"Just cause you got the monkey off your back doesn't mean the circus has left town."Because Drugs Are Bad, the world of fiction is famous for treating drug addicts as feeble, broken people living in disheveled apartments (or in a worst scenario, homeless) and constantly muttering to themselves. However, there has been a general trend lately towards portraying addicts in a more positive light. These drug users, with addictions just as serious, can lead very normal lives, at least to the strangers on the street. They can wake up in the morning, go to work, have a family, and interact socially without any noticeable problems, as long as they are getting their "fix" when necessary. Simply put, the addiction does not rule this person's life. Typically, this kind of addict can go long periods of time without getting their "medicine" and doesn't depend on their drugs as a "crutch". Often, this is because they can always get the drug when they need it or have the willpower to keep themselves from getting out of control. In Real Life these kinds of addicts can go their entire lives without ever becoming dysfunctional. It isn't real likely, but it can happen. Fiction, on the other hand, almost always treats them as ticking time-bombs, slowly working up to the one event that will send them over the edge. While crossing the line into dysfunctional territory definitely happens in Real Life as well, the key difference is that fictional sources treat this as inevitable. Could be justified because fiction typically involves putting characters through unusual, dramatic and stressful situations which does increase the likelihood of an addict becoming dysfunctional. Also conservation of detail comes into play. Its usually not worth mentioning that the character has an addiction if it plays no role in the plot and tells us nothing important about the character. It's common for none of the other characters in the work to even know that there is an issue until it becomes a severe problem. It is also commonly used as The Reveal for a particular character on a Very Special Episode, where it is revealed they have been a functional addict throughout the series and are now coming to terms with it. Compare Dark Secret, for characters with any kind of sinister secret in hiding, and Drugs Are Bad, for when problematic drug use is the only kind of drug use. Also compare/contrast Addled Addict, when drugs and/or alcohol are taking their toll. Compare Recovered Addict, who may cycle into and out of addiction.
open/close all folders
Anime And Manga
- Hyakujitsu No Bara: Klaus exhibits the Descontructed form of this trope. He is implied to have been addicted to morphine in the past, so that once he is injured and needs it to help enhance his performance it's not very effective and he has to increase dosages. As one would expect, he doesn't stop using it after that and it's still up in the air whether he'll be able to curb the addiction again or not.
- Misato of Neon Genesis Evangelion drinks a lot of alcohol, to the point of having a fridge full of nothing but beer, but it's never shown to interfere with her job, where she's actually quite competent and is one of the (relatively speaking) more well adjusted members of an extremely dysfunctional cast. She also seems to quit near the end of the show, replacing alcohol with coffee and cigarettes.
- In A Cruel God Reigns Jeremy becomes a drug addict and prostitute to help him cope with the Post Traumatic Stress Disorder he suffers from due to months of torture and rape at the hands of his step-father. So not quite "functional," but more functional than he would have been.
- Bird's Nest in Copernicus Breathing takes drugs when he is overwhelmed by the memory/ghost of his little brother Michel and is borderline Driven to Suicide.
- Ruriko Daichi from Private Actress is an extremly famous and talented actress. She's also a very bitter Lady Drunk, which is driving people away from her.
- In Cruelty, Reis Northcotte's mother is definitely dysfunctional, but Reis himself fits the bill. The facade is beginning to crack, however.
- Despite his far more well-known breakdowns, Tony Stark actually spent a lot of time beforehand as a functioning alcoholic. Of course, as typical of works of fiction, that went downhill so steeply that he slammed straight into rock bottom. Hard. Granted, Tony's gone through a lot of awful shit, so his descent into full-blown alcoholism wasn't unjustified.
- Tarn of the Decepticon Justice Division in Transformers: More than Meets the Eye is addicted to transformation, but carries out his duty (torturing and killing Decepticon criminals) none the less. Somewhat subverted in that it causes him to rapidly burn through transformation cogs, which can lead to death if he wasn't getting replacements from Pharma
- In Blue Is The Warmest Color, Clementine, who's an English language teacher, became one after being dumped by Emma for cheating on her.
- Eugenesis has Springer, a former junkie who's attempting to wean himself off the normal drugs he used to take and is also dosing up the Transformer equivalent of steroids to try and keep up on the battlefield. He falls off the wagon at the worst possible time and ends up OD'ing just as Autobot City is swarmed by Quintessons.
- Carlitos Way: Sean Penn's character David Kleinfeld
- The Expendables: Gunnar is heavily suggested to be a junkie (a heroin addiction, presumably, based on the typical understanding of the word "junkie", but his exact addiction is a mystery), which heavily clouds his sense of better judgment and seriously afflicts his personality, yet he was still able to take on Ying Yang, and would have beaten him in one-on-one combat had Barney not interfered.
- Ghosts of Mars: Melanie Ballard (Natasha Henstridge) is a drug addict, but manages to hold down a job as a police officer. Ironically, her drug use ends up saving her life. When she's possessed by a martian ghost, Jason Statham's character gives her a puff of her own drug. Melanie can take it, the alien ghost can't and bails out. Compare one of the thugs, who is addicted to a different drug (a highly-nitrated compressed air) that results in him cutting off his own finger and, eventually, dropping a grenade at his own feet. Definitely not an example.
- Minority Report: John Anderton has become addicted to "Neuroin" as a means of dealing with the loss of his son and his being framed for future-murder. He is able to hide this from all but his closest acquaintances, and it does not seem to hinder his ability to function as a cop. It's implied that New hEROIN is specifically designed to produce functional addicts.
- The same drug is also responsible for the creation of the precogs, whose mothers were addicts.
- Implied to be the case with Johns in Pitch Black, who steals morphine from the medkit and injects it into his eyesocket, possibly to avoid leaving visible needlemarks.
- Requiem for a Dream: All the characters begin their addictions completely functional, and most of them are functional for almost the entire film.
- Tropic Thunder: Jack Black's character Jeff Portnoy.
- The title character in Bad Lieutenant Port Of Call New Orleans. To the nth degree, and typically with hilarious results. He's still a good cop, and even a Badass, but always in a believable way (I.E. not an overblown action-movie way).
- "Teardrop" in Winter's Bone. He's competent and level-headed despite being hooked on meth.
- El Indio, The Big Bad of For a Few Dollars More spends the entire film in an opium induced haze. While it definitely effects his personality, it doesn't seem to impair his planning, and he remains an efficent, competent, and frightening villain, who stays one step ahead of Monco and Colonel Mortimer until the final act of the movie.
- Gary King from The World's End is unquestionably an alcoholic, and harder drugs are implied. While he literally prioritizes getting drunk over his own survival at several points, a hint at his suicidal tendencies, he still manages to go hand-to-hand with the Blanks and maintain his toxic charisma.
- Michael of Life of the Party has managed to keep his life together pretty well for being drunk through a good bit of it. However, the movie opens as his attempts start to fall apart.
- Averted in Looper. While both Young!Joe and Old!Joe are relatively efficient at their jobs, both are crippled by the "eyedrop drug", though it's played closer to this trope with Old!Joe since his wife helped him get off the stuff.
- Sherlock Holmes is a cocaine addict, but there was nothing wrong with it back in Victorian times. He apparently needs his fixes only when there aren't any interesting cases to solve.
- Sir Arthur Conan Doyle was actually ahead of his time when he had Watson give Holmes a tongue-lashing over his habit in Sign of the Four.
- Although technically even Holmes fits into the "ticking time-bomb" trope: in one of the later stories (written after the harmful effects of cocaine had become more widely known), Watson mentions that Holmes' addiction had eventually gotten bad enough that it had started seriously interfering with his work, at which point he was finally persuaded to quit.
- By all evidence, James O. Incandenza, Jr., of David Foster Wallace's Infinite Jest was one of these (for the Incandenzas)...until he became a straight-up alcoholic and ended up baking his head in the family microwave.
- Tom Clancy's Jack Ryan has a heroin problem, acquired through a pain medication regimen after a well-meaning nurse gave him a morphine prescription higher than normal during his recovery from the helicopter accident that resulted in his medical discharge from the US Marine Corps. In Patriot Games, it's noted this makes him leery of painkillers in general.
- Tyrion Lannister in A Song of Ice and Fire could be considered one. He is frequently depicted drinking and expresses a fondness for it, but is almost always in control of the situation and manages to perform most of his duties. The fact that his drinking seems to have spiraled out of control at the beginning of A Dance with Dragons underscores just how badly events have spiraled out of control for him.
- Gregor Clegane is the settings' equivalent of a painkiller addict. It doesn't stop him being one of the most deadly fighters in Westeros.
- Christiane F. : Christiane is a drug addict and a prostitute, but for all that she continues to attend school every morning (in Germany at the time, school was only half a day).
Live Action TV
- Many characters are like this in Mad Men, particularly around booze. Don Draper himself can usually work well while being an alcoholic, even boozing up at work. However, when characters in this series fall down the steep slope of addiction, they crash hard.
- 24: Jack Bauer battles a heroin addiction after having to go under a cover as a Junkie just before season 3, but remains functional.
- Southland: John Cooper is originally a functional addict, but is barely functional by the end of season three is given an ultimatum by Ben: check in to rehab or he'll expose him.
- Dexter: Obviously not addicted to a "drug", but still battles with an addiction of sorts and maintains a "normal" lifestyle. Played with, however, when Dexter is forced to go to NA, and uses his "addiction" to give his presence authenticity.
- Heroes: Exaggerated with heroin addict Isaac Mendez, who is actually most functional when he is using heroin.
- Prior to season 6 and his being detoxed at the asylum, Dr. House bounced between functional, barely functional, and "holy-crap-I-need-my-Vicodin-right-now".
- And late in season 7, he appears to be headed for a full-on relapse after dealing with Cuddy's health scare by taking Vicodin. After which she broke up with him, after which he took more Vicodin. It seems to be up in the air whether he continued taking Vicodin following the events that ended the series.
- Law & Order: Special Victims Unit: A replacement ADA is eventually revealed as a functioning alcoholic. She's able to disguise her behavior by being a hardass, but eventually she gets so out of control that she's forced to take a breathalyzer test in the middle of a trial and is subsequently disbarred... or rather, suspended. She returns the following season, attending AA meetings and overall putting in a really solid effort not to drink. Ironically, she's actually nicer when she's sober, even though irritability is an extremely common withdrawal symptom.
- The Wire:
- Jimmy McNulty is a particularly believable example; hard-drinking and described by his best friend as "an emotional train-wreck of a human being", he clearly has many issues. While he is obviously alcoholic, it's not until season 5 that his alcoholism is explicitly called such (it mostly gets accepted as typical "cop" behaviour), but in a scene where the FBI are investigating a fake serial killer McNulty has invented to gain access to funding that would otherwise be denied to less glamourous cases. The FBI only listens to a short piece of "serial killer"McNulty talking, but they use it to nail his personality almost exactly, describing him as an arrogant, high-functioning alcoholic. McNulty is visibly shaken by how accurate they are, especially given that he was loudly proclaiming the inaccuracy of FBI profiles not a minute earlier.
- Bubbles had quite a run of bad luck as the series progressed, but on an average day, he functioned just fine. In spite of how much some police underestimated and even dismissed him, he provided invaluable information and aid on many occasions. In the meantime, he was adept at scrounging up enough money to pay for his drugs through some ingenious scams, good with math, and ran a modestly successful business from a shopping cart for a time.
- Bubbles is still a homeless junkie, despite all that. He has a lot of intelligence and ability but he only ever uses his skills to get more dope, and it's been shown several times that he completely falls apart when he can't feed his habit.
- Discussed by Nate:
"I'm a functioning alcoholic, you know? And the trick is not to get hung up on the alcoholic but celebrate the function part of the sentence."
- Nate's battle with his addiction is a frequent plot point and major recurring theme throughout the series.
- Discussed by Nate:
- Nurse Jackie is a functional addict to Oxycodone.
- Will and Grace: Karen's complete addiction to pills and alcohol is a Running Gag, but she is entirely functional and coherent in her daily life. Oddly, not lampshaded at all in the episode where Will gets addicted to pain pills.
- Played with in Dark Angel. A flaw in Max's engineered genetics means she has tryptophan deficiencies. Without large regular doses, she has crippling muscle spasms. Because of the state of America After the End, the stuff is expensive and hard to come by - though not quite as much as the steady supplies of chocolate, milk, yogurt, red meat, eggs, fish, poultry, and/or peanuts she'd need to get by without supplements. Because she keeps her condition a secret from her friends, they think she's addicted to recreational drugs and throw away her pills before even confronting her. It comes across as kind of a dick move, though it doesn't help that she won't even explain herself even when they stage an intervention for her.
- You could make the argument that just about every main character on MASH has an alcohol problem.
- In one episode Margaret catches an old friend drinking during surgery and busts her. The withdrawal symptoms she goes through are...a bit disturbing. And toward the extreme end, but well within the normal range of alcohol withdrawal symptoms. Alcohol detox (and depressant drug detox in general) is nasty.
- In another episode, Hawkeye temporarily quits drinking, just to see if he can. At first it peps him up, but he becomes irritable and gets on everyone's nerves. Still, he doesn't exhibit truly bad symptoms.
- Breaking Bad:
- Jesse starts out this way, mainly a pot smoker who occasionally dabbles in meth while still functioning close to normal, at least until his girlfriend gets him hooked on heroin and he turns into a junkie
- Andrea is a much more straight example. She is clearly a meth-head, but it doesn't stop her from forming relationships or being a responsible and loving parent. It appears that she's outright stopped using after she and Brock moved into a new (safer) home.
- Babylon 5:
- Doctor Stephen Franklin is addicted to Stims during the third season, having started on them in the second season to keep up with the crushing burden of running an understaffed hospital and dealing with the many crises that occur on the station. When he nearly gets a patient killed due to being strung out from lack of rest and having dangerous amounts of the stuff in his system, he tenders his resignation and goes on a walkabout to detox.
- It is implied in the fourth season that Commander Ivanova is a functioning alcoholic, doing double-shots of vodka to try getting to sleep at night after Sheridan falls at Z'Ha'Dum, Garibaldi is abducted by the Shadows, and she is left trying to help Delenn hold The Alliance together as it threatens to unravel.
- Londo is a more-or-less functional addict, holding down his job despite heavy drinking and gambling; as his arc grows progressively darker, the gambling and the drinking both taper off, except when he's drinking to put his Keeper to sleep. For contrast, Garibaldi is an almost completely non-functional alcoholic; once he starts drinking, things go downhill for him and anyone around him at a staggering rate of knots, but once he's made aware of just how bad it's gotten, he fights his way back to sober and apparently stays there.
- Keep in mind that sobriety and teetotalism is regarded as a vice in Centauri society. Presumably, many in the royal court and governing assembly are functional addicts.
- Justified: Played with. Detroit mob lieutenant Robert Quarles pops Oxy pills like candy, but he's still shown to be a cunning and ruthless villain. However, as his plans are thwarted by Boyd and/or Raylan, his drug use increases and his stability and sanity decrease.
- Colton Rhodes is a former military policeman who was kicked out of the army due to drug use. He initially seems to have his drug use under control and quickly becomes The Dragon to Boyd Crowder. However, a few setbacks and having to go against his Even Evil Has Standards morals causes him to start seriously abusing heroin again and he quickly becomes a wreck. Toward the end of the season he manages to stop using for a bit and he briefly regains his previous competence.
- Zig-zagged in Elementary, given that Sherlock Holmes is a recovering addict. He claims that he doesn't need a sober companion, anonymous meetings, or a sponsor, saying he's done with drugs. However, various episodes reveal that, at different times, he was either a complete wreck or at the top of his game. In fact, one episode ("A Giant Gun, Filled with Drugs") has his former drug dealer come into town asking Sherlock to find his kidnapped daughter. When he notes that Sherlock doesn't appear to be on the same level as before, he offers Sherlock a hit out of desperation. Sherlock appears to want the bag but then throws the guy out. At the end of the episode, he reveals that he fights the desire every day, and that particular temptation was merely one of many. Later episodes reveal that when his addiction was at its peak, he was barely functional and bungled quite a few cases due to this.
- In Sherlock, the titular character's addictions include nicotine (in the form of patches) and mysteries. He can normally function well as long as he has the latter. However, at least one episode has him running around demanding just one cigarette when no cases are available.
DI Lestrade: It's a drugs bust!Dr. John Watson: Seriously. This guy, a junkie? Have you met him?Sherlock Holmes: John.Dr. John Watson: I'm pretty sure you could search this flat all day and you wouldn't find anything that you could call recreational.Sherlock Holmes: John, you might want to shut up now.Dr. John Watson: Yeah, but come on... no...Sherlock Holmes: What?Dr. John Watson: ...You?
- There is also this exchange from A Study in Pink that implies that if Sherlock isn't using currently, he did at some point. (The fact that Lestrade thinks to call it a drugs bust at all also suggests that maybe the police know something that John doesn't.)
- A surprisingly realistic example in Supernatural: by Season 4, Dean is drinking heavily in order to self-medicate his Hell-induced PTSD. He never really quits, but his alcoholism doesn't interfere to any great degree with his ability to function. Bobby and (it's strongly implied) John were also functional alcoholics. It seems to be a fairly common affliction for hunters. The rest of the characters certainly treat it very matter-of-factly.
Sam: Can you even get drunk anymore? It's sort of like drinking a vitamin for you, right?
- Sam is also this but with demon blood instead of alcohol
- A number of characters on Cheers could be considered high functioning alcoholics - excluding Sam, a teetotaller due to his past experiences with the bottle. Norm Peterson might be the prime example. He's able to keep up with his accounting job for years despite the alarming amount of time he spends getting soused at the bar. When he loses his job it has nothing to do with his drinking, and he rebounds into a successful housepainting career.
- Call the Midwife has Nurse Beatrix "Trixie" Franklin, a seemingly bubbly glamour girl who is—although genuinely trying to be happy, positive, and having a good time—also hiding a childhood with a Shell-Shocked Veteran father where she was one of a very small number of good things in his life. While her drinking is always seen as a little on the high side, it doesn't affect her work until Series 4 (1960), when she runs into several major crises at once.
- "I wrote my songs despite the fact that I was a drunk, not because of it." — Warren Zevon, commenting on the early days of his success.
- Doonesbury: Duke has consumed an enormous amount of alcohol and drugs throughout his life, in accordance with the Hunter S. Thompson caricature he was originally. While few of his many schemes and high-profile jobs have proved successful in the end, that hasn't been due to Duke's substance abuse so much as his arrogance, jerkassery and poor judgment even when sober.
- All vampires in This Is War count as this, being equally fleshed-out and functional characters as any other species, but needing regular hits of blood to survive
- Heavy Rain: Norman Jayden is apparently a functional addict of Triptocaine (however, ARI is what's actually causing the withdrawal effects), though he can die from overuse.
- The Templars of the Dragon Age series are essentially this. Their anti-magic powers are strengthened by eating lyrium, which is extremely addictive. All active-duty templars are functional addicts, but for every one of them, there's several for whom the years of enforced lyrium dependency have lead to becoming burnt-out shells. Alistair, a Templar-in-training who became a Grey Warden before taking vows, still has Templar abilities without the lyrium or the addiction - "lyrium just makes templars' talents more effective, or so I was told. Maybe it doesn't even do that."
- Frank Fontaine from BioShock is on ADAM, like the rest of Rapture, but has used just enough of it to survive while avoiding going into full-on Splicer status. When you corner him at the end, though, he overdoses on all of the ADAM in his possession, becoming superhuman... and utterly insane.
- Max Payne, arguably. The painkillers are not just a gameplay mechanic, but per the Word of God, Max has a genuine addiction to them. He still manages to do his job, or at least shoot straight. Which, in Max's case, makes up about 95% of his functionality.
- Deconstructed in Max Payne 3: the painkillers and alcohol (and V drug) combined make Payne superhuman when fighting normal mooks, but half of Payne's problems and failures throughout the game wouldn't have happened if he didn't have a serious need to drink himself stupid. Most notably, Mrs. Branco (his boss' trophy wife) might have stayed alive if Max wasn't busy drinking instead of doing his job - BODYGUARDING.
- High Elves in World of Warcraft were essentially to addicted to magic and functioned for generations by sustaining themselves on the magic of their sacred Sun Well, but when the Sun Well was destroyed their entire race descended into withdrawl and they became the Blood Elves. The Blood Elves started siphoning fel magic from demons to sooth their withdrawl and a faction of them even enslaved an angelic entity to feed off of it. Player Character Blood Elves up to restoration of the Sun Well were functional addicts; and various forms of degenerate blood elves who had descended too deeply into their depraved addictions were common antagonists in the Burning Crusade Expansion.
- Anthony "Gay Tony" Prince from Grand Theft Auto IV: The Ballad of Gay Tony is pretty much constantly off his ass on cocaine. And he somehow manages to run two of Liberty City's hottest nightclubs.
- Trevor Phillips from Grand Theft Auto V is a psychotic speedfreak. He's also a crack pilot, and pretty much rules the meth scene in the desert almost single handed.
- Using chems in the Fallout games can lead to chem addiction, which gives stat penalties while you're in withdrawal. It's not that hard to get by with an addiction, however, as chems tend to be plentiful, and doctors can cure your addiction for a few caps.
- In the earlier games, it was possible to become addicted to Nuka-Cola. Nuka-Cola withdrawal didn't even give stat penalties, just messages about how a Nuka-Cola would be nice to have.
- Every dwarf in Dwarf Fortress "needs alcohol to get through the working day". Trying to run a functioning fortress without booze is generally a bad idea.
- In "Piss" Moira functions well enough to maintain her job as a mercenary, despite a severe drink problem .
- String Theory: Dr. Schtein, without a doubt.
Schtein: I sometimes take amphetamines. You know, to stay alert...but that's more of a casual use thing...Um, then...sometimes I take sleeping pills. You know, the speed sort of keeps me awake. Maybe a little pot, and if someone offered me coke at a party I wouldn't exactly say no, uh...Spent as entire weekend when I was nineteen tripping balls on Ayahuasca...that's not important though, is it?
- Irrelevator: The green stickman is a meth addict who's functional, but he's still pretty stupid most of the time.
- Parody Janeway in SF Debris's reviews of Star Trek: Voyager survives mostly on a cocktail of coffee, booze, nicotine, and an ever-shifting blend of Romulan marijuana and old-fashioned human cocaine. While it wouldn't be technically accurate to call her "functional", given her status as a Memetic Psychopath, most of her dysfunctions are independent of the drugs and come from her being a cackling supervillain.
- We Are Our Avatars: Basse is confirmed to be an alcoholic and regularly engages in drug usage, however she is frankly one of the groups more consistently rational and collected characters.
- Futurama: Bender is essentially a commentary on functional alcoholism, as he literally needs alcohol in order to function, or else his fuel cells run dry, even though it makes him surly and he could actually survive on mineral oil.
- Futurama robots could be an inverse; without alcohol, they get uncoordinated, have difficulty speaking, and are prone to erratic behavior. In other words, sobriety is to robots as drunkenness is to humans. Also, alcohol doesn't make Bender surly, he's always like that; now, having to drink mineral oil instead of liquor, that makes Bender surly.
- Homer from The Simpsons is one, but Depending on the Writer, this can vary greatly.
- Brian on Family Guy—if he's not shown holding a drink or in a bar during an episode, chances are that there will be some reference to him smoking weed.
- Dr Venture on The Venture Bros. is described by the creators of the show as "an addict, not a junkie.". He needs the pills to function (and take care of his various neuroses) but never is portrayed as pathetic because of that, more as a side-effect of why he's REALLY pathetic.
- While generally not vilified, coffee (caffeine) and cigarette (nicotine) addicts count, in addition to common place things such as sugar, salt, and fat, all of which the body naturally craves. As with any stereotypical narcotic, however, an addict of these things will still be pressured by society to quit or cut back when their functionality is affected.
- Drinking enough to get an elephant drunk had been a popular and widely tolerated pastime in the Eastern Bloc throughout the Communist Age (as in the top of yearly alcohol consumption per person, the former Communist countries hold still 11 of the first 12 places as of 2010) and shunned only when the drunkard became too dysfunctional to work and socially interact properly.
- Theodore Dalrymple's Romancing the Opiates, among other interesting facts, describes studies in which people with opiate (i.e. opium, morphine, Heroin, Oxycontin) addictions were able to maintain jobs for years, quite sufficient to maintain their habits. Compared to other abused substances, the short-term effects of opiates is not all that debilitating (compared to say, alcohol or cocaine). There is a theory that argues most opiate addicts are actually depressives who are unwittingly self-medicating (opiates being a mild, but surprisingly broad-spectrum, antidepressant), which means that drug use might actually improve their life, for a while, at least. The problem only appears when these people suffer some crisis like divorce or loss of employment, which will send them over the edge and make recovery so much more difficult if not downright impossible. Further complications generally stems from their need to get money to fund their addiction, which would often lead to illegal activity, and it goes downhill from there.
- The idea of opiates or even opiate addiction being a possible improvement is Truth in Television for some people with the unfortunate combination of treatment-resistant (or at least, SSRI and neuroleptic-resistant) depression and chronic pain (either as a result of or coincidental to the depression). As listed in the Godzilla Threshold article, there have been cases where doctors faced with patients who would otherwise be bedridden or suicidal from this have prescribed opiates (usually suboxone or methadone or low-dose morphine). Sometimes it works, other times it doesn't, and in cases of suicidality has to be monitored very carefully to prevent the opiate from being used in suicide, but it is a last-ditch option to bring someone out of what can be described as a living hell.
- Often Truth in Television because many of the issues that make drug use problematic are from the culture around the drug, the lack of valid safety information, the instability of supply and cost of supply, contamination of the drug, etcetera. For example:
- Someone legally prescribed a powerful narcotic painkiller due to chronic pain but who is educated on the drug, its side effects, proper dosage, proper time to take it, and the like, who can pay for it or have it supplied, who buys it from a legitimate pharmacy rather than a street dealer, and who takes it in order to get through their day with less pain/be capable of working/sleep at night/etcetera may become physically addicted to the drug, but is likely to be far more functional and unaffected than...
- Someone who isn't legally prescribed the same drug, who just heard "it makes you happy" or "it gets you high but don't take too much," who started taking it recreationally but realized the same dose wasn't doing enough after a bit, so instead of taking a break, upped the dose, who buys it from street dealers and/or the internet where one batch or even one dose can be entirely fake or cut to nothing, the next the real thing, and the next the real thing but with something else added to it that shouldn't be there, and who keeps taking it out of fear of withdrawal or the desire for more, and whose money is entirely depleted paying for it alone, much less anything else.
- In the first example of the two above examples, the word "addiction" isn't used as long as the patient is properly taking their opiate pain medication. "Physical dependence" is used to describe the body's need for the medication and "addiction" refers to the psychological dependence on a substance. While long-term opiate pain medication patients are technically physically addicted to their medication(s), there is a conscious effort in the medical community to not label compliant patients as addicts in any way.
- Studies have shown that giving pure medical heroin on prescription left a group of heroin addicts more functional than a control group that was treated with methadone.
- This can be the case with heroin at first. According to this testimony, and contrary to anti-drug PSAs and television, heroin does not make you addicted on the first hit. The truth is far scarier: the first few times someone uses it, no physical dependence is developed, leading users to believe that they can take it without becoming junkies.
- Unlike heroin, cocaine is pretty much addictive with your first try. It makes you feel like the most awesome and wonderful and amazing person in the world on your first go, but you'll never, ever get that same marvellous high again. Addicts spend their lives chasing that first high, which they will never catch, while getting further away with every attempt.