can afford to foot their
own bill, few can have.
The statistics on the success of treatment programs vary
widely (Frater, 2001). Part of the problem with gauging
success are such questions as "How long does someone have
to stay clean before the process is successful?" and "Can
similar statistics be applied to drastically different treatment
programs?" Regardless, for leading characters in these three
films,
success is 100%. The characters leave the centers
clean and are still not using at the end of each film. As
mentioned previously, two characters do die as a result of

their using, and one returns to treatment after relapsing;
however, the viewer is left with the impression that they are
anomalies. By contrast, even the most optimistic surveys
show that at least 50% of people in treatment relapse within
the first couple of years after release; relapsed characters are
actually representative, not atypical.
Similar to earlier alcoholic films, all three movies divide the
treatment experience into stages of detoxification,
confrontation, and submission (Denzin, 1991, p. 223). As the
major characters go through detox, they exhibit signs of
delirium tremens, or the DTs. In his study, Ritson (1979)
claims that DTs are estimated to occur in roughly 5% of
alcoholics (p. 51). He argues that the images appear
unrealistically often in movies because of their "dramatic
appeal." In these treatment films, I would claim that they also
serve to add a further note of seriousness to treatment,
especially given the posh facilities and the frequent jokes
included in all three movies.
These films feature recurring scenes that work to create what
I call a "narrative of treatment" for the viewer. Each character
and his or her belongings are searched for drugs upon
485
entering the facility. The characters either ask or try to use the
phone, only to discover they cannot make a call until
sometime after they detox. After detox (with appropriate
physical symptoms), they meet other patients and their
counselor(s). They attend AA-like meetings, leave the facility
(after a touching farewell moment with other patients and
their counselor), and then in society implement what they
have learned by attending AA or similar meetings. The whole

treatment process is distilled into a familiar narrative.
As noted in the treatment narrative above, AA (although not
always clearly defined as such) is a key feature of the films in
this study. Since the 1940s, AA has continually played a
major role in films about alcoholism, both as a plot device
and during the production process (see Room, 1989). Ritson
(1979) complained that pre-1980s films included very few
scenes about professional treatment, opting instead to present
AA as the only solution. By contrast, recent movies depict
the reality that self-help groups are now an integral part of
the treatment process (White, 1998; see also Denzin, 1987);
as such, much of AA's culture is reflected in these movies.
All three films include "meetings," which "not only provide
the scheduled program for the alcoholic, they also provide a
social environment supportive of abstinence" (Wilcox, 1998,
p.
58).
The jargon and trappings of AA have become adapted parts
of the lexicon of these films. The main characters in all three
movies have a "sponsor" to help them. Phrases and ideas
featured in these films, such as "one day at a time" and "keep
it simple," come directly from AA (Wilcox, 1998). The
concept of "hitting a bottom" can also be attributed to this
self-help program and has been widely adopted by addiction
cinema. According to this
belief,
all alcoholics reach a final
point of desperation, at which point they become willing to
change. Reflecting this idea, each character has a major
calamity that can be identified as an obvious sign of

"unmanageability" and a need to stop using: Daryl steals and
486 SCRIPT(ING) TREATMENT
wakes up next to an overdosed woman, Alice slaps her
daughter, and Gwen drives into a house.
The treatment films do diverge from AA's practices in two
important ways. First, rather than calling themselves merely
"alcoholics," which is the accepted moniker of AA,
characters in these movies use a string of identifiers. For
example, Steve Buscemi, who plays a counselor in 28 Days,
introduces himself as a "drug addict, alcoholic, compulsive
gambler-slash-liar." Only 13% of treatment centers catered
solely to alcoholics in 1990 (White, 1998, p. 268); these three
films probably reflect the reality that treatment facilities work
with people addicted to widely differing substances. Although
AA may focus specifically on alcoholics, most treatment
centers accept any addict (as long as funding is available).
The second point of departure from AA is the lack of a
spiritual dimension to the programs: "Reminding ourselves
that we have decided to go to any lengths to find a spiritual
experience, we ask that we be given strength and direction to
do the right thing" (Alcoholics Anonymous, 1976, p. 79).
Room (1989) noted this same omission in his study of films
featuring AA during the classical alcoholism period. The
search for spirituality may be too difficult to translate on the
screen, or filmmakers may just fear their movies would be
interpreted as endorsing religion. By neglecting to mention
this aspect of AA, however, the films present an incomplete
view of that organization.
Recent movies dramatically alter the face of substance-abuse
treatment from its previous screen depictions. Facilities shift

from stark institutional interiors to sumptuous living and
recreational quarters despite a real-life decrease in such
facilities. The films focus upon the successful treatment of
characters, utilizing AA-like programs and methods. These
narratives establish such a common treatment experience that
audience members can assume they have learned what addicts
go through in treatment.
487
Textual silence
Films create an ideological position both by presenting and
by omitting information and viewpoints. Having discussed
the image of treatment conveyed in these films, I now turn to
treatment issues ignored within their narratives. All three
movies neglect to address economic and policy issues
surrounding treatment, as well as the limitations of the
disease model of recovery.
Like most Hollywood fare, recent treatment films do nothing
to question dominant economic notions of capitalism or
socialized health care. The film industry, like the medical
field, is structured to benefit from the capitalistic system; it
should not be surprising, therefore, that its products do little
to critique the inequity of America's health-care structure.
The treatment system underwent huge shifts in the 1980s as
for-profit companies entered the field, forcing non-profits to
adopt their practices in order to compete. Most treatment
agencies became firmly planted within a purely capitalist
system, where "addicts became less people in need of
treatment and more a crop to be harvested for their financial
value" (White, 1998, p. 281). Only one of the three subject
films addresses the financial aspects of treatment at all. In

Clean and Sober, Daryl asks if the agency takes Blue Cross
just before he is admitted—the only reference to the high
cost of treatment in these motion pictures. These films
ignore economic reality, because insurance companies were
pointing customers toward outpatient care during the same
time period, and "waiting lists for publicly funded
residential programs grew unconscionably long" (p. 285).
One comedy made during the 1990s at least tangentially
critiques the situation: Gridlock'd (1997) features the
adventures of two drug addicts wading through red tape to
get into a government detox facility. By ignoring the
economic factors at work within the treatment field, the
subject films also overlook the true motivations behind such
488 SCRIPT(ING) TREATMENT
programs and misrepresent the availability of treatment
services.
These films also fail to explore any of the myriad political
issues surrounding treatment of addicts. Public funding is
never mentioned or examined. Broader questions about the
arbitrary nature of government distinctions between
substances, such as minimum sentencing of drug offenders
and even the legality of possessing certain substances, are
likewise ignored. In writing about representations of the war
on drugs, Viano (2002) actually identifies
Clean
and Sober as
a return to films such as Reefer Madness (1936)—films that
toed the government line when it came to drug policies. In 28
Days, when Gwen is sentenced to go to a treatment center
rather than serve jail time, there is no questioning of whether

the government should be supporting (what one can guess is)
a private business by mandating that prisoners attend such
facilities. Ignoring such questions helps strengthen both the
government's and the treatment centers' public stances about
addicts and the appropriate ways of treating them.
While encouraging youths to "just say no" and helping to fund
public-service announcements, the United States government
primarily battles addiction through law-enforcement efforts
(see Belenko, 1993; Reeves & Campbell, 1994). Local
governments vie for increased federal funding to fight a war
where addicts seem to be the most easily identified enemy.
The incarceration of the addict, whether in
a
jail or a treatment
facility, represents a statistical win to be used for more federal
dollars. Since states partially pay facilities for drug offenders
sentenced to treatment, this represents a win/win situation for
law enforcement and treatment centers. The benefit for the
addict is rarely questioned.
This brings us to the last major issue ignored by these films:
the lack of any alternative concepts of addiction and
substance-abuse treatment. In a recent book questioning
addiction from a cultural-studies perspective, the authors note
489
that "addiction, therefore, is nothing if not a cultural concept,
despite its affiliations with scientific and medical discourse"
(Redfield & Brodie, 2002, p. 4). All three treatment films in
this study take for granted what has come to be known as the
"disease model" of addiction, a cultural concept popularized
by AA during the mid-twentieth century. This approach,

roughly defined, holds that some persons are genetically
predisposed to compulsive substance use. The idea of
self-
control has combined and morphed into a personification of
the desire to use, pitting addicts against an internal disease
for control of their lives. I am unwilling to argue against a
model that seems successful in treating people who want to
stop using; however, the problem is that this "model" is
presented as scientific truth—especially in these films. Social
science research shows a much broader range of
understanding about the nature of addiction (see Valverde,
1998,
for example) that is ignored by these films. The effect
is to cut off dialogue and to construct only one possible view
of addiction. This model has become naturalized in American
society and is the lens through which all addicts and
treatment efforts are viewed.
Recent treatment films support dominant American ideology
concerning addiction and drug treatment. Despite the lack of
public funding, posh residential treatment centers are
constructed as the only realistic option for keeping addicts
clean. The interdependent nature of law enforcement/
government and such institutions is occasionally depicted but
never questioned or explored. Concepts of addiction as a
disease and AA-based recovery as the best solution are
naturalized in the film texts and close off any alternative
interpretations for the audience. The movies are a direct
reflection of American society's ideological positioning
toward addiction.
490 SCRIPT(ING) TREATMENT

Conclusions on treatment films
While earlier films either lacked depictions of treatments or
presented a montage of needles and DTs, recent representa-
tions have created a stock experience where any moviegoer
can learn what it is like to go through drug treatment. Since
these are the only three modern Hollywood films to offer an
"in depth" look at treatment, their realism and assumptions
should be questioned.
Recent treatment films construct addicts as middle-class,
white, and attractive. Although the depiction of women is
more progressive than in previous addiction films, these
movies still reference racist and sexist stereotypes. African-
American addicts are largely connected with the
"ghettocentric" cycle of Hollywood films from the 1990s.
Popular culture constructs treatment as an option for whites,
while blacks are seemingly left with death or incarceration as
their only escape from the vicious circle of addiction.
Filmmakers may have feared appearing racist if they centered
on African-American users; however, many addicts are left
with no one of their own race with whom to identify.
The representation of treatment centers that emerges from
these films also raises questions. While some addicts might
be able to afford treatment, they are vastly overrepresented in
these movies. The treatment programs depicted in these films
would be unavailable to many addicts with little money and
no insurance. Instead, they would probably receive outpatient
services, leaving them no safe place to detox or live. Going
into treatment with unrealistic expectations might decrease an
addict's desire to get clean and also make it easier to quit a
program.

These treatment films also offer limited understandings of
addiction and options for treating addicts. While the "disease
model" seems to help some people with substance-abuse
problems better understand their experience, there are
491
alternatives. Some addicts have been able to manage their
using or to utilize alternative therapies. In presenting a single
answer for all addicts, there are no options for persons who
may be opposed to this particular approach. In addition, these
films serve as a virtual public-relations/marketing campaign
for what are usually for-profit treatment centers.
But despite the representational shortcomings of these motion
pictures, the filmmakers should be recognized for at least
attempting to address the complex issue of addiction treatment.
Rather than asking why filmmakers make certain creative
decisions, perhaps we can ask why these are the particular
narratives Hollywood is willing to produce. Do executives
believe audiences require a romantic relationship and a happy
ending to watch a film about treatment? Are the fleeting, one-
dimensional minority representations compromises for telling a
story filmmakers are passionate about? Although such
questions do not absolve responsibility for content, they do
acknowledge a filmmaker's reality of working within certain
institutional bounds in order to make a film. The existence of
such pre-existing boundaries is precisely why ideological
studies are needed to reveal the constructs and unspoken
assumptions films make about addiction.
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Denzin, N. K. (1991). Hollywood shot by shot: Alcoholism in American
cinema.
New York: Aldine de Gruyter.
Denzin, N. K. (1987). The
recovering
alcoholic. Newbury Park, CA: Sage
Publications.
Dyer, R. (1979). The role of stereotypes. In J. Cook & M. Lewington
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