On the most recent episode of the controversial HBO show, Euphoria, Rue (played by Zendaya) takes fentanyl. A violent drug dealer gives her a drop of the synthetic opioid drug off of a knife, and she gets high. Rue is nearly catatonic on the couch as her friend Fezco (Angus Cloud) watches, scared for the vulnerable Rue. In order to stop the drug dealer from sexual assaulting Rue, Fezco — a smalltime dealer himself — agrees to buy $300 worth of fentanyl, despite believing it to be too dangerous a product to push.
This is just one disturbing scene of many in Euphoria, which tells the story of a young woman's struggles with substance abuse and addiction. Since the show's premiere, many people have commented that it's too shocking and sensational. That the show chose to feature a drug like fentanyl in the second episode might be particularly alarming to audiences. Does depicting a highly dangerous and illegal drug in a show aimed at teens do more harm than good?
Fentanyl isn't just a random drug that HBO picked to feature; it's been in the news a lot lately, because it's been linked to a number of celebrity deaths and overdoses, from Prince to Mac Miller. The drug is a synthetic opioid pain medication, that's often prescribed to people who have built up a resistance to other opioids, according to the Drug Police Alliance.
When a person takes fentanyl, the drug binds to opioid receptors, which are the areas of the brain that are responsible for pain and emotions, according to the National Institute on Drug Abuse. The effects of the drug can include extreme happiness, drowsiness, nausea, constipation, confusion, sedation or unconsciousness, and problems breathing.
Fentanyl is considered many more times potent than heroin, which is one reason why it's tied to so many overdoses. Clinically, fentanyl is prescribed in patches, lozenges, and injections. But illegal fentanyl is often sold in a powder, spiked in a blotter paper, or mixed with heroin. Sometimes people may not know that they're using fentanyl, because it's in so many other illicit drugs, such as cocaine and heroin.
Going back to Euphoria, although it's a fictional portrayal, the show's creator Sam Levinson said that she hoped their depiction of addiction would allow audiences to be empathetic to the struggles people are going through. "I think any time you put anything on screen, you run the risk of glamorizing it just by the nature of it being on screen," Levinson told Variety. "I don’t want [to be triggering], but we also have to be authentic about it."
Critics of the show have argued that it doesn't accurately represent teen drug use, which surveys suggest is actually declining. One thing the show does well is "set the stage for why [Rue] is turning to drugs and alcohol to feel better," says Kristin Wilson, MA, LPC, vice president of clinical outreach at Newport Academy, an adolescent treatment center for maladaptive coping mechanisms. In the pilot episode of Euphoria, Rue is shown having anxiety attacks and exhibiting symptoms of obsessive compulsive disorder. She's then taken to a psychiatrist, diagnosed with OCD, ADHD, general anxiety disorder, and possibly bipolar disorder, and prescribed a number of drugs.
This is another aspect of the show that Wilson says is true to real life. We know that one in five teens struggle with mental health issues, so there's a great potential to turn to something external to feel better, she says. "Sometimes when you're that young and you're given a pill that says, Here, this is going to fix what's wrong with you, that sets a precedent for a child," she says. "It tells that child, I'm not good enough because I need to be fixed, and Something external outside of me makes me better."
But, even though the show might be somewhat accurate, there's still a lot about it that could be triggering for people, Wilson says. The very first episode, for example, includes overdosing, rape, strangulation during sex, and "a zillion other triggers you could point out," she says. Whether you choose to watch Euphoria or you simply see a headline about it on your news feed, Wilson encourages you to talk about it. And also remember that you don't have to watch at all if it makes you uncomfortable.
Last week, Zendaya posted a message on her Instagram alerting people to the triggering content, and shared a similar sentiment: "Please only watch if you feel you can handle it," she wrote. "Do what’s best for you. I will still love you and feel your support."
If you are struggling with substance abuse, please call the SAMHSA National Helpline at 1-800-662-4357 for free and confidential information.