Drug and alcohol addiction is a topic that has been explored in cinema for decades. It is a sensitive subject that must be handled with care to depict the brutal truths about addiction. These films can be hard to watch due to the physical and emotional agony that the characters go through. Many films, such as Beautiful Boy, starring Timothee Chalamet, are based on true memoirs from those who struggled with addiction. Other films may be pure fiction, but honestly portray the suffering that one goes through while suffering from substance abuse. Regardless, it is important to see the struggles that people face through substance abuse and it creates good, thought-provoking cinema.

Many times, actors will use their own experiences to create an honest performance in a movie about addiction. Ben Affleck used his personal struggles with alcohol to portray a suffering alcoholic in The Way Back. It takes hard work and emotional range to portray someone facing addiction on camera. Many times, we will watch a journey through addiction that ends with recovery. In other cases, there is no happy ending to the film, and the characters are either destroyed or right back to where they started. Unfortunately, not everyone can overcome addiction, so the films have to be honest to that truth. After some tough cuts, let's take a look at the most brutally honest films depicting addiction, ranked.

Updated, August 2022: To keep the article fresh and relevant by adding more information and entries, this article has been updated by Rafa Boladeras.

11 Flight

Denzel Washington Flight
Paramount Pictures

Captain William “Whip” Whitaker (Denzel Washington) is an airline pilot with alcohol addiction (he also likes cocaine quite a lot). Although he's under the influence, he saves this plane from crashing with an incredible maneuver saving almost everyone and avoiding a bigger tragedy. He looks like a hero, until the hospital reveals his blood test and the legal circus around him starts. Flight is Washington’s movie through and through. You can see in every scene how his will is broken time and time again, as the need for alcohol is absolutely irrational and stronger than him. He might be a respected pilot, with a lot of money, but he’s also an addict that can’t stop. He might find ways to hide it, and appear almost functional, but in the end, the consequences caught up with him.

10 The Lost Weekend

The Lost Weekend
Paramount Pictures

Don Birnham (Ray Milland) is an alcoholic writer who tells his brother and girlfriend he wants to stop drinking. The instant he’s left alone, he’ll do whatever it takes to get a drink. That drunk plan will steal his whole weekend, even if he doesn’t remember it. The Lost Weekend was one of the first times Hollywood tackled alcoholism realistically, and people took notice. The movie doesn’t pull away from the worst parts of the addiction, as Birnham will do anything for his next drink. Back then, it was a movie that shocked audiences and became difficult to forget.

9 Drugstore Cowboy

Drugstore Cowboy - Dillon
International Video Entertainment

Based on the autobiographical novel by James Fogle, Drugstore Cowboy tells the story of a group of heroin addicts that rob pharmacies to pay for their dangerous habit, but also how they organize themselves, their superstitions, and the ritual of getting high. Matt Dillon gives his best performance as Bob Hughes, showing how his addiction dictates all the actions, feelings, and ideas he has. The movie also has some dark humor in it, because even in the darkest times people try to make some jokes. This film was also the one that presented Gus Van Sant to Hollywood and the world at large.

8 The Panic in Needle Park

Panic in Needle Park
20th Century Fox

Adapted by the great Joan Didion and John Gregory from the novel by James Mills, The Panic in Needle Park tells the story of Bobby (Al Pacino, in his first lead role) and Helen (Kitty Winn), a couple that will do anything for their next score. The movie is a character study that shows realistically what can happen when heroin is in your life, and the consequences of what someone can do to get it: prison, sex work, anything really. It’s also shot following a documentary style, which gives it even a stronger punch. About shooting that way, director Jerry Schatzberg told Indiewire: “I just felt it was so honest, and that’s the way I wanted to work.”

7 Beautiful Boy

Beautiful Boy
Amazon Studios

Beautiful Boy was based on the memoirs of Nicolas Sheff and chronicled his years of battling drug and alcohol addiction. It depicts the personal turmoil that drugs create while also focusing on how it affects those around you. Steve Carell plays David Sheff, Nicolas' father, who spends years trying to understand what his son is going through, while also trying to help him. It is a heartbreaking story that honestly depicts drug addiction, and Timothee Chalamet gives one of his greatest performances to date.

Related: These Are The Best Timothee Chalamet Movies, Ranked

6 Heaven Knows What

Heaven Knows What - Arielle Holmes
RADiUS-TWC

The Safdie brothers' breakthrough film was also based on true accounts. Arielle Holmes' unpublished memoir Mad Love in New York City was the basis of the film, and depicted her days of living on the streets of New York while suffering from heroin addiction. It is a cold, hard look into the NYC drug scene that is brutal, honest, and sometimes hard to watch. The center of the film is her abusive relationship with another drug addict, Ilya (Caleb Landry Jones) who is the film's main antagonist. The Safdie brothers showcased their sheer talents that kicked off their impressive careers.

5 The Basketball Diaries

The Basketball Diaries
New Line Cinema

The Basketball Diaries was based on Jim Carroll's novel of the same name, and told the story of his years of heroin addiction on the streets of New York City. Leonardo DiCaprio gives a tour de force performance of Carroll as we watch him lose everything due to his addiction. One of the hardest scenes to watch in the film is when Carroll is going through heroin withdrawal. DiCaprio honestly portrayed the pain and torment that people go through when they pursue a life with drugs.

Related: 9 Times Leonardo DiCaprio Should Have Won an Oscar

4 Half Nelson

Gosling sitting in front of the chalkboard in Half Nelson
THINKFilm

Ryan Gosling gives one of his greatest and most underrated performances to date as a public school teacher and basketball coach who is addicted to crack cocaine. The film center is his relationship with a student of his, Drey (Shareeka Epps), who is conflicted when given a chance to work for a drug dealer. Half Nelson comes full circle at one point as Drey sells Dunne (Gosling) drugs in a motel room. It is an honest depiction of drug abuse with a somewhat optimistic ending.

3 Trainspotting

Ewan McGregor Returns as Renton in New Trainspotting 2 Set Photos

Danny Boyle's Trainspotting is undoubtedly one of the most brutal films in history depicting heroin addiction. Although Boyle's direction creates an artistic and beautiful approach to the subject matter, the film is violent, heartbreaking, and hard to watch at some points. The story follows a group of friends living in Scotland, working tirelessly to fuel their addiction. Ewan McGregor gives a fantastic performance as the main protagonist, and the film is filled with his narration to describe the realities of drug addiction and how desperate addicts will become to get their next score. McGregor told The Hollywood Reporter: “Once I’d read it, I thought it was the part of a lifetime, and it turned out to be that.”

2 Leaving Las Vegas

nicolas-cage-leaving-las-vegas
MGM

There has never been a film that depicted alcohol so harshly as Leaving Las Vegas. Nicolas Cage gives the greatest performance of his career as Ben Sanderson, an alcoholic screenwriter, who moves to Las Vegas to drink himself to death and falling in love with a prostitute named Sera (Elizabeth Shue) along the way. The physical effects of alcohol abuse are clearly shown throughout the film, and it is extremely shocking. Cage's performance gives you an honest depiction of what it means to be in the end stages of alcoholism. While we all hope to see Sanderson overcome his addiction, he is unable to, giving us one of the saddest endings in cinematic history.

1 Requiem For A Dream

Leto Connelly Requiem for a Dream
Artisan Entertainment / Summit Entertainment

Darren Aronofsky's Requiem For A Dream is a masterpiece showcasing the tragic effects of drug addiction. The film follows four characters with high hopes and big dreams, but we watch as all of their ambitions are crushed as they fall deep into the grasp of addiction. The film uses music and unique editing techniques to portray drug use and the pain that comes after it. Addiction is the film's main protagonist, and by the end, we see it has won against our four doomed characters. The terrifying climax is a montage of destruction laced together with the piercing, yet brilliant, score. Ellen Burstyn, in particular, gives one of the greatest performances of her career as a woman addicted to diet pills. Burstyn went on to earn an Academy Award Nomination for Best Supporting Actress.