Warning: The following article contains spoiler alerts!
Many years ago, a two-part episode of Fox’s “House” featured an unscrupulous police officer who falls ill with laughter. Yes, that’s right- laughter. Laughter and giddiness, but in completely inappropriate situations (the officer suffers a surface level bullet wound to the head, and as he lies on the ground bleeding he laughs uncontrollably).
His situation gradually becomes anything but funny, as he is wracked with muscle spasms, blindness, extreme, intractable pain, and eventually death. And- what’s worse- the brain-eating amoeba that (SPOILER ALERT) takes his life also infects one of House’s doctors. The title of this episode: “Euphoria.”
Like many English words, “Euphoria” is derived from Greek: Eu (“good”) and Pherein (“to bear”). It’s a good feeling. A great feeling!! It’s excitement and joy and a rush of all things positive and pleasurable and care-free. But, as you may have surmised, it’s also quite short-lived, and, depending on its source, addictive as well. It’s annoying. Isn’t it?
Chronic pain is a thing, but chronic pleasure isn’t, and that’s what many different characters discover on HBO’s very popular but controversial teen drama, Euphoria. Euphoria is nothing new, per se. TV shows like “Dawson’s Creek,” “One Tree Hill,” “Gilmore Girls,” “Degrassi High,” and “The O.C.” all took a stab at the teen genre. Many even did so in a genuine, nuanced, and sincere way– “This is what teen-life is really like…in all its emotional chaos and complexity!” Euphoria does exactly that as well.
Euphoria differs from the other shows not just in terms of cinematography and acting but also in its primary focus on drug addiction (which dilates into a further exploration of addiction in general). 38-year-old creator Sam Levinson (son of the famous “Rain Man” director Barry Levinson) wrote the series to reflect on his own history of substance abuse.
Former Disney Channel star Zendaya plays the main character, Rue Bennett, a 17-year-old fresh out of rehab following a very serious overdose. She tries to find her place in the world alongside Jules Vaughn (Hunter Schafer), a transgender girl with whom Rue develops a rocky relationship, Nate Jacobs (Jacob Elordi), the popular high school quarterback whose anger issues hide his sexual insecurities, Maddy Perez (Alexa Demie), Nate’s popular on-and-off again girlfriend, Alexi Howard (Maude Apatow), Rue’s childhood best friend, Cassie Howard (Sydney Sweeney), Alexi’s older sister, and many others.
The fictional town of East Highland, California is replete with many stereotypical high school characters, such as the “mean girls” and “cocky jocks,” and while Levinson is an older millennial, the show’s themes certainly appeal to all issues “Gen-Z.” These include (but are certainly not limited to): toxic positivity, toxic masculinity, social media, hookup culture, online porn addiction, sexting, gender identity, trauma, co-dependency, dating violence, and, of course, opioid addiction.
As many HBO shows do, Euphoria certainly reaches for shock value. In the first episode alone, Rue’s overdose is explicitly shown (she lies on the floor, unconscious, with vomit beside her, as her younger sister panics), her 17-year-old friend’s dalliance with an older man in a seedy motel is explicitly shown, and the whole series is full of male nudity (also all explicitly shown)!
The cinematography is both hypnotizing and kaleidoscopic. The filters frequently shift from jade and citrine to violet and lilac to reflect Rue’s rapid mood swings, and the camera is always in motion (sinking into pools, breaking through walls, and spinning alongside carousels).
All of the nighttime escapades- drinking and dancing and more- are all luminous and psychedelic. A postmodern, dreamlike state where all things nihilistically hedonic take highest precedence…that is, until the “high” wears off! All the bright colors fade, the orgiastic festivities end, and only the cold, unforgiving light of day remains. In Rue’s case, the opiates have worn off!
So, what are opiates after all? Opiates fall into a large biosynthetic group of drugs known as benzylisoquinoline alkaloids, the major psychoactive derivates of which include morphine, codeine, and thebaine.4 Naturally occurring alkaloids are found in the opium poppy.4
The opium poppy, also known as the “breadseed” poppy5 or its formal designation- Papaver somniferum6– is a rather eye-catching annual herb. 100 centimeters tall, this glaucous, greyish-green flower with large, lobed leaves, a hairless, rounded capsule with a fluted cap and stigmatic rays, and four white, red, or mauve-colored petals, is native to the eastern Mediterranean but has been cultivated across Europe and Asia.7, 8, 9.
Its traditional use can be traced all the way back to the Neolithic period, but it was undoubtedly in the 19th century when opiate use exploded. “Opium dens” notoriously emerged in both major Chinese cities like Hong Kong as well as Victoria-era London. Sherlock Holmes, the famous fictional sleuth, was written as an opium addict, and Karl Marx famous invoked the drug when referring to religion as the “opiate of the masses.”
In the early 20th century, Arthur, Mortimer, and Raymond Sackler- three Brooklynite children of Jewish, Polish and Galician immigrants11– bought a small pharmaceutical company known as Purdue-Frederick (later, Purdue Pharma and Mundipharma).12, 13 Arthur, who attended medical school and worked at the Creedmoor Psychiatric Center in Queens alongside his siblings, is often cited as an early pioneer in medication techniques that ended the dreaded, common practice of lobotomies, and also a key figure in the fight for the racial integration of blood banks.11
However, their foray into medical advertising came at a major cost, namely the widespread sale of prescription opioids. Nonfiction books like Empire of Pain by Patrick Radden Keefe and Hulu’s TV mini-series Dopesick tracked the crisis(es) that followed as a result.
Prescription opioids, such Methadone, oxycodone (OxyContin®), Hydrocodone (Vicodin®), Alprazolam (Xanax®), Diazepam (Valium®), Benzodiazepines, and Lorazepam (Ativan®), are typically used for treating moderate-to-severe pain following injuries or surgeries.1 Their purpose is to sedate, induce sleep, prevent seizures, and relieve anxiety, and they also help with chronic, non-cancer-related pain such as osteoarthritis.1
When an opiate enters the nervous system, it acts as an “agonist” (or binding agent) upon G protein-coupled receptors (GPCRs, for short), which in turn mediates our sense of vision, smell, taste, and pain.10 A signaling cascade occurs- potassium ion channels are stimulated, and both calcium ion channels and adenylate cyclase are inhibited.10 The net effect- the hyperpolarized neuronal cells reduce their emission of neurotransmitters, and, long story short, patients feel a lot better!10
Opiates’ intense capacity to heal what aches comes with a very dark side. In 2016, more than 11.5 million Americans reported misusing prescription opioids.1 The number of prescribed opiates in use the following year was over 191 million, and at least 1 in 4 patients who takes opiates is addicted to it and receives long-term therapy.1
The side effects, which include (but are not limited to) constipation, nausea, vomiting and dry mouth, sleepiness, dizziness, confusion, depression, itching, sweating, low testosterone levels, increased pain sensitivity, and physical dependence, are bad enough on their own.1 Add its literal breath-taking capacity, and you have quite the deadly, widespread threat on your hands.1
The most sinister and powerful offender amongst these opiates currently sweeping the nation is undoubtedly Fentanyl. Fentanyl (C22H28N2O), usually prescribed in the form of lozenges or transdermal patches, is typically used for treating severe pain (such as advanced cancer), but it is fifty-to-one-hundred times more potent than morphine,2 and in the recreational market, it is often mixed with heroin and/or cocaine.2
The number of these synthetic opioids in use in 2020 was 18 times higher than it was in 2013, and more than 56,000 people died from Fentanyl in 2020.2 Other Fentanyl analogs include Carfentanil (which is 10,000 times more potent than morphine), Acetylfentanyl, and Furanylfentanyl, all of which are similar in chemical structure but cannot routinely be detected (a specialized type of toxicology test is required).3 Fentanyl is so dangerous that even Rue hesitates to ingest it.
In Euphoria’s second season, fifth episode, “Stand Still Like a Hummingbird,” all the flashy effects and voiced-over montages disappear, and Rue must alone come face-to-face with her problems! This one sequence at the beginning of the episode by itself may have easily earned Zendaya her most recent Emmy award! Rue storms into her sister (Storm Reid) Gia’s room, raging at her in front their mother, Leslie Bennett (Nika King). Leslie has disposed of Rue’s extremely expensive drug supply, and Rue believes her sister has ratted her out.
Unfortunately, Rue is in withdrawal, and her emotions are everywhere. Her mother and sister yell at and plead with her, but it all falls on deaf ears. Nothing but the drugs themselves can placate her. Rue alternates between rage, sadness, and contrition as she ransacks the house, breaks down a door, denounces her friends, and derides Leslie as a “bad mother.”
Later, on the way to a clinic, she sprints out of her mother’s car in heavy traffic and hides out at Alexi’s house. She publicly rats out Cassie for cheating (romantically) during an intervention, steals jewelry from a random home, and begs for drugs from her local dealer, Fezco “Fez” O’Neill (Angus Cloud).
The most telling episode though is a special, Christmastime bottle-episode entitled “Trouble Don’t Last Always: Part 1: Rue.” Rue, having recently relapsed, sits with her sponsor, Ali Muhammed (Colman Domingo), at a local diner on Christmas Eve. The two discuss addiction, family, society, and life. Ali discusses his abusive father and estranged daughters, and Rue tries to come to terms with her condition as a disease.
Rue begins her dialogue with platitudes, but Ali cuts through all of that. Rue, whose father died from cancer when she was 13, began using opiates to cope with the grief and trauma, and believes “drugs are the only reason she hasn’t killed [herself].” She condemns herself, recounting a story in which- desperate and strung out- she held a knife at and threatened to kill her mother.
Ali reminds her just how potent a force of nature addiction really is and that, whatever she may think about herself, “[she] didn’t come out of the womb evil.” In accordance with the “higher power” principle, Ali encourages her to believe in “poetry.”
“Poetry” (however one may construe it) provides meaning, and addiction thrives where meaning is lacking. In the absence of any real meaning or purpose, all that remains is nothing. Nothing but suffering, and that will easily push just about anyone towards the most easily attainable and pleasurable state. Not a happy or joyous state, but a pleasurable one…a mask or a band-aid if you will. Once that “click” is hit, though, it drops below baseline, and what follows is a vicious, never-ending, dopaminergic cycle that fuels addiction.
All the characters, each of whom has a deeply troubled past, cling to something short-term, and it never provides enough satisfaction. In a brief anecdote, Ali recounts walking into a Nike store during a Black Lives Matter protest and seeing a sign reading “Our Lives Matter.”
Ali was annoyed, as his impression was that of conspicuous, consumerist virtue-signaling instead of actual revolution. Actual revolutions, he insists, are slow, deliberate, persistent, and perseverant, and “immediate gratification/satisfaction,” so to speak, generally don’t occur. Patience is necessary.
In Rue’s case, though, “gratification” or “satisfaction” aren’t even necessarily what she seeks. She seeks a certain, untrammeled “stillness” or absence of pain/suffering…one that her system craves in the form of opiates, but one that takes different forms for different people.
Euphoria is a peculiar phenomenon. Like what the aptly named show’s various characters discover, not only does it not last forever, but it spikes, and the highest of highs frequently come with the lowest of lows. The shallow, upward incline towards longer-lasting joy and meaning is a far better pursuit than the immediate pleasures of the moment (assuming you have faith in the goal of longer-lasting joy and meaning). Hopefully Rue finds that in the end!
 https://www.cdc.gov/opioids/basics/prescribed.html,  https://www.cdc.gov/opioids/basics/fentanyl.htm,  https://www.cdc.gov/drugoverdose/deaths/synthetic/index.html,  “Canadian Guideline for Opioid Use for Pain — Appendix B-8: Opioid Conversion and Brand Availability in Canada”. nationalpaincentre.mcmaster.ca. Retrieved 2016-04-18.,  “Breadseed or opium poppy, Papaver somniferum“ (PDF). University of Wisconsin Extension, Master Gardener Program. Retrieved 21 November 2020.,  Botanical Society of Britain and Ireland. Archived from the original (xls) on 26 June 2015. Retrieved 17 October 2014.,  Stace, C. A. (2019). New Flora of the British Isles (Fourth ed.). Middlewood Green, Suffolk, U.K.: C & M Floristics.,  Clapham, A.R.; Tutin, T.G.; Warburg, E.F. (1981). Excursion flora of the British Isles (3 ed.). Cambridge, U.K.: Cambridge University Press.,  Reader’s Digest Field Guide to the Wildflowers of Britain. Reader’s Digest. 1981. p. 32.,  Pathan, Hasan; Williams, John (2012). “Basic opioid pharmacology: an update”. British Journal of Pain. 6 (1): 11–16,  Gerstmann, Evan (May 10, 2019). “Harvard, Arthur Sackler And The Perils Of Indiscriminate Shaming”. Forbes.,  “Who are the Sacklers, the family at the center of the opioid crisis?”. Jewish Telegraphic Agency. February 22, 2020. Retrieved June 2, 2019.,  Wu, Kane (May 5, 2021). “Sackler-owned Mundipharma seeks bids for China unit in over $1 billion deal -sources”. Reuters. Retrieved May 17, 2021.