(Updated 5/20/20) A list of movies about mental health and substance abuse – includes PDF printable discussion questions
By Cassie Jewell, M.Ed., LPC, LSATP
The following is a list of films that are appropriate to show in treatment settings. This post includes movie summaries and downloadable PDF handouts with questions for discussion. Please note that some of the films on this list are graphic and may not be appropriate for children or adolescents.
Hint: The handouts contain spoilers; do not provide until after the movie ends.
Ben Is Back (2018)
103 minutes (1 hour, 43 minutes), R-rating for language and drug use
Summary: Julia Roberts plays a mother, Holly, whose 19-year old son, Ben, surprises her by returning home for Christmas. Ben is newly in recovery; his addiction has placed a tremendous strain on the family in the past. Ben’s younger siblings are happy to see him, but Holly, fearing that he is not ready, is apprehensive. That evening, the family attends church. When they return, they find their home burglarized and the dog missing. Ben blames himself, believing someone from his past took the dog to get his attention; he leaves to look for the dog. Holly goes with him, but they’re later separated, and Holly attempts to track Ben. Eventually, she ends up at an abandoned barn where she finds her son on the floor, unresponsive. The movie ends with her administering Narcan to Ben.
127 minutes (2 hours, 7 minutes), R-rating for strong language and content relating to drugs, sexuality, and suicide
Summary: Winona Ryder plays Susanna, a young woman with borderline personality disorder, who is sent to a psychiatric hospital after a suicide attempt in the late 1960s. She befriends Lisa (Angelia Jolie), who carries a diagnosis of sociopathy (antisocial personality disorder). Initially, Susanna is in denial about her mental condition and is not open to treatment. However, she reaches a turning point after a tragedy.
123 minutes (2 hours, 3 minutes), PG-13 rating for mature thematic elements including substance abuse/recovery, some sexual situations, language, and brief violence
Summary: Trevor (Haley Joel Osment) starts a chain reaction of goodness for a social studies project with a plan to change the world for the better. In this film, Trevor is a high school student whose mother, Arlene (Helen Hunt), struggles with alcoholism and whose father is abusive. He rises above unfortunate circumstances with the kindhearted idea to do a good deed, but instead of requesting payback, asking the receiver to “pay it forward” to at least three people – and on and on. While the movie has a bittersweet end, the message is uplifting and powerful.
Summary: Charlie is an unpopular high school freshman, a “wallflower,” who is befriended by two seniors, Patrick and Sam (Emma Watson). The movie is about their friendship and Charlie’s personal struggles with the recent suicide of his friend and his own mental illness. Throughout the film, Charlie has flashbacks of his aunt, who died in a car accident when he was 7. It’s eventually revealed that Charlie’s aunt molested him; a sexual encounter with Sam triggers Charlie’s repressed memories. Charlie has a mental breakdown.
Other great resources for using clinical films as therapeutic interventions include the book Movies & Mental Illness: Using Films to Understand Psychopathy, 4th ed. (by Danny Wedding and Ryan M. Niemiec) and the site Teach With Movies.
Kratom is a tropical tree native to Southeast Asia. It’s becoming increasingly popular in the United States. It’s used for pain relief, mood enhancement, and to manage opioid withdrawal symptoms or reduce/stop opioid use. This post explores the use of kratom as a potential treatment for opioid use disorder.
By Cassie Jewell, M.Ed., LPC, LSATP
Kratom (mitragyna speciosa)
is a tropical tree native to Southeast Asia and, like coffee, is part of the
Rubiaceae plant family. Ingesting kratom leaves produces a high. Taken in small
amounts, kratom leads to stimulant-like effects (i.e. increased energy and
focus – stronger than caffeine, less intense than cocaine). When taken in
larger doses, the high is similar to that of an opioid (euphoria, drowsiness,
“pinned” pupils, dry mouth, sweating, nausea, constipation, etc.) Kratom is
unique in that it produces both stimulant and opioid-like effects.
Note: “Opioid” is the term used for any drug that binds to the opioid receptors in the brain. An “opiate,” on the other hand, is a naturally occurring chemical found in the poppy plant, such as morphine or codeine. All opiates are opioids.
In the United States, kratom users cite pain relief as a primary motive
for use. Kratom, an opioid agonist, works by binding to opioid receptors in the
brain. It can be effective for both acute and chronic pain. Others report using
kratom for energy, increased focus, lower levels of anxiety, to reduce/stop the
use of opioids, to reduce symptoms of PTSD or depression, and to elevate mood.
Kratom is legal in Virginia; it’s sold at vape or “head” shops as
a loose powder or in capsules. (Alternatively, kratom can be purchased online.)
Packaging is typically labeled “botanical sample only; not for human
consumption.” The extremely bitter powder can be sprinkled over food or brewed
into a tea. It’s easily swallowed in capsule form.
What does kratom mean for the opioid epidemic in America? Will
kratom one day play a key role in the treatment of opioid use disorders? Or will
it fall into the “harm reduction” category? Is it a natural pain medication, a
safe alternative to highly addictive opioid pain killers?
Or, will we find that kratom, like heroin, is habit-forming and
deadly? Currently, the research is mixed.
to Opioid Drugs
The results of a 2019 survey published in Drug and Alcohol Dependence revealed that 90% of respondents found kratom
effective for relieving pain, reducing opioid use, and easing withdrawal
In 2011, researchers discovered that kratom alleviated morphine
withdrawal symptoms. A more recent study indicated that kratom may reduce
Earlier this year, researchers found that kratom use was
associated with significant decreases in the occurrence and severity of opioid
adverse effects; kratom lessened the discomfort of opioid withdrawal. Multiple
studies have substantiated these findings, suggesting that kratom is a useful
medication for opioid addiction and withdrawal.
Interestingly, in 2007, it was found that kratom reduced alcohol
withdrawal behaviors. More recently, researchers discovered that kratom
decreased alcohol use; this suggests that kratom may help those with alcohol
use disorders (AUD) in addition to opioid addiction.
Compared to heroin, kratom is less addictive and has milder withdrawal
symptoms. Furthermore, the risk of deadly overdose is reduced with kratom use. A
2018 literature review indicated that kratom may have harm-reduction potential
for individuals who want to stop using opioids.
According to the CDC, there were 152 kratom-involved deaths
between July 2016 and December 2018 (“kratom-involved,” meaning kratom was a
factor). In seven of those deaths, kratom was the only substance found in
toxicology tests (although it should be noted that the presence of other
substances was not fully ruled out). It’s possible to overdose on kratom, and
when combined with other drugs or medications, kratom can be fatal.
In rare cases, kratom has been linked to liver toxicity, kidney
damage, and seizures. In the case of a 32-year-old woman who was using kratom
for opioid withdrawal, kratom was likely the cause of acute lung injury. Kratom
use may also cause cardiac or respiratory arrest.
Kratom’s harmful effects are not limited to the body; a 2010 study
linked chronic kratom use to alterations in working memory. In 2016,
researchers found that kratom use was associated with cognitive impairment. An
additional 2016 study supported previous findings that kratom may affect
learning. In 2019, researchers found that high doses of kratom were linked to memory
deficits. In contrast, a 2018 study indicated that high kratom consumption was not related to long-term cognitive
impairment. That same year, researchers found that long-term kratom use did not
appear to cause altered brain structures. More research is needed in this area.
Regarding whether or not kratom is addictive, multiple studies have found that regular kratom use leads to dependence, withdrawal symptoms, and cravings. Kratom cessation may also cause psychological withdrawal symptoms, such as anxiety and depression.
Will kratom step up as the hero of today’s opioid epidemic?
Doubtful. And for kratom to be a viable treatment option, more conclusive research
is needed. Additionally, researchers must study the safety of long-term kratom
While it’s unlikely, kratom use could lead to adverse health
effects or cognitive impairment; it could also fatally interact with other
substances or medications. Furthermore, long-term use may lead to addiction. In
sum, the majority of the literature suggests that kratom is, by no means, safe.
That being said, when compared to shooting heroin, kratom is safe (a safer alternative, at least). And if someone chooses to use kratom to reduce/stop their opioid use, I won’t lecture about the “dangers” of kratom. Until we have more answers, I will hold to the view that kratom is a harm-reduction measure… and it has the potential to save lives.
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A person who struggles with a substance use disorder is choosing that life. Why interfere? (Especially when all that money could be spent saving more DESERVING lives.) “Junkies” don’t deserve second chances because #JunkieLivesDontMatter
By Cassie Jewell, M.Ed., LPC, LSATP
Disclaimer: If you happen to believe that addiction is a choice – “They’d quit if they really wanted to” or “They made the choice to use; they made the choice to die” – then scroll on to the next blog. You’d only scoff at this post because #JunkieLivesDontMatter
This blog post is inspired, in part, by a Facebook meme.
The meme said,
“So if a kid has an allergic reaction the parents have to pay a ridiculous price for an Epi pen. But a junkie who has OD’d for their 15th time gets Narcan for free? What a screwed up world we live in.”
Implications: “Junkies” don’t deserve a second chance at life. They’re a waste of resources because they lack the willpower to stop using. A person who struggles with a substance use disorder is choosing that life. Why interfere? (Especially when all that money could be spent saving more deserving lives.)
If you believe it’s screwed up for a “junkie” to have a chance at life (and recovery) because they “chose addiction,” your opinion is contrary to the National Institute of Health, the American Medical Association, the American Psychiatric Association, and decades of scientific research. You’re either ignorant (maybe willfully so) or impressively arrogant. (Alternately, you could just be a jerk.) You’re a part of the movement: #JunkieLivesDontMatter
Many have joined the movement, as evidenced by the following Facebook posts:
“Out of all of the houses, 2 hobos decided to overdose on my front steps… thank god the medics got here in time to ensure they could die another day…”
“I think we had less ODs before Narcan came on board. They realize they can be saved if gotten to in time. Maybe they need to be locked up & not let out until they attend rehab while in jail.”
“If it can be easily established that they have a recent history of drug [abuse]… then yes… withhold the lifesaving drug because they chose this. It’s harsh, but justice is not served by saving them.”
“If you don’t have it figured [out] by the 3rd overdose, you are just prolonging the inevitable and wasting tax payers money.”
“If we are repeatedly saving your life and you are not willing to change this behavior, why should we be obligated to keep saving you?”
“My personal opinion is we can’t keep letting people overdose and saving them just so they can repeat the cycle.”
“By continuously administering Narcan, sure, we’re saving their life, but are they really living? I don’t think so.”
“No CPR for You, Fatty — You Chose Soda and Fast Food… Now Suffer the Consequences!”
According the the American Psychiatric Association,
Addiction is a scientifically proven brain disease. Despite this, many persist in the belief that it’s a choice, or worse… a moral failing. (Note: This notion comes from an early model of addiction, “the moral model,” which was deeply rooted in religion. Addiction was attributed to a sinful nature and weakness of character. Therefore, the addict must repent… or suffer the consequences of his/her actions; addiction warranted punishment, not empathy. Unsurprisingly, this created stigma. It also prevented those struggling with addiction from seeking treatment. Centuries later, many hold on to the view that an individual suffering from a substance use disorder is lazy or weak.)
Today, in the midst of the opioid epidemic, stigma’s unrelenting grip perseveres. Stigma is a poison; it’s dehumanizing. It’s easy to forget a person is a person when you view them as garbage, trash… a “junkie.” Stigma tells us, “Take out the trash.”
To fully recognize stigma’s impact, compare addiction to other diseases. Consider common medical emergencies; many are related to lifestyle. Imagine being hospitalized after your third stroke, and the doctor telling you, “This is the third time I’ve saved your life, yet you refuse to exercise. I shouldn’t be obligated to continue to provide life-saving care.” Or, imagine a long-time smoker who develops lung cancer; they’re not demeaned, called names, or denied treatment. Moreover, an EMS worker wouldn’t withhold CPR from an individual in cardiac arrest if they were obese. It’s not a debate.
If you’re unfamiliar with the term “enable,” it means “to provide with the means or opportunity.” When applied to substance use, it means a person in active addiction is provided with the means to continue to use. With substance use disorders, how can you know the difference between helping and enabling? This post explains how to tell the difference and provides 7 tips for helping a loved one who struggles with addiction.
By Cassie Jewell, M.Ed., LPC, LSATP
With substance use disorders, how can you know the difference between helping and enabling? I’ve worked with family members who inadvertently fueled their loved one’s addiction. They “helped” by bailing them out of jail, giving them money, etc., which only permitted the individual to continue to get high. It’s hard for family members to differentiate between behaviors that help versus enable.
If you’re unfamiliar with the term “enable,” it means “to provide with the means or opportunity” or “to make possible, practical, or easy” (according to Merriam-Webster). When applied to substance use, it means a person in active addiction is provided with the means to continue to use.
When I worked at a substance use treatment center, I taught families and loved ones that helping a person in active addiction means supporting their basic needs, such as food, water, shelter, and clothing. (If someone is in jail or treatment, their basic needs are met; therefore, bailing them out would be enabling.) Thinking in terms of “needs vs. wants” helps you to recognize enabling.
Distancing yourself (or setting a boundary) with your daughter will be difficult because you want to help. In the past, by “helping” her, you’ve enabled her addiction (which hurts her in the long run) and leaves you emotionally depleted. There’s a very fine line between helping and enabling; it’s not clear-cut. (Plus, it can be counterintuitive for a parent whose job has always been to protect your child.)
When a parent has a son or daughter who struggles with addiction, it’s especially difficult to make the distinction between helping and enabling. A parent’s natural inclination is to nurture and protect from harm. It’s heart-wrenching to see your child in pain. But if a parent doesn’t set (and adhere to) healthy boundaries, they will quickly become emotionally drained (as they enable their child’s addiction).
Here are some suggestions for helping (instead of enabling) a loved one who’s actively using:
Never (ever) offer money.
If asked for cash for food, for example, buy groceries instead (or offer to take them to lunch). I worked with a father who bought a bag of groceries for his son, who struggled with severe alcoholism and was homeless, on a weekly basis. This is an excellent example of helping a loved one versus enabling their addiction.
If asked for help paying bills, say no.
If your loved one doesn’t have to pay the electric bill, they’ll spend the money on drugs or alcohol. Furthermore, if you protect them from the consequences of not paying bills (i.e. having the power shut off), your loved one is less likely to see a need for change. (People don’t change when they’re comfortable.)
If you’re unsure where local trainings are offered, a Google search for “Narcan training” or “opioid reversal training” will link you to resources in your area. Most trainings are free. Keep a Narcan kit on your person at all times. Provide your loved one with a kit (or two) as well. This is not enabling. This is potentially saving a life and offering an opportunity for recovery. (A dead opioid-user will never recover.)
Offer to help them get into treatment.
Become familiar with the different treatment options in your area. Don’t give ultimatums (i.e. “If you don’t get treatment, I’ll divorce you”) or make threats (especially if you’re not willing to follow through). Be supportive, not judgmental. Be patient; when your loved one is emotionally and physically drained from addiction’s painful consequences (or when they hit “rock bottom”), they may decide it’s time to get help. And you’ll be ready.
Recognize that your loved one is not the same person they were before addiction.
Substance use disorder is a debilitating disease that damages the brain; it changes how a person feels and thinks. With addiction, the brain’s reward center is rewired, resulting in a biological “need” for drugs/alcohol. (Compare this to your need for food or water or air.) Your loved one’s addiction will lie to you; they will do whatever it takes to get their “needs” met. Your loved one’s addiction will steal from you. (Lock up your valuables if they have access to your home… and even if they don’t. I’ve worked with more than a few individuals who have broken into their parents’ home for either money for drugs or valuables to pawn for money for drugs.) Your loved one’s addiction will betray you. Accepting the nature of addiction allows you to set healthy boundaries.
By engaging with others with similar struggles, you’ll learn more about supporting your loved one (without enabling their addiction). You’ll also build a supportive network by connecting with others, strengthening your emotional health.
When in doubt, try asking yourself one (or all) of the following questions:
Will my actions allow my loved one to continue to drink or use? Is this a “want” versus a basic need? Will my actions prevent them from experiencing a natural consequence? If the answer is yes, it’s probably enabling.
Addiction is a devastating, but treatable, disease. The road to recovery is difficult and long (with many detours). If your loved one has a substance use disorder, be kind and compassionate; they’re in an unthinkable amount of pain. They didn’t choose addiction. The best way to support them is by setting healthy boundaries to ensure you’re not enabling continued use. Boundaries allow you to help them without furthering their addiction. Boundaries also serve as protection for you and your emotional health; you’re in no position to help if you’re emotionally, financially, and spiritually depleted.
Please share in a comment your suggestions for helping a loved one who is struggling with addiction.